Local Government and Social Care Funding Debate
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Andrew Gwynne
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Local Government and Social Care Funding
Andrew Gwynne Excerpts(5 years ago)
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Andrew Gwynne (Denton and Reddish) (Lab)
I beg to move,
That this House notes that despite the Prime Minister announcing that austerity is over, local authorities’ spending power per household is on course to fall by an average of 23 per cent by 2020, and that nine of the 10 most deprived council areas in this country have seen reductions that are almost three times the average of any other council under this Government; recognises that this has resulted in social care budgets in England losing £7 billion; further notes that at the last General Election Labour committed to a fully costed plan to invest an additional £8 billion in social care over this Parliament; and calls on the Government to ensure that local authorities and social care are properly and sustainably funded.
If I may, I seek the indulgence of the House to briefly place on record, as shadow Communities Secretary, my utter shock and revulsion at the recent terrorist atrocities, both in Northern Ireland and in Sri Lanka, over the Easter break. We send our condolences to the families affected and to their communities. Coming so soon after the terrible events in Christchurch, New Zealand, just before Easter, they serve as a bleak reminder of how fragile our human rights and freedoms are, and how we must redouble our efforts in this place and outside to hold our communities together.
Sir Peter Bottomley (Worthing West) (Con)
The whole House will be grateful for the way the hon. Gentleman has introduced the debate and for those sentiments. Does he agree that people do such things for publicity and public reaction, and that we should take care to ensure that our publicity and our public reaction confronts and confounds their aims, so that what they do will be in vain, even though it has taken a terrible toll on those directly affected?
Andrew Gwynne
The hon. Gentleman is absolutely right. We should stand firm against terrorist atrocities wherever they are perpetrated. We should stand strong as a community, both in the United Kingdom and in the global community, against such acts of terror. We should call them out wherever they take place.
I welcome the opportunity to raise the important matter of local government funding in an Opposition day debate, especially considering how scarce the opportunities are for the Opposition to raise matters in such debates. I pay tribute to the shadow Leader of the House, my hon. Friend the Member for Walsall South (Valerie Vaz), whose dogged pursuit of that issue has allowed us to debate this important matter today.
In this place our discussion has been dominated by Brexit, but across the country our local councils, and the local services people rely on, are straining at the seams. I pay tribute to councillors of all political persuasions and none for the work they do in serving their communities. I pay tribute to the council officers and dedicated public servants who deliver neighbourhood and care services on the frontline. Years of uncertainty and unfair funding have created a quiet crisis that is now impossible to ignore. Under this Government, the facts speak for themselves: local authorities have faced a reduction to core funding of nearly £16 billion since 2010. That means that councils will have lost 60p out of every £1 that the previous Labour Government provided to spend on local services.
When the Prime Minister entered Downing Street, she promised to build a country that works for everyone, and she then promised an end to austerity. As her time in office probably comes to an end, we are able to reflect on both of those promises. Like in many areas of her leadership, I am sure we will all find that in both those areas she has been sorely lacking.
Diana Johnson (Kingston upon Hull North) (Lab)
As usual, my hon. Friend is making a very clear statement about the situation local government finds itself in today. My council is one of the 10 councils to have suffered the heaviest cuts, yet I represent a constituency and a city that is one of the most disadvantaged in the country. It is clear that the decisions that were made about where the cuts should fall have meant that they have been put on the shoulders of the poorest and the most vulnerable, not the richest in society.
Andrew Gwynne
My hon. Friend is absolutely right. She champions the cause of the communities of Kingston upon Hull. It is one of the most deprived local authorities in England, yet it is one of the areas that have received the heaviest cuts to their spending power since 2010. That was a political choice, and one that has decimated many communities, including the one she represents, across England.
Ms Karen Buck (Westminster North) (Lab)
I am sure my hon. Friend will come on to this argument, but does he agree that cuts to essential local government services in many areas inevitably lead to additional expenditure elsewhere? I think particularly of the decimation of youth services and early years prevention, which has undoubtedly contributed to the extra stress and extreme youth violence on our streets.
Andrew Gwynne
My hon. Friend is absolutely right. We used to have something called Total Place, which was all the public sector bodies working together towards a single strategy for a local area. What we have seen as a consequence of the austerity since 2010 is a complete breakdown of that collaborative working. It is worse than that, however, because rather than public bodies working together collaboratively, pooling resources and getting the best possible levels of services for communities, we have seen cost-shunting. For the sake of saving money on youth services, we are seeing a rise in crime that is pushing up costs for the police. Because of the cuts to police budgets, those costs are shunted on to other public bodies. That is not a common-sense approach to dealing with people’s needs and services, to building stronger communities or to spending public money wisely.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
On cost-shunting, just this morning we heard from representatives of families with children with special educational needs and disabilities. They were talking about their needs not being met through the education budget, the high needs block from local government or the health needs budget, because each is trying to get the other to pay the bill. Children with special needs and disabilities are falling through the gap and remaining unsupported.
Andrew Gwynne
My hon. Friend is absolutely right. There are too many instances across the public sector where cost-shunting is resulting in precisely what my hon. Friend says: vulnerable people falling through gaps that should not exist. I think that in their heart of hearts, Conservative Members, who clearly deal with casework that is similar to ours, will know that that is happening in their areas too.
Andrew Gwynne
If the hon. Gentleman is going to apologise for the cuts he has forced on our local communities, I will give way to him.
James Cartlidge
Very kind of the hon. Gentleman. He was referring to what has happened since 2010. Let us just remind ourselves that the 2010 Labour manifesto said that certain areas would be prioritised and protected. Will he remind us whether that included local government?
Andrew Gwynne
I remind the hon. Gentleman that the 2017 Labour manifesto said that we would put money back into our public services, something that he has failed to do in the almost three years since that general election.
Rachael Maskell (York Central) (Lab/Co-op)
My hon. Friend is making an incredibly pertinent speech. Does he not agree that it is completely perverse that public health budgets in York under the Tory-Liberal Democrat council have been slashed, when the NHS 10-year plan says we have to invest in public health?
Andrew Gwynne
It shows precisely the short-sighted way that the Government have approached funding local government. The fact that they passed on public health budgets to local government was, I think, a good move. It was one of the few things in the Lansley Act—the Health and Social Care Act 2012—that I thought was good, because it took back to local councils precisely what they were invented to tackle, which is to improve the health and wellbeing of the citizen. Of course, many councils started off their lives 150 or so years ago as local boards of health. Having that focus on public health and on health and wellbeing is absolutely right, but we cannot do that while cutting those budgets. That is the scandal: the areas that have seen the biggest cuts to their spending power, the areas that have seen the biggest cuts to the revenue support grant, and the areas that have seen the biggest cuts to the public health grant are the ones that need that resource the most.
Toby Perkins (Chesterfield) (Lab)
Let me make a point that neatly sums up what my hon. Friend is talking about. In Chesterfield, we have had a reduction of 43.2%. I took the time to look at the reduction in the Minister’s constituency and it is only 12%. That is not a difference of just a couple of per cent. It is three and a half times more in my constituency.
Andrew Gwynne
As my hon. Friend will hear as I develop my argument, that is not just a one-off. It is happening across England and it is unfair. The Tories do not get that blatant unfairness, because they have not seen the same levels of cuts in many of their areas that we have seen, yet the impact that has had on the communities we represent cannot be expressed loudly enough.
Andrew Gwynne
I give way to my hon. Friend, who will express loudly the cuts to her area.
Gloria De Piero
Let me take my hon. Friend to Nottinghamshire, where spending on adult social care is now £33 million lower than it was under Labour. That is £71 lower per head, as need is increasing. Is it not always the case under this Government that vulnerable people are paying the price?
Andrew Gwynne
I will give way to the right hon. Gentleman in a second, if I can answer my hon. Friend the Member for Ashfield (Gloria De Piero) first. It is worse than that, because those are the headline figures. We know that that local authority will have shifted money that was allocated to neighbourhood services to prop up the people-based services of adult and children’s social care, so although social care has been cut in real terms, it would be far, far worse were it not for neighbourhood services bailing out the gaps.
Mr Dunne
The hon. Gentleman is being generous in giving way. He talks about unfairness. Does he not recognise that it was under the previous Labour Government, in which he served, that the unfairness was introduced through the funding formula allocations, which shifted resources from local government in shire counties into metropolitan areas such as the one he represents?
Andrew Gwynne
The right hon. Gentleman has made the case for me. Let me dumb it down for him—I do not wish to appear condescending, but it really is as simple as this: there has always been a recognition by Governments of all colours that not every area has the same baseline. Some areas have greater need and often those areas have less of an ability to raise income locally. Because of that, there has been a mechanism, or a formula—for example, whether that was the rate support grant that became the revenue support grant—to ensure that resources from the centre followed need. What we have seen under his Government is a 60% cut to the revenue support grant. Sixty pence in every £1 for the two councils in my constituency, Stockport and Tameside, is a lot of money. A 60% cut to a very small revenue support grant is different—a number of Conservative Members’ councils have only small revenue support grants, or no revenue support grants in some cases. Sixty per cent. of nothing is nothing and that is the unfairness. A 60% cut to my area cannot be filled in by council tax rises, so it means rises in council tax for poorer services. Cuts are cuts—it is as simple as that.
John Redwood (Wokingham) (Con)
My area is one that got a really bad deal under past Governments and is still getting a bad deal. Let me build a bit of cross-party support. It is obvious that the Government have to find more money for social care for future year budgets, and it needs to go to my area and some areas represented by Opposition Members. It needs to be done fairly, but what is Labour’s current thinking on how much individuals and families should contribute, because in social care, one of the big issues is how much of the family asset and income is at risk? Does it have any new thinking on that?
Andrew Gwynne
Of course, individuals and families are taking the hit from all the cuts, and they are having to step in.
Andrew Gwynne
Let me answer the right hon. Member for Wokingham (John Redwood) first. We have to have a sensible discussion about how we are going to fund social care. Yes, it is about money, and we have pledged to ensure that there is £8 billion for social care—that was in Labour’s manifesto in the 2017 general election—and we need to make sure that that commitment remains in our future manifesto and is updated, because it needs that immediate cash injection to start with. However, we also need to look very seriously at how we provide adult social care. I really do wish that we could try to break down some of the politicking that has gone on for far too long—[Interruption.] Members can heckle, but it is a fact that before the 2010 general election, Andy Burnham, the then Health Secretary, sat down with the Liberal Democrat health spokesperson and the Conservative health spokesperson to try to work out a way forward. We went into that 2010 general election with poster boards about Labour’s “death tax”. That serves nobody. We need to make sure that we will have something that is sustainable for the long term, and I hope that we can genuinely get to a place where we can do that and talk about how we fund adult social care and children’s services going forward.
Several hon. Members rose—
Andrew Gwynne
I will give way to my hon. Friend the Member for West Ham (Lyn Brown) and then I need to make progress.
Lyn Brown (West Ham) (Lab)
I am grateful that my hon. Friend has mentioned children’s services. Clearly, the overspend on children’s services has hit a new high of £800 million—and of £12 million in Newham alone last year—and it is calculated that this funding gap will get to £2 billion by 2020. Is it not a complete and utter nonsense, and unsustainable for councils, to be told that they should be using what little reserves they still have to keep safe our very vulnerable children?
Andrew Gwynne
My hon. Friend is absolutely right. Politics is a question of priorities. I often remember the 2017 Budget, when the Government put forward measures to cut the bank levy by £5 billion. We tabled an amendment to the Budget proposing that £2 billion of that same money should go to fully funding children’s services, because we see precisely the cost-shunting that I talked about earlier with children’s services. It is frankly scandalous that vulnerable children and families are not able to access the support that they need.
Damian Green (Ashford) (Con)
The hon. Gentleman is being generous in giving way. I say this, again, in the spirit of co-operation across the Chamber. He makes the point about adult social care. At whatever level it is funded, he and others have pointed out the unfairnesses between different parts of the country because it is funded through local provision. Has he considered, or would he consider, going back to a system where the money is provided and distributed nationally rather than locally, so that this particular problem will be taken off the backs of local government?
Andrew Gwynne
Of course, I would be very happy to look at any suggestion. My hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) leads on social care issues for the Labour Front-Bench team, but the fundamental issue is that the money has to come from somewhere and some of that has to be centrally provided. We have set out how some extra resources can be put forward for social care.
Several hon. Members rose—
Andrew Gwynne
I will give way later on, but I want to make some progress.
The Prime Minister has said that austerity has ended—she said it in her conference speech last October—but instead of an end to austerity, in January we saw a local government finance settlement that once again cut even deeper into council budgets.
Andrew Gwynne
The Minister says it went up, but actually it confirmed what many of us feared, because under this Government there will never be an end to the pain of austerity. Nothing has changed. Let’s bust this myth. This year’s funding package, while it offered an increase in spending power next year for local government, came with a £1.3 billion extra cut from central Government funding to the revenue support grant. An uplift in spending power has been paid for by local people through increased council tax. That is not fiscal devolution; it is another attempt by this Government to shift the burden on to local taxpayers and to devolve the blame for these decisions to councillors of all political persuasions, including Conservative councillors.
Areas such as the one I represent cannot bring in anything like the resources they need to meet the growing demand for social care and our neighbourhood services through local council tax increases alone. This has left areas with the greatest need unable to mitigate the cuts imposed by the Government and residents paying more in council tax for services to be stripped back even further.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
My right hon. Friend the Member for Ludlow (Mr Dunne) made the point that the last Labour Government shifted money from the shire counties to the metropolitan areas. The shadow Secretary of State described them as areas of increased need, but does he recognise that in rural areas such as Lincolnshire, where my constituency is, services cost more to deliver because of the geography?
Andrew Gwynne
The hon. Lady makes the case that in rural areas there are greater costs to providing services. In some cases, that is correct, but it is a minority of cases. All the evidence, including in a report commissioned by the Secretary of State’s Department, shows that the opposite is actually true. I do not want to get into an argument with the hon. Lady about how we should cut the cake. The cake is shrinking. We need to grow a bigger cake so that we can share out the slices more fairly. As we continue to shrink the cake, all we do is pit her area against my area and her area’s needs against those of the area I represent.
Ellie Reeves (Lewisham West and Penge) (Lab)
Lewisham Council has had to propose a 2% precept to fund the widening gap in adult social care, yet Lewisham is among the 20% most deprived boroughs. Does my hon. Friend agree that rather than asking some of the poorest to pay more, we need proper funding from central Government for essential adult social care?
Andrew Gwynne
My hon. Friend is absolutely right. We need to grow that cake and the distribution of resources has to follow need. If we are serious about tackling health inequalities, if we genuinely want a fairer, more equal country, if we want to narrow the gap in life expectancy between the richest and poorest, which sadly is widening, we will not do it by cutting resources and services in the areas that need them the most.
Jack Dromey (Birmingham, Erdington) (Lab)
My hon. Friend is making a powerful case. A man who gets on the train at Birmingham New Street and gets off in Erdington, either at Gravelly Hill station or Erdington station, is likely to live seven years less than one who continues out into the leafy shires of Four Oaks. Birmingham City Council is the sixth most deprived in the whole country, yet it suffered the biggest cut in local government history—of almost £700 million—with another £80 million to come. Does he agree that what is grotesque about the treatment of a great city such as Birmingham is not just the scale of the cuts—including 12,000 staff gone from the city council—but the unfairness compared with the treatment of some of the leafy shires? Birmingham is high need but is being treated as a low priority.
Andrew Gwynne
I absolutely agree with my hon. Friend. The treatment of the great city of Birmingham has been appalling. The people of Birmingham deserve the resources they need to have decent public services. He has been a feisty champion of the needs of the people of his constituency and that great city and will continue to make that case.
Steve McCabe
If ever there has been a city subject to close Government scrutiny it is Birmingham. For five years, it has been subject to the Government’s improvement panel, so the Secretary of State knows the financial situation in Birmingham inside out. How does he justify forcing up the council tax in a city where 42% of the children are in poverty?
Andrew Gwynne
Absolutely. I will leave it to the Secretary of State to answer that, because I think that Birmingham has been dealt a bad set of cards by this Government.
It is not just Birmingham. Researchers from Cambridge University have exposed the uneven impact of the Government’s funding of local government. They have found that since 2010 changes in local authority spending power have ranged from a drop of 46% to a fall of a mere 1.6%. When we compare these reductions to the indices of deprivation, we see that more deprived areas have been forced to undergo bigger cuts in service spending, with smaller spending cuts in the least deprived areas. Nine of the 10 most deprived councils have seen cuts three times the national average.
These findings are backed by the Institute for Fiscal Studies, which also suggests that since 2016 the most well-off councils have actually seen an increase of 2.8% to their spending power, while the poorest areas have seen very little growth, despite having faced the largest pressures on their services.
Naz Shah (Bradford West) (Lab)
Does the shadow Secretary of State agree that the fact that eight of the 10 councils receiving the largest cuts are Labour-controlled while eight of the 10 receiving the lowest cuts are Conservative-controlled reinforces the need for this Opposition day debate?
Andrew Gwynne
Absolutely. We have to highlight the unfairness. We have to keep on until the Government wake up, smell the coffee and understand the damage they are doing to the fabric of so many communities in England through cutting our local neighbourhood services and depriving people-based services, such as adult social care and children’s services, of the resources they need.
Vicky Ford (Chelmsford) (Con)
Essex County Council is the second largest provider of children’s services by head of population. It has gone from being a failed children’s service in 2010 to now being ranked outstanding by Ofsted, despite there being less money going into the service, but because of a focus on early intervention and partnership working. Does the hon. Gentleman agree that what makes a difference is not just funding for our services but how the money is used?
The Parliamentary Under-Secretary of State for Housing, Communities and Local Government (Rishi Sunak)
How can he disagree with that?
Andrew Gwynne
I can disagree with the hon. Lady because, for a start, funding for children’s services has increased in Essex. She should perhaps check that. If she is saying there is not a crisis in children’s services, she is going against all the evidence put forward by the Conservative-controlled Local Government Association.
Conor McGinn (St Helens North) (Lab)
I thank my neighbour in the north-west region for giving way. He is making an incredibly impassioned and very pertinent speech. Will he join me in praising Labour-run St Helens Council for protecting services through an integrated St Helens Cares model and the creation of a people’s board, but does he agree that even an innovative council that puts its residents first cannot possibly mitigate the funding cuts of 71% that St Helens Council has suffered since 2010? That is simply not sustainable.
Andrew Gwynne
My hon. Friend is absolutely right. I pay tribute to Labour councillors like those in his constituency who are making incredibly difficult decisions. They are the last line of defence for many of our communities, and they are doing what they can, but with both hands tied behind their backs by a Government who simply do not understand the basic economics of the areas that we represent.
Andrew Gwynne
I will give way shortly, but I want to deal briefly with the issue of social care before I begin my concluding remarks.
The largest of the pressures on services remains the pressure on adult and children’s social care. According to the Local Government Association, adult social care services face a £1.5 billion funding gap next year, and £2 billion is needed for children’s services.
Given that the Cabinet are too interested in internal machinations, and given the absence of any leadership from the Prime Minister, we have yet to see the much promised social care Green Paper. In fact, this year’s April Fool revealed himself to be the Health Secretary after he missed his own new deadline of 1 April for the Green Paper—but no one was laughing, because that was the fifth missed deadline, following the summer of 2017, the end of 2017, the summer of 2018, and the autumn of 2018. Despite those delays, it seems that little progress has been made.
There is so much concern in the sector that last month 15 key organisations—including the LGA, the Society of Local Authority Chief Executives and Senior Managers, and NHS organisations and charities—were forced to write to the Government expressing their concern that Brexit was becoming a distraction from any action to deal with the real crisis that is affecting the services on which people rely.
Mr Betts
There are clearly differences between the cuts made in different authorities, but there is a collective view in local government about the crisis in social care. When Councillor Paul Carter, chair of the County Councils Network and leader of Kent County Council, gave evidence to our Committee during our last inquiry into adult social care, he simply said, “We are approaching a cliff edge.” It is possible that some councils will not immediately follow Northamptonshire over that cliff edge, but it will not be long before they do unless there is a fundamental change in the funding of social care in this country.
Andrew Gwynne
My hon. Friend is absolutely right. Let me say to the Secretary of State that if he will not listen to the Chair of the Committee, he should listen to the leaders of his party’s own councils, who are saying precisely the same. There is a cliff edge, and no action that the Government have taken so far has done anything to remove it. It may have pulled a few councils back and given them a few years before they topple over, but unless we fundamentally change the Government’s approach to social care services, we will not be able to solve the crisis in local government.
For the first time in England, we have seen a standard £2,000 tax bill introduced by a Conservative council. We have also seen the costs of the failures of this Tory Government. For instance, the cost of the failure of Tory-controlled Northamptonshire County Council has been pushed on to local people because the Secretary of State allowed it to raise its tax above normal limits as it grapples with bankruptcy. Local people are paying the price of Tory mismanagement: that is what happens when the Tories do not fund local government and are in charge of the town hall.
Austerity is not over, but across the country Labour councils and councillors are showing that it does not have to be this way. Under the shadow of the present Government, Labour councillors are innovating, standing up against austerity, and protecting local services. They are the torch bearers for the new politics that we will see with the next Labour Government. On 2 May, there will be a clear choice: continued austerity with the Tories, or proper investment, fairness and a real change, with Labour councils making a real difference to the communities they represent.
We need a Labour Government because we need a Government who are committed to funding children’s services, funding adult services, funding neighbourhood services, rebuilding our communities from the grass roots up, putting pride back into civic professions, and encouraging our communities to grow and prosper. We will rebuild this country, for the many and not the few. I commend the motion to the House.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
First, I would like to pay tribute to the fabulous work of the council staff in my area and the local councillors of the Conservative party, independents and others, who work so hard to deliver excellent services for our community.
My right hon. Friend the Member for Ludlow (Mr Dunne) made the point that the previous Labour Government moved funding from shire constituencies to metropolitan areas. As a resident of both South Kesteven and Westminster, I thought it would be useful to illustrate the difference between the two. In South Kesteven District Council area, the average weekly gross wage is £453.20, and the council tax for a band D property is £1,589.38 a year. In Westminster, where I am during the week, the average weekly wage is £786.10, and band D council tax is £710.50. This means that the average person in Westminster is earning more than £300 a week more but pays £879 less in council tax for their local services.
Despite the challenges to funding and the fact that if Lincolnshire County Council were funded the same per capita as the average council in the country, it would receive £116 million more than its current budget of roughly £500 million, it has been able to do some very innovative things with its funding. We have discussed the environment a lot this week. South Kesteven District Council introduced “The Big Clean” initiative last year, which visits each village of the district to remove fly-tipping, clean signs, remove undergrowth and do other things suggested by the local residents to improve the environment in which people live and ensure that they can take pride in their surroundings.
Gravity Fields festival, which has been running since 2012, is an innovation of our local council. This goes beyond delivering the basic services; this is the best in the country. It is a festival of art and science inspired by Sir Isaac Newton, who was from Grantham and went to the local school. The festival not only provides the people of Grantham with information on art and science and very interesting experiences, but it raises £1 million for the local area through visitors staying there and spending their money on food and drink and the like. This is a Conservative council doing its best to deliver really innovative stuff, despite having a stretched budget.
North Kesteven District Council, which covers the other part of my constituency, is similar. It has looked carefully at the challenge of being good to the environment while providing the social housing that is required. It has won awards for building curved homes and passive houses, delivering the next generation of social housing in an environmentally sustainable way. It is not only providing basic services but going above and beyond, to provide excellent services. Lincolnshire County Council receives lower than the average per capita funding, as I have said, but it is still providing our children and young people with what Ofsted describes as “strong and effective” services for those with special educational needs and disabilities.
The ageing population presents one of our nation’s most profound challenges. It raises critical questions about how, as a society, we enable all adults to live well in later life and how we deliver sustainable public services to support them to do so. There will be 2 million more people aged over 75 in the next 10 years, and many of those will be managing long-term conditions. It is vital to make sure that local councils are supported to provide for elderly citizens so that they can age with dignity. That is why I am glad this Conservative Government have invested in social care, with a 23% increase in the improved better care fund to £1.8 billion, an additional £410 million through the social care support grant and £10 billion for adult social care being provided to councils by 2020.
I really welcome the additional resources that have been provided for social care by this Government, but as a Member representing a rural constituency it is important for me to emphasise that an extra £1 for social care in London will go further than an extra £1 in Lincolnshire. Rural areas face higher costs for the delivery of public services than urban areas. [Interruption.] The hon. Member for Denton and Reddish (Andrew Gwynne) says from a sedentary position, “That’s not true”, but if one is visiting an elderly person in their home and then travelling on to visit the next elderly person in their home, there is of course a gap.
Andrew Gwynne
I am not saying that is not true; the Ministry of Housing, Communities and Local Government’s own report says it is not true.
Dr Johnson
I hear what the hon. Gentleman says, but it seems to me that rural shires often have Conservative-led local authorities that provide their services more efficiently. In practice, if we ask a carer to go out to visit three elderly people in a morning, for example, and those houses are very close together, as they may be in Westminster, they will be able to visit, spend longer with them and have lower travel costs than they would if they had to visit three houses in my constituency, which covers 433 square miles and is all within the same county council.
As I was saying, when it comes to social care, this problem is in large part due to both the demographics and the distances involved. As I have said, my constituency spans 433 square miles and has a low population density, and there are longer travel distances for staff to deliver care. Furthermore, Sleaford and North Hykeham, as a rural area, has a higher number of older residents. Those older residents have worked hard their entire lives and now need support from our public services to ensure that they can maintain a higher quality of life.
However, this is not all about funding. Actually, I think it is sad that so much of the debate has focused almost entirely on who is going to provide the most money, while only a little bit has been on how to pay for it, and not so much on innovation and quality of care. The important thing is not shouting about who can spend the most money, but who can deliver the best outcomes and provide the best care for people, because that is surely what everybody on both sides of the House wants.
Last year, there was the launch of the National Centre for Rural Health and Care in Lincolnshire. This is a grouping of the NHS, the University of Lincoln, Health Education England, Public Health England and the East Midlands Academic Health Science Network. This pioneering group will look at improving how we deliver care in local areas.
There is also the social care and digital innovation programme, which is run by NHS Digital. This gives money for local projects, so somebody with a local project that they think could improve care for residents, if they had a little bit of start-up funding to test it, could receive money to support the design and trial of digital solutions to improve care and provide value for money. Previous projects include an exoskeleton device in the Isle of Wight to give people greater independence, and the provision of Amazon Alexa in Hampshire to help people to maintain independent living.
There are other projects, too. In Cornwall, Peninsula Community Health Services is looking at how to prevent pressure sores. We know that 500,000 people in this country develop a pressure sore every year. These are excruciatingly painful, can become infected and, in the worst cases, can lead to such a serious infection that the patient dies. The continuous pressure monitoring technology devices will be able to help people identify hotspots even before the skin damage occurs and prevent that from happening. That is an investment in something that, overall, will not just improve patient care but save money.
The Leeds Care Record looks at how information can be shared—data protection means that in some cases it is difficult to share information held by hospitals and GPs—and how referrals are made. When I first qualified as a doctor, all the letters were dictated and signed, but now they are typed and sent electronically. Cumbria, for example, saves £400,000 a year by sending referrals electronically. That also saves time, which means not only saving money but improving the efficiency of the service delivered to patients.
I am glad that the Government acknowledge the need to change the outdated funding formula, which has failed accurately to recognise the discrepancy in need between urban and rural areas; that need is often hidden in rural areas. As Ministers review the consultation findings, I hope they will ensure that the new funding formula adequately takes that into account.
Finally, as a member of the Conservative party, which has long been the best custodian of the public finances, I say that it is imperative that money is spent both wisely and efficiently. The issue of social care goes much wider than just funding. Despite the challenges facing local councils, I have seen at first hand how the brilliant work by North and South Kesteven District Councils and Lincolnshire County Council can support the people in my constituency and make our resources go as far as possible.
Caroline Dinenage
I am just going to make a bit of progress.
The hon. Member for Glasgow North East (Mr Sweeney) highlighted the difficult choices we have had to make. By painting an even bleaker picture of how things have panned out north of the border, he showed just how difficult those choices have been.
The hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) spoke movingly about her constituents, Paul and Lily. She was right to highlight the very personal cases and individual stories that every single one of us comes across in our constituency casework. If she wants to send me more details, I am happy to raise the issue with my colleagues at the Department for Work and Pensions.
The population is ageing. The number of people aged 75 and over is set to double over the next 30 years, and the number of people of working age with care needs is also growing. Some of today’s speakers have painted a picture of a social care system that is broken as a result of a lack of funding, but the truth is that while money is undoubtedly tight, if we are to face the challenges of an ageing population, we need to do more than just put more money in. We need a large-scale reform of the system if we are going to face the future with confidence that we can care for and support those who most need it. In the short term, we have put in around £10 billion of additional funding, but we will be bringing forward an adult social care Green Paper that will look at the long-term funding of adult social care.
Question put and agreed to.
Resolved,
That this House notes that despite the Prime Minister announcing that austerity is over, local authorities’ spending power per household is on course to fall by an average of 23 per cent by 2020, and that nine of the 10 most deprived council areas in this country have seen reductions that are almost three times the average of any other council under this Government; recognises that this has resulted in social care budgets in England losing £7 billion; further notes that at the last General Election Labour committed to a fully costed plan to invest an additional £8 billion in social care over this Parliament; and calls on the Government to ensure that local authorities and social care are properly and sustainably funded.
Andrew Gwynne
On a point of order, Mr Deputy Speaker. I am really pleased that the practice of having Opposition day debates has resumed, although it is regrettable that the Government’s practice of not voting on them seems to have resumed as well. This implies Ministers’ acceptance of the motion, and that they are acknowledging unfair cuts impacting on the most deprived communities and the social care crisis. What can be done to bring Ministers to the Dispatch Box, in the terms of the motion before the House today, before the local elections so that they can set out how they are going to solve the funding crisis?