Adult Social Care

Robert Buckland Excerpts

Thursday 8th March 2012 Commons Chamber

[Sir Alan Meale (Mansfield) (Lab)]

I congratulate the hon. Member for Truro and Falmouth (Sarah Newton) and my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) on their tenacity in securing this debate. Hon. Members from all parts of this House should give them credit for their hard work and effort.

In this important debate, I wish briefly to raise the issue of people suffering from autism and Asperger’s syndrome. As hon. Members will be fully aware, those conditions are extremely serious. Both are lifelong disabilities and they affect sufferers in a number of different ways. I fully accept that some people who have either of those conditions are able to live semi-independent lives, with only partial support, but others—indeed most—need a range of specialist support throughout their lives. Although they do not represent everybody who needs adult social care, I am not talking about a small number of people. Approximately 1% of people in the UK have autism, and they and their families account for at least 2 million involved citizens in the UK, which represents, on average, approximately 3,000 people in every constituency in Britain.

Yet, even given those numbers, the National Autistic Society says that sufferers routinely struggle to access the services they need and that when they do access them the outcomes are largely poor. NAS research also shows: two thirds of all adults with autism say that they do not have enough support to meet their needs; more than 60% of these adults rely absolutely on their families for financial support, with approximately 40% of them having to live at home with their parents; and only 15% of people with autism are able to find full-time work.

Failures to provide such support are also very expensive to the ordinary taxpayer. According to the National Audit Office, if local services supported only 4% of adults with high-functioning autism, that would be cost-neutral, and if they supported only 8%, that would save the Government at least £67 million a year. As a number of hon. Members have said, the Dilnot commission on funding of care and support stated a number of good things, in particular that the present system was both unfair and underfunded. It called on the Government to increase spending on social care and to limit the cost and charges for those who need it.

The report’s key recommendations included the need for national eligibility criteria, with all those who enter adulthood with health and social need being eligible for free state support immediately rather than being expected to pay themselves. This is where I have a slight difference with the Minister, who said that it is not only about money. For many people who come to my surgery at their wits’ end, it is about money. Indeed, even those who had money do not have very much left in their late adulthood to spend either on themselves or on their loved ones, so money is very important.

In conclusion, I believe that the adoption of the Dilnot recommendations would lead to an entirely fresh approach that would deliver greater awareness of autism, and in particular of the sufferers’ needs, care and, of course, support. It would also put in place measures to relieve the short-term crisis in funding in social care.

[Mr Robert Buckland (South Swindon) (Con)]

The hon. Gentleman is quite right to raise important statistics about people with autism, but may I urge him, when he speaks passionately about it, not to refer to people as suffering from the condition but rather to acknowledge that they have the condition and have great potential and that what we should all be doing through the care system is ensuring that they realise that potential? Does he accept that?

[Sir Alan Meale]

I fully understand the direction that the hon. Gentleman is coming from, but let me just say that I am the son of a permanently and seriously disabled person and he was that way all of my life. I also served as a board member of the Portland training college for the disabled in Nottinghamshire and have been deeply engaged in matters connected with the seriously disabled for years. Believe me, when I use the terms “suffering” and “sufferers”, I mean them not in a derogatory sense but to highlight the plight of the people who I am talking about.

In conclusion, I believe that adopting Dilnot would put in place measures to relieve the short-term crisis in social care funding and, most importantly, establish sustainability for care and support in the longer term.

--- Later in debate ---

[Mr Robert Buckland (South Swindon) (Con)]

I do not know whether I should thank my hon. Friend the Member for Hexham (Guy Opperman) for that warm-up act. I know my place, and I am more than happy to take part in this interesting and varied debate.

There is no doubt that the facts that face us all as parliamentarians are pretty stark. We know that 11 million people alive today will live to be 100 and that the population who are over 65 is projected to grow by 50% over the next 20 years. The expected number of working age adults with a learning disability will rise by about 30% over the same period. My hon. Friend the Member for Totnes (Dr Wollaston) reminded us that we should celebrate the fact that we are all living longer rather than being a permanent Jeremiah figure when it comes to these statistics. However, they do pose us quite a stark challenge.

Much has rightly been said today about the army of carers. I add my voice to that chorus of opinion about the invaluable work they do. My hon. Friend the Member for Congleton (Fiona Bruce) estimated that their work saves our economy £119 billion a year. I support the arguments made by my hon. Friend the Member for South Northamptonshire (Andrea Leadsom) in respect of carer’s allowance for people post retirement. It is a sensible and thoroughly appropriate point to make in this debate, bearing in mind the need to create an incentive to care for people at home.

Many hon. Members have mentioned local carers centres. I pray in aid my local centre, the Swindon carers centre, which provides an excellent support service for carers, many of whom are young people still at school caring for an adult relative. It provides a focus and brings people together in the way that has been described and organises carers days in my constituency in which I and others take part. The messages we get from those events are messages not just of emotion, but of hard facts about the reality of life for carers on the ground. Frankly, they are the greatest experts on the people they care for, which is why they must be involved as service users in developing the services on which they rely. Carers are a huge resource, as we have heard, and must be an important part of the service.

Two key principles underlie the reform of social care: first, transparency—I have already mentioned the need for carers to have knowledge of and access to local services—and the way we track national funding and how it is spent locally; and secondly, predictability and reliability for those who need care and their families. They need to know that they can work within the system and rely upon it in the long term.

We have heard a lot today about care for the elderly, and I support the observations made by hon. Friends and Opposition Members. Rather like the hon. Member for Mansfield (Sir Alan Meale), I want to focus on those with learning disabilities. I am grateful to him for raising the issue of autism, which is rather close to my heart, as I think most Members will know, as I chair the all-party group on autism. Before dealing with the issue, it is right that I emphasise the importance of advocacy for people with learning disabilities.

There are many independent charities and voluntary organisations across the country that provide a voice for adults with learning disabilities. In my constituency the Swindon Advocacy Movement, which receives sustainable funding from the local authority, works hard on that philosophy. It draws in people in with learning disabilities so that they can be part of the planning for the service, which enables them to speak for themselves, because advocacy is not just about people like us talking for people like them; it is about enabling those people to do it themselves. I know that the hon. Member for Mansfield and I agree on that point, because I raised it when I intervened on him earlier. What we want to see is a service that enables people with learning disabilities to stand on their own two feet as much as possible and to play a full and active part in our society. That is why I believe passionately in local advocacy, which will help us see an end to the Winterbourne Views of our society and the betrayal of all the principles we believe in become very much a thing of the past.

We also heard about overarching frameworks within which care services should be developed, and I want to thank my hon. Friend the Minister publicly for following my advice, and that of many others, by referring the quality standard for care of adults with autism to the National Institute for Health and Clinical Excellence. He knows that I and others have been working on that issue for some time. It was the subject of a 10-minute rule Bill I introduced last year. As an aside, I urge him to look at a quality standard for care for children with autism, because I strongly believe that it is the transition from childhood to adulthood that we are still getting so badly wrong in this country.

I will pause for a moment and deal with the threshold into adult social care and how we need to plan adequately for that while the person is still young so that adult social services are working hand in glove with children’s services. In particular, when we develop our policy on special educational needs—I know that this is not the responsibility of the Minister’s Department, but it is a point that should be made—we must ensure that the new care, health and education plans go up to the age of 25. It is absolutely vital that we stick to that proposal, which was set out so helpfully in the special educational needs Green Paper, so that the threshold issue can be dealt with properly and there can be proper and adequate further education provision for young adults. There is a dearth of provision for young adults between the ages of 18 and 25, particularly those with autism and related conditions. It is in those seven key years of life that adult social care often fails and when we do not address issues of education for young adults with autism. Ambitious about Autism’s “Finished at School” campaign, which I had the privilege of launching in Parliament a few months ago, calls for that extension of provision.

I have referred to the key principles that underlie the Law Commission’s report on adult social care that was published last year, which we all know about. There needs to be a single duty on authorities to meet eligible needs, a duty for carers assessments to be undertaken and—something that we have perhaps not touched on in this debate—a duty for adult protection cases to be investigated by local authorities or other agencies. We are getting child protection largely right, but let us not forget vulnerable adults, whether they be elderly people or people with learning disabilities. To return to the Winterbourne View scenario, there needs to be a proper mechanism by which we investigate cases in which the welfare and safety of vulnerable adults has been called into question.

It has been a pleasure to take part in this debate. It was particularly reassuring to receive a clean bill of health from my hon. Friend the Member for Totnes. Dare I say that I am in the same age group as her? I will leave the Chamber thoroughly reassured. Finally, if we do not address these issues, we will fail not only current generations, but the generations to come.