PARLIAMENTARY DEBATE
Adult Social Care - 28 January 2020 (Commons/Commons Chamber)

The Government have enshrined in legislation through the Care Act 2014 a council’s statutory duty to meet eligible needs for adult social care. We have given councils access to up to £1.5 billion more dedicated funding for social care in 2020-21 to help them to meet this requirement.

Figures from Age UK show that 1.5 million people aged 65 and over have an unmet social care need, and Age UK estimates that this figure will rise to 2.1 million by 2030 if we carry on as we are. In my constituency, that equates to 3,012 older people with unmet needs and 2,517 older people providing unpaid care. Those are real people who are not getting the help they need. The Prime Minister said last summer that he had a plan to “fix” social care. Where is it?

As I have explained, the Care Act sets out the requirement that entitles individuals to a care needs assessment and sets a minimum national threshold at which care should be delivered. We have backed councils up by giving them access to £1.5 billion in additional funding in the next financial year. In the hon. Member’s constituency, that will equate to an additional £5.1 million from the new social care grant. This is something that the Government take very seriously.

According to the Institute for Fiscal Studies, more than 1.8 million older and disabled people are currently going without the support that they need to live independently. This crisis has come after the Conservative Government abolished the independent living fund and cut nearly £8 billion from adult social care budgets. In 2017, we were promised a Green Paper, but there has been nothing. Months ago, the Prime Minister stood on the steps of 10 Downing Street promising to “fix” social care, so when will the Government finally publish those plans?

We just do not recognise the figures that the hon. Lady is parroting. Public spending on adult social care in 2018-19 reached £17.9 billion in cash terms, which is the highest level on record. Since 2016-17, our sustained investment has enabled spending to increase by 7% over this period. But do not take it from me—the Local Government Association said last year:

“This is the biggest year-on-year real terms increase in spending power for local government in a decade and will allow councils to meet the rising cost and demand pressures they face in 2020/21.”

While the Scottish Government spend 43% more per head on social care, this Government’s NHS Funding Bill does nothing to address the £6 billion funding gap in England. Does the Minister accept that she cannot fix the NHS without fixing social care?

I completely agree with the hon. Gentleman that adult social care and the NHS are indelibly linked. The one must support the other, and the one drives costs with the other. The over-65 population is projected to rise over 50% by 2035, so putting social care on a sustainable footing where everyone is treated with dignity and respect is one of the biggest challenges we face in society. That is why it is one of the Prime Minister’s biggest priorities.

Scotland introduced free personal care for the elderly in 2002, and this has now been extended to those under 65 who need it. Will the Minister follow the Scottish Government’s lead and introduce free personal care so that people can live with dignity in their own homes?

The Prime Minister has set out his plans. He wants to seek political consensus and bring forward a plan for adult social care this year, and we are looking at a whole range of solutions, including free personal care. The issue we see in Scotland is that the initiative must be backed up with a huge amount of money. The money that the Scottish Government used to give to individuals covered around 50% of their care home costs and now only covers around 25%. That is why we must ensure that we address this issue with a long-term view.

It is time to tackle unmet need, which is clear from my hon. Friends’ questions. Ministers say that they want to seek a consensus on the future of social care, but we already have a proposal with wide-ranging support, including from former Conservative Chancellors in the Lords, major national charities, and the official Opposition: free personal care funded from taxation. Will the Minister accept that the way to move things forward is for the Government to join the existing consensus on introducing free personal care?

The Prime Minister said that the Government will deliver on our promises. We will bring forward a plan for social care this year—

When?

This year. However, there are complex questions to address. A Joint Committee of the Housing, Communities and Local Government Committee and the Health and Social Care Committee came up with an entirely different solution—a social insurance model—which shows why we want to build a consensus. Even the Liberal Democrats have said that they want to build cross-party consensus, but we know the hon. Lady’s view on cross-party consensus: her way or the highway.

Given that we will not end the annual cycle of winter crises until we fix the problems in adult social care, does the Minister agree that, however important the commitment that people will not have to sell their home, the absolute priority in any discussions with the Treasury must be to get more money to local authorities so that they can discharge their responsibilities to older and more vulnerable people?

My right hon. Friend did some incredible work in this area when he was Secretary of State for Health and Social Care. In fact, he presided over the Department being renamed to draw reference to the importance of social care. He is absolutely right that we must ensure that councils have the money they need for the short term, but we must also work towards a consensus so that everybody will have safety and security and that nobody will be forced to sell their home to pay for their care.

I declare my interest as a member of Kettering Borough Council. Taking advantage of imminent local government reorganisation in Northamptonshire, will the Minister continue to encourage local councils and the two local hospitals to bring forward innovative proposals under one budget for an integrated health and social care pilot in Northamptonshire?

My hon. Friend has already been a really good champion of collaborative health and social care work. He has made some excellent suggestions, and we have seen how things such as the better care fund, through which health and care pool their resources, can have a positive effect for local communities. I encourage his local area to look closely at how that sort of work can be maximised and moved forward.

As the Minister will know, the particular problem in rural areas is that need is not just unmet, but unseen. What steps has the Minister taken, or what does she have in mind, to fix the situation and find that need so that it can be met?

My hon. Friend is right to draw attention to rural sparsity and the challenges facing rural communities. We are committed to undertake a review of relative needs and resources, and it will be a thorough evidence-based review of the costs facing all authorities, including how factors such as rurality, sparsity and other geographical features affect the cost of delivering services across the country and how to account for them in a robust manner.

For the record, I declare my interest as the spouse of an NHS doctor. The Pinn Medical Centre in my constituency is due to close its walk-in service so that Harrow CCG can save money, but the likely diversion of patients to local A&E services will end up costing the NHS more. Will the Minister join me in encouraging the CCG to consider the wider context of NHS budgets and to support the service while local NHS providers consider how to increase access to GP appointments in line with our manifesto commitments?

My hon. Friend is right to highlight the importance of access to primary and community services within Pinner. My right hon. Friend the Secretary of State will be happy to meet him to discuss the matter further, but we will support anything he is doing to assist his local services.