Vulnerable Adults: Transport

Rebecca Long Bailey Excerpts

Thursday 21st January 2016 Commons Chamber

[Rebecca Long Bailey (Salford and Eccles) (Lab)]

Before my hon. Friend the Member for Ilford North (Wes Streeting) leaves the Chamber, I would like to wish him a very happy birthday and congratulate him on his point of order.

I thank the Minister for attending what I have no doubt will be a lively and informative debate. It might be helpful if I first define what specific kind of transport I am focusing my comments on today. Adults with special educational needs often attend day centres or schools. Until recently, many councils have provided accessible transport to allow the most vulnerable to access these facilities, often by way of a bus or the provision of a driver plus an expert escort on board to ensure safety. That support is a vital service in many communities, providing independence for those with special needs and peace of mind for their parents and carers. It also provides a much-needed break for the unsung heroes of social care who struggle with the commitments of family life and work alongside caring for their loved ones.

Let me set a backdrop for the harrowing tale I am about to tell. In 2014 my local council, Salford City Council, was ordered by the Government to find £25 million of so-called savings in its budget. That was in addition to £97 million in spending cuts that it had already suffered since 2010. As an already efficient and well-respected council, it had already sought to find every possible means of saving money through genuine efficiency gains. It had fought for four years to find ways to save money or reduce spending here and there in order to ensure that all services for the most vulnerable residents across Salford were unaffected. By 2014 the council was way beyond being able to salami-slice budgets and, as a result, was forced to look at making real changes to a wide range of services. Our mayor, councillors and council officers were put in the agonising position of having to prioritise which types of care they provided and to determine who was the most vulnerable, instead of simply protecting all the vulnerable, as it had done before.

[Angela Rayner (Ashton-under-Lyne) (Lab)]

This year, £16.4 million has been taken out of Tameside council’s budget for adult social services, £11.1 million has been taken out of Oldham council’s budget for adult social services and a deficit of over £20 million has been forecast for Tameside general hospital. Cuts to front-line local services not only cost more in terms of the quality of life for the individuals affected, but cost us all more in the long run. Does my hon. Friend agree that these cuts are really short-sighted and damage not only our local services, but our NHS, which has to pick up the pieces afterwards?

[Rebecca Long Bailey]

I thank my hon. Friend for those helpful comments. I completely agree. As she will hear, Tameside is not alone in suffering such savage cuts.

Salford City Council had to face the difficult decision to cut the in-house provision of vulnerable adult transport for over 200 families across the city, amounting to a £500,000 cut in transport support for those with special needs. That was alongside the £400,000 that the Government’s cuts took from the provision of adult social care support to those with learning difficulties in the same year. I must add that prior to the cuts the transport service was rated excellent as a council service. It was not inefficient and there were no plans to cut it had the funding been available.

Commenting on the Government cuts at the time, our mayor, Ian Stewart, stated that

“this is not about efficiencies any more. These cuts will cause untold damage to the services we provide”.

Even in this desperate funding crisis, the council worked hard to make the best of a terrible financial situation. In partnership with the individuals affected and their carers, appropriate alternative arrangements were made. Transport was not ended for anyone until suitable alternative arrangements had been agreed. The good news is that a number of parents were generally happy with the council’s new arrangements, because they can individualise their journey times. That means that they are not spending significant amounts of time on transport, which previously resulted in some people arriving at the day centre in an agitated mood. The council is very much aware that the change is not universally popular, and it continues to work with any individuals who express concern. The fact remains, however, that it does not hold sufficient funding to provide an in-house passenger transport service as it was provided.

I have spoken at length to some of the families affected. I have heard their tales of despair and their worry about which other services that they rely on might be cut in future. I have listened to the mayor, our councillors and council officers, who have frankly lost faith in the Government’s commitment to provide a welfare system, which should be there to look after the vulnerable. In the wider context, for the 2014-15 financial year, a total of £4 million had to be cut from community health and social care, £2.4 million from public health, £4.7 million from support services, £5.6 million from education, and £4 million from environment and community safety. These are not “efficiency savings”—they are cuts to front-line services.

Perhaps in 2010 there were areas where genuine savings could be made with minimal knock-on effects on front-line services, but by the time £97 million has been taken from the budget, there is nothing left to cut but vital front-line services. Even the Prime Minister’s own council leader had to explain this principle to him following the now infamous letter in which he criticised his local council’s cuts to front-line services. By 2016-17, Salford City Council will have to make budget cuts of £188 million in order to balance its budget; £83 million of that sum alone is the amount by which the Government grant has been cut. That is a cut of over 43%, but in real terms the figure is much higher.

This is not just an issue for Salford City Council. Every council has faced vast reductions in funding from central Government, and my local council is not alone in having to cut transport for those with special educational needs. Countless numbers of local authorities have reduced or completely ceased to provide transport for vulnerable adults. It is rather tenuous, therefore, for the Government to argue that all these councils have made the choice to cut such an important service when they could instead have made efficiency savings in their back offices. These councils have no such choice any more.

When my constituents visited me about this issue, my first reaction was to try to locate funding elsewhere. What about the northern powerhouse, I thought, all that money that is supposedly being unlocked in the north—surely Salford’s vulnerable people deserve a piece of that? When I examined the detail I became even more disillusioned. We have often heard the Chancellor wax lyrical about his so-called devolution revolution, which he argues will enable areas such as Salford to raise and spend revenues locally, but he fails to acknowledge that councils in poorer areas have very limited revenue-raising capacities.

For instance, the policy to allow councils to set and retain their own business rates without the safeguard of a grant scheme has the potential to create severe inequalities among different areas of Britain. Indeed, the director of the National Institute of Economic and Social Research has said that while he agrees with the principle, it would be “inconceivable” not to keep a grant scheme. He stated:

“does this have the potential to disadvantage deprived areas and advantaged rich ones?..Absolutely!”

The Institute for Fiscal Studies has expressed concern that such a move would create winners and losers, with poorer areas seeing a fall in revenue. Let us not forget that we are already seeing disparities between local authority cuts. Between 2010 and 2015, Salford saw cuts of £210 per head, while authorities such as Epsom and Ewell saw only a £15 per head decrease. With local government funding being cut in terms of the grant by 56% by the end of this Parliament, it is frankly terrifying for Members like me whose local councils will see even more significant reductions in their spending power.

The same issue arises with regard to the social care precept, which would allow councils to raise council tax by 2% in order to fund social care. The president of the Association of Directors of Adult Social Services has warned:

“The Council Tax precept will raise least money in areas of greatest need which risks heightening inequality.”

[Barbara Keeley (Worsley and Eccles South) (Lab)]

My hon. Friend and parliamentary neighbour is making a great speech in support of our local council and about the difficulties it faces. On the social care precept, does she agree that a council such as ours, which has lost £15 million from its adult social care budget, will be able to raise, at most, only £1.5 million to £1.6 million? The gap is enormous. We no longer want to hear Ministers saying that they have put extra funding into social care, because, frankly, they have not.

[Rebecca Long Bailey]

My hon. Friend is right: councils in deprived areas will have the greatest social care needs, yet they will raise less than a third of what more affluent areas raise through this approach. I really fear that any revenue we raise across the city of Salford will barely touch the sides of the funding crisis in social care. Sadly, the Minister may be hoping to say that services such as in-house transport for vulnerable adults could be funded through a future increase in the social care precept, but that is not likely to be an option for Salford City Council. As I have outlined, councils in deprived areas have already been hit the hardest, and they will be hit worst again by the measures in the latest spending review.

The Government have had since 2010 to convince us that their argument for local government austerity is necessary. In that time, they have slashed the budgets available to councils for vulnerable adult transport and other essential services, while at the same time handing out tax breaks for millionaires, slashing inheritance tax and, despite their rhetoric, doing very little to crack down on tax avoidance. In fact, only in December we heard that five of the largest banks in the UK paid no corporation tax at all in 2014, despite making billions of pounds in profits.

The Prime Minister gave the game away in an interview on Monday morning, when he said that

“if you are a Conservative, you don’t believe in a big state”.

I fear that that is what these cuts are all about: rolling back the state and going back to a time when the vulnerable relied on the philanthropic donations of wealthy people with a conscience.

The cuts that have been inflicted on my city are clearly a political choice, not an economic necessity. My and my hon. Friend’s city is living in fear, with the sword of Damocles hanging over our heads, waiting for the next savage cut to drop.

I look forward to hearing the Minister’s comments and I hope he will be able to reassure me that my fears are unfounded. I also hope that as a result of this debate he will ensure that there is a much-needed boost to local government funding, in order to provide essential services such as the one I have outlined. I hope he amazes me with what he is about to say.

--- Later in debate ---

[George Freeman]

I will come on to the numbers for Salford. I rang Salford this morning to get the very latest numbers, and they make quite interesting listening.

Let me just set the scene on the settlement. In the context of the tough public sector finances, we listened to local government and took steps to protect social care services. In the spending review, we reflected that by introducing a 2% social care precept to the council tax for authorities with social care responsibilities. It is ring-fenced: it has to be spent on social care. The precept could mean up to £2 billion of additional funding for social care by 2019-20, which would be enough to support more than 50,000 people in care homes or 200,000 people in their own homes. In addition, we have secured a further £1.5 billion by 2019-20 through extra funding for the better care fund, which brings that funding to a total of £5.3 billion. Those resources are secure, and they are in the hands of local authorities.

Let me turn to transport for disabled people in Salford. Rightly in my view, the provision of social care and the question of how to meet local need are very much matters for the local authority, as I think hon. Members would agree. That is at the heart of this issue. I understand that Salford City Council has decided that the transport needs of people who require support to get to local day care and respite care services can best be met, in the patients’ interests, by closing the in-house passenger transport unit and providing suitable alternatives for individuals.

I also understand from the local authority that a significant number of parents and carers have commented on how much better the arrangements are because they can individualise journey times. Instead of having to wait and then sit on the council bus to get to services, going on very long routes, the vast majority of users are getting a much more personal and bespoke service. It means that the users of the service do not spend significant amounts of time on transport, which used to result in some of them arriving at a day centre or home upset, agitated, delayed and frustrated.

The council has worked hard to resolve the concerns that have been expressed by care users and their families. Having spoken to the council this morning, I understand that all have now accepted the new arrangements. Indeed, the director of adult social services at Salford City Council has told me that he considers the change to be

“a success both in terms of outcomes for individuals and in delivering a saving to the council budget.”

[Rebecca Long Bailey]

The Minister is quite right in what he says. The ability of my local authority to do more with less has been extremely amazing, but the fact remains that the review of special needs transport would not have occurred to this extent had the funding not been taken away. I do not dispute that it is right to review the service and the needs of individuals on an ongoing basis, but it should not have been done in such a forthright and extreme way. That would not have occurred had the funding not been taken away.

[George Freeman]

I am not sure what the question was. It is interesting that the hon. Lady is saying that the review was the right thing to do and the service has improved, but the rationale for doing it was wrong. I beg to differ. If the rationale that we have to deliver more for less leads good councils, in this case Salford, to find a better way to deliver services that uses less money and provides a better service, that is good. It is exactly what we want councils across the country to do.

For far too long, local government has been hidebound by receiving far too much of its funding from central Government. For me, as a localist, it is anathema that the majority of local government spending comes from central Government. That is why we have begun the process of seriously rebalancing the funding settlement by providing more powers and freedoms locally to raise money that can be spent on locally agreed priorities. The social care precept and the retention of business rates locally are powerful things for which many of us have campaigned for years.

If Salford uses the full social care precept flexibility that we have just provided, it could raise £7.6 million in 2019-20. That will be on top of Salford’s additional income from the better care fund of £10.5 million in 2019-20.

This is not about cuts. It is about a Labour council making prudent decisions that not only improve the way in which services for vulnerable people with disabilities are delivered, but do so in the most cost-effective way. The council’s prudence extends to its decision to nearly double its non-ring-fenced reserves from £29.7 million in 2010 to £56.5 million at the end of 2014-15. I will just say that again: the council doubled its reserves to £56.5 million over the course of the coalition Government.

[George Freeman]

I will take the question as being, what do I think about that statement? The hon. Lady is right that the funding ramps up, but she is not right in saying that it does not come on stream until 2020. Indeed, I have looked at the figures for Salford. The money that will go to Salford from the better care fund will be £1.1 million in 2017-18, £6.1 million in 2018-19 and £10.5 million in 2019-20. Similarly, the precept will rise over the course of this Parliament, depending on Salford’s decisions on raising it.

Salford’s reserves have gone from being £29.7 million in 2010 to £56.5 million. Those reserves are public money that is there to be used prudently. In this period when we are all having to make sure that our children do not inherit ever more debts, I do not think the fact that Salford City Council is having to dip into its reserves to ensure that it is able to provide services—which, remember, are costing less but delivering better quality—is the savage crisis that the hon. Lady referred to.

[Rebecca Long Bailey]

I invite the Minister to visit the city of Salford. He will see the extent of the damage that this Government have done to local authority services. It is not just social care that is experiencing a large funding gap. Salford is experiencing a large-scale regeneration and is coming out of its post-industrial decline, but all that is at risk. He made the fantastic comment that we have increased our reserves, but there is much more that needs to be done in Salford.

[George Freeman]

I would happily welcome the chance to debate more widely the economic regeneration of Salford, which I hugely welcome. Since the floods have been mentioned, may I extend my sympathy, and that of the Government, to those who have been affected? However, this debate is on transport for vulnerable adults and when I spoke to Salford Council this morning, it told me that all those affected—I believe there are 200 families—are happy with the new service and believe that it is providing a better service for vulnerable adults in Salford.

The hon. Lady has cleverly used the debate to make wider points about the Government’s approach to care, which is perfectly within her rights. I have tried to deal with them. She says that we are underfunding local government, but in the recent comprehensive spending review, local government made clear to central Government that it foresaw a shortage of £2.9 billion that it was worried would not be met. That is why we gave local government a funding settlement of £3.5 billion, to ensure that the shortage we were warned about was properly met. We went further and gave local government the right to raise up to what will equal £2 billion in 2020 to fund that care gap, and a four-year settlement so that it can plan ahead—one of the other key asks. We have put an extra £1.5 billion into the better care fund, which now totals £5.3 billion for the integration of health and care.

The plea may go up that that is not enough, but money does not grow on trees and we can only fund what we can from our strongly recovering economy. However, I do not believe that that fits the pattern of “savage cuts” described earlier. I merely repeat that if the picture that the hon. Lady painted about transport for vulnerable people in Salford were true, I would be very concerned. However, when I spoke to the Labour-run council, it told me that it believes it is delivering better services at a more efficient cost, and that all those in the families involved have settled and are happy with that. The council’s reserves are up substantially on where the Labour Government left them, to the extent that over the next one or two years, while the extra money that we have put in comes on stream, it will have those reserves that it built up during the coalition Government. I simply do not recognise the picture of savage cuts and austerity that the hon. Lady presents.

[Rebecca Long Bailey]

I am quite concerned about the Minister’s comments. I spoke to the council this week and received similar comments, including notification that large numbers of the families were happy with the new service—I outlined that in my speech. I also highlighted that the council was aware that some families are not happy with the amended service, and it continues to work with them to try to reach a sensible conclusion on the matter. That is why I have raised this issue in the Chamber today.

[George Freeman]

I am delighted that we close on a point of unanimity: we agree that Salford council is doing a good job and has managed well the issue of transport for vulnerable adults. I was merely dealing with the wider points that the hon. Lady sought to make about the Government’s more general approach to care, to which it is my duty to respond. I welcome the work that Salford council is doing to look after its most vulnerable citizens, and I hugely support it in that. The Government’s vision is to give councils more freedoms and funding to provide for local people in the way that they see fit; in that way, all councils can do what Salford has done and deliver more for less.

Question put and agreed to.

Mental Health

Rebecca Long Bailey Excerpts

Wednesday 9th December 2015 Commons Chamber

[Rebecca Long Bailey (Salford and Eccles) (Lab)]

In Salford and Eccles, we know only too well about the urgent need to provide better mental health services, but I want to focus specifically on children’s mental health services. As we have heard, a significant proportion of lifelong mental health problems start in the teenage years, yet only 6% of the mental health budget is spent on child and adolescent services. YoungMinds, a leading mental health charity, has confirmed that, due to local government cuts, 60% of local authorities have either cut or frozen their child and adolescent mental health services budget since 2010.

Research has shown that early intervention is of paramount importance, with one in 10 children encountering a mental health problem, which, without early intervention, is likely to become a more chronic problem in later life and thus a greater burden on the NHS. Early intervention is also key to ensuring that an issue does not escalate to the stage where hospitalisation is required. One in-patient bed costs a staggering £25,000 a month. It is perfectly clear that adequate investment in the lower tiers of CAMHS provision is not just a question of social conscience, but a matter of economic common sense.

I must also address the systems in place for ensuring that children who present with mental health issues receive the requisite help at the earliest opportunity. GPs play an incredibly important role in early intervention, as they are often the first point of contact for parents whose child is experiencing a mental health problem. GPs have, however, voiced the concern nationally that they are not sufficiently equipped to deal with children with mental health issues and their training does not prepare them adequately for such situations.

Time and again, I am made aware of cases in my constituency where a child did not present symptoms clearly enough to a GP, a referral was not made and the problem, which could have been dealt with relatively easily, escalated to the point where the child became seriously ill and required hospitalisation. Other barriers to referral include the body mass index limits in relation to eating disorders, which my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger) highlighted earlier. What further support and guidance will the Government provide to GPs in order to address the issues?

The case for effective early intervention in Salford becomes even more convincing when we consider the shortage of in-patient beds in Greater Manchester. I have been working with a family in my constituency whose child desperately needed urgent treatment but who, due to the lack of available beds, was admitted to a general paediatric ward, where they waited for months until a child mental health bed became available. Although the staff on that ward were amazing and did all they could, the simple fact remained that this child was not on the correct ward and was therefore not receiving the psychiatric treatment that was immediately required.

Although I appreciate some of the measures that the Government have taken, I have serious concerns that they will barely begin to address the issues that I have raised today.

A&E Services

Rebecca Long Bailey Excerpts

Wednesday 24th June 2015 Commons Chamber

[Rebecca Long Bailey (Salford and Eccles) (Lab)]

Thank you, Madam Deputy Speaker, for giving me the opportunity to make my maiden speech during this debate.

Earlier this year, our A&E department at Salford Royal hospital—a flagship of NHS excellence—endured a period of crisis that was a symptom not just of the national shortfall in funding but of the far wider challenges we face in my constituency of Salford and Eccles. None the less, Salford, Eccles, Swinton and Pendlebury collectively make an amazing place to live, in terms of both the spirit of their people and their ambition to achieve the unthinkable.

We have a rich political history. I am a proud socialist, and if any city personifies the struggles of the working class and the Labour movement, it is Salford. Salford was pivotal in the creation of the trade union movement, with Salford and Manchester trades councils founding the TUC in 1868. On 1 October 1931, thousands swarmed to Salford town hall, where a violent demonstration took place. It came to be known as the battle of Bexley Square. They were protesting at the 10% cut in unemployment benefit introduced by the new national Government. Sadly, we face similar struggles in Salford and Eccles today.

Freidrich Engels’s pioneering work, “The Condition of the Working Class”, was inspired by the struggles he witnessed in Salford, where he owned a factory and could often be found drinking in The Crescent pub with Karl Marx. Members will be delighted to know that Engels’s magnificent beard has inspired a climbing wall sculpture in Salford. The 16-foot beard statue—a “symbol of wisdom and learning”—will stand on the University of Salford’s campus. Members will be able to scale the impressive beard to a viewing platform at the top, where they might find time to rest and contemplate.

We are a city facing the legacy of post-industrial decline. Members may recall the song “Dirty Old Town”, penned by Ewan MacColl and later sung by, among others, The Pogues, about finding love in 20th century industrial Salford by the gasworks wall. The gasworks wall still exists today, but Salford’s gas industry has largely disappeared, along with our mining community, destroyed in the 1980s, as was our large shipping, engineering and manufacturing base. Thousands of lives, hopes and dreams were shattered, with generations locked in a cycle of low-paid unskilled work. We were told that free market globalisation of industry would eventually see wealth trickle down from the top. We are still waiting.

We were a city on its knees and we can be thankful for the foresight of Salford’s Labour councillors who encouraged investment and growth. They championed the transformation of the derelict docks into Salford Quays, now a residential and cultural quarter housing the Lowry gallery, theatre and shopping centre. Again, it was the Salford Labour Council and our local MPs who ensured the building of Media City, the new headquarters for the BBC and ITV, against resistance from a southern-based media that saw anything north of the Watford gap as a social and cultural backwater.

I would like to pay tribute to my predecessor, Hazel Blears. Elected alongside a record number of women MPs in 1997, Hazel is admired by many, including me, for breaking the glass ceiling not just for women in Salford but for all women from working-class back grounds like myself. Indeed, much of Hazel’s time in the House was dedicated to promoting schemes that would give young people from disadvantaged areas the chance to forge a career in politics and other vocations.

I would also like to honour Ian Stewart, who served as MP from 1997 to 2010, for the now abolished constituency of Eccles. Ian was a proud trade unionist, like myself, who never forgot the poverty and struggles of his childhood. Recently, in his current role as Mayor of Salford, Ian urged the Government to rethink the savage cuts to the Salford City Council budget, austerity measures that are neither justified nor necessary. These cuts are now sawing through the bones of our already fragile public services and they severely impact on the most vulnerable.

It might startle hon. Members to hear that life expectancy in the more deprived parts of my constituency is lower than the life expectancy of people living in the Gaza strip. Some 30% of children in parts of my constituency live in poverty. Our unemployment rates are above the national average and our wages for those in work far below it. Many families are trapped in a cycle of poverty and low-paid and insecure work. The gap between rich and poor is now growing at a faster rate than in the Victorian era. Evidence from the world over indicates that health outcomes are linked not just to material poverty but economic inequality. It reduces social cohesion, leading to more stress, fear, and insecurity, which places even greater strain on our NHS and public services. Our NHS will only truly succeed when we invest in people and their quality of life. That means adequate funding for our public services, decent and affordable housing, well-paid secure jobs and a clear and apparent reduction in income inequality between those at the top and those at the bottom.

My constituency and its people have a proud socialist history. I intend to use my time in the House to fight for them to have a proud socialist future as well.