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Westminster Eye: An insight into the week of politics 6 February - 10 February

Monday 6 February

David Morris MP received a reply to his question to the Health Minister on what steps he is taking to improve the services offered to patients following discharge from an NHS hospital. Social Care Minister, Paul Burstow, said that no one should be made to stay in hospital longer than necessary. The NHS and social care must work together to ensure people have the support they need on leaving hospital. He added that the new Clinical Commissioning Groups will bring together general practitioners, specialist doctors and nurses to shape the best local care for patients, helping to avoid unnecessary delays. The Government would continue to take significant steps to improve the services offered to patients following discharge from hospital. For example, it had been announced on 3 January 2012, a one-off additional allocation of £150 million to primary care trusts in England, for immediate transfer to local authorities for investment in social care services which also benefit the health system. The aim was to reduce the pressure on health services, and particularly hospitals during the winter period. This new investment will enable local services to discharge patients from hospital more quickly and provide support for people in their own homes. The Department is investing extra cash to help people return to their homes after a spell in hospital—by 2012-13 this will be £300 million per year and will help people to leave hospital more quickly and get settled back at home with the support they need.

Tracey Crouch MP received a reply from Paul Burstow on the representations he had received on the reform of social care. Paul Burstow said that the care and support White Paper and progress report on funding reform, planned for spring 2012, will set out the Government's plans for reforming the care and support system. The Government had launched "Caring for our future" in Autumn 2011. He had worked with leaders from the care and support community, and with expert reference groups, to seek a broad range of views from people who use care and support services, carers, local councils, care providers and the voluntary sector. During the engagement and since it formally ended, Ministers have met with a range of organisations about reform of care and support. The Department is currently reflecting on the findings and will continue to work with stakeholders to develop policy and to help the Government decide the approach to the care and support White Paper and progress report on funding reform.

Tracey Crouch MP had asked a second question relating to the assessment made of the effect of changes in funding for social care on (a) avoidable emergency admissions and (b) NHS costs. Paul Burstow responded by saying that effective partnership working and integration are key enablers in delivering against the Quality, Innovation, Productivity and Prevention challenge within the NHS, and supporting improved efficiency within social care. This includes ensuring the people do not stay, in hospital longer than they need to.

He continued that the Department has put in place practical measures to support social care services, in the context of a challenging local government settlement, and to encourage improved joint working between primary care trusts and local authorities. In 2011-12, £648 million has been allocated to PCTs to transfer to councils for spending on social care services that also benefit health. The Department has been clear that PCTs and local authorities will need to work together closely in order to agree appropriate areas of social care investment, taking account of joint priorities identified by the Joint Strategic Needs Assessment for their local populations. Evidence from a survey of PCTs suggests that this funding is being used both to prevent unnecessary admissions to hospital (through crisis response services for example), and to ensure people are able to leave hospital quickly (through intermediate care and re-ablement services for example). A further £150 million (rising to £300 million in 2012-13) has been allocated to PCTs for the development of post-discharge support and re-ablement services. There is local discretion over how this money is to be spent, but in a letter to the service the Department has been clear that:

"This funding is intended specifically to develop current reablement capacity in councils, community health services, the independent and voluntary sectors, with the objective of ensuring rapid recovery from an acute episode and reducing people's dependency on social care services following discharge."

In addition to these funding streams, the Department announced on 3 January 2012 that it was making a further £150 million available to PCTs, to transfer to local authorities for spending on social care. The Department has set out that this funding should be used to target delayed transfers of care which are attributable to social care services. He finished by saying that recently published data shows that the number of patients experiencing delayed discharge from hospital has fallen to its lowest level since this data has been collected. In December 2011, 3,659 patients experienced a delayed transfer of care, a 5.6% fall on the same month last year. This he claimed suggested that additional funding provided by the Government to promote joint working between health, and social care services is having a positive impact in reducing costs to the NHS.

In response to a question from Karen Buck MP on what the change has been in the proportion of gross current social services expenditure on meals and personal social care for people aged over 65 by each local authority in the period from 2001-02 to 2010-11, Paul Burstow said that the information requested is currently being collated and will be placed in the Library as soon as it is available.

In the House of Lords Lord German asked the Government what proportion of the £648 million allocated for local authority spending on social care that also benefits health in 2011-12 was spent on (1) prevention services, (2) communicating equipment and adaptations, (3) telecare, (4) crisis response services, (5) maintaining eligibility criteria, (6) re-ablement, and (7) mental health. A reply is awaited.

Tuesday 7 February

Ann Clwyd MP received a reply from the Minister on when the Department's planned White Paper on adult social care is expected to be published. Paul Burstow acknowledged that urgent reform of the care and support system is needed to provide people with more choice and control and to reduce the insecurity that they and their families face. He added that the Government are taking decisive steps so people can plan and prepare for their care needs, access high quality care when they need it, and exercise choice and control over the care they receive. The care and support White Paper and progress report on funding reform, planned for spring 2012, will set out the Government's plans for transforming the care and support system. It remained the Government’s intention to legislate as soon as possible afterwards.

The previous week Tracey Crouch MP had asked the Communities and Local Government Minister what recent representations he had received on the role of local authorities in the reform of social care. Robert Neill said that the Secretary of State for Communities and Local Government has received no formal representations on the role of local authorities in social care reform. However, the Department for Health carried out an engagement exercise with stakeholders on priorities for reform last autumn and will publish a White Paper on the reform of adult social care in the spring. The Department for Communities and Local Government has been working closely with the Department for Health to understand the impact of social care reform on local authorities and to clarify their role in this area.

Hazel Blears MP had asked the Work and Pensions Minister what recent discussions he has had with his ministerial colleagues on planned reforms to the funding of social care. In her reply Maria Miller said that Ministers have had a number of discussions with ministerial colleagues in the Department for Health over the last year to discuss the findings of the Dilnot Commission on the funding of social care, and the forthcoming care and support White Paper.

Wednesday 8 February

Caroline Flint MP received a reply to her call to ensure that all people over 75 years old are automatically placed on the cheapest tariff by their gas and electricity supplier. Energy Minister Gregory Barker said that the Warm Home Discount scheme has been introduced to provide targeted support for low income and vulnerable households.The type of support offered and eligibility criteria for the scheme were consulted on and the final scheme has been designed to provide targeted support to those who need it most. This includes specific support for the poorest pensioners. This year alone, over 600,000 pensioners in receipt of pension credit guarantee credit only will receive the £120 core group discount. In total the scheme will assist around two million low income and vulnerable households each year. In addition, all pensioner households already receive the winter fuel payment and are among those eligible for the cold weather payment.

Dr Thérèse Coffey asked the Cabinet Office how many pensioners were employed in 2009-10 and in 2010-11. In his reply Mr Hurd said that the numbers were approximately 1.4 million for each year.

The House of Commons Health Committee published its report in social care and called for the government to press ahead with the £1bn long-term care funding reforms proposed by the Dilnot Commission. The committee also claimed cuts in support are driving increased demands on the NHS as they called for an overhaul of the way the system is run. In its report the cross-party group of MP recommended that elderly care, health and housing services are joined up to stop patients being "passed like a parcel" from one service to another. The MPs suggested that failure to link up commissioning and provision across the services leads to more hospital admissions, later discharge and poorer outcomes.

Pensions Minister Steve Webb said that over one million pensioners who may be entitled to Pension Credit should check if they are missing out on extra cash. Up to £2.93 billion of Pension Credit goes unclaimed every year and as many as 1.6 million people could be entitled to this money. He added that if average temperatures are recorded as or forecast to be zero degrees Celsius or below over seven consecutive days, then people who get Pension Credit are automatically entitled to a Cold Weather Payment. The Government had made over three million Cold Weather Payments so far this winter.

Dr Huppert asked the Secretary of State for Health how much funding was provided for medical research into dementia in (a) 2008-09, (b) 2009-10 and (c) 2010-11; and what proportion of the health research budget this represented in each year. Simon Burns responded by stressing that dementia is a research priority for the Government. Through the National Institute for Health Research and the Policy Research Programme, the Department funds a wide range of research on dementia including research on causes, diagnosis, treatment, and organisation and delivery of health and social care services. The proportion of the Department's central research and development revenue budgets spent on dementia research in 2008-09 was £18.4m (2.2%), in 2009-10 £12.7m (1.4%) and in 2010-11 £18.6m (1.9%).

Questions tabled for answer at Health Orals on 22 February included one from Lorely Burt MP who asked what steps the Department of Health is taking to improve the standard of dementia care in hospitals. In addition David Crausby MP asked what recent assessment has been made of the quality of services for older people.

The House of Commons is now in recess and returns on 20 February.

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