Local Government and Social Care Funding

Maria Caulfield Excerpts

Wednesday 24th April 2019 Commons Chamber

[James Brokenshire]

I totally agree with my hon. Friend. Joint working has been done on delayed discharges of care. It is about ensuring that there is good practice and sharing that more broadly. We are doing that equally in children’s social care, where the Department for Education is providing funding to ensure that that is better adopted. It is about good practice and looking at the outcomes. The simple binary approach that the Opposition take is, I think, mistaken.

Another issue on which the hon. Member for Denton and Reddish was fulsome was that of council tax. I want to remind Labour Members that it was the Labour Government who made ordinary families pay the price for their failures, with band D council tax more than doubling under Labour and families paying an extra £750. Even now, Labour wants to abolish the council tax referendum limit, which prevents excessive rises in council tax. It is all very well for the hon. Gentleman to suggest that he is on the side of ordinary hard-working families, but that is not what we saw from Labour in government and it is not what we are seeing now. The real price of Labour is that it always costs you more. This is not just about the cost of a Labour Government; it is also about what people are paying now. Households in Labour-controlled areas have to pay higher council tax to make up for incompetent collection. In the worst-hit areas, Labour councils have unpaid council tax bills of up to £100 million, which is the equivalent of £439 for every household. The 10 councils with the worst collection rates in England are all Labour-run.

[Maria Caulfield (Lewes) (Con)]

It is true that Labour is promising £500 billion of extra spending, but what it is not telling ordinary hard-working families is that that will mean an increase in income tax and a doubling of national insurance, council tax and VAT. Those are not my words, but those of a former Labour shadow Chancellor.

[James Brokenshire]

The interesting thing about some of our earlier exchanges was the acknowledgement that the last Labour Government, going into the 2010 election, did not guarantee to protect local government. We have had to make difficult choices and confront difficult issues to put the public finances back on an even keel, and that has not been easy. I pay tribute to the innovation that councils have been engaged in up and down the country to help us to put this right. It is telling that there was no acknowledgement of that in the hon. Gentleman’s opening remarks.

--- Later in debate ---

[Maria Caulfield (Lewes) (Con)]

It is a pleasure to follow the hon. Member for Sheffield South East (Mr Betts), the Chair of the Select Committee. I agree with everything that he said in the last part of his speech. It is a shame that his Front-Bench team did not take a similar approach. The shadow Minister spoke for nearly 40 minutes and did not come up with one solution or proposal as to how we improve social care.

I am a great believer in the idea that it is not what you do but the way that you do it. In the same way, I believe that it is not how much you spend but how you spend it that makes the difference. As someone whose constituency falls in the county of East Sussex, which has the highest number of over-85 year olds in the country, I can speak with first-hand knowledge about the pressures on our social care system. I am not saying to the Minister that East Sussex does not need more funding, because it most definitely does. East Sussex has set up its Better Together system, working hand in hand with the NHS. Last winter, by working with the clinical commissioning groups and funnelling money into community care beds, it managed to reduce its delayed discharges by 33%, and that was despite an 11% increase in demand. The £2.5 million extra given to East Sussex by the Government this winter went into the system and, as a result, there were no delayed discharges or ambulances queuing up at the hospitals’ closed A&Es. The system was able to cope even with an increased number of norovirus and flu outbreaks.

Last year, we were subjected to urgent question after urgent question about the winter hospital crisis. Sadly, even with the system coping so well this winter, we have not had any acknowledgement of how hard NHS staff and local council staff have worked to ensure that, despite the extra pressure, there was no winter crisis this year. That success is because councils and the NHS are working much better together than they have ever done before.

We need to see what East Sussex is doing across the board. Although it is welcome that we now have a Health and Social Care Department, we are not seeing that joined-up working at a national level. I am concerned that if we do not see that joined-up work across the board, the £20 billion extra going into the NHS will be eaten up by the pressures on social care. If patients do not get the social care they need, their health will deteriorate, they will be admitted more often, they will be sicker when they are admitted and they will be in for longer periods of time. Their discharges will be delayed and their outcomes will be poorer. Not funding social care properly, or not using that money wisely, is a penny-wise and pound-foolish approach.

When this Session comes to an end and we have a new Queen’s speech, I hope that social care will be top of the agenda. I wish to see three things. First, there is the funding of social care. I am sad that the amendment to this Opposition day motion was not selected. I too have a copy of the report of the joint Select Committees, “The long-term funding of adult social care”. The hon. Member for Sheffield South East is right: instead of having a Green Paper, let us just get on with the recommendations in this report, because there is cross-party support for looking at a social care premium system, such as the one in Germany. We must be honest with the British public: there will need to be funding for social care. We need to have something, instead of people who have worked hard all their lives selling their homes to pay for social care—and not realising that that is what they will have to do—or refusing social care until they reach a crisis point and then have to pay for it.

[Andrew Lewer (Northampton South) (Con)]

I invite my hon. Friend to agree that, notwithstanding her radical suggestion, which was also made by the Chair of the Housing, Communities and Local Government Committee, about not bothering with the Green Paper, it would nevertheless be helpful if the publication of the Green Paper was now actually announced as a date—not as a month, a season or even a festival, which is the latest estimation we have had, but actually as a date.

[Maria Caulfield]

My hon. Friend is quite right. I am being slightly facetious in saying that we do not need to bring out the Green Paper. However, it would be very welcome indeed if the Green Paper contained some of the Select Committee’s recommendations.

We need a long-term funding solution, and I have discussed this with the Minister previously. The four-year settlement for local government was really helpful. If local authorities could have a 10-year settlement like the NHS has just had, they could do far more with their money, even if they were not seeing the significant increases that they would particularly like.

My third request is to look at the better use of our healthcare and social care professionals. We have grown up with a historical medical model that has depended on doctors and GPs, but people often need a diverse range of professionals to help them. The East Sussex Better Together model has just announced its community pharmacy programme, which is improving communications for patients discharged from hospital and helping them with their medication. The transfers of care around medicine project, or TCAM, is enabling those patients at risk of delayed discharges or readmission to hospital to have a dedicated pharmacist to help them, because we know that having problems with medication is one of the core reasons that people fail when they are discharged from hospital.

Under the community pharmacy programme, pharmacists would have access to patients’ medications, and would be able to answer their questions, monitor side effects and issue repeat prescriptions—things that often do not happen when someone is discharged home. The research and evidence base show that following such a model will reduce admissions and length of stay, and give patients a better experience and better outcomes. Some 112 pharmacies in East Sussex are going to take part in the project, which is a joint working venture between the county council and the clinical commissioning groups. I encourage the Minister to look at rolling this scheme out across the country, so that we can move away from being so dependent on GPs and doctors. I am conscious that there are a number of doctors in the House this afternoon. Doctors do valuable work, but there are other healthcare professionals that we should also be using.

This is not just about funding. Although the Government have given £20 billion extra for the health service, funding for local councils has increased by £1.3 billion this year—an increase of 2.8% compared to last year—and we have given extra money for winter funding, it is what authorities do with that money that makes the biggest difference. We need a long-term solution and a specific funding supplement, as recorded and recommended by the Select Committee. We also need to make better use of some of the fantastic resources that we sometimes fail to recognise. We can do a lot more, even with the existing resources. I am disappointed that the Labour Front-Bench spokesperson did not take the same tone as the Chair of the Select Committee, because we can do more to improve the lives of our constituents.