There has been quite a varied reaction from constituents who have got in touch following the Prime Minister’s announcement to reform Health and Social Care funding. While I find it difficult to vote in favour of tax rises, the social care sector has been crying out for a sustainable funding package for at least the last 20 years. There is no perfect way to meet this funding requirement, and the attempts of previous governments to bridge this gap with a more ‘soft touch’ approach have not been successful.
I am pleased that we are finally addressing this long overlooked issue within social care, but we must be sure that this is not just more money which is consumed up by inefficiencies in the health care system, it must deliver value for tax payers. Similarly, we must ensure that the other parts of this industry are not overlooked. Local Authorities play the largest role in providing social care for children and working age adults, this represents about two thirds of social care spending. Local Authorities and the other charities and private sector providers must be fairly included in these reforms to ensure this both delivers quality of service for those receiving support and value for money for those who are going to be contributing more through tax.
You can read my full contribution to the debate below:
The key issue for me is not so much with raising the funds—there are no perfect solutions for that—but with the spending of them. I am more than happy to look my constituents in the eye and say “I voted to raise taxes” if I can demonstrate that we have something to show for it. Those of us with a local government background will know that the social care sector has been crying out for a sustainable financial settlement for at least two decades.
The fair access criteria that were implemented by a Labour Government in 2003 precipitated a financial crisis in a sector that was already under pressure by removing local authority discretion over services and failing to provide the funding for the new model, and charging policies and council tax precepts have proved unable to bridge that gap. As a chairman of a social services committee in those days, I looked my local residents in the eye while imposing Labour’s charging policy for social care on them, so I welcome the Government’s courage in bringing forward a proposal that looks both realistic and workable.
Does my hon. Friend, with his local government background, think that this policy will fit within a wider local government finance reform agenda?
My hon. Friend is absolutely correct to highlight that wider reform agenda. I know we are anticipating more detailed proposals from the Government in due course, but it is clear, as he will know from his local government experience, that if we in this House are serious about fixing social care—much of which is not about the elderly, but about working with adults and children with disabilities—we must learn the lessons from the sector of several decades of change.
First, we must reflect on the lessons of the better care fund, which taught us that councils have been the efficient delivery partner. Even when the sole focus has been to relieve pressure on the NHS, councils have been much more efficient on the whole in using those funds. We must avoid, as many Members have said, that convenient political mistake of allowing all the money to disappear into an NHS black hole with nothing to show for it. However, having learned the lessons of the better care fund, we have to ensure that those additional national insurance costs do not consume the extra funding. I have heard Ministers’ assurances about this, but the care sector has heard many times of new funding that has been cancelled out by deductions from other budgets, so we need absolute clarity that this will find its way to the frontline.
The second point I would like to highlight is that this does not just affect the elderly. About two thirds of social care costs are for working age adults and children, and the NHS is barely involved in many of those cases. However, the costs can be eye-wateringly high, so we need to make sure that as we direct those funds, as my hon. Friends have highlighted, they are getting to where they are required.
The third lesson, which has been mentioned by a couple of Members, is about how the market responds. We have a thriving market for social care in this country, including charities, the private sector and local authorities. We know many of those organisations will see the £86,000 as a very tempting target: the sooner someone spends their £86,000, the sooner the state steps in. We need to ensure that we have learned the lessons of what has happened with the involvement of some businesses, particularly in the children’s social care sector, and make sure this is not seen as simply an opportunity to rip off the taxpayer.
Finally, may I urge Ministers to review the operation of the fair access criteria and the rules that underpin them? The rule of provide for one and provide for all, which was clarified by a subsequent judicial review for the London Borough of Harrow, forced the retrenchment of local authorities in adult social care towards serving only the most critical needs of people in our constituencies.
My hon. Friend is giving an excellent speech. One thing he has touched on, but perhaps not expanded on, is the efficiencies that local government has found. Are there any particular lessons that he thinks are relevant to the NHS as we move forward?
Concluding rapidly, Madam Deputy Speaker, that is a very important point. We need to recognise, as many constituents are surprised to discover, that as a matter of law very strict eligibility criteria restrict what they can access. We need to ensure, as we reform the sector, that we free up local authorities to use these resources to meet the demographic challenges.