(12 years, 9 months ago)
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I see the situation rather differently from the hon. Lady. Local authorities such as Oxfordshire are committed to delivering good-quality social care for elderly people. The challenge for them is to ensure that the increasing number of elderly people, often with increasing needs, receive appropriate care, whether at home or in residential care. A tight budget presents them with a significant challenge, but it is a challenge to which they are committed.
I appreciate that the hon. Lady comes from a unitary authority, but for two-tier authorities in shire counties such as mine, social care is now their most significant contribution. Increasingly, schools and education are running themselves, so authorities are going to be judged on the quality and the way in which they deliver social care.
One thing that concerns me is local accountability. In a sense, the hon. Gentleman is making an argument for more local control, because democratic local accountability means that people in a local care home will have immediate recourse to elected local representatives, rather than having a simple national scheme such as the national health service. Perhaps if the national health service had more local accountability, we might not see some of the things that are happening at the moment.
I am not entirely sure where the hon. Gentleman is going with that point, so if the House will excuse me, I will not follow him down that particular line.
I do not think there is any lack of local accountability as far as the national health service is concerned. The Oxfordshire joint health overview and scrutiny committee is meeting today and will consider, for example, possible service changes at Horton general hospital in my constituency. The committee will, I am sure, vigorously interrogate the senior management from the Oxford University Hospitals NHS Trust and from the Oxfordshire and Buckinghamshire PCT cluster.
In the debate on social care, we must not underestimate the burden or the toll on carers of the task of looking after elderly people with age-related difficulties. Carers UK has found that carers providing significant amounts of care are twice as likely to suffer from ill health as non-carers. In 2008, a survey of heavy-end carers showed that more than half of those caring were in debt, and nearly three quarters were struggling to pay household bills. A large number of carers, about 1 million, have given up work or reduced their working hours because of caring. The peak age for carers is between 45 and 65, which is often the age at which they would be at the peak of their training, skills and career experience. That can be a cost not only to the carer, but to businesses and employers as they lose key people who have to care for relatives.
We have seen some excellent organisations such as Employers for Carers, which was set up by Carers UK and seeks to bring together numerous employers, generally larger ones, to promote flexibility and workplace support for employees juggling work and care, but that is not always possible for small and medium-sized employers. There is also a cost to the NHS. Sometimes, if we are not careful, there is a trade-off between the quality of social care, the provision of sufficient beds in nursing homes and residential care homes, and the need to prevent delayed discharges and bed blocking in hospitals. We had a debate on that not long ago, to which I contributed. In Oxfordshire, we are grappling with the issue of delayed discharges. If we are not careful, the cost to the NHS of delayed discharges will be significant, particularly at a time when more and more hospital treatments can be offered as elective day treatments. Generally, people are spending less time in hospitals, so delayed discharges add particular cost to the NHS.