Social Care — House of Commons, 2016-11-16
Topic: Health
Helen Olivia Bicknell Whately (Conservative, Centre-right): A while ago, I spent a week in intensive care—not, I assure Members, as a patient—and I remember well how the unit was unable to admit a seriously sick patient because there were no beds free, and there were no beds free in the intensive care unit because there were none free in the hospital. The ward sister told me that that was because patients, particularly elderly patients, could not be discharged because there were no care home places for them. She described that as bed blocking. That is a familiar story, particularly to hon. Members in the Chamber, but I should tell the House that that was 20 years ago. Delayed transfers of care, as we now call them, are nothing new The fact that this is nothing new is a reminder that the problem will not be easily solved; there are no easy answers, but that is not to say that we should not try. In fact, I believe that we should and must try. We must address the problem of delayed transfers of care, not only because NHS hospitals need to use their beds for acutely sick people who need acute hospital care, but because hospital is a very bad place for patients to be, particularly older patients, if they are ready to go home. It is absolutely the worst place for older patients, when they could be at home regaining their mobility, as opposed to losing it stuck in a hospital bed. A few weeks confined to a bed in an acute hospital can mean that an older person never walks again, even though they went in perfectly able to walk and live independently. I say that from the experience of my own grandmother. I appreciate the efforts being made across the system to solve this problem. I know that hospitals and the social care system across the country are working together to speed up discharges; to put in place packages of care; to identify who needs single-handed versus double-handed care; and to try to make best use of limited resources. I know that that work is being done in Kent in my constituency. A few months ago, I convened a meeting between East Kent NHS hospital and Kent County Council specifically to talk about what they were doing to reduce the number of delayed transfers of care. I should give Kent some credit, as this year the number has fallen significantly: it approximately halved between last June and this June, so it really is possible to make progress, even in a tight financial situation At the regional level, the STPs, the devolution deals in places such as Greater Manchester, emerging accountable care organisations and vanguards such as Encompass in east Kent are really working on how to bring health and social care together and how to improve the situation with delayed transfers of care. They must prioritise this and they have to go beyond questions of whose budget the money comes from, whose money it is, whose problem it is and whose patient it is. Instead, they need to look at the problem as a whole and take account of the patient as an individual. They should simply look at what care the patient needs, not whether it is part of one system or another. I would like to thank all those working on this across the country for their efforts. They are working not just to free up much needed beds, but for the sake of individual patients who need better care outside hospital That brings me to the question of money. As a society, we face the challenge of people living longer, needing more care and rightly expecting better care. Thanks to the work of the CQC inspecting care homes and care providers, we are seeing some transparency in the quality of care, and we are identifying where there is poor care. Thankfully, the vast majority—70% or so—of care providers are either good or outstanding, but a significant minority is not good enough. It is good to see, though, that the majority of those are, in turn, improving I welcome the improvements to care, driven in part by the CQC and greater transparency, but we cannot get away from the need for more money in the system. We all know that the Government have recognised that. Despite the large deficit and debt left by the Labour party in 2010, the Government have committed to funding the NHS through the five year forward view and to increasing funding to social care. Social care funding is rising in real terms. I enormously welcome the social care precept—the extra 2% that Kent and other councils are levying to increase the funding for social care. I have not heard a single person in my area complain about that levy—that increase in the amount of council tax that has to be paid—which I think shows widespread support for funding more care It is good to spend money where we can on social care as well as to maintain the commitment to funding the NHS, but there is a case for work to be done so that we know what any extra money spent on social care will achieve. To what extent might it achieve savings for the NHS? When I asked the experts questions in this area, I encountered a lot of vagueness about what could be achieved for the NHS by increased spending on social care. Finally, I emphasise the importance of having a system that truly joins up health and social care, so that each pound is spent most effectively across both those areas and so that each person gets the right care for them. It should not depend on whether they are in the NHS or social services spheres; it should be the right care for every individual person.