Social Care — House of Commons, 2016-11-16
Topic: Mixed Topics
Daniel Leonard James Poulter (Conservative, Centre-right): It is a pleasure to follow the hon. Member for Halifax (Holly Lynch), who articulately outlined several of the human challenges facing some of her constituents due to problems in the social care system. We have heard many contributions from right hon. and hon. Members today, many of whom drew upon their own front-line experience of working in the health and care system and of the difficulty in getting the right care that people up and down the country are facing We must remember that we are debating issues that affect real people and real people’s lives, which we sometimes forget in the heat of political debate. We need to remember that social care and good social services are about providing basic dignity in the care of older people and disabled people with things such as dressing, eating and washing. No Member should forget the importance of personalised care that provides dignity. We need a system that is not only more integrated and joined up, but better funded than the current system, which is not adequately financed to meet the needs of the people it looks after I want to talk briefly about welcome initiatives such as vanguards, the better care fund and the STPs, which are moves in the right direction. I also want to discuss the future. The right hon. Member for Leigh (Andy Burnham) was right when he highlighted some of the missed opportunities over the past two or three decades to grip the issues of improving social care and properly funding a sustainable health and care service. Before I do all that, it is worth pointing out some of the fundamental challenges facing the health and care system today However one dresses up the figures, there is an undoubted trend towards increasing delays in transfers of care. That is the truth that the figures show us. Of course, there are areas of good and bad practice, but the national trend in delayed transfers of care shows increasing pressure on the system. Budget reductions in the social care sector are real and amount to about £4 billion over the past decade. It is welcome that more money is coming into the system through the local precept, but that barely touches the sides when we consider the challenge of also meeting the increased demands of paying the national living wage. The NLW is a welcome initiative that will raise the living standards and quality of life of many care workers by properly rewarding them for their work—or make a much better contribution towards doing so—but the change is nevertheless putting budgetary pressure on local authorities, which manifests itself in difficult decisions about how care is provided and rationed on the frontline One of the big trends of the past decade has been that many local authorities have tightened the eligibility assessment for social care. It is effectively now the case that someone has to be in severe need to receive social care, so we must recognise that the tightened criteria mean that those who receive social care are no longer those in moderate need. That is symptomatic of some of the budgetary pressures that the system faces The welcome initiatives—the vanguards, the better care fund and the STPs—are all about the better joining up of what health and social care do together, but we must remember that STPs have perhaps come about in spite of the Health and Social Care Act 2012 rather than because of it. Prior to the 2012 Act, we had strategic health authorities, which helped to co-ordinate care at a regional level. Those were abolished and disappeared. STPs are now a welcome return to the recognition that we need a degree of regional co-ordination of our health and social care system in order to deliver the right care. That co-ordination must be across primary care, secondary care and social care. Housing providers are equally important, because many delayed discharges from hospital are due to the lack of appropriate housing for people with mental health conditions and dementia who do not have the right houses or the right circumstances at home. That is an important part of delivering those local plans to make sure that the system works better for people The elephant in the room is of course funding. Yes, we need to transform services, and more money is needed to do that. There are transformation budgets available through STPs to support clinical commissioning groups in delivering improvements in the NHS, but that will barely touch the sides and will not make enough of a difference. The great tragedy is that if we really want to drive integration, we must put the money into the same place. We must properly fund the integration and joining up of care. The loss of opportunity before the 2010 election was highlighted by the right hon. Member for Leigh. I urge the Government to look again at having cross-party talks to consider a sustainable future for the health and care system in which we all believe.