Adult Social Care

Selaine Saxby Excerpts

Wednesday 8th March 2023 Commons Chamber

[Selaine Saxby (North Devon) (Con)]

It is a pleasure to see you back in the Chair on International Women’s Day, Madam Deputy Speaker. It is also a pleasure to follow the hon. Member for North Shropshire (Helen Morgan), whose constituency reflects mine in many ways. I will bring some colour from a constituency perspective to many of the issues and challenges that she highlighted around providing social care.

Devon is a prism of the future, because it has an elderly population that is only getting older. If anyone wants to see what the rest of the country will look like in 20 or 30 years, they should come to Devon. Similarly, if any of the great ideas coming out of this debate can be trialled or tested, I recommend Devon to the Minister as a great place to come. We are already on the journey of our county council frantically trying to balance its budget. Some 25% of the budget is spent on adult social care, and that amount has increased by 23%, adjusting for inflation, in the last decade alone.

As the hon. Member for North Shropshire mentioned, rurality is a huge factor. North Devon is remote, rural and coastal, so the distances involved in providing adult social care are monumental. The dramatic rise in energy costs has had a huge impact on social care providers’ ability to deliver the same service, and the increase in the council’s budget, unfortunately, does not fully reflect that.

Rurality also has an impact on the manner in which care is delivered in those communities, because of the distance that individual teams have to travel between daily stop-offs. That is overlaid with the pressures being placed on the hospital, which mean that some carers are having to make multiple visits a day—perhaps three—to one family, where they might previously have made one or two. That is escalating into a snowball effect of costs rising far higher than is reflected by the council.

I am now being contacted by providers of social care who are concerned about what is happening and their ability to continue to provide the care. One innovative care provider pays its care workers on a shift basis to reflect the distances travelled and the amount of time that care workers are not working, as opposed to paying them on a contact time payment methodology. Given the likely decrease in the next budget, however, it is unlikely to be able to continue that, even though offering that great package is how it has been able to train up and retain its fabulous staff team. If someone has to drive between appointments, why should they not be paid for the driving time, if it is the only way to get there?

We need to redesign the scheme for remote rural locations. As the Minister knows from his previous roles, we have a particular housing pressure in North Devon, so a different way of looking at it would be to remunerate a social care worker with accommodation as part of their package. That would enable them to serve that remote rural community without having to spend hours in the car driving between remote rural communities. The Department for Levelling Up, Housing and Communities might not be the right Department to suggest that to, but we cannot keep on pretending that the system is working. We need to find other ways and different solutions, particularly when rurality is being overlaid on the other pressures. At the moment, clients are being transferred away from better-qualified, better-quality care providers because the council budgets will not stretch, which is not right for the individuals involved. It feels fundamentally wrong that that is happening on my doorstep.

In North Devon, we are home to a fabulous hospital, which is the smallest and most rural in mainland Britain. It is not right that there is regularly a queue of ambulances outside it because we cannot discharge out of the back end due to a lack of social care. I have social care providers telling me that they have capacity but the council will not pay their rates to provide it.

As part of this process, I hope that somebody will look at the fair cost of care exercise in Devon, because there is some concern that the data that has been submitted is perhaps not being accepted as the true price of delivering that care. We need to acknowledge the prices involved, because these are humans who we need to look after and care for in our communities. There is also a concern that the cost pressures faced by the council are driving growth in the number of unregulated personal assistants and private carers.

[Mr Betts]

The hon. Lady is talking about the fair cost of care. I declare an interest as a vice-president of the Local Government Association, where there is a real concern that the money that the Government made available was not based on the detailed assessment that councils had done about the difference between what people pay for their care privately and what councils are paying. If councils suddenly ended up with that extra cost, the Local Government Association’s view is that the amount would be much more than the amount that the Government were putting to one side in their initial reform proposals.

[Selaine Saxby]

I thank the hon. Gentleman for his intervention; much more work needs to be done in this space.

We need to look for longer-term funding solutions. That is true for social care, but also for potholes, which I will mention while I have the opportunity, as my right hon. Friend the Member for Ashford (Damian Green) did. Part of the reason why some funding settlements do not add up is that when we provide a short-term funding solution, we cannot plan for the long term. I estimate that we are paying twice as much per pothole repair as a result of short-term settlements that stop councils from being able to plan effectively for their workforce, the work and the use of materials. I hope that there will be an opportunity to address some of those problems, because the pressure on budgets is having an impact on all council services, not to mention the individuals and the fantastic care staff involved.

--- Later in debate ---

[Lee Rowley]

I am grateful to the hon. Lady for her intervention. I will come to her points in a moment.

I acknowledge the point that my hon. Friend the Member for North Devon (Selaine Saxby) made about rurality, which is one reason why it is important that there is a balanced understanding that some funding is raised locally. Different parts of the country will have different requirements, pressures and challenges, which, in many parts of the country, will include rurality. I accept that that creates an issue in certain places. From a local government perspective, rather than an adult social care perspective, we have tried to acknowledge that, at least in part, in the local government finance settlement through the rural services delivery grant. I am always happy to look at that and to talk to my colleagues in more detail, as we prepare for funding settlements in future years.

[Selaine Saxby]

Does my hon. Friend acknowledge that in massive counties such as Devon, outside the urban south, the very rural hinterland causes variance from the average, and that top-tier authorities should have much more leverage to offer settlements with a far greater differential between rural and urban areas?