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.
Baroness Jolly asked the Government what support and guidance is being offered to pathfinder clinical commissioning groups in commissioning integrated health and social care services. A reply is expected after 12 January.
The Department of Health published a package of data. This included November’s figures for the delayed transfers of care. In comparison with October, November’s figures showed a drop in delays in total days from 118,664 to 116,572 made up of improvements in both acute and non acute delays. However, numbers of cases were up slightly from 4,196 to 4,215.
A new survey of care provided by local councils, published by Labour, reveals increases and disparities in charges for services for vulnerable elderly and disabled people.
Councils are increasing charges for:
- home care: the average hourly charge is now £13.49, a rise of 6% since 2009-10
- Meals on Wheels: the average charge is now £3.44 per meal, a rise of 13%
- transport: for example to day centres: the average charge for a journey is now £2.32, a rise of 33%
These increases mean the average yearly cost for an older person who pays for ten hours of home care a week is now £7,015 a year. Older people who also get Meals on Wheels every day now pay an average of £8,271 a year. With transport charges to go to a day centre three times a week an older person now pays £8,633 per year. There are differences in the price people pay for care, depending on where they live. This ranges from free home care in Tower Hamlets to care costing £20.34 per hour in Cheshire East.
The Department of Health announced that additional sums of money are
being made available for social care and housing support. The Department
made an additional £150 million revenue available via primary care
trusts in order to address delayed discharges, and a further £20 million
capital expenditure to add to the Disabled Facilities Grant, making it easier for disabled people to live in their own homes.
"Older people often need particular
Secretary of State for Health, Andrew Lansley
support after a spell in hospital to settle
back into their homes, recover their
strength and regain their independence.
This money will enable the NHS and
social care to work better together
for the benefit of patients."
In a letter published in the Daily Telegraph today, a group of more than 60 government advisers, charity directors and independent experts called on the government and the Labour Party to overhaul England's "failing" social care system. The letter follows new evidence last week of rising care bills for families, and costs to the NHS of 'delayed discharges'. It argues that, alongside celebrating the fact that the UK population is living longer, action must be taken to meet the 'unavoidable challenge' of how to support increasing numbers of older and disabled people who need care.
The letter argues that the current social care system is failing this challenge, with serious consequences for society, family life and the economy - leaving older and disabled people at risk, families facing huge care bills, businesses losing staff who are forced to give up work to care for loved ones and the NHS coping with avoidable hospital admissions and 'bed blocking'.
The signatories say that meeting this challenge this will require 'political leadership'. They urge the Prime Minister to 'seize the opportunity' of cross-party talks on the future of social care to 'deliver a social care system which can provide the well-funded and high-quality care and support we would all expect for ourselves and our families.'
In the early part of the week political commentators speculated that the Queens Speech, outlining the legislative programme for the coming year, will take place on 9 May, with a fall back to 16 May if this does not work.
It was reported that three million lives could be improved across England thanks to new high-tech healthcare. After seeing the technology in practice in Cornwall, Care Services Minister Paul Burstow pledged to make it available to more people with long term conditions.
In order to make this a reality, over the next five years the Department of Health will work with industry, the NHS, social care and professional organisations to bring the benefits of assistive technology such as telehealth and telecare to millions of people with long term conditions. Telehealth and Telecare use electronic equipment to read vital health signs such as pulse, weight, respiration and blood oxygen levels, which can be read remotely by health professionals in a different location. It means that people can stay in the comfort of their own homes with the peace of mind that a doctor or nurse will be alerted should there be a problem.
Housing Minister Grant Shapps launched a new deal to help older people to continue living comfortably in their own homes - with particular support for those leaving hospital. With nearly one in five of the whole population expected to be aged 65 or over by 2020, Ministers are determined to ensure elderly, vulnerable people get the help they need to live independent lives, and can be safe in the knowledge that they won't get ripped off by dodgy dealers and fraudsters. Mr Shapps has given £51 million towards Home Improvement Agencies, who will provide help and advice including:
- housing advice, including help to move to more suitable accommodation if needed
- handyperson services, including small home repairs, home safety and security adaptations
- energy efficiency advice
- arranging for adaptations and home repairs to be made, including grab rails, stair-lifts and major work such as ground floor extensions.
These agencies also offer hospital discharge services - ensuring older people leaving hospital care are given the support they need to be able to recuperate in the comfort of their own homes. He has also announced £1.5 million funding for FirstStop, which provides independent advice to older people looking to plan their future housing needs - whether in their own homes, or in care homes.
A number of bodies including WRVS called on the Government to affirm its commitment to volunteering by making portable Criminal Records Bureau (CRB) checks free to volunteers.
Whilst the Government has confirmed that CRB checks themselves will remain free for volunteers, a decision has yet to be made about the cost of the online system that will ensure volunteers will not have to be checked every time they begin a new role. In the current system CRB checks are free but not portable, but Government risks solving one problem only to create another if in the proposed new system they are portable but not free.
The King's Fund and the Nuffield Trust jointly called for an ambitious new goal to be set to ensure that delivering integrated care assumes the same priority over the next decade as reducing waiting times was given over the last. The new goal to improve the experience of patients with complex health needs is the central recommendation in a new report published by the two think tanks. The report argues that integrated care - which aims to co-ordinate care more effectively around the needs of patients - is essential to meet the needs of the ageing population and transform the way care is provided to people with long term conditions. The report follows the Prime Minister's pledge earlier this year to make integrated care one of his five key priorities for the NHS.
On the same day it was reported in Thursday’s Guardian that David Cameron has ordered health and social care services to be brought together in order to benefit patients in a move which government advisers are calling the NHS's most urgent overhaul. Reports suggest that the prime minister has been persuaded by senior doctors and Downing Street health advisers that, without integration, the NHS could become unsustainable due to rises in the number of patients with long-term health conditions such as obesity, diabetes and breathing problems.
Prime Minster David Cameron, made a speech in which he outlined plans to require nurses to make hourly ward rounds and for members of the public to make inspections of wards. Mr Cameron wants nurses to focus on "patients not paperwork" while all hospitals will be expected to implement regular ward rounds "to systematically and routinely check that patients are comfortable, are properly fed and hydrated". This follows a spate of critical reports last year over the levels of care of the elderly in hospitals including by the Care Quality Commission where it found a fifth of NHS hospitals were breaking the law on care of the elderly. Its study also found half of hospitals were failing to provide all-round good nutrition to elderly patients while 40% do not offer dignified care.
So not the usual cut and thrust you would find in the Chamber, but some interesting developments which set the scene for 2012. Both the Lords and Commons return on 10 January.
Posted by Steve Smith, Public Affairs Officer at 11:45
Friday, 06 January 2012.
delayed transfers of care,
social care and housing support,
Disabled Facilities Grant,
Home Improvement Agencies,
Criminal Records Bureau (CRB checks)