Social Care

Debate between Kate Green and Philippa Whitford

Wednesday 25th April 2018 Commons Chamber

[Dr Whitford]

I utterly agree. Obviously, we recognise the change in title of the Secretary of State. I am sure that many of us across the House hope that that would mean a move towards a more joined-up approach to health and social care. The pressure on the NHS is absolutely exacerbated by problems in social care.

[Kate Green]

There is an inconsistency between funding through continuing healthcare as part of NHS provision and the funding that is available to support people through social care. Does the hon. Lady intend to suggest that that discrepancy should in some way be rectified so that there is not a difference between the routes through which someone comes into the care system?

[Dr Whitford]

Many relatives and patients complain about the fact that, depending on which illness people have towards the end of their life, they will either be supported in an NHS or hospice system or they will pay for it in the social care system. A fragmentation has resulted from the Health and Social Care Act 2012 and the change in structure. Someone’s treatment may be delivered under NHS England as a specialist service for so many days, but then they go back to the clinical commissioning group and the ongoing care is suddenly not there. It is all very disjointed. In actual fact, we require an entire approach that joins up health and social care for the entire patient pathway. We should not expect patients to navigate from one pothole to the next.

We have exactly the same challenges with an ageing population. Indeed, the Scottish population is older and ageing more quickly than the English population. In all these debates, I always say that we must not look on this as a catastrophe. Having spent over 30 years of my life trying to get people to live longer, I ask Members to remember the alternative—living shorter. However, without public health changes and a game-changing approach, we are not ageing well; and we need to age well. But that will take a long time to turn around. We need to look after the people who require care right now.

Having failures in social care traps people in hospital. In Scotland, although we have a long way to go as well, delayed discharges from hospital have dropped in every year since 2014, when the integration started. Between 2010 and 2017, the average hours delivered through home care have doubled from six to 12 per week. In future, a quarter of us will die in a care home, so what kind of quality of care do we want to have, and what kinds of palliative care skills would we like our nursing homes and care homes to have? We need to create links between the hospice movement and care homes so that those skills and that supportive approach are shared.