Social Care

Scott Mann Excerpts

Wednesday 25th April 2018 Commons Chamber

[Scott Mann (North Cornwall) (Con)]

It is a pleasure to follow the hon. Member for Redcar (Anna Turley) and to take part in this very important debate. For me, this is the biggest service delivery challenge that we face as a nation. The UK has an ageing population and a finite amount of money, regardless of what Members on some Benches in this place say. We have to focus on delivering outcomes for people. Sometimes that gets lost when we are chasing our tail and focusing on dealing with conditions, rather than with prevention. We face a challenging environment in terms of service delivery. That is why I would support a royal commission on social care, and I agree with and echo the sentiments of my right hon. Friend the Member for Ashford (Damian Green) on that.

In Cornwall, the challenges are compounded, and let me explain why. The last census showed that 22% of people in Cornwall were over 65, and this will increase as more and more young people leave the county to seek work or a career. I believe that the next census will show that the problem has been compounded even further. As for the rural sparsity of Cornwall, we have 550,000 people in this county of ours across almost 150 miles of coastline. Traditionally, we have had a low-wage economy and a much less competitive marketplace, particularly in care. This highlights the rural productivity lag and the economic challenges facing the day-to-day delivery of care in our area. It is the perfect storm.

A typical day for a carer in Cornwall might involve long journey times to make care visits, difficulties parking and meeting care time targets and delivering complex care in pressured timeframes, and when people step in to cover sickness or pick up a complicated care package because someone is away, it can be particularly difficult. It is easy to see why people might choose to work in a supermarket or another career, rather than work in the care sector, but there might be light at the end of the tunnel. Recent changes implemented by the Royal Cornwall Hospital, which now agrees care packages when people arrive at hospital, have improved the system, increased bed capacity and helped people return to their own beds—in my view, a person’s own bed is the best bed for them. The £12 million the Government recently provided to Cornwall Council, for which I thank them, has also helped.

Technology, which has been alluded to, has a huge part to play in delivering care in rural communities. There are big opportunities here. The roll-out of 4G, 5G and broadband will make rural communities much better connected, while the GovTech initiative, which the Government recently announced, is looking at health provision. We have a chance to utilise technology to take a much more community-focused approach to care. The Post Office has a part to play as well. I recently attended a dinner hosted by the Post Office, and what it does in terms of care in the community should be welcomed.

I am vice-chairman of the Parliamentary Internet, Communications and Technology Forum, and I had a very interesting discussion with somebody recently about a social care app they were developing to provide a care service that works in much the same way as Uber, by linking purchasers and care providers, and which could cut out some of the top slicing by private providers and local authorities and put that money directly into the pockets of carers, who, instead of surviving on the national living wage, could see a significant uplift in income.

It is vital that we retain good people in the profession and boost morale. If we can create a better and more effective system in our rural areas, that is what we should do. So I say to the Government: be bold, go for the technology and see what we can do. The provision of social care needs to be much more socially inclusive and decentralised. We need to empower individuals—both carers and their loved ones—and create a balance that puts rural communities on a level playing field with urban communities. This matters to people in North Cornwall and so it matters to me. I want to make sure we get it right.

[Kelvin Hopkins (Luton North) (Ind)]

It is a pleasure to speak once again in a debate on this important subject. I applaud my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), the Labour Front-Bench spokesperson, who has made this speech before and been resolute in standing up for the care industry, and I support the Labour motion, which is very good. The hon. Member for Central Ayrshire (Dr Whitford), who spoke for the Scottish National party, also made some very important points.

I support what the royal commission on long-term care for the elderly said 19 years ago: long-term care should be free at the point of need and paid for out of general taxation. I want to go beyond what Labour is saying at the moment, however, which I applaud and support, and look to a world with free long-term care and a care service run on exactly the same basis as the national health service. We were moving in that direction just before we lost office in 2010. The then Secretary of State for Health suggested a national care service like the national health service. I intervened on him and said, “Yes, and paid for out of general taxation and free at the point of need,” but we did not get it. We did not get the support all those years ago, despite the support of many Members for the royal commission report, strong support in the country and a trade union-led campaign calling for free long-term care. It was all to no avail and so the issue has rumbled on ever since. The issue did not go away, however, and I raised it myself in the Chamber several times over those years.

Eventually, the Dilnot commission was set up, and in its 2012 report it recommended a compromise. Sir Andrew Dilnot, whom I know well, is a superb man, and he did a brilliant job. He came up with a compromise that he thought might be worn by the Treasury, proposing that self-funding should be capped at £35,000 for a lifetime. The Government dragged their feet and resisted, but eventually, after wriggling a lot, they agreed to a lifetime cap of £72,000—twice the amount that Sir Andrew had suggested. Even then, however, that was deferred until 2020, and now it seems to have been deferred indefinitely. We are well away from where we should be. Scotland, of course, has had free care, and I applaud Scotland for that. I do not know why we should not follow suit.

If self-funding affected only the wealthy, it would not be such a worry, but it actually affects millions of working-class families. The first generation who became owner-occupiers have been particularly badly hit. Successive Governments have wrung their hands about the difficulties experienced by young people in achieving owner-occupation, while at the same time cutting off one of the only possible routes to owner-occupation for many: the cascading of family equity down the generations, whereby the capital in Granny’s home passes down to grandchildren when she ends her days.

I hold resolutely to the view that long-term care should be free to all, and funded from progressive taxation at the point of need. I am not too concerned about how that taxation is raised—it could be national insurance, income tax or a hypothecated tax—but the money should come from general taxation.

[Scott Mann]

The hon. Gentleman is making a valid point about the funding of care, but I should be interested to know whether he considers the use of technology, which I mentioned and which was mentioned by a couple of my colleagues, is an option that might enable us to do things slightly better.

[Kelvin Hopkins]

I am always in favour of improving the way we do things, and technology is of course important.