Social Care Funding

Penny Mordaunt Excerpts

Thursday 10th November 2011 Westminster Hall

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

It is a pleasure to speak under your chairmanship, Mr Robertson, as it will be to speak under Mr Bone’s chairmanship later. I thank hon. Members for coming along to the debate. Given the importance of the debate in the main Chamber on armed forces personnel, the level of support in this Chamber shows how important this topic is to our constituents and to people throughout the country.

The question of who pays for care has vexed politicians for decades. There has been no shortage of good ideas, based on evidence garnered from the many Government reviews and commissions over the years, but there has been a failure in political will, resulting in only limited action being taken. However, demographic change and its impact is now an issue moving rapidly up the political agenda. All parties have signalled a desire for a long-term, all-party solution to the care crisis. It is clear that now is the time for us to take action.

During the debates on the Health and Social Care Bill, there was little dissent from the view that the integration of health and social care is a good thing. In the Budget debate, there was no opposition to NHS money being given to councils to integrate services. The Care and Support Alliance, made up of more than 52 major organisations representing older and disabled people, those with long-term conditions and their families, has come together to support reform. Polling evidence from ICM last year showed that 62% of the public saw care reform as one of the most important issues for the Government to focus on, and more than 50% of people felt that political parties were not doing enough to work together to improve care for older people. There is therefore a clear mandate from the people whom we represent to work together to find solutions to the problems.

The coalition Government clearly understand, and are committed to reform. They set up the Commission on Funding of Care and Support under the leadership of Andrew Dilnot, who was supported by Lord Norman Warner and Dame Jo Williams. Their report, published in May, described the care funding system in England as “not fit for purpose” and needing “urgent and lasting reform”. From our constituency work, we all know that there is great uncertainty and that people are worried about the future, but most people are realistic. Just as they know that they should save for their old age, they know that they will need to make contributions to the cost of their care in later life. They crave a clear path, set out by the Government, that shows them how the costs will be fairly borne—how they will be divided fairly between themselves and the state. Above all, people want to be relieved of the fear and worry about the availability and quality of care as well as how they will pay for it should they need it.

[Penny Mordaunt (Portsmouth North) (Con)]

I congratulate my hon. Friend on securing the debate. Does she think that our constituents are also ambitious about what they want care in the future to look like, and that the challenge for the Government is not just about finding ways to fund what currently goes on, but about considering how we meet the massive unmet need in dementia care, for example? I am thinking of bathing facilities and all the other things that we want our constituents to have but that too many of them do not have access to at all.

[Sarah Newton]

My hon. Friend makes an excellent point about the fact that there is inconsistency across the country in the quality and type of care available. The best care, which some people experience, should be available for everyone. We all want that for our constituents. As people in their 50s grow older, they will have far greater demands, which will be different from those of the generation now in their 90s or over 100. They will be looking to technology and innovation to come up with a range of services that will support them in leading life to the full, and in living healthily and productively as part of society, for as long as possible, so I agree with my hon. Friend’s point.

We know from our debate in this Chamber last week on the quality of care that elderly people experience in some parts of the NHS and from other care providers that the vast majority of people of all ages want elderly people and people with disabilities to be shown far greater kindness and respect. The commission says that the main failings of the current system are that it is confusing, is perceived to be unfair and is unsustainable.

--- Later in debate ---

[Sarah Newton]

The hon. Lady makes a fair point. We all understand that local authorities have had to make some major decisions about the allocation of resources and their priorities in serving their communities. I am proud of my council in Cornwall, which did not cut one penny from adult social care funding last year. In fact, this year, that funding could increase by £3 million or £4 million, although the council has not yet finalised its budget. It is very disappointing that some councils—although not all—have not used the money for such important purposes. It is estimated that approximately 7% has been cut from adult social care budgets across the country.

We have begun to see the effects of the withdrawal of the key services that the money should be funding, and which have been designated to prevent health problems among older people. The withdrawal is contributing to a far greater pressure on hospital beds. Delays in the discharge of people from hospitals are significantly higher than they were in the same months last year. Over 75% of delayed transfers for acute care are for people aged 75 and over. Research by Age UK and WRVS will be published in the next month or so, and it will provide evidence of the impact of councils not using the additional funds that they have been given by the Department effectively and of the additional pressures that that has put on hospitals and families.

[Penny Mordaunt]

Does my hon. Friend agree that whatever the size of a council’s budget, we need to ensure that it makes best use of the money? Some poor commissioning practices have gone on, discriminating against independent providers such as the Alzheimer’s Society and Age UK, which not only do a better job at a lower cost, but can rely on enormous amounts of volunteer and carer support and a whole raft of other stuff. We must ensure that there is a level playing field for those people.

[Sarah Newton]

I agree. My hon. Friend makes that important point extremely well. Local authorities and the NHS have had a silo mentality on commissioning. Undoubtedly, funds that could have driven up the quality and choice of care to support people have been wasted. I hope that the reforms that the Government are setting in train will overcome those issues. When the health and well-being boards come into play, if they link up properly all the providers in a community and set the agenda for commissioning services to improve health outcomes, they could have a powerful impact and achieve some of the things that my hon. Friend has highlighted.

In this debate, when we are talking about the budgets of the NHS and of local authorities, we must never forget that it is families who care for their grown-up children with disabilities or for elderly family members. Informal carers provide more support than any Government could ever afford to pay for. The most recent research from the charity, Carers UK, estimates that there are more than 6 million carers in the UK. The care and support that they provide to help people remain safely in their own home are valued at a staggering £119 billion per year, which is far more than the annual cost of all aspects of the NHS. Support to carers must be central to the future provision of services. It is informal carers, families and, in the majority of cases, women who worry most about cuts to services that enable them to help and care for their elderly and young family members.

Who pays for care is just one of the questions that the Government’s reforms of social care must address. There are issues of quality and regulation of services, training and pay for those working in this sector, as well as choice. The Government’s reforms need to look at finding solutions that work for different generations. Young people who will be saving for their old age and auto-enrolled into pension schemes could be incentivised to make an additional contribution each month to an insurance policy that will pay for their care later in life should they need it. The package of reforms developed by the commission has been welcomed by the financial services industry, which sees opportunities to develop new products to enable people to pay for their contributions towards the costs of their care.

The Dilnot commission’s package of reforms to support families in their caring responsibilities will require an extra £1.7 billion a year—a figure that will rise with an ageing population. Whether or not the commission’s reforms are implemented in part or in entirety, it is clear that more money needs to be found for social care and NHS integration. While I do not underestimate—I am sure none of my colleagues in the Chamber do—how difficult it will be to find that sum during this Parliament, constructive ideas have been given to the Treasury on how that spending commitment could be achieved without increasing taxation or borrowing more money. Consideration should also be given to removing the upper age limit on national insurance contributions, which could raise £3 billion a year, and to further reform to pension tax relief for higher-rate taxpayers.