Care Services (Older People)

Debate between Paul Burstow and Tracey Crouch

Tuesday 7th June 2011 Commons Chamber

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

Let me start by congratulating my hon. Friend the Member for Eastbourne (Stephen Lloyd)on securing the debate and setting out the issues so clearly, as well as for his work as an officer of the all-party group on dementia. I suspect that many of his colleagues in the Chamber listening to the debate have been inspired to be here by their association with that group.

Social care is seldom in the news for good reasons and my hon. Friend was right to begin by referring to some of the most recent scandals that the House discussed earlier today, not least the terrible abuse at Winterbourne View. As I said earlier, the events that took place in that hospital were appalling and, as I explained, I am determined to do everything I can to ensure that the lessons are learned, understood and acted on swiftly.

My hon. Friend has painted a fairly bleak picture of social care, and although I am not quite so gloomy I am not complacent about what needs to be done. The system of social care that the Government inherited last year was and still is fragile. The legal framework that governs social care was written for a bygone era and is now so complex and byzantine as to leave people confused and frustrated. The way that we pay for long-term care is a classic wicked issue of politics—one that is occasionally taken out of the “Too difficult to deal with” drawer, only to be looked at and shoved firmly back in again—because most people in this country are blissfully unaware of how social care is paid for. They are blissfully unaware of the fact that it is not free, that it never has been free and that many people face the potential of catastrophic costs when they come into the social care system.

My hon. Friend has rehearsed his views about what future funding arrangements might look like. I am clear that there is no perfect solution—no solution that can possibly please and satisfy everyone—but we need to strive to reach a settlement that requires trade-offs but also secures the necessary change and sustainability of a system for the future. That is why the Government have been quick to put in place the building blocks of a reform system—quickly establishing the Dilnot commission to recommend reform of how we pay for care and support, and securing the current system by committing an extra £2 billion for social care by 2014.

My hon. Friend talked about the importance of integration. I can tell him that the unprecedented transfer of NHS resources to social care, which this year amounts to £650 million, is indeed fostering new relationships between local government and the NHS to allow the greater integration and closer working that are essential to enable us to deliver better services for the public whom we are here to serve. He also talked about the schism between health and social care. It is worth noting that that schism was set into the very foundations of the NHS under the National Health Service Act 1946 and then the National Assistance Act 1948, so we have to look back a long way to see when that split occurred.

The main focus of my hon. Friend’s remarks has been the challenge of dementia. Each year, about 65,000 people are diagnosed with dementia, which touches the lives of many families, as he has demonstrated by relating his experience with his two aunts. The number of dementia cases is set to rise by 38% over the next 15 years. That rise reflects the fact that many more of us are living for longer, but we should not cast that in the language of consternation. We should see it as a cause for celebration that so many more people are living for so much longer; the key is making sure that in those extra years we have quality of life as well. That is why we need the NHS, as well as social care and society, to rise to the challenge.

Let me offer some hope to my hon. Friend. We can do much better for people with dementia and their carers. In coming to office, I took the view that we should stick with the existing national dementia strategy and deliver it in full, because at our heart the coalition Government are committed to the notion of greater personalisation so that people have real control over the services that affect their lives and so that carers have a much bigger stake in the system. As he has said, commissioning is key to delivering that vision and the objectives in the strategy. Good commissioning can make a huge difference.

[Tracey Crouch]

The Minister mentions carers, who have a very difficult job—none more so than those who care for people with dementia. Next week is carers week. Will he join me in congratulating those who care for people with dementia, which is particularly challenging? Those people are often the unsung heroes of our society.

[Paul Burstow]

I am very grateful to my hon. Friend for making that very important point. The 6 million or more carers in this country are undoubtedly the backbone of our care system and save us a large sum of money—over £100 billion according to the most recent estimate by Carers UK. I will go beyond thanking them and make the point that the Government have committed £400 million extra to supporting the extension of respite support for carers. We are determined to make sure that that money gets through to those who need it.

My hon. Friend the Member for Eastbourne’s remarks about commissioning and the need for it to be multidisciplinary, involving social care and other expertise, is undoubtedly right. Indeed, my Department is in the process of developing a pack to support health and social care commissioners, particularly in relation to dementia commissioning. It will offer guidance on key aspects of dementia care and the need for early diagnosis and intervention. My hon. Friend was right to refer to the under-diagnosis and late diagnosis of dementia and how that can reduce life chances and the opportunity to plan for the progression of the disease. There will also be guidance on offering better support for people at home and in care homes and on providing better care in hospitals, which means addressing issues of training that have been mentioned.