Adult Social Care

Debate between Sarah Newton and Heidi Alexander

Monday 16th July 2012 Commons Chamber

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

I am delighted to follow the hon. Member for Scunthorpe (Nic Dakin), as I completely agree that this issue is about leadership. Some of my hon. Friends alluded to a better-tempered debate, such as the Back-Bench business debate, to which all parties made thoughtful contributions, based on a great deal of expertise from different walks of life—whether from people in the medical profession, those who had spent their life in social services or those who had a personal point of view from being a carer. We heard some heartfelt contributions in that debate, so I think we are united in the desire to do something about this issue.

What I have found deeply disappointing about today is the fact that this debate was called in the first place. There was significant and genuine desire by this coalition Government to solve once and for all this problem that everyone agrees needs to be solved. Everyone agrees that it needs cross-party support—for reasons that are obvious to anyone sitting in the Gallery or watching this evening’s debate and to all the various voluntary organisations that have been very substantially misquoted or very selectively quoted this evening. There is a unity of purpose, but it is not being served by the Opposition who are tabling Opposition day debates, falsely dividing the House.

If the Opposition were to put their efforts into working closely with the two parties that form this coalition to come to a sensible solution, I believe that measures would be in the White Paper, but we are still seeing sledging and negative comments from Opposition Front-Bench Members as we have seen all day. It is deeply disappointing that the Opposition are so thoroughly letting down the people whom they claim they represent. I do not believe it is too late, and I really urge them to get back to the table and to be more positive about the steps that the Government are taking—[Interruption.] Here we go again; I cannot even finish a sentence without Opposition Members chuntering.

The fact is that I worked very closely with a number of Opposition colleagues. Various Members have talked about the very good work we did in the inquiry led by the all-party group on local government that looked at this issue. There was an all-party agreed proposal that identified many measures—which the Government have picked up in the draft White Paper—that we can achieve together. The effort should be focused on what we agree on, so that we can offer the reassurance that is needed by the desperately worried people all around the country that have been quietly identified this evening. People are worried not only about the social care system now, but the social care system in the future. We should be reassuring these people and giving them hope that this House has the necessary combined will and determination. I do not think any of us want to face the electorate at the next general election saying that this problem has not been solved.

As to the timetable, yes, I would love to be able to stand here today and congratulate the Government on finding every penny to fund a long-term solution. If we can get the cross-party talks into gear in September, we should be able to put in place the mechanism that, as confirmed by the Secretary of State, could be built into a Bill and put before Parliament. When all parties have agreed on how this is to be funded—as many people have rightly said, it will cost billions of pounds every year and we are in a very difficult financial situation, so all parties must agree on how those billions can be found—there is every possibility that such a Bill will get through Parliament and, when next year’s comprehensive spending review is developed, the money will be found.

Yes, it is frustrating if we have to wait another year or 18 months. Before I entered the House, I spent the best part of my adult life working for Age Concern England and for the International Longevity Centre in the UK, coming up with solutions that previous Governments certainly kicked into the long grass, so this is our best hope in a generation.

[Heidi Alexander]

I respect the hon. Lady’s work on this issue, but does she recognise that there is almost universal agreement outside the House that the big disappointment is that there were no proposals last week on how, in the longer term, we provide the funds that we all want for care for the elderly and those with disabilities?

[Sarah Newton]

I accept that there is genuine disappointment, but people equally understand that all parties in the House must be committed on where the billions of pounds each year will come from, so that the proposals are sustainable for the long term, and so that people can save and invest without fear of the rug being pulled from beneath them.

The proposals are a sticking plaster—there is no doubt about that—but if only people could hear the facts, they would appreciate that more money is being put into the system while the problem is being resolved for the long term. It is not true that all councils are cutting back. Cornwall council has not cut its adult social care. It is working in extremely innovative ways with the NHS and the voluntary sector to ensure that services are improved. I do not accept the shroud waving from Opposition Members, who say that every part of the country is in crisis.

Social Care Funding

Debate between Sarah Newton and Heidi Alexander

Thursday 10th November 2011 Westminster Hall

[Sarah Newton]

My hon. Friend the Member for Congleton (Fiona Bruce) makes her point very passionately, as she always does, in standing up for the family. Of course, it is the family who take full responsibility in most cases for the care of elderly people, but we must remember that the funding of adult social care is also available for adults living with disabilities. Families are the foundation of all care at the moment. I am sure that, with the Government’s support, they will continue to be the core building block of the care system. She is quite right to raise that issue so that we can all show appreciation for the huge army of people who are quietly getting along each day to provide invaluable support to their loved ones.

The commission made a series of key recommendations. I cannot do justice to the report in the time that I have available, but to help our debate, I will summarise them briefly. The major one is to cap the lifetime contribution that an individual needs to make to adult social care costs to £35,000. Not everyone will be able to afford to make a personal contribution, so the commission recommended that means-tested support should continue and that the asset threshold for those in residential care, beyond which no means-tested help is given, should increase from £23,250, as it is today, to £100,000. Those who enter adulthood with a care and support need should immediately be eligible for free state support.

The commission also recommended reconsideration of the existing benefits that support the elderly. People should contribute to their living costs, which the commission estimated as between £7,000 and £10,000 a year. It recommended that the Government should urgently develop a more objective eligibility and assessment framework and that they should encourage people to plan ahead for later life with an awareness campaign, and develop a major new information and advice strategy to help people when the need for care arises. Carers should be supported by improved assessments, which should take place alongside the assessment of the person being cared for. Finally, the Government should review the scope for improving the integration of adult social care and other services, such as NHS services and housing, to deliver better outcomes for individuals and better value for the taxpayer.

The commission’s report was met by a broad coalition of support from a wide range of stakeholders and was warmly welcomed by all political parties. That contrasts with the acrimonious debates on the issue during the general election campaign. Since the report’s publication, the Department of Health has committed to consult on the recommendations and to consider other important recommendations proposed by the Law Commission.

The Government have recognised that they must take urgent action to address the current funding issues. While real spending on the NHS has risen by £25 billion since 2004, spending on social care for older people and adults with disabilities has simply not kept pace. Figures from the Department show that over the past four years, demand has outstripped expenditure by 9%. Since the coalition came to power, it has clearly understood that that balance in expenditure is wrong. Money for the NHS has been redirected to councils so that they can spend more money to support families, elderly people and adults living with disabilities to live independent lives. Additional money has been allocated for a range of support to enable people to remain safely in their own home and for adaptations that prevent accidents and illnesses that lead to people having to spend time in hospitals.

[Heidi Alexander (Lewisham East) (Lab)]

I congratulate the hon. Lady on securing the debate. She is talking about the additional resources that have been given to councils from the NHS budget. Will she reflect on the scale of cuts that local authorities are dealing with when setting their overall budgets? Does she feel compelled to comment on the claim that that is giving with one hand and taking away with the other?

[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.

--- Later in debate ---

[Heidi Alexander (Lewisham East) (Lab)]

I wanted to speak in this debate because I have had two specific personal experiences in the past couple of years that have led me to think that finding a way to fund elderly care in this country is probably one of the biggest challenges that we face. I wish to take a few minutes of Members’ time to share those experiences, which I hope will underline to the Minister the urgency with which the Government need to act.

Before I became a Member of Parliament, I was a councillor in the London borough of Lewisham and can honestly say that the worst meeting I ever had to attend was when the council was reviewing the eligibility criteria for adult social care. At the time, we were looking at whether we could sub-divide the category of “substantial care needs”, which are really serious needs for which people need help. It is about basic human dignity, so it was a difficult thing to consult on at the time. Hundreds of people attended the council meeting and I remember being almost moved to tears by some of the testimony that people gave about the support that they received. I am pleased that, that year, my local authority of Lewisham chose not to do away with funding substantial care needs. It still funds such needs, although in the current economic and financial climate, Lewisham has had to increase considerably the charges for care packages.

I realised at that time that adult social care in this country is woefully underfunded. It constitutes such a large proportion of local authority budgets that, in the present climate of huge cuts to local councils, they are faced with very difficult decisions about how they can fund care provision, while setting a balanced budget elsewhere. I am concerned, as I said in my intervention, that the so-called extra money being diverted from NHS budgets into adult social care is not really extra money at all. When the large cuts to the budgets of local authorities are taken into account, that money is merely being used to prop up what was already being done. For example, from my local authority experience, I know that out of a £270,000 million revenue budget, Lewisham council spends approximately £100 million every year on adult social care. If it has to find £80 million worth of cuts in the next three years, it has to take some very difficult decisions about how to make all that work.

My experience in Lewisham also told me that in this country we do not fund the sort of preventative care that is necessary to avoid having higher care needs later on in life. I urge the Government to consider how we can provide more preventative support, so that we do not have huge outlays further down the line. As people get older, their care needs become a lot more complex. If we can intervene earlier and provide the right sort of support, perhaps we will not have such high expenditure further down the line.

I said that I had two personal experiences that led me to take part in the debate. My other experience is very personal. Last year my nan passed away, after suffering with Alzheimer’s for a number of years. She spent the last years of her life in a care home. My hon. Friend the Member for Luton North (Kelvin Hopkins) spoke earlier about the experience of working-class people and what it means for them to pay for their care. My nan was a working-class woman. She worked very hard all her life and saved hard to buy her own home. She never went on a foreign holiday. She was very frugal with her money. She ended up having to sell her home, which was worth about £140,000, and using the small amount of savings that she had to pay for her care. There is obviously a limit on how much money one has to pay for such services. Her estate was worth in the region of £23,000 at the end of that process, but my family paid more than £100,000 for her care. The local authority picked up the costs of that care towards the end, because all her savings had been used. I think it would break her heart to think that what she had worked hard for all of her life did not get passed on in any significant way to my father, to my aunt, or to her grandchildren.

[Sarah Newton]

The hon. Lady has highlighted another illusion in the system: the illusion of the separation between the so-called self-funders and others. There are very, very few people who end up fully self-funding their care. Most people deplete their resources and end up having to be funded by local authorities. We must not always see the issue in black and white. Of those who self-fund, about half go on to require support from local authorities.

[Heidi Alexander]

The hon. Lady makes a very good point and I agree completely that there is not a clear distinction between self-funders and local authority-funded clients. I reiterate the point made by my hon. Friend the Member for Luton North about how wealth is inherited in our society. My family, perhaps unwisely, have not planned greatly for their retirement. My dad is a self-employed electrician. I think that he was planning to use some of the money that came from the sale of his mother’s house to fund his retirement. He does not in any way begrudge the money that he spent on my nan’s care towards the end of her life. I do not begrudge it. She had fantastic care in a fantastic care home, and that is completely right. However, I know that he feels that the system is perhaps not really fair. He asked me questions about people who play the system, and whether people transfer homes into somebody else’s ownership so that they do not have to pay.