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Westminster Eye: An insight into the week of politics 9-18 May

Wednesday 9 May

The Queen's Speech included a draft bill to modernise adult care and support in England, setting out what support people could expect from government and what action the government would take to help people plan, prepare and make informed choices about their care.

The main benefits of the draft Social Care Bill would be:

  • modernising care and support law to ensure local authorities fit their service around the needs, outcomes and experience of people, rather than expecting them to adapt to what is available locally
  • putting people in control of their care and giving them greater choice, building on progress with personal budgets
  • consolidating the existing law by replacing provisions in at least a dozen Acts with a single statute, supported by new regulations and statutory guidance
  • simplifying the system and processes, to provide the freedom and flexibility needed by local authorities and social workers to allow them to innovate and achieve better results for people
  • giving people a better understanding of what is on offer, to help them plan for the future and ensure they know where to go for help when they need it

The main elements of the draft Social Care Bill are:

  • modernising the legal framework for care and support, to support the vision of the forthcoming White Paper on care and support
  • responding to the recommendations of the Law Commission, which conducted a three-year review into social care law
  • establishing Health Education England as a non-departmental public body
  • establishing the Health Research Authority as a non-departmental public body
  • creating a London Health Improvement Board
  • carrying out engagement and pre-legislative scrutiny on the draft Bill, as many in the social care sector have called for, to enable government to listen to people with experience and expertise, to make the most of this unique opportunity to reform the law

Under changes announced in the Queen's Speech charities will be able to claim top-up payments on up to £5,000 of small donations without needing Gift Aid declarations,. This scheme will be particularly helpful for small charities that rely on bucket collections, which can find it impractical to get the necessary paperwork that Gift Aid requires.

Meanwhile in the Lords, Lord Touhig asked the Government what steps they are taking to provide support for people with dementia. A reply is awaited.

Thursday 10 May

During Commons Oral Questions to the Leader of the House Glyn Davies MP said that the Queen's Speech included a commitment to a draft Bill on adult social care, which is a hugely complex and important subject. He asked if the Leader of the House agreed that there should be debates on it during the new Session to ensure that the momentum of this important policy is not lost. In his reply Sir George Young said that he agreed. He referred to his response to the shadow Leader of the House. This was one of the issues that the last Government did not address. He continued that the current Government had commissioned the Dilnot report, and a White Paper will be published this spring containing proposals on adult care. There will then be a draft Bill to take the agenda forward. In the meantime, resources have been put into the NHS and adult services to give more support to social services departments, which he recognised are under pressure.

Monday 14 May

Baroness Wheeler tabled a Lords Oral Question to ask the Government what is the timetable for the draft bill to modernise adult care and support in England announced in the Queen's Speech and to what extent the proposals in the bill follow the recommendations of the Dilnot Commission. An answer is expected on 11 June.

Tuesday 15 May

Harriet Harman MP received a reply to her question to the Chancellor of the Exchequer what estimate he has made of the likely revenue to the Exchequer from the cap on tax relief for philanthropic activity as a result of his proposal. David Gauke responded by saying that the Government announced at Budget 2012 a proposal to introduce a limit on all previously uncapped income tax reliefs from April 2013. This included the charitable reliefs for Gift Aid, Payroll Giving and gifts of land and shares. Costings approved by the Office for Budget Responsibility were published in the budget. He added that the Government estimated the philanthropic element of this to be £50 million to £100 million. The Government had clearly stated its intention that those charities which rely on large donations are not significantly affected. To this end discussions with stakeholders from the charity sector are currently taking place to better understand any impacts. This will inform a formal consultation on the delivery of the measure over the summer.

Hilary Benn MP asked the Communities and Local Government Minister what guidance he has provided to local authorities on the application of business rate relief in respect of properties that are used wholly or mainly for charitable purposes. David Evennet MP asked Health Ministers how many people aged over 60 received a free prescription in each of the last three years. Answers to these questions are expected on 21 May.

In the Lords on the 15 May , Opposition whip Baroness Wheeler accused the government of breaking their promises on social care. By not committing themselves to a comprehensive Bill and a timetable for the implementation of reform the government was shying away from the needed reform she said. She added that the lack of legal framework in the Bill and explanation of how the £1bn shortfall in funding was to met, whilst trying at the same time to extending personal budgets was going to raise expectations that could not be met. She said, "Reform of social care must deal with the interrelated issues of long-term funding which allows for people to plan for the costs of retirement, improved quality of care through integrated health and social care commissioning".

Lord Adebowale, chief executive of Turning Point, said that the failure of the draft Social Care Bill to address funding must be addressed urgently. "I was one of 78 signatories to an open letter sent to the Prime Minister earlier this month organised by the Care and Support Alliance" he added. "It warns that the system is chronically underfunded and that, without reform, too many old and disabled people will be left in desperate circumstances, struggling on alone and living in misery and fear."

Lord Warner argued that the draft Bill on adult social care would not deal with funding. "Funding social care has become a ticking time bomb, not least because a financially challenged NHS picks up the tab for the social care casualties who end up occupying inappropriate and expensive hospital beds," he said.

Speaking about social care, Baroness Tyler of Enfield said the forthcoming White Paper, the funding progress report and the draft Bill should be seen and judged as "an overall package." She felt Dilnot provided a framework for a long-term settlement for funding social care though noted concerns about affordability.

Lord Smith of Leigh talked about social care as it impacted upon the NHS. "Unless we get social care right, the NHS will not be able to achieve those savings", he said and called for radical change and integration of health budgets.

Lord Collins of Highbury touched on the Dilnot review into social care, saying the care system had reached breaking point, but the government seemed further away from addressing the "fair and sustainable solutions" arising from the review.

Baroness Barker asked what progress had been made on delivering greater integration of health and social care.

Wednesday 16 May

During Prime Minister’s Questions Dan Jarvis MP claimed that it was clear that the Government did not have a comprehensive long-term strategy for care. He asked the Prime Minister if he agreed that the sharp increase in home care charges revealed by figures released is the result of the Government’s cut of £1 billion from local council budgets for older people. The Prime Minister replied by saying that the figures were incorrect. He continued that in the spending review the Government had put £2 billion extra into adult social care, but had inherited a situation where there is not a clear strategy or pathway for social care. There was a need to deliver one. That is why there will be a White Paper this year. Ian Lucas MP asked when the White Paper would be published. The Prime Minister reminded the House that the Opposition had 13 years to do something, but that they ducked decision after decision. Royal commissions were held, but nothing was done. He concluded that within two years the Government had done far more than the opposition did in 13 years.

Michael Meacher MP asked the Secretary of State for Health how many persons in England were receiving care packages for the years 2001-02 to 2010-11; and what the average expenditure per person in each of these categories for each of these years was. In his reply Paul Burstow provided the information in a series of tables. The tables showed that gross current expenditure on older people for the year 2010-11 was £9.44m compared with £6.17m in 2001-2. The number of clients who were older people in 2010-11 was 1,064,475. The average expenditure per service user who fell into the older people category had increased from £5.2k in 2001-2 to £8.9k in 2010-11.

Thursday 17 May

Hazel Blears MP received a reply to her questions on how many people were in receipt of free residential care on the most recent date for which figures are available; the level of the means test capital limit for those requiring residential care if it had been increased in line with inflation since 2010; whether an impact assessment had been undertaken in respect of the decision not to increase the means test capital limit for those requiring residential care since 2010; and how many people were paying for all of their residential care on the most recent date for which figures are available.

Social Care Minister Paul Burstow responded saying that unless clients are in receipt of NHS Continuing Healthcare, which is fully funded by the NHS, all care home residents contribute towards the cost of their care. People with more than £23,250 in capital pay the full cost of personal care. People with less than £23,250 in capital can ask their local authority for assistance with the cost of personal care. In both cases, if individuals are assessed as eligible for NHS funded nursing care, primary care trusts have a responsibility to pay a flat rate contribution towards registered nursing care costs.

In reply to the second part of the question Mr Burstow said that at the end of the third quarter of 2011-12, the number of people eligible for NHS Continuing Healthcare was 54,833. Continuing Healthcare can be provided in a variety of settings, including care or nursing homes and in the community. Information on the care setting of individuals in receipt of NHS Continuing Healthcare is not collected.

He added that had the capital limits been uprated in line with general inflation, he estimated that, assuming the normal rounding process: the lower limit would be £15,000 now, rather than £14,250, as set in 2010; and the upper limit would be £24,500 now, rather than £23,250, as set in 2010.

The decision in the Spending Review 2010 not to increase capital limits was taken in order to help local authorities, at a time of financial stringency, to maintain the level of services they provide. The Spending Review 2010 covers government spending up to April 2015. However, the capital limits are being kept under review in order to monitor the impact of not increasing them.

The Department undertook an equality impact assessment in respect of the decision not to increase the capital limits for those requiring residential care in 2011. Information on the numbers of people funding their own residential care costs is not collected centrally.

Chris Skidmore MP asked how many patients received treatment from the NHS for dementia in each year since 1997. A reply is expected on 24 May.

Friday 18 May

Kelvin Hopkins MP tabled an Early day motion “That this House notes that hospital care for older people is currently an area of public concern and that all patients' experience of care should be one of safety, dignity and comfort, delivered by staff that have the right skills to care; welcomes the Royal College of Nursing's report on Safe staffing for older people's wards and its recommendations; and calls on the Government to adopt the report's recommendations to ensure the provision of good quality, compassionate and safe nursing care for all older people in hospital and thus to meet the expectations of patients, nurses and the public, both now and in the future.”

During the course of the week the Conservative Party held elections for the influential 1922 Committee. Of interest was that while Tracy Crouch stood down, Penny Mordaunt and Simon Kirby, who have both shown interest in older people issues of late, were elected.

For Labour there was a reshuffle of the Front Bench in the Lords. Baroness Angela Smith joins Lord Denis Tunnicliffe as a deputy chief whip, and Baroness Smith will also work alongside Lord Richard Rosser in the Home Office team. Baroness Glenys Thornton will move across from Health to lead on Equalities. Lord Phil Hunt takes on Health as well as being Deputy Leader.

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