Local Government and Social Care Funding

Tom Brake Excerpts

Wednesday 24th April 2019 Commons Chamber

[Rachel Maclean]

I thank the hon. Lady for that point; we work together on the all-party group and we share those concerns. I was about to press the Minister for more updates on when we can see the Green Paper, because while this debate is about local authority funding, of course there is also the role of carers and joining up the role of carers in the national health service and in local authorities. Those services have to work together and that is a critical part of this debate.

[Tom Brake (Carshalton and Wallington) (LD)]

Will the hon. Lady give way?

[Rachel Maclean]

I am sorry—I will not, because I do not have very much time, and I have a lot to get through.

We cannot artificially separate these two pots of funding. Instead, we must link them together more holistically. The NHS long-term plan includes some welcome focuses on carers—perhaps the hon. Lady agrees they are helpful—among which I would highlight the use of innovative technology, such as smart home technology, that can, for example, monitor when a dementia sufferer does simple things such as turn on the kettle or switch on a light, and which can be linked to an app to enable someone such as a relative—like myself, for example—to see what their loved one is doing at any given time. It is great that some utility companies are developing apps that can work in this space. I welcome that. We have to get behind those efforts to join up care.

I want to highlight another aspect of the carer spectrum. Young carers are often completely hidden from view, yet they do a fantastic job supporting their loved ones, and it often has a knock-on impact on their schooling and mental health—40% of young carers suffer from mental health problems. My final point about carers is the importance of companies and employers having a proper strategy for people juggling work and care. Most carers work, or try to work—often they have to leave work—and we should consider how we can better support them to provide that care. It is great to see the Minister for Care in her place. I know she is engaged in the detail of these issues.

I turn now to my constituency and my council, Worcestershire County Council. Of course, it faces pressures, like councils up and down the country, but I applaud it for its work in managing these pressures. In meetings with me it has called for the consultation on the fairer funding review to be brought forward quickly so that it can have more certainty to plan ahead. It needs certainty by October to plan for future savings it will need to make. It has had to find savings of £22.9 million already. A positive development in our area, however, has been the work across councils to bring forward the 75% business rates retention pilot, which has resulted in up to £4.9 million more to spend on social care. This has relieved the pressures considerably. Given that the county council spends 41.8% of its net budget on adult social care, and that we have a rising population of people demanding social care, this is really important and very welcome, but it has to be a sustainable settlement that the council can build and plan on.

I turn now to the second half of the equation—it is a shame this is sometimes neglected by Opposition Members. The shadow Secretary of State talked about growing the pie. This is critical. As well as looking at where the money comes from, we as Conservatives try to think about how we can generate more money—more pie—in our local areas. For me, at the heart of that is creating thriving local areas and town centres where people want to move to and businesses want to invest, which in turn generates more revenue and more business rates and a virtuous circle for our local economy.

That is at the heart of our “Unlock Redditch” strategy. My Conservative colleagues have had one year in office in Redditch town hall. They took control this time last year, after eight years of Labour, when there was no positive vision for the future. They have taken control and set out how they will build more social housing and help to empower businesses and the local community to build a thriving town we can all be proud of. It is a positive aspiration for our future and I am completely behind the strategy. It is about having a mission and a plan for the future. That is what we have in Redditch. Let me take this opportunity to say to anyone in Redditch who may be watching the debate, “It is vital that you go out and vote Conservative in the local elections.” If people vote Conservative, we can retain control of our town hall and continue the effective and careful management that has enabled our team to deliver services in the face of spending pressures and pressures on budgets. Similarly, Worcestershire County Council, in the face of some difficult decisions, has maintained essential services such as libraries and social care.

Let us put aside the hysterical political polemic that we sometimes hear from the Opposition Benches, and focus on working together. We have seen some excellent examples of that, so let us focus on it now, and grasp the opportunity to provide a great social care system in our country.

--- Later in debate ---

[Norman Lamb]

I am deeply concerned about the future—or lack of a future—of the transforming care programme. One of the problems is that it is often NHS England that is funding care in an institution, and when a local authority is under financial stress, there is not much of an incentive to take that person out of the institution and make them the responsibility of the local authority. There has to be a way of funding the building of infrastructure to support people in the community. That is what has failed to happen so far.

This is not a static issue that we face. There is growing pressure. We are all living longer, often with chronic conditions that in the past used to kill us. That is a great triumph of man and womankind, but there is a cost attached, yet we have no mechanism to address the increasing funding needs of social care and, in particular, dementia.

The hon. Member for Chelmsford (Vicky Ford), one of the valued members of the Science and Technology Committee, made the point that the cost to society of dementia is about £26 billion every year, but that is going to rise dramatically. Whatever we say about spending money efficiently—I completely agree about the need to spend money efficiently and to innovate and do things in a more effective way—the dramatic rise in demand inevitably means that we will have to spend more as a society on supporting people with dementia and on research to find cures for dementia.

[Tom Brake]

Will my right hon. Friend give way?

[Norman Lamb]

I will briefly, but I am having glowers directed at me by you, Mr Deputy Speaker.

[Tom Brake]

Does my right hon. Friend agree that one of the ways of supporting people who need care, such as dementia sufferers, is to support their carers, and that there is a very important role for organisations such as the Sutton Carers Centre in providing support to the network of carers who support people with dementia and others with long-term conditions?

[Norman Lamb]

I very much agree, and those organisations do incredibly important work.

I want to mention the Care Act 2014, which I was responsible for taking through Parliament. I think it was widely regarded as good legislation, but I fear that it has been undermined by a failure to commit sufficient resources to really realise the transformation that it was designed to achieve in personalising care and putting the individual at the heart of everything that local authorities do. In particular, we legislated for a cap on care costs in that Act, but as soon as the Conservatives got rid of the Lib Dems from the coalition, that commitment was abandoned. All the work that we did in consulting and legislating for a cap on care costs to protect people from catastrophic cost has been lost. Of course, we know that in the 2017 general election the Prime Minister paid dearly for that politically, because the replacement proposal was sorely lacking and amounted, in many people’s eyes, to a tax on dementia.

I am conscious that you want me to shut up very soon, Mr Deputy Speaker, but I want to say something very briefly on future funding. It seems to me that if we are to achieve a sustainable settlement, we have to work on a cross-party basis and the Government have to embrace that. The motion still prompts the question of where the money is going to come from—it does not answer that question.

There are a range of solutions. My party and I have proposed a dedicated health and care tax that would appear on people’s pay packets so that everyone could see where the money was going, and which would be informed by an independent assessment, perhaps every five years, of how much the health and care system needed. It would take the politics out of the calculation of how much the care system needs. Then the parties could argue about whether they were prepared to meet those needs through an increase in that dedicated tax.

If we are to solve this, it will require political will. There has been a failure of the political class, not just in the last few years but ever since the late ’90s, when a royal commission established by the then Labour Government came up with proposals that were never implemented. It has been kicked in and out of the long grass ever since, and we are still waiting for a solution. It is time we found one, because we are letting down too many people in our country.