Adult Social Care

Lee Rowley Excerpts

Wednesday 8th March 2023 Commons Chamber

[The Parliamentary Under-Secretary of State for Levelling Up, Housing and Communities (Lee Rowley)]

I add my voice to all those who have welcomed you back to the Chair in recent days, Madam Deputy Speaker.

I thank right hon. and hon. Members who have spoken in this debate. It has been a good debate that has highlighted some of the challenges, and demonstrated some of the opportunities in this area. I am particularly grateful to my near neighbour and Chair of the Levelling Up, Housing and Communities Committee, the hon. Member for Sheffield South East (Mr Betts). We do not agree on everything, but he had a long and illustrious history in local government before he joined this place, and since then he has taken a significant interest in this subject. I am grateful to him for introducing the debate in such an even-handed manner.

As all those who have spoken today have indicated, this is an important area of policy for a variety of reasons. That is why there is such close working between the Department for Levelling Up, Housing and Communities and the Department of Health and Social Care, given the importance of the issue, the need to get it right, and the need to continue to make progress on some of the challenges that have been highlighted. We have also worked closely to ensure some of the achievements that have come forward in recent years. As hon. Members will know, policy is largely within the Department of Health and Social Care and the funding process, via the local government finance settlement, is within the Department for Levelling Up, Housing and Communities.

I will try to answer the questions as best I can on all the elements that have been raised today. Colleagues raised a substantial number of points that fall into three broad buckets: first, where we are; secondly, where we are going; and thirdly, what we do about the long term. I will take those three points in turn.

First, there is no disagreement across the House that there are challenges, and that there have been difficulties on both a macro level and across government and society as a whole. There are also challenges within adult social care. More broadly, over the past 20 years, under Governments of all parties, we have seen changing demographics. It is great that more people are living longer, but that creates challenges for whoever is on the Treasury Bench to ensure that the Government support people to the extent that they can. There is often greater acuity with individuals in the system, and more have multiple conditions. More broadly, in recent years and despite valiant attempts by the hon. Member for Luton North (Sarah Owen) to gloss over them, we have received the challenges of inflation, of external events and of covid, all of which have created issues across the Government. A mature debate will recognise and acknowledge those challenges, and seek to build on them and resolve them over time.

The hon. Member for Sheffield South East is correct to say that funding has been much questioned over the past 13 years, and we will all have different views on that. The issue has been much discussed since 2010, just as the reasons behind decisions that were taken between 2010 and now have been much discussed. I will not detain the House by repeating those reasons, other than to say that we know them, and that they are at least anchored in a set of decisions that were taken before 2010. It is also important to acknowledge—I hope hon. Members will do this—that significant additional funding has gone in and is going in over the remainder of the spending review period, with £2 billion of additional grants in 2023-24, and nearly £1.5 billion of additional funding in 2024-25. Money is not everything, but ultimately there is a recognition in all parts of the House that there are challenges with adult social care, and more money has gone in.

The hon. Gentleman also talked about the way we fund. Although I accept challenges from right hon. and hon. Members about the right balance, I hope we can agree within our discourse that it is reasonable and proportionate for us to have both funding provided centrally and an element of local funding, not least so that there is linkage between how organisations and local councils decide to spend that money in the locality and how they raise it. As I say, I accept that there are different views about what the proportions should be, but I hope that future discussion of this issue acknowledges the reality and appropriateness of that balance.

Although I am trying not to be too political, it is important to note that some of the challenges have been in place over recent years because there has been a challenge with Government funding over the course of 13 years. We have been trying to keep taxes down for people when we are able to do so. It is important to note that council tax more than doubled under the last Labour Government, and we have spent a significant amount of time and effort in the local government system since 2010 making sure that increases are as low as they can be.

[Barbara Keeley]

The Minister is talking about the balance between funding being found locally and funding from central Government grant. The issue I have outlined is that it would be unreasonable for a local authority to have to find something like £1 million extra. I have talked about placements for people with learning disabilities or autistic people that can cost up to that. That cost is being borne by the NHS, yet it could be much lower if the person had suitable housing found for them in the community. It is not reasonable to expect a local authority suddenly to find a large amount of money if a case comes up. Together with colleagues from the Department of Health and Social Care, will the Minister look at the idea of a dowry that I put forward, so that people do not have to spend 10, 20 or 30 years in horrible NHS institutions that are often far from home and unsuitable? This is just a logistical problem about where the money is, and it seems that of all the problems we could solve, this is one we should be doing something about.

[Lee Rowley]

I am grateful to the hon. Lady for her intervention. I will come to her points in a moment.

I acknowledge the point that my hon. Friend the Member for North Devon (Selaine Saxby) made about rurality, which is one reason why it is important that there is a balanced understanding that some funding is raised locally. Different parts of the country will have different requirements, pressures and challenges, which, in many parts of the country, will include rurality. I accept that that creates an issue in certain places. From a local government perspective, rather than an adult social care perspective, we have tried to acknowledge that, at least in part, in the local government finance settlement through the rural services delivery grant. I am always happy to look at that and to talk to my colleagues in more detail, as we prepare for funding settlements in future years.

[Selaine Saxby]

Does my hon. Friend acknowledge that in massive counties such as Devon, outside the urban south, the very rural hinterland causes variance from the average, and that top-tier authorities should have much more leverage to offer settlements with a far greater differential between rural and urban areas?

--- Later in debate ---

[Lee Rowley]

I certainly acknowledge that there are differences in individual circumstances between rural areas, urban areas, and suburban and near-rural areas, one of which I have the privilege to represent in Derbyshire. The finance settlement seeks to acknowledge that to some extent. As I will come to in a moment, we are also introducing Oflog—the office for local government—which will seek to understand how councils spend the money they receive or raise, so that we can understand the differences that occur around the country and also how people choose to make decisions arising from those differences.

Let me come to the second point, which is where we are going.

[Mr Betts]

rose—

[Lee Rowley]

If I may make a little more progress, I will happily give way to the hon. Gentleman.

I recognise the points that have been made about reform. I note that the hon. Gentleman, my right hon. Friend the Member for Ashford (Damian Green) and others highlighted the importance of looking at how we can continue to improve adult social care in the round and over time, and I pay tribute to my right hon. Friend for his work in the all-party parliamentary group on adult social care in that regard. I also note the broader questions of what we do over the long term, over many years and decades, and some of the issues that the hon. Member for Worsley and Eccles South (Barbara Keeley) highlighted, and also the intervention from my right hon. Friend the Member for East Yorkshire (Sir Greg Knight) about the importance of carers, which I absolutely acknowledge. I will certainly pass back to my colleagues in the Department of Health and Social Care all the policy points, which absolutely have been heard today.

Both my right hon. Friend the Member for Ashford and the hon. Member for Sheffield South East highlighted alternatives, and mentioned Japan and supplements. Decisions about how best to fund the system are long-standing and challenging, and there are always alternatives; I hope it will be recognised that the Government have tried to resolve some of the issues through changes and proposed reforms over the last couple of years, even if they are later than originally intended. There is acute difficulty and challenge in reforming this area, and successive Governments of different colours have been unable to do what many people would like to happen, yet we are determined as a Government to get it right. I hope we have demonstrated progress—both in the short term through further amounts of funding, and through the reforms we proposed a couple of years ago—and we will continue to try to do that.

[Mr Betts]

I thank the Minister for giving way; his further comments were quite helpful because they lead on to the intervention I was going to make, which comes back to local funding for social care. The joint report by the two Select Committees in 2018 said:

“There should be a continuation for the foreseeable future of the existing local government revenue streams.”

That was accepted, but we went on to say, very clearly, that a new source of funding is needed for social care to recognise the gaps that exist. Does the Minister accept in principle that the Government must come up with a new, discrete source of funding for social care? The Government sort of got there two years ago, then backed off. Are they going to come back to that at some point?

[Lee Rowley]

As I think the hon. Gentleman is aware, substantial additional funding has gone into the system. I am always happy to discuss the best way that that should be structured—obviously that is a multi-departmental discussion—but I hope there is an acknowledgement that additional funding has gone into the system and continues to go in. The additional information given in our announcements about the remainder of the spending review, over the coming financial year and the year after, demonstrates our commitment to do that. We hope that will have a positive impact on the challenges that have been articulated.

Finally, I want to talk about the long term, which hon. Members from across the House raised in their speeches. We acknowledge that there is a desire, and it is important to try to plan for the long term. We will bring forward a plan for adult social care reform in the spring. I hope that will answer some of the questions that hon. and right hon. Members have raised and assuage some of their concerns locally. To answer the challenge from the hon. Member for North Shropshire (Helen Morgan) about a long-term settlement for councils, while some of the long-term nature of that is debatable, I hope that the broader policy statement, which the Government announced several weeks ago with the local government finance settlement, demonstrates our intent to move forward with a longer-term understanding of what councils can expect to receive from Government, where we are able to do that. As I have highlighted, in the long term we are also seeking to introduce new elements to government, such as the office for local government, which hopefully will provide information not just about what is happening, but information that explains in more detail how local government is spending that money.

[Helen Morgan]

rose—

[Lee Rowley]

I have detained the House, but I will be happy to give way briefly.

[Helen Morgan]

I am grateful to the Minister. The point about long-term funding is so important. Until a couple of weeks ago, care providers in Shropshire did not know by how much their rates would increase in the new financial year, and they were considering handing their contracts back. It would have cost the council a fortune just to find someone who was willing to fulfil some of those care packages. Councils need long-term funding for their own financial stability and to find care packages at an achievable cost.

[Lee Rowley]

I am happy to confirm that the Government are trying, where we are able, to offer greater visibility of what is coming and greater long-term understanding. We will continue to try to do that across the local government finance settlement, and I hope this policy statement is an indication of that.

[Sarah Owen]

I appreciate the Minister’s generosity in giving way, and I completely agree on the kind of long-term futures that we talking about for local government, yet we are 23 days away from local authorities setting their budgets and they have still had no indication about their public health grants. If we are going to treat local authorities with respect on healthcare, surely they should be given that well in advance.

[Lee Rowley]

I know that my colleagues across Government will be working hard to get the final elements of the settlement out as soon as possible, but I hope the hon. Lady will acknowledge that, on the basis of my conversations with local government over the past few weeks, there is a recognition that the settlement has provided a good level of funds, that it will be moving in a positive direction and that it provides the stability and greater certainty that local government has requested and that we have responded to as a Government.

To conclude, I again thank the hon. Member for Sheffield South East for instigating and opening this debate. I also thank everybody outside this place who supports adult social care. It is an extraordinarily important part of local government and the state’s activities in general. As has been outlined in this debate, we need to support the most vulnerable and those in need, irrespective of age or condition. Through the changes that are coming in the new financial year, we are trying to provide additional funds, support and taxpayer subsidy to do that, and to ensure that local government can continue to build and improve for the long term in such an important policy area.