Social Care

Margaret Greenwood Excerpts

Wednesday 16th November 2016 Commons Chamber

[Margaret Greenwood (Wirral West) (Lab)]

I think we all agree that the way in which a society looks after its vulnerable and elderly is a mark of its humanity. By that measure, our Government are failing. Social care services are facing financial crisis under the Tories, with social care funding slashed by £4.6 billion over the course of the last Parliament. We know that demand for care is rising, yet fewer people are receiving services. Between 2001 and 2015, the number of people aged over 85 increased by more than 38%, and the number of people with limiting long-term illnesses increased by 1.4 million, which means that the challenges are great. Despite rising demand, fewer people are receiving support. Research by the King’s Fund and the Nuffield Trust shows that 25% fewer older people are receiving social care support today than just five years ago. Research by the London School of Economics shows that 500,000 people who would have had access to social care in 2009 are no longer entitled to it.

Funding for social care remains insufficient and that only increases the cost to our national health service, as many Members have observed, The Government have announced increased funding from 2017-18 for the NHS better care fund, which aims to integrate health and social care and allow councils to raise council tax by up to 2% to fund adult social care from April. However, there is a shortfall of £1.1 billion simply to maintain care levels at the 2014-15 level. According to the King’s Fund, £5.5 billion has been taken out of social care budgets in the past six years. The most recent budget survey by the Association of Directors of Adult Social Services in England highlights that an extra £1.1 billion of investment is needed simply to maintain care provision at the same level as last year.

Research from the Nuffield Trust, the Health Foundation and the King’s Fund demonstrates that, even if every council were to utilise the precept, the estimated funding gap, taking into account the impact of the living wage, will be between £2.8 billion and £3.5 billion in 2019-20.

ADASS states that the social care precept this year raises less than two thirds of the calculated costs of the new national living wage. This significant and sustained underfunding is resulting in a loss of independence and quality of life for older and disabled people, and reductions in carer support, undermining the positive changes for carers introduced in the Care Act 2014.

In the past six months, 62% of councils have had residential and nursing home closures and 57% have had care providers hand back contracts. The closure of services and the handing back of contracts have affected more than 10,000 people using council-funded care.

There is significant regional variation, too. ADASS has already reported the inequality in funding for local authorities collecting the 2% precept, stating that it raises

“much more in some areas than others and raises least in areas with the greatest need for social care.”

Although the Government have said that the additional funding from the better care fund will be used to top up funding for local authorities that will raise less from the precept, that extra funding will not be released until 2017-18 when it will deliver only £105 million.

I wish to talk very briefly about the impact on the national health service. Before doing so, let me say that, despite the Secretary of State’s warm words around STPs and local decision making, he is doing nothing to allay the fears of patients, carers and NHS staff in Wirral about the risks that are posed to services at Arrowe Park hospital in my constituency.

We know that good social care is far less costly than a hospital stay. The crisis in social care means that patients are forced to stay in hospital for weeks or sometimes months longer than they need to because they cannot get the care they need in the community. The social care crisis is affecting our NHS. The Care Quality Commission said recently that the level of cuts to social care is forcing hospitals to admit more patients as emergencies, who they are then unable to discharge because the social care that they need is not available for them at home. The number of patients unable to leave hospital because of the unavailability of social care has risen 70% since 2012. The CQC’s most recent annual report shows that the number of hospital bed days lost through patients being unable to leave because of social care not being available has increased by 70% since April 2012.

Delays in securing these vital social care services and the desire to free hospital beds can put extra pressure on families at the point of discharge. Evidence shows that of carers who have recent experience of hospital discharge, a quarter report that they were not consulted about the process. Almost six in 10 carers said that they did not feel that they had a choice about providing care to the person following their discharge from hospital. In other words, families feel that there are no alternatives available.

If a carer is unprepared or simply unable to care for their loved one when they are discharged and no support is put in place, families can find it difficult to cope. This not only has a huge impact on the individual needing care, but can cause significant cost to the NHS, as re-admission is more likely. It is important that in debates such as this, we remember those people who do not have family to help them. The implications for them are far worse. It is vital that we address the failings in our social care system. The Government must find the money needed to fund it properly.

Finally, I want to say a few words about the impact on carers. I have a large number of carers in my constituency who play a vital role in providing care, but it is unfair to expect them increasingly to prop up a social care system in crisis. With that in mind, I urge the Government to do all they can, to take note of the concerns expressed in today’s debate, and to find the funding both to address the current crisis and to put in place a long-term settlement to ensure that care is there for those who need it, whether they are elderly or vulnerable in any other respect.