Adult Social Care

Debate between Margot James and Liz Kendall

Monday 16th July 2012 Commons Chamber

[Liz Kendall]

I always respect the hon. Gentleman’s interventions, but he seems to forget that we faced up to those difficult decisions and choices on adult social care in “Building the National Care Service”. We tried to get cross-party agreement on those proposals, but they became a political football at the last general election. The hon. Gentleman should be encouraging those in his Front-Bench team to engage seriously in cross-party talks and to take the difficult decisions that need to be taken.

[Margot James (Stourbridge) (Con)]

Will the hon. Lady give way?

[Liz Kendall]

I want to make some progress, then I will give way.

Labour proposed better information and national minimum standards to tackle the postcode lottery in care. We also proposed that everyone should have the right to have a personal budget—which we introduced—that people should be able to take their care package with them if they moved to a different area, and that carers should have the right to have their own needs assessed and met independently of the person for whom they cared.

The difference between the Labour Government and the present Government is that we set out the difficult decisions about how those changes would be paid for. The absence of that information is the gaping hole at the heart of this Government’s plans. There is a risk that their promises of new rights and services will be meaningless without the ability to fund them properly. Indeed,

“this White Paper is not worth the paper it's written on.”

Those are not my words, but those of the Alzheimer’s Society, which has damned the White Paper as a massive failure. Similarly,

“the key test for this White Paper was to deliver an urgent timetable to reform social care funding. The Government has failed this test.”

Again, those are not my words. They are the words of the Care and Support Alliance, which consists of more than 65 organisations that represent and support older and disabled people.

--- Later in debate ---

[Margot James (Stourbridge) (Con)]

I will start my contribution with some points that I wanted to make earlier in the debate about the origin of the problems. I accept that there are severe problems with adult social care. I do not know where the hon. Member for Leicester West (Liz Kendall) got her figures about the last Government’s record on adult social care spending, but according to local government figures, between 2004 and 2010, spending increased by 0.1%. Meanwhile, the population of over-65s grew by 7.7% and the number of over-80s by 11.6%.

[Liz Kendall]

I am grateful to the hon. Lady for being more generous with her time than perhaps I was. I got my figures from an independent assessment of Labour’s record in Government that was produced by the King’s Fund before the last general election.

[Margot James]

I am grateful to the hon. Lady for clarifying that. According to local government statistics, in the six years up to 2010, the spend was flat, and I have mentioned the demographic pressures. Interestingly, the same analysis states that over the same time, NHS expenditure rose by 27%, expenditure on the police rose by 20%, and even expenditure on schools rose by 12%.

A picture is emerging of the deprioritising of adult social care under the last Government. That is the origin of the problem that we are debating. That is what gave rise to the restrictions of the eligibility criteria for care. Long before this Government came to office, many local authorities started to restrict eligibility to those in moderate need of care and then to those in critical need of care.

Minister for Older People

Debate between Margot James and Liz Kendall

Thursday 28th June 2012 Commons Chamber

[Liz Kendall]

I think we made big improvements for older people, but far more needs to be done. One of the biggest challenges—transforming the care system for older people—requires action across Government. It is not something that a Minister for older people could do on their own. They would need the Treasury, No. 10, the Department for Work and Pensions and other Departments to be closely involved. It is a matter of having someone who can help to co-ordinate action across Government and provide a stronger voice at Cabinet level. That is the role a Minister for older people would perform.

Let us consider some of the other areas in which we need to make sure that older people’s needs and concerns are heard. Take education policy, which some might not think would be relevant. We need to understand that as people live longer and need to work for longer, lifelong learning is essential to help them to develop new and different skills. In family-friendly working, we need to understand that a quarter of all grandparents— 3.5 million in total—are still working as well as helping to look after their grandchildren.

Several hon. Members have mentioned housing policy. We must ensure that there is a range of good-quality options for people as they get older, so that they are not given a choice between living in their own home or a care home; there should be various stages in between. Transport policy is also very important. I am sure that many hon. Members find that bus services are a big issue in their constituency. Making sure that services are linked up is a big challenge. Our energy policy must also take into account the needs of older people, many of whom have very high energy and heating bills, particularly if they have long-term health conditions.

Having a Minister for older people in Cabinet would help to ensure that all Departments were more aware of the issues and concerns I have raised, but the final and most important reason why we need the role is that, as a society and a country, we need to face up to the major economic and social challenges of demographic change. That is a key issue behind Grey Pride’s campaign and is highlighted in the motion. Many hon. Members have spoken about pensions, and I am sure the Minister will speak about them too, but I will focus on care and support.

That must be one of top priorities for the Minister for older people because it is one of the biggest challenges facing Britain today. That is why one of the options would be to have the Minister for older people in the Department of Health, because the key to transforming the care system is in transforming the NHS. Social care budgets have been under increasing pressure for many years, but the care system has now reached breaking point. Adult social care makes up around 40% of local council budgets—up to 60% in some areas—and it is their biggest discretionary spend. When the Government are cutting local council budgets by a third, it is inevitable that services for older people will suffer. Figures from the Department for Communities and Local Government show that more than £1 billion has been cut from local council budgets for older people’s social care since the coalition Government came to power. The result is that councils are raising their eligibility criteria: 80% now provide care only for those with substantial or critical needs, up from 50% only four years ago.

[Margot James]

Does the hon. Lady not accept that the phenomenon of councils changing their eligibility criteria to restrict care to critical level started way before the cuts to local government budgets?

[Liz Kendall]

I did say that social care budgets had been under increasing pressure for many years, but local councils are now facing cuts of a third in their overall budget. Adult social care is their biggest discretionary spend, so they face real challenges and are moving their criteria from modest to only substantial and critical need.

Preventive services have all but disappeared in many areas. Fewer older people get free care; more end up having to go into hospital, or are unnecessarily stuck in hospital or more expensive residential care. Charges are increasing across the country and vary hugely depending on where people live. It is not just older people who are suffering, but their families. Carers suffer ill health and some have to give up work because the right services are not available. There are costs to the taxpayer if they are not in work and contributing financially. There are also increased benefit bills.

The fundamental problem, and another reason why a Minister for older people is important, is that our welfare state was established in a very different age. In 1948, average life expectancy was 66 for men and 71 for women; now, it is more than 78 for men and 82 for women. Some health conditions that are now common amongst older people, such as dementia, were almost unknown back then, and many disabled children died at a young age. Social expectations were very different. Disabled adults had fewer rights, and people automatically assumed that women would stay at home to care for their families.

Big Society

Debate between Margot James and Liz Kendall

Monday 28th February 2011 Commons Chamber

[Margot James]

I would like to consider that suggestion more fully. It is a laudable one, which would address the problem of over-dependence, although I fear that too great a bureaucracy would be required to oversee such an idea, resulting in two steps forward and one step back.

[Liz Kendall]

What other sources of income should the voluntary sector turn to, if the hon. Lady believes that it is too reliant on council and central Government funding?

[Margot James]

There are many voluntary and charitable organisations that derive no income whatever from the state, such as the air ambulance, which one of my hon. Friends mentioned earlier. It raises £48 million a year through a lottery and fundraising volunteers. A dear aunt of mine aged 88 has a standing order for the air ambulance, which is how such organisations get their money. The hospice movement is another case in point. My local hospice, Mary Stevens hospice in Stourbridge, receives only 18% of its funding from the primary care trust and raises the rest of its money itself. I am very much in favour of grants from local authorities. When I was a local councillor, I served on the board of a charity that received virtually all its income from the primary care trust and the local authority, which was detrimental.