Care Bill [Lords]

Debate between Stephen Dorrell and Bill Esterson

Monday 16th December 2013 Commons Chamber

[Mr Dorrell]

I shall come on to that point, but to react directly to the hon. Lady’s point, surely it is much better to intervene before the patient arrives in hospital in the first place, preventing the avoidable episode of care. The hon. Lady talks about discharge, and she is, of course, quite right, but how much better is it to prevent the case from arising in the first place, which is what clause 2 is about?

[Bill Esterson (Sefton Central) (Lab)]

I think that is precisely the point my hon. Friend the Member for Bridgend (Mrs Moon) was making. The money simply is not there in local government. When 20% of the adult services budget has been lost, the services are not there and the care managers are not there to do the assessment to decide whether to keep people at home or to help them get out of hospital. The service back in the community, after people have come out of hospital, is not there either. Does the right hon. Gentleman accept that that money has to go back in?

[Mr Dorrell]

Of course I accept that if we have more money, we can do more, but I do not think that that exempts us, particularly given the public finances we inherited in 2010, from the obligation to see how we can get more for the £125 billion of taxpayers’ money that is already committed to health and social care in England.

That brings me to clause 3. The only way to deliver person-centred care and early intervention to prevent avoidable cases, is to reinvent care on a much more integrated model between the national health service and the social care authorities. That is why there is the obligation in clause 3 to consider integrating health and care. In that way we will not think of the NHS as one bureaucracy and social care as another, but instead think of it, as Mike Farrar said when he was at the NHS Confederation, as a care system that provides medical support when necessary, rather than as a medical system that provides care support when it has got the money—that is how not to do it.