Social Care (Local Sufficiency) and Identification of Carers Bill

Kerry McCarthy Excerpts

Friday 7th September 2012 Commons Chamber

[Barbara Keeley]

I have not followed that as closely as I might have done, so I hope that we will hear from my hon. Friend later about the practice in Wales. However, we have much to learn from other countries.

It is important that we bear in mind the shrinking provision of social care because we know that demand is growing. Since 2010, local councils’ adult social care budgets have been cut by more than £1 billion, and a further £1 billion of cuts is expected. The number of vulnerable older and disabled people who have their home care services fully paid for by their local authority has fallen by 11% over the past two years. According to a survey by the Care and Support Alliance, services have been cut to 24% of disabled adults. Research by Age UK shows that cuts to council budgets mean increased fees for services—in fact, service fees have increased by 13% over two years. Almost half of all local councils are charging more, or making new charges, for home help or day care. One in six councils has reduced personal budgets for care packages, and almost half of all councils have frozen the rates that they pay for residential care. In addition, the fees for both residential care and nursing home care have increased by 5% on average during the past year.

Those are important statistics, but sadly they are not routinely gathered so that they can be scrutinised by, for example, the Health Committee. They were mainly gathered through freedom of information requests by my hon. Friend the Member for Leicester West (Liz Kendall) and various organisations. Local authorities do not have a full picture of local care provision, particularly that needed by the 80% of care users who are self-funding. Those self-funders—people whose assets exceed the means test for local authority support—spend £5.5 billion a year on care, with top-ups to statutory services costing them another £1.15 billion. It is vital that we have a better and more complete picture of social care provision, including that very large amount for self-funders.

Clauses 1 and 2 introduce a strategic duty on local authorities in England to ensure that sufficient social care services exist in their local area to meet the care needs of disabled people and carers. They seek to move towards local authorities having a total and accurate picture of what is purchased and provided in their area. Existing duties on local authorities relate only to those for whom the local authority has a statutory responsibility—disabled people and carers who meet eligibility criteria and who do not exceed means-testing thresholds.

It might be argued that the Government’s draft Care and Support Bill introduces a duty on local authorities to establish and maintain the provision of information and advice relating to care and support for adults and carers. The draft Bill says that a local authority must promote the efficient and effective operation in its area of a market in services for meeting care and support needs. However, that duty does not cover an assessment of local sufficiency, and it is that picture that can truly help carers and disabled people, particularly in terms of working, as we have just discussed.

Andrew Dilnot, in his 2011 report, set out the need to place duties on local authorities to provide information, advice and assistance services in their area, and to stimulate and shape the market for services. Moving to embrace a duty to develop a full picture of care and support services, and to assess the sufficiency of those services, will assist local authorities in developing their role as market shapers.

Clause 2 includes a duty to promote sufficiency of the supply of care, which, as we have discussed, would bring a new focus on the importance of social care in promoting and enabling work for disabled people and unpaid family carers. Carers UK has analysed local authority joint strategic needs assessments, which is really the only assessment that we have, but this analysis has shown that the majority of those assessments do not link care provision with work, so clause 2 would link well with Government strategies around work for carers and people with disabilities.

[Kerry McCarthy (Bristol East) (Lab)]

A couple of weeks ago in my constituency, I met a group of young adult carers aged from 18 to 24 who, for the most part, look after disabled parents, but sometimes siblings as well. They have particular needs because they are at the stage when they want to get on with their careers and perhaps go to university, and they have to make the choice between that and putting their life on hold to care. Does my hon. Friend agree that we need particularly to look at the needs of that group, who do not fall into the same category as other adult carers?

[Barbara Keeley]

I do, and I will come on to the issue of student carers. The Bill explores student carers for the first time. I do not know why the issue has not been discussed more in the House, but it is vital that we, as constituency Members, take note of it.

Joint strategic needs assessments done at local level do not link care provision with work, and that is why the clause is important. The Department of Health has an upcoming event on developing care markets, the invitation to which we received yesterday. It says:

“the ability to choose from a variety of high-quality services should be available to all people in a local area, regardless of who pays for their care.”

Age UK, in its support for my Bill, commented on that Government aim to give people who need care and support a greater choice. It said:

“this cannot become a reality unless local care markets work effectively to provide people, including those with specialised needs, with appropriate services. Whilst we welcome proposed duties in the draft Care and Support Bill that would require local authorities to take steps to ensure that appropriate services are available this falls a long way short of a requirement to ensure sufficiency. We will certainly be advocating for a Bill or subsequent regulations that will include more specific duties on local authorities.”