Local Government and Social Care Funding

Sarah Wollaston Excerpts

Wednesday 24th April 2019 Commons Chamber

[Norman Lamb]

If we are honest, every Government have some responsibility. The reductions started before 2010. I absolutely accept—[Interruption.] Let me address this point; I am trying to be straight with the hon. Gentleman. I think mistakes were made by the coalition Government in terms of the hit local government took during that period. The contrast between the support for the NHS by increasing investment in real terms and the cut to social care does not make sense, but that is what happened. I recognise that. It was above my pay grade, but I do not think it was the right decision to make. I hope that that is of some help to the hon. Gentleman.

[Dr Sarah Wollaston (Totnes) (Change UK)]

My right hon. Friend makes some really important points about the first 1,000 days of life, but equally there are similar arguments relating to the end of life. For example, too many people who need social care end up in a much more expensive place at the end of their life—in a hospital setting, where they do not want to be—for the want of the right investment in social care. Does he agree that we should apply the principle of investing to save across the whole of life?

[Norman Lamb]

I absolutely recognise and accept that point.

The hon. Member for Chesterfield (Toby Perkins) intervened to challenge the point about spending under the coalition Government. There was a crisis in public finances in 2010 which did have to be addressed, but I do accept that the balance between social care and the NHS was not optimal. I also want to address other areas where the underinvestment or disinvestment in preventive services has borne a heavy cost.

The hon. Member for Lewisham, Deptford (Vicky Foxcroft), who has done very good work on youth violence—I have been part of the commission looking at that—made the point that many of the preventive services that are there, particularly during teenage years, to stop the risk of young people slipping into gang violence have been stripped away in many of the poorest communities. Again, the impact of that has, at least in part—it is very hard to judge cause and effect—been an increase in violence on our streets at the awful and dreadful cost to many of those affected by it.

I want to turn specifically to social care. It is worth reflecting on why social care is so important. It is there to give people the chance of a happy life and a good life, as far as they are able to enjoy that if they are struggling with a range of conditions. It is there to help people to remain independent in old age, to support people so that they do not end up needing the NHS, with an enormous impact on their wellbeing. One of the problems we face is that unless you or a family member experiences the need for social care, it is hidden from view. Very many families across our country simply do not see the impact of the underfunding of social care today, but it is very real. There are over 1 million older people who are not getting the care they need. As Simon Stevens, the chief executive of the NHS, has pointed out on many occasions, if people do not get social care support, that has an impact on the NHS. The funding settlement for the NHS simply will not work unless we address the under-resourcing of social care.

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[Dr Sarah Wollaston (Totnes) (Change UK)]

It is a pleasure to follow the hon. Member for Redcar (Anna Turley).

I start by thanking and paying tribute to all the frontline care staff around the country, and to all the family carers, informal carers and those working extremely hard in voluntary services in all our constituencies. In my constituency, I pay tribute to Dartmouth Caring, Totnes Caring, Brixham Does Care, South Brent and District Caring, and Kingsbridge and Saltstone Caring. I know that similar voluntary services are working across the country in tandem with the NHS to provide excellent care to our constituents, but they are under pressure as never before.

There is a devastating impact on those affected—those who are not getting the care services they need; not only working-age adults but older adults, and their families. There is also an impact on the NHS. If people cannot access care services, there is not only an impact on their dignity, mobility and wellbeing but they are much more likely to end up in hospital—a place they do not want to be and at much higher cost—sometimes with serious illnesses or injuries that could have been avoided by better prevention and early intervention.

We need to deal with this issue, and the House needs to appreciate the scale of the challenge. Let us look at the demographics. We know from the Office for National Statistics that, last year, 18% of our population nationally was aged over 65, but that in 14 years’ time 23% of our population nationally will be over 65. Of course it is a good thing that people are living longer, but they are living longer with multiple disabilities and we need to be prepared for that. We need to be prepared not only for the scale of the shortfall we face right now but for what is coming in the future. When we talk about social care funding, we need not only to acknowledge the impact of the shortfall we have here and now, and how we are going to deal with it, but to plan seriously for what is coming down the track.

In my constituency, we are already there. My constituency has a much older population than in many parts of the country and, even when they can afford to pay for care, people cannot find the workforce to care for them. There is a real crisis in our social care workforce, which needs investment. We need to value and nurture that workforce. We know what works, but we also know it will require serious investment.

I am afraid that one of the features of such debates is that the blame bounces backwards and forwards when, in fact, cross-party working and consensus building is what is really needed. The funding choices we face are difficult. I agree with the hon. Member for Redcar, who highlighted why this cannot all be funded at a local level. Doing so just widens inequality, because the areas that are least able to pay have the greatest need. It is unrealistic for everything to come from a local level, so we need to work towards a national solution to the problem.

The Health and Social Care Committee, which I chair, has worked together with the Housing, Communities and Local Government Committee—I pay tribute to the hon. Member for Sheffield South East (Mr Betts), who has also spoken about this—and we know what works. The tragedy is that we could deal with the problem. Our joint Committees looked at the options and achieved a cross-party consensus; we worked alongside a citizens’ assembly, because we think it is really important to build consensus outside this House. There are some principles we should be following. I urge the Minister, in her response, to tell us when the social care Green Paper will be published and commit to ensuring that it looks at the work of our joint Select Committees and the citizens’ assembly.

We can move forward, but if we have learned anything from the Brexit process, surely it has to be that we cannot build consensus at the end of a process; we have to build it in right from the start. I hope that the Green Paper will be designed to achieve that, and that it will set out the principle of fairness in the funding of social care. One statistic that we should all be aware of is that in the next 14 years, as our demographic changes and the percentage of our population aged over 65 increases to 23%, there will be 4.4 million more citizens aged over 65 but only 1.5 million extra citizens aged under 65. It is simply not sustainable to allow all the extra cost to fall on working-age, employed adults, so we must look at how to spread it fairly across the generations and between the employed and the self-employed.

I agree with Members who have talked this afternoon about reimagining national insurance as national health and care insurance. If we are truly to move towards a system that expands not only eligibility but quality, we need to bring more funding into the total system; the funding cannot just come from local sources. I urge the Minister to set out what she feels about the measures highlighted in the joint Select Committee report, and whether the Government will commit to coming up with a solution that can deliver real change, rather than kicking the issue down the line.

The wrong lesson to learn from the last general election campaign would be, “Don’t ever set out who has to pay more.” We all need to do that now, between elections. We must be realistic with our constituents about the fact that everybody needs to pay more, and we must build their trust in the idea that the increase will be delivered fairly. The consequences of doing nothing will be that more and more of our constituents will be left in desperate conditions, without carers to look after them; more and more of our care providers will go to the wall; and there will be no increase in the quality of care delivered on the ground, because there will not be the funding to support the workforce. We have to grasp the nettle with these difficult choices.

Before I close, I want to say something about Brexit. There is no version of Brexit that will deliver anything positive for health and social care, especially if we look at the impact on the workforce. The Minister will know that in parts of the south-east and London, in particular, social care is very heavily dependent on access to a workforce from the European Union. That is also the case in my constituency. Nationally, around 7% of the social care workforce are from the EU. If we cut off access to that workforce, not only will we miss out on an incredibly important and valued skilled workforce by making it more difficult for them to come here, but we will add costs. Many of the people who work in social care—in fact, the vast majority—will not meet the current proposed earnings thresholds that will allow them to come here easily on, for example, tier 2 visas.

We need a way to nurture our workforce and to make it easy for people to come here to work and to feel valued. I do not want to meet any more people in my constituency who work in the NHS and social care and tell me that after decades of dedicated service to this country, they no longer feel welcome.

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[Caroline Dinenage]

I think the honest answer to that question is that there will be a bit of both. The Green Paper is a big document which covers a range of issues. It will be possible for some developments to take place immediately, but others will take longer.

[Dr Wollaston]

The Minister’s reply suggests that the Green Paper already exists. There is a great deal of frustration about the delay. The Green Paper was supposed to follow hard on the heels of the 10-year plan, because the two were closely linked. The Secretary of State gave a pledge from the Dispatch Box that it would be published before Christmas. Will the Minister at least set out the reasons for the delay, and give some indication of when we might expect it? It is such a crucial document.

[Caroline Dinenage]

As the hon. Lady will know, a version of the Green Paper already exists, but that does not mean that we are resting on our laurels while we are waiting for an opportunity to publish it. We are continuing to improve it and evolve it so that when we do publish it—as soon as possible—it will be in the best possible shape.

My hon. Friend the Member for Chelmsford also spoke about dementia, and about the importance of investing in dementia care and research. We lead the world in this regard, but we know that there is more to be done if we are to achieve our aspiration of being the best place in the world in which to live with dementia by 2020.

The hon. Member for North Tyneside (Mary Glindon) spoke about some of the difficulties for councils that had been addressed by “working smarter”. She also said that she thought it unfortunate that councils had had to raise council tax in order to have the money that they need. I point out to her gently that the average annual increase in council tax bills from 1997 to 2010 was 5.8% and since 2010 it has been only 2.2%—half what it was under the previous Labour Government.

The hon. Member for Lewisham, Deptford (Vicky Foxcroft) spoke about youth violence and the importance of schools, social services, voluntary sector organisations and public health bodies working together through a community-led approach to deal with it. She was absolutely right.

My hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson) spoke about the challenges facing rural communities and the higher costs of delivering things such as domiciliary care. She also spoke about the importance of innovation, quality of care and being outcome-focused. She spoke glowingly about the National Centre for Rural Health and Care.

I always listen very carefully to what the right hon. Member for North Norfolk (Norman Lamb) has to say because he has done this job. He spoke about the importance of investing in prevention and said that social care must help people stay independent for longer. He admitted that this job is not quite as easy as it looks and that when he was fulfilling it, there were difficult funding decisions that had to be made. It will be no surprise to him that that continues to be the case and that nothing has changed since he left the role. It is important that he recognises that the challenges continue.

The hon. Member for Chesterfield (Toby Perkins) said that innovative choices have had to be made, that there are better services that cost less in his constituency and that the local authority has had to invest in order to save money. He did make a couple of errors, unfortunately. He mentioned that Labour councils are producing lower council tax, but everybody knows that it is actually Conservative councils that deliver better value for money, with a combination of delivering great quality services while keeping council tax lower than either Labour or the Liberal Democrats.

The hon. Members for Burnley (Julie Cooper), for Bradford West (Naz Shah), for Warrington South (Faisal Rashid), for York Central (Rachael Maskell) and for Peterborough (Fiona Onasanya) all made passionate speeches, mainly about the impact of austerity on areas of deprivation.

The hon. Member for Redcar (Anna Turley) spoke about an innovative employment hub that has grown from the loss of the steelworks in her constituency. She spoke about the Care Academy in Cleveland, which is doing great work equipping more people for roles in adult social care. She mentioned how the challenges of caring for an ageing population are being addressed at a local level. I say to her that that is something that will have to be addressed not just at a Government level, but at a local level and a voluntary level. We all have to work together to face these challenges, which are being faced the world over.

The hon. Member for Totnes (Dr Wollaston) spoke about how important it is to have cross-party and collaborative work on this issue. We all face difficult choices. For too long, adult social care has been used as a political football. Even today, the Opposition spokeswoman talked about the dementia tax once again. That is very unhelpful language that does not help us come to a meaningful consensus or to work together.

Housing

Sarah Wollaston Excerpts

Tuesday 9th April 2019 Commons Chamber

[Kit Malthouse]

My hon. Friend, in his customary manner, has raised an important but detailed point. I will go away and ascertain what the timetable might be and keep him posted about where things might go next.

[Dr Sarah Wollaston (Totnes) (Ind)]

Does the Minister accept that “generation own” is particularly challenging in areas such as South Hams in my constituency? It has the highest property price to earnings ratio in the south-west—11.7—and part of that is driven by second home ownership. Will he touch on what can be done where the impact of second home ownership is particularly high to make this an affordable dream for young families?

[Kit Malthouse]

The hon. Lady raises an issue that, in certain parts of the country—including in my constituency —can have an impact, albeit that I think it is sometimes overstated. Having said that, the Government have taken steps, such as giving councils the power to charge premium council tax on empty homes and second homes, which should help with that issue. In the end, however, in areas such as the hon. Lady’s, most of the problem will be solved by increasing supply. I recently attended a meeting with the Campaign to Protect Rural England down in her part of the world, where I tried to explain to 240 people who were not best pleased at the idea of having a significant number of homes in their area that this was their moral duty to the next generation and that they needed to accept the homes, control them, design them well, and make them fit in and enhance their local communities. We have a growing population and in popular areas where people want to live and from which young people are often driven out, the solution will be to build more homes.

Happily, the picture is also improving for renters. We are cracking down on rogue landlords and from 1 June, the Tenant Fees Act 2019 will come into force, banning unfair letting fees and capping deposits. These vital steps will protect tenants and save them millions. We will also set out our position shortly on longer-term tenancies, because those in the private rented sector can face a high degree of insecurity. It is time that we put that right. Indeed, landlords could also benefit from more stability. As well as feeling more secure, nothing is more important than people being safe in their homes, so we will also be implementing a new regulatory framework for building safety. It is no small task but it is the debt we owe to those who suffered so terribly from the Grenfell fire, because everyone must be safe and feel safe in their home, no matter where they live.

Oral Answers to Questions

Sarah Wollaston Excerpts

Monday 4th March 2019 Commons Chamber

[Rishi Sunak]

I praise North West Leicestershire District Council, which I know well. My hon. Friend is a well-established champion of the council and he is right to highlight its focus on creating a pro-growth culture in its area, using the tools at its disposal to drive economic growth, keep taxes low for its taxpayers and provide high-quality local services.

[Dr Sarah Wollaston (Totnes) (Ind)]

Has the Minister read the letter to the Prime Minister—it was sent last week but published over the weekend—from Health for Care, which is a new coalition of organisations that speak passionately about their view that social care is on the “brink of collapse”? Will he meet me to discuss the coalition’s concerns, the report published by the Health and Social Care Committee, which I chair, and the Housing, Communities and Local Government Committee, our findings and the work that we did with the Citizens’ Assembly?

[Rishi Sunak]

I praise the work done by both Select Committees in producing some options for the social care Green Paper, and I know that they are being actively considered, as they should be. To the hon. Lady’s broader point, her characterisation is perhaps a little unfair, because good things are happening in social care. The recent publication of the delayed transfer of care statistics showed that they have halved since the peak of a couple of years ago, which shows that good progress is being made.

Local Government Funding Settlement

Sarah Wollaston Excerpts

Thursday 13th December 2018 Commons Chamber

[James Brokenshire]

I appreciate the hon. Gentleman’s comments, but I am disappointed that he has not recognised the increases in spending that were set out in the Budget and that I have underlined, and the fact that I highlighted further spending in today’s statement. To take up his theme, one of my colleagues questioned whether the hon. Gentleman might be the Gwynch that stole Christmas. He should recognise that even in his local area there is Stockport Metropolitan Borough Council, with an extra £5.6 million in core spending; Tameside Metropolitan Borough Council, with an extra £4.5 million in core spending; and Oldham Metropolitan Borough Council, with an extra £3.6 million increase in core spending.

The hon. Gentleman should recognise the context of the work that the Government have done to clear up the mess that we inherited. [Interruption.] No, no— the UK economy has grown for five years, there are 3 million more people in employment since 2010, and manufacturing has grown for its longest period in the past 20 years. I recognise that local government has contributed to the hard work involved in clearing up that mess. We know that the demand on local services has increased. We have recognised that in the statement and will ensure not only that councils have the tools and flexibilities to deliver efficiently and effectively, but that they will have the additional funding that I set out today. We are equipping councils well.

The hon. Gentleman highlighted several points about deprivation. The most deprived authority’s core spending power is 23% higher than that of the least deprived. We take council tax into account in funding and when we look into issues of equalisation. He also highlighted the issue of negative RSG. I addressed clearly and firmly in my statement how that will be dealt with.

On social care and the £650 million, the hon. Gentleman questioned the need for strong integration—strong working between our councils and our NHS—to deliver quality services. That is profoundly what needs to happen so that we are looking after the most vulnerable in our communities. I am sorry if those on the Opposition Front Bench do not acknowledge or accept that. It is a fact that 93% of local authorities recognise that the better care fund has promoted integration and improved joint working in their areas.

This is a statement and settlement that, yes, acknowledges and recognises the pressures on social care, and that there is more work to do in respect of the forthcoming Green Paper and on how we will apply the learning from local government to drive better services. I will continue to be a champion for local government and what it delivers and does in our communities. I am proud to support local government and that positive work within our areas.

[Dr Sarah Wollaston (Totnes) (Con)]

Devon has successfully piloted the 100% retention of business rates, and it has injected an additional £20 million into Devon to support local economic growth and public services, but the pilot is due to end in March. Surely the whole point is to continue pilots that are a success. Can the Secretary of State provide any reassurance for Devon as to whether it will be able to continue, because it was not in the list of counties that he mentioned?

[James Brokenshire]

I recognise the challenges and issues over the business rates retention pilots. Not everyone has been successful in relation to the pilots for 2019-20. We are piloting on the basis of 75%. That is on the basis of the new system that is being introduced in 2020 so that we can properly understand how it will operate in practice. I will certainly highlight to my hon. Friend some of the other issues in relation to, for example, the rural services grant, and how that will be beneficial to her local community, but, obviously, we will look at the representations that are received through this provisional settlement.

Windrush

Sarah Wollaston Excerpts

Monday 30th April 2018 Commons Chamber

[Dr Sarah Wollaston (Totnes) (Con)]

Will the Home Secretary assure the House that he will do everything in his power to make sure that nobody faces unnecessary delays or costs for NHS treatment in the future, as we saw in the case of Albert Thompson? Will he meet me to discuss the wider policy so that other people do not face unnecessary delays in the NHS as a result of our policy on visas for NHS staff?

[Sajid Javid]

My hon. Friend is right to raise this issue and I very much agree with what she says. What happened to Albert Thompson was completely unacceptable. We do not want anyone else to be in that situation, and I will very happily meet her.

Rating (Property in Common Occupation) and Council Tax (Empty Dwellings) Bill

Sarah Wollaston Excerpts

2nd reading: House of Commons & Programme motion: House of Commons & Ways and Means resolution: House of Commons
Monday 23rd April 2018 Commons Chamber

[Dominic Raab]

I am not quite sure what means the hon. Gentleman has in mind for achieving that, but perhaps we can thrash that out in more detail in Committee. Of course we will always remain open to adopting the smartest ways of doing things to ensure that we get the right balance.

[Dr Sarah Wollaston (Totnes) (Con)]

I welcome the Bill and its measures to give councils the tools they need to ensure that we drive down the number of empty properties. Will the Minister also use this opportunity to ensure that those who own second homes are contributing their fair share through council tax, and that they are not able to sidestep that by opting to pay business rates and then claiming eligibility for small business rate relief? If we are to achieve our goals on decent, affordable homes, it is important that everybody should pay their fair share.

[Dominic Raab]

My hon. Friend makes a powerful point. The situation to which she refers is slightly different from that of vacant homes, but I would say that we need to balance the economic impact of any measures in that area with the underlying public policy imperative that she has rightly referred to. We have also made changes on holiday homes in the context of council tax and stamp duty. We will keep the point she raises under due consideration and I have also discussed it with the Minister for Local Government.

In addition, our new homes bonus scheme provides a financial reward for councils that bring empty homes back into use, so this involves a carrot as well as a stick. This has generated £7 billion in new homes bonus payments to local authorities since 2011. Since these measures took effect, the number of properties left empty in England for six months or longer has fallen by a third since 2010, from 300,000 to just over 200,000. So these measures can work and they can deliver changes in behaviour.