Health and Social Care

Kevin Foster Excerpts

Monday 27th February 2017 Commons Chamber

[Kevin Hollinrake]

My hon. Friend makes a very strong point. I do feel that we need more money now. I am sure the question of whether more money might be available is taking up some of the Chancellor’s time as he works on his Budget calculations for 8 March. In the short term, we need more money to plug the gap. In the longer term, we need a cross-party conversation on how we solve this problem.

The Select Committee has been an excellent forum through which to explore this issue and many others. As the hon. Member for Sheffield South East (Mr Betts), the Committee Chair, mentioned in his remarks, we went to Germany to examine its system. It was very enlightening. In 1995, Germany moved from one system to another: from a local government-funded system that just did not work—they clearly saw this coming before we did—to a social insurance system. They are more used to that system in Germany, which has similar systems in place for health, pensions, unemployment and accident insurance. It works very well. It is cross-party, seems to be apolitical and takes a salary contribution of about 1.175%. It is a bit like auto-enrolment, but it is compulsory—it is a mandatory scheme. It means that when people need care they have a pot to call on. Needs are independently assessed, so they receive the level of provision that suits them. It can also be used to provide domiciliary care. Money coming back out of the system at the right time can go to help family members look after the person who is ill, so it has a social benefit as well as being a sustainable system that works in the longer term. We should look at that model. It is not the only one, but I reiterate—I know Members on both sides of the House feel the same way—that we should look at this issue in a cross-party way to ensure long-term sustainability.

[Kevin Foster (Torbay) (Con)]

I am very much enjoying my hon. Friend’s speech. Does he agree that the current method of local government funding does not help? There is a ward in my constituency where 9% of the population are aged over 85. Demographics are not properly reflected and the challenges faced by coastal communities in particular, as opposed to some of the more traditional challenges here in London, are not reflected in funding schemes.

[Kevin Hollinrake]

My hon. Friend makes a very good point. The evidence clearly shows that the current methods of funding adult social care do not correlate with the needs in those areas. We need to take a strategic look at that. The Government are moving toward a different way of funding local authorities by 2020. A key part of business rates retention is the consideration of the allocation of funding. It is critical to put need first and foremost, so that need and the cost of delivering services are the cost drivers. Having a fair and transparent system is fundamental.

On adult social care and learning disabilities, one of the most heartening examples of how to deliver them in a different way, rather than looking at them from a single viewpoint, is the Botton Village “shared lives” concept, where people look after each other—co-workers and people in need of care alike. It is a fantastic and inspirational scheme.

Finally, I will touch on a couple of very small points. We should look at how people are charged for domiciliary care. Financial assessment for domiciliary care is different from that for residential care. I think money could be taken out of the system—it does not make much sense to me that the Government fund one thing one way and another thing another way—or people could contribute, if their houses are taken into account in their domiciliary care assessment.

My final point relates to co-terminosity. There are so many different services provided by so many different agencies working in different geographical boundaries. Co-terminosity works well in Sheffield, where all the agencies work together very effectively. In my area, it is completely different. There is a real mish-mash of different providers and geographical areas, which makes it difficult to provide a joined-up service.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

Often, the NHS estimates day debate is a rather perfunctory affair, but this year, five years into the reign of the present Secretary of State, we are entitled to ask what on earth is happening to our NHS and social care system. Can we any longer afford the extraordinary complacency of this Government? As an Opposition MP, I sometimes worry that, either by design or simple neglect, they will finally fulfil our worst fears that the Tory party is destined to destroy the NHS.

[Kevin Foster]

So much for cross-party dialogue.

[Steve McCabe]

I don’t think I need any lectures on cross-party dialogue from the party of the death tax and the £8 billion financial fib.

In Birmingham, we have seen £28 million cuts to the social care budget, bringing the service to its knees. Elderly people are being treated like cattle, lying around on trolleys, waiting in corridors and dispatched from hospital in the middle of the night. Everywhere we look, we see our hospitals, GPs and social care services collapsing under the strain.

This Secretary of State is quite happy to flex his muscles when it comes to bullying junior doctors, but it is always someone else’s fault when it comes to resources, management and administration of the NHS. There was a time when the deal was simple: in return for the red box and a ministerial salary, Ministers took responsibility —the buck stopped with them. But no more. I have lost track of how many parliamentary answers begin with the words, “The Department does not collect that data centrally,” or “It would not be cost-effective to provide information in that format”. Basically, Ministers do not know, do not want to know and do not want us to know what is really happening. They no longer preside over a genuinely national health service. Whether it is the postcode lottery that characterises the provision of IVF, with clinical commissioning groups ignoring NICE guidelines and making up their own criteria as they go along, or children’s dentistry, where there is a growing crisis and a heavy reliance on hospital emergency surgery because of the lack of provision and monitoring of proper dental services for children, all this Government want to do is hide behind and blame others for their shambolic decisions.

The latest disaster is the business rates revaluation, which in Birmingham is estimated to see a rise for University Hospitals Birmingham’s Queen Elizabeth hospital from £2.8 million to £6.9 million per year—talk about robbing Peter to pay Paul! And yet Ministers from the Department for Communities and Local Government and the Department of Health have not even met to discuss the problem—although I note that private hospitals get an 80% reduction because they are registered as charities.

In my constituency, we have been fighting a battle to save our Katie Road walk-in centre for several years: we have had stop-go consultations, money wasted, explanations and excuses that vary from month to month, consultations announced and then scrapped, and now we have a sustainability and transformation plan that sadly, as acknowledged, has turned into a secret strategy drawn up by non-elected bureaucrats from which the public and their elected representatives have been largely excluded. It seems that Katie Road is now caught up in this fiasco. With its contract scheduled to finish on the 31st of next month, we still do not know what is happening, although if rumours are true, even more money that ought to be spent on healthcare in Birmingham is about to be siphoned off to rescue bankrupt neighbours.

Only the other week, I discovered that the contract for South Maypole GP services was to be cancelled. It is apparently no longer cost-effective—not cost effective to provide GP services to the sick and elderly! Only under this Secretary of State could the NHS have come to this.