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Find out about the people behind Royal Voluntary Service in our series of guest stories from our volunteers, staff and partners.
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Tuesday 20 March
On Tuesday Ian Paisley
MP received an answer from the Minister on whether his Department has considered a cap on lifetime social care payments. Minister Paul Burstow
said that the coalition agreement set out the Government's clear commitment to reforming the system of social care to provide much more control to individuals and their carers, and to ease the cost burden that they and their families face. This commitment to reform is why Government acted quickly to set up the Commission on Funding of Care and Support
, which published its report in July 2011.
He added that the Commission recommended a "capped cost model", where people's lifetime care costs are limited at between £25,000 and £50,000. Once someone has accrued eligible care costs up to this level, the state would cover their remaining care costs. The Commission's report has formed the basis of Government's recent engagement with stakeholders. This engagement exercise examined the impact of these recommendations, and brought them together with other priorities for reform from across the social care system to look at the trade-offs between them. When the Commission published its report in July 2011, Government set out their commitment to publish a White Paper on social care and a progress report on funding reform in the spring-a timetable to which we remain committed.
Helen Jones MP asked the Communities Minister what estimate he has made of likely changes to the number of pensioners who will take up council tax benefit if localisation of the benefit is introduced. A reply is expected next week
Wednesday 21 March
On Wednesday during the Cabinet Office Commons oral answers session, Lilian Greenwood
MP asked what recent discussions the Minister had had on the types of Government funding models available to the voluntary and community sector. The Cabinet Office Minister Nick Hurd
said that the Government wanted to help the voluntary and community sector to become more resilient by developing three pillars of funding: traditional giving, income from the state including more opportunities to deliver public service and a new pillar, and the emerging market of social investment.
In her supplementary question Lilian Greenwood said that many local voluntary organisations were set up to complement statutory services. She believed that if the predominant funding source for the voluntary sector is now to be public sector contracts, thousands of valuable voluntary groups throughout the country be left high and dry, showing once again the Government's contempt for the big society that they championed. Nick Hurd said that the Government is developing three pillars of funding, with the encouragement of high levels of giving, including a very generous tax incentive introduced by the Chancellor in the previous Budget; a new source of funding, social investment; and the launch of the world's first social investment bank within a few weeks. The Government wants to do more with the sector to help deliver public services. The Government will be opening up new opportunities for charities and social enterprises to help with that aim.
In the same debate Phil Wilson MP said that a survey commissioned by Charity Bank had revealed that more than 20% of charities have suffered from the cancellation of contracts with businesses and Government bodies in the past year. He asked if the Minister agreed that the Government's refusal to recognise the needs and benefits of charities and voluntary organisations in policy formulation is preventing such organisations from getting vital funding to which they are entitled. Nick Hurd said that this was an important point and that any commissioner in the public sector needs to engage with stakeholders in communities before commissioning services, not least in the voluntary and community sector, whose stakeholders tend to have a much better understanding of the needs of the people the Government was trying to help.
Seema Malhotra MP asked what assessment the Minister had made of the change in the level of funding to the voluntary sector in 2011-12. Nick Hurd MP responded by saying that most voluntary sector organisations receive no public funding at all, but those that do cannot be immune from the need to reduce public spending. That is why the Government is taking active steps to help the most vulnerable organisations, to encourage more giving and social investment, and to create new opportunities to deliver more public services.
In the following question Seema Malhotra MP said that the most recent report by the National Council for Voluntary Organisations shows that, according to the Government's own figures, charities are facing cuts of £1.2 billion in public money per year. She asked if the Minister agreed that the Government need to do more to support the voluntary sector to address what the NCVO had described as a "toxic mix of circumstances" affecting charities. Mr Hurd replied by saying that almost 80% of charities receive no money from the state, but the Government has made it clear that those that do cannot be immune from cuts. This Government is taking action to protect the most vulnerable organisations, create new sources of funding and open up new opportunities for charities and social enterprises to deliver public services.
Yvonne Fovargue MP asked what steps the Minister is taking to ensure that the community and voluntary sector is considered in policy formulation in all Departments. In replying for the Cabinet Office, Oliver Letwin MP said that the Government’s agenda is to give community groups and other voluntary sector organisations a much wider role in fulfilling the demands and needs of the public than they have had in the past. That is why, in considering each of our public service reforms, the Government had paid particular attention to the question of how the voluntary and community sector can work through them and help them.
In her supplementary question Yvonne Fovargue MP said that research by the NCVO has shown that Government Departments plan to cut a further £444 million of funding from the voluntary and community sector. She asked if the Minister agreed that that is evidence of the complete disregard of his own Government for that sector. Oliver Letwin replied by saying that this was not the case. In 2010-11, the funding stood at rather less than £200 million, but in 2011-12 it went up and it has almost maintained the 2011-12 levels, still above those of 2010-11-for 2012-13. The Government is investing in the voluntary and community sector, not disinvesting in it.
On Wednesday several questions of interest were tabled and selected for Health oral questions scheduled for Tuesday 27 March. Nick Smith MP is to ask what recent assessment has been made of the performance of services for older people. Meg Munn MP is to ask what steps the Minister is taking to ensure that people receiving care at home funded by the NHS are involved in making the arrangements for that care. Finally Margot James MP will ask what assessment has been made of the conclusions and recommendations of the joint report by the NHS Confederation, Age UK and the Local Government Association on improving dignity in the care of older people.
Alun Cairns MP received an answer to his question to the Treasury asking if they will review the policy on VAT insofar as it affects charitable organisations who serve their local communities. Treasury Minister David Gauke replied saying that the Government valued the contribution of charities across a wide spectrum of national life and interests.
He added that the UK has one of the most generous tax systems for charities in the world. Existing reliefs for charities are worth over £3 billion a year. Within this, are existing VAT reliefs worth over £200 million per year. These include zero rates for charities on sales of donated goods, medical equipment and the construction of charitable buildings. In addition Gift Aid, the largest single relief, is now worth nearly £1 billion to charities each year. In terms of whether the Government could extend the VAT reliefs further; in many cases, EU VAT rules mean that it would not be necessary or possible to provide a refund scheme to any contracted provider of public services. The provision of any services under a contract, by a charity or a business, will normally be regarded as a business activity and thus within the scope of VAT. Therefore, if the services provided are taxable the provider will be able to recover their VAT costs through the normal VAT system. However, if the services provided are VAT exempt, any form of VAT refund is prohibited under EU VAT law. Where a provider does incur irrecoverable VAT in the provision of public services, these costs should be taken into account by the contracting public sector organisation when agreeing funding.
Diane Abbot MP asked what estimate the Health Minister has made of the number of NHS patients in England who are housebound. A reply is awaited.
Thursday 22 March
On Thursday Andrew Rosindell
MP asked what steps the Health Minister is taking to increase the number of doctors specialising in geriatrics. A reply is awaited.
Monday 12 March
On Monday Helen Jones
MP received an answer to her question to the Secretary of State for Communities and Local Government asking how many local authorities have increased charges (a) for the use of day centres and (b) for transport to day centres in 2011-12; and how many local authorities plan to increase such charges in 2012-13. Minister Robert Neill
said that the information requested was not held centrally.
The previous week Tracey Crouch MP had asked what assessment the Health Minister had made of the conclusions and recommendations of the joint report by the NHS Confederation, Age UK and the Local Government Association on improving dignity in the care of older people. Social Care Minister Paul Burstow said that the Department welcomed the publication of the Commission's draft report, which aimed to help drive improvements in the quality of care provided to older people in hospitals and care homes. He looked forward to the publication of the Commission's final report.
He added that the Government was determined to root out poor quality care in the NHS through a range of actions. The NHS Operating Framework for 2012-13 established the issue of high quality, dignified and compassionate care as one of four key priorities for the NHS.
In addition, on 6 January, the Government had announced a series of measures to improve the quality of nursing care and free up nurses to provide the care patients and relatives expect. The measures included setting up a new independent Nursing and Care Quality Forum, tasked with ensuring that the best nursing practice is spread throughout the NHS and social care.
Meanwhile in the House of Lords, Lord Lester of Herne Hill asked the Government whether they will bring into effect the power conferred by the Equality Act 2010 to make age discrimination unlawful in providing goods, services and facilities, including health care, to the public. In her reply Baroness Verma said that following a public consultation last year, the Government was still considering the scope for and content of exceptions from any age discrimination ban and will announce how it intends to proceed in due course.
David Morris MP had asked Health Ministers what steps the Department of Health is taking to ensure that all elderly people are treated with respect and dignity in hospitals. On the same day he also asked Work and Pensions Ministers what steps their Department is taking to assess the implications of the Dilnot Report.
Tuesday 13 March
On Tuesday Paul Burstow replied saying that the Government is determined to root out poor quality care in the NHS. The Government is taking action on a number of fronts, including measures in the 2012-13 Operating framework, where quality of care, particularly for older people, is established as one of the four key priorities for the service, giving it equal billing with Operational Performance, the Quality, Innovation, Productivity and Prevention programme and Reform.
He added that the Care Quality Commission will be building on the 100 Dignity and Nutrition inspections it undertook in 2011 on behalf of the Department by undertaking a further 700 inspections this year. To improve on these inspections, the Prime Minister recently announced a new patient-led inspection regime, looking at nutrition, privacy, cleanliness and dignity.
In addition, there are also a number of National Institute of Health and Clinical Excellence quality standards that are either in place or are being developed for a range of conditions and pathways affecting older people, including incontinence, nutrition support in adults, patient experience in adult NHS services, delirium, dementia, osteoarthritis and falls in a care setting. There is also renewed funding for National Audits relevant to older people's care. There are a number of indicators in the NHS Outcomes Framework to support better care for older people around dementia care, hospital acquired infections, emergency readmission rates, improving recovery from fragility fractures and helping older people to recover their independence after illness or injury. The Government had established the National Nursing and Care Quality Forum to work with patients, carers and professionals to spread best practice to increase the quality of services to older people.
In regards of the Dilnot question directed at the pensions Minister, Paul Burstow said that following the publication of the report of the Commission on Funding of Care and Support, the Government announced they would consult with a range of people and organisations involved in care and support on their recommendations and social care reform more broadly. "Caring for our future: Shared ambitions for care and support engagement" ran between 15 September and 2 December 2011. The Government will publish their plans for social care reform in a care and support White Paper and progress report on funding in the spring.
Virendra Sharma MP had asked the Department of Health a series of questions the previous week. The first two questions focused on telecare. In summary, he asked what assessment the Department has made of the effect of telehealth and telecare services on improving patient experience and also of delivering efficiency savings in the NHS and adult social services. Virendra Sharma MP also asked what plans the Department has to support (a) primary care trusts, (b) clinical commissioning groups and (c) local authorities to commission telehealth and telecare services for people with long-term care needs. Replies are awaited.
In replying Paul Burstow said that the Department has been trialling the effect of telehealth and telecare in the Whole System Demonstrator programme, a large-scale randomised control trial. Early headline findings published by the Department on 5 December 2011 had demonstrated that when used appropriately there is potential to reduce emergency admissions and mortality. The Department estimated that there are three million people with long term conditions who could benefit from this approach, which is why the Department and leaders from industry signed a concordat demonstrating a commitment to deliver telehealth and telecare to those who will benefit. This is the Three Million Lives initiative launched on 19 January 2012.
On Wednesday Jim Cunningham MP asked what steps the Government is taking to ensure consistent levels of provision of social care support. Paul Burstow referred the MP to the reply that he gave him on 5 December 2011.
Virendra Sharma MP had asked the Health Secretary what proportion of the £648 million allocated for local authority spending on social care that also benefits health in 2011-12 was spent by each local authority in England on (a) prevention services, (b) communicating equipment and adaptations, (c) telecare, (d) crisis response services, (e) maintaining eligibility criteria, (f) re-ablement and (g) mental health. Paul Burstow said that in September 2011, the Department collected information from primary care trusts to understand how the transfer of NHS money was progressing and on which services it was being used. A demonstrative graph of all of the forms that the money is being spent on can be found in the NHS publication "The Quarter".
He added that when the information was collected, the majority of money had yet to be transferred, but agreements had been made which set out on which services the money would be spent.
The proportion of £648 million NHS transfer to local authorities was spent on different services as follows:
- Prevention (not including community equipment and adaptations) -10%
- Community equipment and adaptations - 5%
- Telecare - 4%
- Crisis response services - 8%
- Maintaining eligibility criteria - 18%
- Re-ablement - 18%
- Mental health - 5%
The remainder of the transfer was spent on the following services:
- Integrated crisis and rapid response services - 8%
- Bed-based intermediate care services - 10%
- Early supported hospital discharge schemes - 8%
- Other services - 14%
The MP also quizzed the Minister over his plans to introduce a national assessment framework for social care. Paul Burstow replied saying that the Government will publish their plans for social care reform in a care and support White Paper and progress report on funding in the spring. This will include responding to the recommendations made by the Law Commission and Commission on Funding of Care and Support on assessment.
Philip Davies MP received a reply to his question to the Work and Pensions Minister asking how much has been paid in each of the last three years in winter fuel payments to people in care homes. Steve Webb said that the requested information is not available as DWP datasets do not identify people who are resident in care homes receiving winter fuel payments.
Tim Farron MP had asked the Health Department how many people have received care packages following an assessment by social services in each local authority in each of the last five years. Paul Burstow replied saying that data on the provision of care packages provided by Councils with Adult Social Services Responsibilities (CASSR) is collected and published by the Health and Social Care Information Centre via the National Adult Social Care Intelligence Service.
During Prime Ministers Questions on Wednesday Gordon Marsden MP observed that study after study showed that it is crucial for older people that NHS services work closely with social care. His primary care trust in Blackpool has been doing that by working alongside the council's social services in the same set of offices. He asked why the Deputy Prime Minister was supporting a Bill that scraps trusts and such co-operation, and that puts the health of older people, including those in his constituency, at risk.
Nick Clegg MP in responding said that he backed a Bill that included, for the first time, statutory obligations to integrate social and health care. He agreed that one of the abiding failings of the health service is that social and health care are not properly integrated. There has not been much integration over the past ten years but Government was trying to change that. He added that the creation of health and wellbeing boards will bring together representatives of the NHS and social care.
Wednesday 14 March
On Wednesday, Jim Cunningham
MP received an answer from Paul Burstow
to his question on what recent steps he has taken to improve (a) cancer, (b) accident and emergency, (c) paediatric and (d) geriatric services in the West Midlands. In response to geriatric services, Paul Burstow
said that the provision of national health services is a matter for the local NHS. The Department encourages providers to increase the quality of their services to older people, by sharing best practice, bringing people together, and putting in place the right system incentives. The Department aims to keep older people well and out of hospital; to help older people regain their independence after a period of support; to provide older people with advice and choice around their end of life care; and to give older people a greater say in their care.
On Thursday Paul Burstow responded to Tim Farron’s question on what estimate he has made of the cost of (a) continuing care assessments and (b) core assessments by social services in each local authority in each of the last five years. Paul Burstow said that no assessment of the cost to local authorities of continuing health care, and core assessments by social services had been made.
Posted by Steve Smith, Public Affairs Officer at 00:00
Friday, 16 March 2012.
local authorities charges,
NHS Operating Framework,
Nursing and Care Quality Forum,
respect and dignity in hospitals,
Dilnot Report ,
Commission on Funding of Care and Support,
Care Quality Commission,
National Nursing and Care Quality Forum,
telehealth and telecare services,
Three Million Lives,
social care support
Monday 30 January
On Monday Chris Skidmore MP received an answer to his question to the Department of Health on what proportion of finished admission episodes the patient was over (a) 65, (b) 80 and (c) 90 years in each of the last five years. A finished admission episode (FAE) is the first period of inpatient care under one consultant within one healthcare provider. In reply Paul Burstow published a table which showed that FAEs amongst the over 65 age group was 34%, for the over 80 year age group 13% and for the over 90 year age group 2%. The situation in percentage terms had remained fairly static over recent years.
Caroline Dinenage MP had asked what information the Department of Health has received from primary care trusts on plans for spending the 2011-12 NHS social care allocation; which services the money has been allocated to; and what proportion of the money is expected to be spent on older people. She also asked what estimate the Department has made of the difference between the number of people eligible for social care support in England and those receiving formal support from public or private sector agencies.
In his reply Paul Burstow said that his Department collected information from primary care trusts in September 2011 to understand how the transfer was progressing and on which services it was being used. The information suggests that the money is being used on a wide range of services. He said that a full breakdown of this can be found in the NHS publication The Quarter which has been placed in the Library. The Department did not collect information on what proportion of the money is being spent on older people. In response to the second question Paul Burstow said that the Department of Health has not made estimates of the difference between the number of people eligible for social care support in England and those receiving formal support from public or private sector agencies. He acknowledged that unmet need is difficult to precisely define and measure. The eligibility framework issued by the Department seeks to support councils in prioritising funding on those with the highest need. The Government is clear that everyone who thinks they may be in need of care and support is entitled to an assessment, and if this assessment concludes that services are required to meet the person's assessed needs and the person qualifies under the means-test, services must be provided.
Also on Monday Caroline Flint MP asked the Minister for Energy and Climate Change if he will make it his policy to ensure that all people over 75 years old are automatically placed on the cheapest tariff by their gas and electricity supplier. Tracey Crouch MP what recent representations the Department of Health had received on the reform of social care and also what assessment they had made of the effect of changes in funding for social care on (a) avoidable emergency admissions and (b) NHS costs.
On the same day Jim Shannon MP asked what guidelines the Health Minister had issued to care homes on the prevention, treatment and care of fractures resulting from falls by people with osteoporosis.
In his response Paul Burstow said that the Department of Health provides guidelines through the Department's falls and bone health commissioning toolkit. In addition, the National Hip Fracture Database, which audits the care of hip fracture patients, and the Royal College of Physicians' Falls and Bone health audit also apply to all care settings including care homes.
Last week Paul Maynard MP asked what proportion of gross national income is spent on services for the elderly. In answering Mark Hoban said that many public services are shared across groups, for example expenditure on roads. It is therefore not possible to provide a clear split between the proportion of national income spent on any particular age group. However, the Office for National Statistics publishes an allocation of some public services to households in The Effect of Taxes and Benefits on Household Income, 2009-10. This includes an analysis of certain benefits in kind for non-retired and retired households for expenditure in 2009-10.
Thursday 2 February
Tim Farron MP received a reply to his question on what assessment had been made of the effect of the social care system on the financial sustainability of the NHS and what assessment had been made of the prospects for using increased resources for social care to reduce avoidable emergency admissions and NHS costs. Paul Burstow replied 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 that people do not stay in hospital longer than they need to.
He went on to say 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 (PCTs) 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".
Finally 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.
David Morris MP asked the Health Minister what steps he is taking to improve the services offered to patients following discharge from an NHS hospital. A reply is awaited.
Mike Weatherley MP received a reply from Minister Paul Burstow on whether he plans to produce a national standard for care homes on the prevention, treatment and care of fractures resulting from osteoporosis and falls. The Minister said that the Health and Social Care Bill makes provision for the National Institute for Health and Clinical Excellence (NICE) to produce Quality Standards that relate to social care, which would potentially include care homes. The added that the Government’s engagement exercise - Caring for Our Future: Shared ambitions for care and support - sought to understand people's priorities for reform to help inform the approach to be set out in the forthcoming White Paper on adult social care. Responses to the engagement in relation to quality welcomed planned work to extend NICE Quality Standards to social care, and highlighted the potential role clinical audit practice might play in driving up quality in the sector. The Government are now considering these proposals before they set out their plans in their White Paper on care and support.
Tim Farron also asked the Chancellor what discussions he has had with the Secretary of State for (a) Health, (b) Communities and Local Government and (c) Work and Pensions on the potential for reform of the funding of social care to result in savings to the public purse across Government. Minister Danny Alexander said that Treasury Ministers have regular discussions with ministerial colleagues on a range of issues. On the funding of social care, the Government welcomed the work of the Commission on Funding of Care and Support chaired by Andrew Dilnot, and committed to consider the recommendations carefully. He added that the Government has been engaging with the care sector to develop and refine their priorities and plans for action, bearing in mind the financial context. They will publish a White Paper on wider social care issues including a progress report on funding reform in the spring.
Hazel Blears MP received number of responses to her series of questions to the Departments of Health and Work and Pensions on what discussions they had held with other Departments on planned reforms to the funding of social care the uses of funding allocated to social services. In responding Paul Burstow said that the coalition agreement set out the Government's clear commitment to reforming the system of social care to provide much more control to individuals and their carers, and to ease the cost burden that they and their families face. This commitment to reform is why the Government acted quickly to set up the Commission on Funding of Care and Support, which published its report in July 2011.
When the commission published its report, Government set out a clear timetable for assessing the impacts of the commission's recommendations, making the necessary trade-offs with other priorities for social care reform, and deciding on the best way forward. The Government has said that it is working towards a White Paper on social care and a progress report on funding reform in spring 2012. The Government remains committed to that timetable.
The commission's report has formed the basis of Government's recent engagement with stakeholders. This engagement exercise examined the impact of these recommendations, and brought them together with other priorities for reform from across the social care system to look at the trade-offs between them.
In addition to the Government’s work with social care stakeholders, the Department is looking in detail at the impact of the commission's recommendations. A full assessment of the recommendations will be included in the progress report, which will be published in the spring. The contents of that report cannot be pre-judged now by commenting in detail on the impact of the recommendations.
On the specific question of the assessment of the use of funding allocated by the Department of Health to social services, Paul Burstow said that local authorities are responsible for decisions on spending on adult social care. He continued that at a national level, the NHS information Centre collects detailed information on Personal Social Services (PSS) expenditure. The spending review outlined an additional £1 billion per annum by 2014-15 to be allocated within the NHS to be spent on measures that support social care. The Department collected information from primary care trusts in September 2011 to understand how the transfer of NHS money was progressing and on which services it was being used. The information suggests that the money is being used on a wide range of services.
Hazel Blears MP had also asked the Secretary of State for Health what estimate he has made of the cost to the public purse of funding for adults no longer able to fund their own social care in each of the last five years. Paul Burstow replied that in the current social care system, people who can afford to pay are required to fund their own social care out of their income and assets. In some cases, people need long-term social care, and some of them will, over time, use up their assets to the point that they qualify for state support to fund their own care. At this point, the local authority will provide them with support to pay for care. The Government do not centrally hold information on how many people spend down their assets and are subsequently supported by the state, nor do we know the total cost of supporting these people.
Hilary Benn MP had asked a series of older people related questions. He asked what estimate had been made of expenditure by each local authority (a) overall and (b) per head of population on social care in each of the last 10 years. In his reply Paul Burstow said that data on local authority expenditure on social care are collected and published by the Health and Social Care Information Centre. Data on local authority expenditure on for 2001-02 to 2010-11 are provided in the tables which have been placed in the Commons Library. Final data for 2010-11 will be published in March 2012.
He also asked questions relating to the spending on Meals on Wheels by each local authority (a) overall and (b) per head of population on Meals on Wheels for pensioners in each of the last 10 years and what the average charge was for Meals on Wheels services in each local authority area in each of the last 10 years. Paul Burstow said that information on the average charge for Meals on Wheels services is not collected centrally. He added that data on local authority expenditure on social care is collected and published by the NHS Information Centre via the National Adult Social Care Intelligence Service online analytical processing tool. Data, provided by the Information Centre, on local authority expenditure on meals for older people - aged 65 or over - for the years 2001-02 to 2010-11, has been placed in the Commons Library.
Tracey Crouch MP asked the both the Communities and Local Government and Welfare and Pensions Ministers what recent representations they had received on the role of local authorities and the welfare system in reform of social care. A reply is expected early next week.
Ann Clwyd MP asked the Health Minister when he expects to publish his Department's planned White Paper on adult social care.
Next week (8 February) the Health Committee publishes its report into its inquiry into social care.
Posted by Steve Smith, Public Affairs Officer at 00:00
Tuesday, 07 February 2012.
NHS social care allocation,
social care services,
Social Care Bill,
Commission on Funding of Care and Support,
Health and Social Care Information Centre,
Meals on Wheels
It was a bumper week in Parliament on social care issues.
Monday began with Lewisham East MP Heidi Alexander tabling an early day motion that read:
“That this House notes that cross-party commitment and co-operation is urgently needed to reform the way that adult social care is delivered; acknowledges the desire amongst all parties for this reform; recognises how important it is that the reports of the Law Commission and Commission on Funding of Care and Support are acted upon; further notes that local government is ready to work with central government on this extremely pressing agenda; and calls for immediate and detailed debate on how to take reforms forward and a subsequent care and support reform White Paper and Bill to follow promptly”. The motion presently has the support of eight MPs.
An All Party Parliamentary Group open meeting took place on Monday evening to discuss the Andrew Dilnot report. Andrew Dilnot gave a similar presentation that he gave at Independence Day. Other speakers included Barbara Keeley, Emily Thornberry, Lord Warner and Earl Howe. There was some time for questions in the last 15 minutes or so and preference was given to APPG members and other MPs in the room. They easily took up the time and so no additional questions were taken from the floor.
Paul Burstow replied to Penny Mordaunt’s question from the previous week. He acknowledged the WRVS commissioned report by Frontier Economics and said that he recognised that investment in integrated preventative services by the NHS and local authorities led to better outcomes for individuals including helping people to live independently for longer, and can also realise efficiencies for both the NHS and local authorities. The Government had invested £150 million in the NHS this year to support re-ablement, which will help people recover their independence after a spell in hospital.
Paul Burstow also responded to Claire Perry’s question on reviewing the allocation of social care funding following the increase in the number of delayed discharges from hospital in May. He said that no one should be made to stay in hospital longer than is necessary. The NHS and social care must work together to ensure people have the support they need on leaving hospital. Some patients need particular support after a spell in hospital to settle back into their homes. The Government has recently increased the level of investment made available to local health and care services to spend on front line services and helping people return to their homes after a spell in hospital. The spending review recognised the importance of social care and the Government had allocated an additional £2 billion by 2014-15 to support the delivery of social care. As part of this funding, this year funding of £150 million has been made available for re-ablement and £648 million for social care spend that benefits the NHS which could help to reduce the level of delayed discharges. Local authorities are responsible for decisions on how to allocate their resources.
Health Oral Questions took place on Wednesday afternoon. The questions generated a fair amount of debate around social care including the recommendations made within the Dilnot report. A number of MPs raised questions of interest to WRVS. These included Stella Creasy MP asking what estimate had been made of the change in net public expenditure on older people's social care since April 2010. She also quoted the Association of Directors of Adult Social Services, who reported that nearly £1 billion is being taken out of social care budgets following cuts and asked when the Minister would deliver interim funding relief, so that patients can be discharged from hospital, and to avoid a crisis in social care.
Paul Burstow said that expenditure on social care for older people was £7.5 billion for 2009-10. He added that £700 million of the £1 billion is to be found not through cuts in services, but through efficiency savings, for example through the use of telecare, which significantly reduces costs, and investment in re-ablement services, which save resources and help people to get back on their feet. When it comes to investment, the Government have already made clear their commitment through the spending review, and are investing, by the end of this Parliament in 2014-15, an additional £2 billion.
Bob Blackman MP claimed that the extra money being given to adult social care was good news, but in Harrow, the council was setting the £2.1 million additional funding against redundancies, rather than passing it on to the weak and the vulnerable and asked that action be taken to ensure that the new money reaches the people who need it. Paul Burstow said he was determined to make sure that the additional resources that the NHS is transferring to social care delivers real benefits for people who need social care services, protect services, and allow local authorities to make the right decisions about how they continue to support not just investment in prevention, but those most in need.
Pat Glass MP was disappointed that the Government's White Paper would not be published until the spring, and asked if the Government agree to take forward the commission's recommendations on national eligibility criteria and portable care assessments? Paul Burstow the ADASS survey showed that the majority of local authorities moved, under Labour, to "substantial" needs being the test for access to social care. The Law Commission has made recommendations portability that the Government have to consider, and would need to look to legislate on that.
In the Lords Baroness Smith of Basildon received a reply to her question on what steps the Government had taken to ensure that the additional funding allocated for social care is being spent as Ministers intend. Earl Howe in his reply said that the additional funding for social care has been allocated in two distinct ways, through formula grant to local authorities and from the NHS to local authorities. In 2011-12, an additional £530 million was allocated to local government in addition to existing departmental grants for social care. This funding was allocated to local authorities through the local government formula grant. Formula grant is not hypothecated for different services and it is therefore not possible to determine how much of the additional funding through local government has been allocated for social care. However, the Government do receive local authorities' budgeted spend on adult social care through the revenue account data returns in June of each year.
In addition to funding through formula grant, the Government provided a specific allocation of £648 million to Primary Care Trusts (PCTs) for 2011-12. As part of the Government's planning and assurance processes for 2011-12, they are holding strategic health authorities (SHAs) to account for ensuring that arrangements are in place between local authorities and PCTs for the funding to be transferred and objectives for the investment agreed. Local authorities and the NHS have been working together to agree how this funding should be best used to support social care services. NHS planning assurance showed that all SHAs had confirmed there were local plans in place to agree the transfer. Government will continue to get information on the progress of the money as the NHS financial reporting year progresses.
In addition to this funding, the Government allocated £150 million to PCTs in 2011-12 to develop local re-ablement services in the context of the post-discharge support plans submitted to SHAs this December. It is for PCTs and local authorities locally to agree the plans for this funding. In 2010-11 an extra £162 million to local health and care services to spend on front-line services. In addition, £70 million was made available for re-ablement services in 2010-11.
Emily Thornberry MP asked what the timetable is and what are the reasons are for the time taken to publish the findings of the Whole System Demonstrator programme on telemedicine.
Stuart Andrew MP asked the Secretary of State for Health whether there will be a person appointed to the NHS Commissioning Board who’s main duty is to promote integration across health and social care and. how he plans to promote the integration of health and social care budgets. In response to the first part of the question Simon Burns said that the Board itself will determine its own appointments but will include people with a range of skills and experience covering both health and social care.
Paul Burstow, in replying to the second part of the question, said that flexibilities in the NHS 2006 Act already support opportunities for integrated working by facilitating lead commissioning, integrated provision and pooled budgets. Greater integration had been identified between health and social care as a key priority and has demonstrated its importance by the development of new and integrated health, social care and public health outcomes frameworks. Furthermore, there will be a stronger duty on the NHS Commissioning Board, clinical commissioning groups, the health and well-being boards and monitor to encourage integrated working at all levels. Improving integration between health and social care will also be one of themes of the engagement exercise following on from the Government's response to the report of the Commission on the funding of care and support.
Thursday saw the publication of Healthy Lives, Healthy People: Update and Way Forward which sets out the Government's vision for a public health system that places local communities at its heart. It will have a clear focus on prevention and reducing inequalities and will work across Government to address the wider social determinants of health.
On Thursday Tom Blenkinsop MP asked what recent estimate Government had made of the annual cost to local authorities (a) in Teesside and (b) nationally of the provision of social care.
The week ended with Andrew Dilnot, head of the Commission on the Funding of Care and Support, saying that he will be disappointed if the Government have not released a white paper responding to his recommendations by April 2012.