Adult Social Care

Sheila Gilmore Excerpts

Monday 16th July 2012 Commons Chamber

[Paul Burstow]

Obviously, I will happily look at the report and I look forward to meeting the all-party group to discuss its findings and recommendations later.

I want to report to the House the findings of the ADASS survey, which was published recently. Last year’s survey found that for every pound saved by local authorities in social care, 69p came through greater efficiency. This year, it found that that had risen to 77p in every pound. Yes, some councils are cutting services, and last year 23p in every pound that councils saved came from service reductions, but this year that figure is just 13p in every pound. Local authorities are getting smarter in organising their services, so I want to pay tribute to those councils and councillors who have worked hard with service users, carers and providers to protect services to make the best possible use of the extra money the Government have provided. As a result, between last year and this year, council budget spend on social services has gone down by just 1%.

[Sheila Gilmore (Edinburgh East) (Lab)]

On the question of efficiencies, would the Minister include councils that tendered a service and made a saving, but to the detriment of the end user of the service? That is how we got to the 15-minute, short-term care options. Is that an efficiency or a cut in service?

[Paul Burstow]

When there is a crude race to the bottom and contracting is by the minute simply to ration access to the service, resulting in a care home provider or home care provider delivering care on a very time-and-task oriented basis, that is totally unacceptable. We know that in places such as Wiltshire, where home care services are organised on an outcomes basis, that is delivering better results for the service users and releasing resources to reinvest in services.

--- Later in debate ---

[Julie Hilling]

Yes. The cuts faced by northern local authorities in particular are dire. Bolton will have to find £100 million worth of cuts during the current Parliament.

[Sheila Gilmore]

Does my hon. Friend agree that it simply is not good enough to express—as the White Paper does—concerns about matters such as short periods of care time, or the fact that some carers are not even earning the minimum wage, if there is no way of making things work financially? I do not believe that councils have chosen 15-minute slots deliberately; I believe that they have done it in order to save costs and make efficiencies. Similarly, there are carers who have to pay for their own travel.

[Julie Hilling]

We have to realise that we are facing a crisis now, not a crisis in the future. People in our constituencies are suffering daily. A young man in my constituency who has learning difficulties and has relied on carers to help him with his everyday life will now see his carer only once a week. Contact with a carer is the only contact that many such people ever have with another human being, and that contact is now going. It is truly a false economy. This low level of care for people with moderate needs is what keeps them in their homes, keeps them healthy, and stops them ending up in residential care prematurely. Bolton is managing to maintain substantial and critical care, but it will have to find £34 million in cuts over the next two years, and it is worried that it will have to join other councils in only providing critical care.

Paying for home care is a huge worry. The average cost is £13.61 an hour, but it can be a great deal more; in Brighton and Hove, carers cost £21.50. It is not unusual for people paying for care to have to find more than £10,000 a year to cover that cost. That spending needs to be taken into account if we are to have caps over the whole amount. Many Members will know that my mother has been in and out of care over the past 12 months. We have spent £20,000 since October on her care.

The cuts to local authority budgets are affecting other support services, and the consequent cuts to the voluntary sector are having dire consequences. The voluntary sector provides luncheon clubs, social activities and carers groups, all of which are under pressure or at risk.

Horwich visiting service in my constituency has lost funding and can no longer employ its part-time co-ordinator. That was the person who recruited volunteers, sorted out the police clearance, provided training, ascertained the needs of clients and supported the volunteers. The volunteers will continue to visit the elderly and disabled people with whom they are currently in contact, but it will not be possible to recruit new volunteers or take on new clients.

The fees local authorities pay to care homes is also an issue. There has been a significant real-terms cut over the last two years. That inevitably impacts on care. It also means self-funders are charged more in order to subsidise the costs of council-funded residents.

The choice of home is another huge concern. The other day, I was speaking to one of the police officers on the parliamentary estate. He told me his mother was in a care home. He and the family had chosen a home that suited her needs and they had sold her house to pay for the care, but now the money is running out and he does not know whether the local authority will pay the care home fees, whether his mum will have to move or whether the family will somehow have to pay the additional costs. If the cap is ever introduced, that will be too late for him, but he still needs to know that the care costs will be met in future.

The needs of the elderly and disabled do not move in a straight line. Some people may need to go into care for a period of time, such as when recovering from an illness or an accident, but, with support, they may be able to return home. However, we were told that after six months my mum would have to sell her flat to pay for her care. In fact, after eight months in a care home, she has returned to her own flat. That shows that people do not move in a straight line through the system. Decisions should not be taken on the basis of cost alone; they should be taken on the basis of needs, too.

Let me conclude by reading out a comment from a constituent of mine called Amy:

“Alongside the funding crisis there is also a huge injustice in the way we pay for care. This includes the dementia tax, where tens of thousands of families are left to pay all their care costs whilst other terminal conditions are paid for by the NHS.

The significant cost of care means many carers face financial hardship and are often forced to give up work.

We need reform to build a fair and sustainable care system which delivers dignity, independence and peace of mind.”

Amy is right. We need to get on with this. We need to find a solution where people’s needs are taken into account, and where people do not live in fear for both themselves and their families. We need to find a solution to this problem that all of us can live with, and that cares for people who are in need in our society.