Adult Social Care

Heidi Alexander Excerpts

Monday 16th July 2012 Commons Chamber

[Paul Burstow]

My hon. Friend is absolutely right to highlight that issue, which the Low Pay Commission has commented on over a number of years, including before this Government came into office. In our White Paper, we make it very clear that local authorities, as the commissioners of such services, must be mindful of their responsibilities in ensuring that the resources they provide to providers are sufficient to allow them to fulfil their legal obligations.

[Heidi Alexander (Lewisham East) (Lab)]

The Minister talks about the financial pressures faced by local authorities in providing care to elderly and disabled residents, but is he aware that the cost to local authorities of self-funders who have to fall back on the state is in the region of £1 billion a year? Does he agree that that is a very unpredictable thing for local authorities to deal with? What proposals does he have to help local authorities in that regard?

[Paul Burstow]

I am grateful to the hon. Lady for her question, because it allows me to talk about some of the points I think will directly address it. Reform of our care and support system is about more than just who pays for care; it is also about some other very important issues. A central proposition in the White Paper we published last week concerns the move from a service focused on managing crisis, and often not doing so very well, to one focused on supporting people’s well-being by concentrating on early intervention and prevention. That is why, alongside the White Paper, we published a draft Bill that will underpin the reforms we intend to make, consolidating, simplifying and modernising the legislation. The Bill sets out for the first time in statute some very clear governing principles about how decisions are made in social care, focusing on people’s well-being and living by the idea set out by our first White Paper in government of “No decision about me, without me”.

The Bill sets out a number of important changes that go to the heart of people being able to plan, prepare and have proper choice about the care available to them. First, it makes it a requirement for local authorities to ensure that there is a universal offer of information and advice so that people can plan and prepare. Secondly, it requires for the first time local authorities to focus on prevention. Thirdly, it requires a sufficiency of quality care so that choice is available to people locally. Fourthly, it requires integration and co-operation not just between the NHS and social care but between those agencies and housing.

The Bill will not only do that; it will simplify the point of entry into the state system. It will ensure consistent national eligibility and, for the first time in Government legislation, will ensure that there are rights for carers not just to an assessment of their needs but to support for those needs. It will also deal with the often mentioned issue of protection from disruption when people move from one part of the country to another or when a child moves from children’s services to adult services. It will guarantee continuity of services, which is not currently provided for.

Personal budgets, which were started by the Opposition but have not stuck well because of the legal framework, will for the first time be given a clear legal basis. I am delighted to say that whereas when this Government came to office in 2010 we inherited 168,000 people receiving personal budgets, by March of this year 432,000 people were benefiting from them. There will also be clear legal duties on the NHS, police and councils to safeguard people.

At the heart of our White Paper reforms is the notion that we need less variability on quality, to ensure that providers are responsible for driving up quality and accountable for doing just that, and to have more and open information about the quality of provision. That is why our provider quality profiles will provide that information in a way that will allow people to compare and rate providers for the first time and why we are putting an extra £32.5 million in to support those services.

--- Later in debate ---

[Sarah Newton (Truro and Falmouth) (Con)]

I am delighted to follow the hon. Member for Scunthorpe (Nic Dakin), as I completely agree that this issue is about leadership. Some of my hon. Friends alluded to a better-tempered debate, such as the Back-Bench business debate, to which all parties made thoughtful contributions, based on a great deal of expertise from different walks of life—whether from people in the medical profession, those who had spent their life in social services or those who had a personal point of view from being a carer. We heard some heartfelt contributions in that debate, so I think we are united in the desire to do something about this issue.

What I have found deeply disappointing about today is the fact that this debate was called in the first place. There was significant and genuine desire by this coalition Government to solve once and for all this problem that everyone agrees needs to be solved. Everyone agrees that it needs cross-party support—for reasons that are obvious to anyone sitting in the Gallery or watching this evening’s debate and to all the various voluntary organisations that have been very substantially misquoted or very selectively quoted this evening. There is a unity of purpose, but it is not being served by the Opposition who are tabling Opposition day debates, falsely dividing the House.

If the Opposition were to put their efforts into working closely with the two parties that form this coalition to come to a sensible solution, I believe that measures would be in the White Paper, but we are still seeing sledging and negative comments from Opposition Front-Bench Members as we have seen all day. It is deeply disappointing that the Opposition are so thoroughly letting down the people whom they claim they represent. I do not believe it is too late, and I really urge them to get back to the table and to be more positive about the steps that the Government are taking—[Interruption.] Here we go again; I cannot even finish a sentence without Opposition Members chuntering.

The fact is that I worked very closely with a number of Opposition colleagues. Various Members have talked about the very good work we did in the inquiry led by the all-party group on local government that looked at this issue. There was an all-party agreed proposal that identified many measures—which the Government have picked up in the draft White Paper—that we can achieve together. The effort should be focused on what we agree on, so that we can offer the reassurance that is needed by the desperately worried people all around the country that have been quietly identified this evening. People are worried not only about the social care system now, but the social care system in the future. We should be reassuring these people and giving them hope that this House has the necessary combined will and determination. I do not think any of us want to face the electorate at the next general election saying that this problem has not been solved.

As to the timetable, yes, I would love to be able to stand here today and congratulate the Government on finding every penny to fund a long-term solution. If we can get the cross-party talks into gear in September, we should be able to put in place the mechanism that, as confirmed by the Secretary of State, could be built into a Bill and put before Parliament. When all parties have agreed on how this is to be funded—as many people have rightly said, it will cost billions of pounds every year and we are in a very difficult financial situation, so all parties must agree on how those billions can be found—there is every possibility that such a Bill will get through Parliament and, when next year’s comprehensive spending review is developed, the money will be found.

Yes, it is frustrating if we have to wait another year or 18 months. Before I entered the House, I spent the best part of my adult life working for Age Concern England and for the International Longevity Centre in the UK, coming up with solutions that previous Governments certainly kicked into the long grass, so this is our best hope in a generation.

[Heidi Alexander]

I respect the hon. Lady’s work on this issue, but does she recognise that there is almost universal agreement outside the House that the big disappointment is that there were no proposals last week on how, in the longer term, we provide the funds that we all want for care for the elderly and those with disabilities?

[Sarah Newton]

I accept that there is genuine disappointment, but people equally understand that all parties in the House must be committed on where the billions of pounds each year will come from, so that the proposals are sustainable for the long term, and so that people can save and invest without fear of the rug being pulled from beneath them.

The proposals are a sticking plaster—there is no doubt about that—but if only people could hear the facts, they would appreciate that more money is being put into the system while the problem is being resolved for the long term. It is not true that all councils are cutting back. Cornwall council has not cut its adult social care. It is working in extremely innovative ways with the NHS and the voluntary sector to ensure that services are improved. I do not accept the shroud waving from Opposition Members, who say that every part of the country is in crisis.