Social Care Funding

George Hollingbery Excerpts

Thursday 10th November 2011 Westminster Hall

[John Pugh]

rose—

[George Hollingbery (Meon Valley) (Con)]

rose—

[Mr Peter Bone (in the Chair)]

Order. I intend to begin the wind-ups at 5 o’clock. Two more hon. Members wish to speak, and it is now 4.26 pm. I do not know whether this has been mentioned, but the Leader of the House has attended the debate, which shows its importance.

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[George Hollingbery]

Perhaps the problem is even deeper. People in my constituency surgery do not just say that they think others have had a free ride; they say that they are actively advising younger people and their families not to save for old age, because it is no longer worth doing so. Plainly, the system is stacked so far to the advantage of those who do not save that people should not save at all.

[John Pugh]

The hon. Gentleman has usefully illustrated my point. We can argue that the state does not have a duty to preserve a family’s inheritance, notwithstanding the valiant defence of inherited wealth from the hon. Member for Luton North (Kelvin Hopkins). In normal circumstances, that is an unusual stance for him to take.

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[George Hollingbery (Meon Valley) (Con)]

It is a pleasure to serve under your chairmanship, Mr Bone, and I congratulate my hon. Friend the Member for Truro and Falmouth (Sarah Newton) on securing this important debate. Had I not come last in the roster this afternoon, I would—of course—have made a philosophical, wide-ranging and sparkling speech on the philosophical implications of the Dilnot report. Hon. Members will be glad to hear that I am not going to do that, and I will restrict myself, if I can, to a few small points that have not yet been covered in any great depth. I apologise for being absent from the debate for an hour, but next door to the Chamber the Surviving Winter appeal was being launched. The appeal transfers the winter fuel allowance from those who do not need it to those who do and, if I may make a quick plug, anybody who would like more details about it should speak to me after the debate.

Some difficulties over the local funding of care for the elderly need to be pointed out, and I know that the Minister will have seen the submission to the process by Hampshire county council. My hon. Friend the Member for Stourbridge (Margot James)—who unfortunately is now leaving the Chamber—talked about private citizens having to pay more than the county council for care, and that view is supported in a letter that I received recently from Mr Winterton-Smith, who wrote to me at great length about the difficulties he faces in financing care for his mother.

I looked up some statistics. Market research by Laing and Buisson in “Care of Elderly People UK Market Survey 2010-11” estimates the average weekly cost of nursing care in the southern home counties, which includes Hampshire, as £787. On average, Hampshire county council’s nursing care beds cost £650 a week. That is a difference of over £5,000 a year for the private carer, and it is a substantial gap that needs to be looked at.

Hampshire county council’s submission shines a spotlight on the number of self-funders in the southern counties, and in Hampshire, nearly 60% of those who receive elder care are self-funders. One imagines that the funding pattern could become enormously complicated if some parts of the country need massive cash inputs to deal with people converting from self-funding to being funded by the state. I point that out in passing because I was asked to do so by Hampshire county council, which I am partially representing today.

I was always attracted to the insurance model; it seemed to be a way of providing for future care in a proper way. Unfortunately, however, it looks as if that model is too complicated for institutions to price properly, and even the guarantee provided by Dilnot does not provide sufficient certainty for insurers to enter the market in any real number. The Joseph Rowntree Foundation and the International Longevity Centre have pushed forward insurance models, but Dilnot speaks about the market and explicitly rejects such models as stand-alone solutions. He believes that insurance models can be part of a solution and that some schemes will help, but the overall model is rejected.

Policy Exchange—not the favourite think-tank of Opposition Members, I know—published a report last year entitled “Careless.” I have spoken widely about countries such as Germany and Japan that have partially insurance-funded models of care, but are beginning to struggle with the implications of rising costs, and such models are beginning to look unsustainable. The Policy Exchange report gives a figure of £106 billion for the full cost of replacing care that is provided throughout the community, both privately and publicly, to those who need elder care. All sorts of perverse incentives might arise in a system that provided universal care. People who now provide care for nothing would, quite understandably, not provide it in the same way as they used to. The sum of £106 billion is a frightening figure to consider. I have no particular basis on which to back up that number, however, but I merely cite it from that report.

We have talked a little about the link between adult social care and health spending, and cross-departmental spending. When I was reviewing the literature, I noticed a reference to a spat that occurred in County Durham when the local PCT spent money on gritting the roads. It did so because it felt that it was a good way to prevent accidents and stop people needing adult social care. To me, that made a great deal of sense. The council, however, got into the most terrible trouble; all sorts of newspaper articles said that it was foolish or idiotic and did not know what it was doing. The harsh reality is that trips and falls cost the health service money, and they cost many elderly people their independence, and later their freedom.

The council’s decision is exactly the sort of thinking that led to what I will happily call the excellent Total Place initiative launched by the previous Government. That agenda has real potential to provide some of the funding that we require to solve the problem of care for the elderly in the long term. Breaking down the barriers between Departments, and pooling spending to deal with complex objectives, are ideas that the coalition must pursue if we are to make real inroads into solving problems such as the care of older people in times of increasing complexity and tighter spending.

[Sarah Newton]

My hon. Friend makes an incredibly important point. Does he agree that we have huge unmet housing needs for the ageing population, and that we have not thought about the types of homes that would most appropriately enable people to live comfortably at home? By planning services in a particular location, all the aspects that impact on whether people live healthier and longer lives could be better developed and delivered.

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[George Hollingbery]

I am grateful for that intervention, which leads me neatly into my next point, which is always the danger of briefing one’s colleagues about what one might say, then being called last in the debate.

There could be a great deal of entrepreneurial thinking on cross-departmental spending and other areas that do not immediately seem relevant to social care. As many of my colleagues will know—including the hon. Member for Lewisham East (Heidi Alexander) who is a member of the Select Committee on Communities and Local Government—I am slightly obsessed with planning and I have become an appalling anorak since I came to Parliament whenever we talk about planning. I believe, however, that there is potential in the planning system to mitigate costs. If, when designing new communities in major and strategic development areas—6,000, 7,000 or 8,000 houses at a time—we plan properly for the needs of older people, and build the right sort of accommodation and adaptable homes that can be used in future and adapted later, people will be able to stay in their community and be close to their support networks. If such centres are built near shops, supermarkets and hairdressers, people can carry on living in the same place for a long time. By then moving a few hundred yards out of their house into one of these facilities, they can leverage the asset that they have grown over the years and look after themselves more efficiently.

In short, this issue is not only about adult social care or Department of Health budgets: we need entrepreneurial thinking across the public sector to ease the problem. I hope that the Minister will encourage all his colleagues across Departments to do just that.