Oral Answers to Questions

Paul Burstow Excerpts

Tuesday 12th July 2011 Commons Chamber

[Roberta Blackman-Woods (City of Durham) (Lab)]

15. What assessment he has made of the conclusions and recommendations of the recent report by the Commission on Funding of Care and Support.

[The Minister of State, Department of Health (Paul Burstow)]

As the Secretary of State said in his statement to the House last week, the Government welcome the report of the Commission on Funding of Care and Support and will consider its recommendations carefully.

[Bill Esterson]

The Government may say that they welcome the report, but can the Minister explain why the White Paper on social care will now be published in spring 2012 rather than in December 2011, as the commission’s report recommends? Do the Government want it to be kicked into the long grass because of Treasury interference?

[Paul Burstow]

The hon. Gentleman is entirely wrong. The Government’s approach is to have discussions with the official Opposition and to engage fully with stakeholders from Age UK, Carers UK and many other organisations, not just about funding reform—which is an important part of our reform of social care—but about questions of quality and law reform.

[Chris Ruane]

My constituency in central north Wales contains a high percentage of pensioners, many of whom come from the industrial cities of the north-west and Birmingham. What protocols exist to deal with cross-border issues involving pensioners’ care?

[Paul Burstow]

That important question must be partly addressed by the hon. Gentleman's colleagues in the Welsh Assembly, but one of the issues raised by the Law Commission’s recommendations on law reform that we must address is that of ordinary residence tests to ensure that people have access to the right care at the right time and in the right place.

[Ms Stuart]

The Minister said that he was engaging fully with stakeholders. Does that include the Treasury, given reports that the Dilnot proposals are being strangled at birth?

[Paul Burstow]

Cross-government discussions take place about any matter that requires legislation and funding—and of course the Treasury plays its part in those discussions.

[Roberta Blackman-Woods]

Does the Minister agree that the Government need to act quickly on the commission’s report, not least because the Southern Cross situation, which is affecting many people in my constituency, has shown that the current model, which involves relying largely on private care, is simply not sustainable?

[Paul Burstow]

We will return to that important matter later, with the urgent question. However, we must examine the position of Southern Cross and the business model that underpinned it very carefully, in order to understand how such a model was agreed to under the arrangements for regulating care providers that existed before the establishment of the Care Quality Commission.

[Mr Stephen Dorrell (Charnwood) (Con)]

It is now more than a decade since Sir Derek Wanless first identified a funding gap in long-term care for the elderly. I welcome the Dilnot report, but will the Government act quickly to establish a partnership arrangement enabling private money contributed through insurance to be added to some public money, so that that funding gap can be filled?

[Paul Burstow]

The answer to the first part of the right hon. Gentleman’s question is that the Government are already committed, through the spending review, to the provision of an additional £7.2 billion for social care over the next four years, which will involve an unprecedented transfer of resources from the NHS to social care. As for the second part of his question, the Dilnot report makes many recommendations, and the Government will work through them and present their conclusions next year.

[Duncan Hames (Chippenham) (LD)]

The question of who benefits from the proposals, and by how much, depends on the assumptions made about the potential maximum outlay on care home residence under the existing arrangements. That may change as the length of time for which people live in care increases. Does the Minister accept that if the implementation of the proposals is to be progressive, both now and in the future, the Government will need to test, and keep under review, their assumptions about the longest likely duration of care in homes?

[Paul Burstow]

That is an important point. One of the factors that will change those assumptions is the extent of our effectiveness in preventing and postponing the need for such services. “A vision for adult social care”, which we published last year, emphasised the need for more investment in preventive measures. That is why we have provided, and continue to provide, additional resources for reablement, which not only does the individuals concerned a great deal of good but saves money for social services authorities.

[Sarah Newton (Truro and Falmouth) (Con)]

Does my hon. Friend agree that in the months before the White Paper is published it will be important to take time to build the necessary all-party cross-House support for long-lasting reform?

[Paul Burstow]

My hon. Friend is absolutely right, and the exchanges on the Secretary of State’s statement last week made it plain that we are committed to having those discussions and working to secure a long-lasting reform. That is the only way in which such a reform can secure the necessary changes, both in law and funding, for this country.

[Rachel Reeves (Leeds West) (Lab)]

The Southern Cross crisis is causing extreme anxiety to the people who live in the homes, including the one at Hopton Mews in Armley, in my constituency. How will the Government ensure that local authorities and the Care Quality Commission have the necessary resources to oversee the transfer of homes to their new operators?

[Paul Burstow]

I shall certainly elaborate on how we are doing that in greater detail later. For some months we have been working with the landlords, the lenders and Southern Cross, and making sure that local authorities are fully prepared for any likely contingency and the CQC is ready to deal with re-registrations, should that become necessary.

[Emily Thornberry (Islington South and Finsbury) (Lab)]

The Minister of State has told us that one of the reasons why the publication of the White Paper has been delayed is to allow cross-party talks, so I wonder whether he can help us: when will the meeting between the Prime Minister, the Deputy Prime Minister and the Leader of the Opposition take place?

[Paul Burstow]

I am surprised that the hon. Lady does not know. As I understand it, there is a date in all three people’s diaries, but it is not for me to share that date. Although we do need to have cross-party talks between the leaders and the health spokespeople involved, we should also look back and draw some lessons from the royal commission on long-term care. What surprises me is that when that report was published by the right hon. Member for Holborn and St Pancras (Frank Dobson), all that was offered was a debate—not a debate that the Government would lead, but a debate that would take place across the country. We are still waiting for the end of that debate. This Government have a timetable and a commitment to engage.

[Mr John Baron (Basildon and Billericay) (Con)]

3. What arrangements he plans to put in place to ensure clinical commissioning groups are held accountable for their performance in respect of cancer outcomes.

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[Stella Creasy (Walthamstow) (Lab/Co-op)]

12. What estimate he has made of the change in net public expenditure on older people’s social care since April 2010.

[The Minister of State, Department of Health (Paul Burstow)]

The latest available data on social care expenditure are for 2009-10, when net expenditure on social care for older people was £7.5 billion.

[Stella Creasy]

Many of my constituents will have been deeply concerned by the admission of Peter Hay, the president of the Association of Directors of Adult Social Services, that nearly £1 billion is being taken out of social care budgets following cuts to local government, and by his warnings about the consequences for provision. When will the Minister deliver interim funding relief, so that patients are not stuck in hospitals because they cannot be discharged, and so that we can be sure that we will avoid a crisis in social care?

[Paul Burstow]

If the hon. Lady had read on, she would have found that £700 million of the £1 billion is to be found not through cuts in services, but through efficiency savings, for example through the use of telecare, which significantly reduces costs, and investment in reablement services, which save resources and help people to get back on their feet. That is all in the report that she is waving around. When it comes to investment, the Government have already made clear their commitment through the spending review, and are investing, by the end of this Parliament in 2014-15, an additional £2 billion—something that her party did not do when in government.

[Bob Blackman (Harrow East) (Con)]

The extra money being given to adult social care should be good news, but in Harrow, the council, which is Labour-run, has applied the £2.1 million additional funding to redundancies in general areas, rather than passing it on to the weak and the vulnerable. Will my hon. Friend take action to ensure that the new money provided by the Government reaches the people who need it?

[Paul Burstow]

I am absolutely determined to make sure that the additional resources that the NHS is transferring to social care deliver real benefits for people who need social care services, protect services, and allow local authorities to make the right decisions about how they continue to support not just investment in prevention, but those most in need.

[Pat Glass (North West Durham) (Lab)]

It is disappointing that we will now not see the Government’s White Paper until the spring, but will the Government agree to take forward the commission’s recommendations on national eligibility criteria and portable care assessments? The Minister will understand that that is now urgent, given the Southern Cross crisis.

[Paul Burstow]

The hon. Lady raises a question about eligibility; of course, we know from the latest figures in an ADASS survey that the majority of local authorities moved, under Labour, to “substantial” needs being the test for access to social care; that happened on her watch, not this Government’s watch. When it comes to portability, the Law Commission has made recommendations that the Government have to consider, and yes, we need to look to legislate on that.

[Hazel Blears (Salford and Eccles) (Lab)]

The Minister was present this morning at the launch of a report on dementia care by the all-party group on dementia. He will know that the key recommendation is to shift resources from acute hospital care to more preventive services in the community. What steps will he take to ensure that that shift really happens, over and above the £1 billion that has been allocated, much of which has already been spent by local authorities on plugging the gaps caused by other cuts in their budgets?

[Paul Burstow]

As the right hon. Lady was at the presentation, she will know that it was also identified that we currently spend about £8 billion on dementia services, and the Audit Commission identified that we could save at least £300 million through better use of preventive and early-intervention services. The Government have set out a very clear approach. First, we need to invest in services to provide for earlier diagnosis, because that is the best way to plan for dementia. Secondly, we need investment in services in our hospitals that shorten the length of stay and deliver good quality. Thirdly, we need care homes with the right training for staff, so that they can manage dementia and behaviour problems effectively.

[Alun Cairns (Vale of Glamorgan) (Con)]

13. What progress he has made in reducing the use of mixed-sex accommodation in the NHS.

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[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

18. What steps he is taking to improve cancer care for older people.

[The Minister of State, Department of Health (Paul Burstow)]

We are working with Macmillan Cancer Support and Age UK on a £1 million programme to improve cancer care for older people. The programme consists of 13 pilot sites across the country to improve intervention rates for people over 70 who have a cancer diagnosis. Pilots will introduce new ways of assessing older people for cancer treatment, offer short-term, practical support for older people undergoing cancer treatment and will address any age discrimination in cancer services by identifying and addressing the training needs of all professionals working with older people.

[Mrs Hodgson]

I am sure that the Minister will have seen the report published today by the Roy Castle Lung Cancer Foundation, which reiterates the considerable research showing that older lung cancer patients do not receive the same level of treatment as younger lung cancer patients. In fact, it shows that a 60-year-old sufferer is six times more likely to be given surgery than an 80-year-old sufferer, which obviously means that their outcomes are considerably worse. How does the Minister explain that inequality and how can it be tackled?

[Paul Burstow]

I am grateful to the hon. Lady for highlighting that further piece of evidence that shows why the Government have already given a commitment to ensure that there are no exemptions for the NHS from the application of our duties in respect of age discrimination, as there should be no place for age discrimination in the NHS. In addition, the work we are doing with Macmillan Cancer Support and Age UK is the way forward to ensure that we learn the lessons and drive up standards for the care of older people.

[Rachel Reeves (Leeds West) (Lab)]

T1. If he will make a statement on his departmental responsibilities.

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[John Healey (Wentworth and Dearne) (Lab)]

I want to say to the Health Secretary directly that it is a disgrace how he and his Ministers have ducked responsibility for reassuring more than 30,000 elderly and vulnerable residents whose homes may be at risk because of the financial crisis at Southern Cross. Today’s urgent question is the second time in a month that this House has had to drag Ministers to Parliament to explain what is going on. Southern Cross is set to close down completely by October. Will the Secretary of State give a commitment this afternoon to the residents of Southern Cross, their families and 40,000 staff that Ministers will in future show leadership and make public statements to this House?

[The Minister of State, Department of Health (Paul Burstow)]

I am grateful to the right hon. Gentleman for his question. He will of course know that when the first urgent question was asked, the Government had already provided a written ministerial statement setting out these matters in great detail, and we are happy to answer the questions that hon. Members will want to put in the urgent question later on. We have also said throughout that we do not help the welfare or interests of residents by an ongoing running commentary on these matters.

[Mr Rob Wilson (Reading East) (Con)]

T6. Despite the Government making available an additional £400 million for primary care trusts to support carers, I understand that my local Princess Royal Trust carers service is finding it very hard to engage with the local PCT in my constituency. Will Ministers remind PCTs to follow guidance and work with local carers’ organisations to develop plans for using the additional Government money that has been provided?

[Paul Burstow]

I share the hon. Gentleman’s concern. The NHS operating framework that the Government published last December makes it abundantly clear that primary care trusts need to work with their local authorities and care organisations to agree a budget and, where possible, to pool it so that it can be provided to individuals to enable them to get respite in the way that suits them best. I will certainly be pursuing this through the Government’s normal assurance processes to ensure that these things happen through the operating framework, but the hon. Gentleman might also want to invite his local overview and scrutiny committee to call to account local commissioners for the way in which they are behaving at the moment.

[Mr John Spellar (Warley) (Lab)]

T3. NHS West Midlands is cutting nurse training next year by a fifth and predicting a reduction of 7.25% over five years in the qualifying work force—not bureaucrats, but nurses—thereby denying youngsters in this country training for a worthwhile profession and career. Is not this a scandal and a shambles, and what is the Minister going to do about it?

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[Paul Burstow]

That is exactly what the Government are doing. We have had those discussions with the devolved Administrations, and officials are engaged with the landlords and lenders to ensure that they are doing just that. I look forward to answering the urgent question shortly.

[Andrew George (St Ives) (LD)]

It is acknowledged that the rising rates of norovirus are worse where there is a shortage of acute hospital beds. How does the Secretary of State square the understandable desire to get on top of hospital-acquired infections with his zeal to reduce acute hospital beds?

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[Mr Pat McFadden (Wolverhampton South East) (Lab)]

The Secretary of State will be aware that there has been a tripling of prescriptions for drugs such as Ritalin, or to give it its generic name methylphenidate hydrochloride, in the past decade. He will also know that National Institute for Health and Clinical Excellence guidelines state that those drugs should not be prescribed to children under the age of six. Why cannot his Department give a breakdown showing how many of those prescriptions are going to children under the age of six? Will he heed the call from the Association of Educational Psychologists for a review of the growth of the prescription of those powerful psycho-stimulants to very young children?

[Paul Burstow]

The right hon. Gentleman raises a very important point. We need to ensure that we have the right data to understand prescribing practice properly, so that we can both challenge bad practice and ensure that the NICE guidance is properly followed. I would like to look more closely at his points and then write to him in detail.

[Mr David Evennett (Bexleyheath and Crayford) (Con)]

Will my right hon. Friend join me in congratulating advisers working for Bexley stop smoking service, who helped more than 1,600 people stop smoking last year? Does the Minister agree that helping people stop smoking should remain an important public health priority?