Examination ofWitnesses (Question Numbers
80-99)
MR DAVID
BEHAN, MR
JOHN BOLTON,
MS ALEXANDRA
NORRISH AND
MR JEFF
JEROME
29 OCTOBER 2009
Q80 Dr Taylor: When do we expect
Ipsos MORI to give us this sort of report or to give you the report?
Ms Norrish: We need obviously
to give them the time to do the analysis. We do not have a publication
date set yet but I imagine it will be in the New Year.
Q81 Dr Taylor: You have mentioned
the theoretical footfall at the roadshows. At your 36 events what
sorts of numbers of people did you actually get coming to those?
Ms Norrish: We have had anything
between 80 and 100 at the majority of them. We deliberately set
them so we had a Thursday afternoon, a Thursday evening, a Friday
and a Saturday morning event in each region so that we could reach
as wide a range of different people as possible, so, in particular,
carers and working people who could not make normal working hours
events were able to come to the Thursday nights and Saturday mornings.
Thursday nights were often smaller but often very, very good discussions
whereas the other events tended to be larger.
Q82 Dr Taylor: I am still completely
puzzled why I have missed out on these entirely. So out of these
36 how many would have been in the West Midlands?
Ms Norrish: Four.
Dr Taylor: I still feel terribly guilty
about this. I would love to know if other people have attended
these or knew of them.
Sandra Gidley: No.
Q83 Dr Taylor: Everybody is shaking
their heads so we who should be aware of these sorts of things
were not.
Mr Behan: My understanding is
that all MPs were written to. I will check that immediately I
go back to the office. If Richard is worried he has missed out
we can advertise the events on 3 and 4 November in Brighton and
London respectively and if MPs feel they have missed out they
have the opportunity to come and attend one of our final events.
What you will see, just to expand the answer to Richard, is that
a lot of the events are interactive, they are discursive and we
ask people for instance to give their comments freely using different
media. We then ask people whether they work in social care or
they are a carer or they are a person who uses services to identify
that by virtue of a coloured spot, and Ipsos MORI will then try
and segment the views we are getting based on whether people are
using services, caring or working in those services and so the
richness of the data. That is why it will take them some time
because it will not just be a quantitative assessment "we
had this many in", but there is some attempt to get into
the richness of the information.
Dr Taylor: I would love to know if I
did receive something.
Chairman: Can I just say, Richard, I
knew about the further consultation and the other Rotherham MPs
and I have sat down with the Rotherham Pensioners Action Group
and discussed it in detail and they submitted evidence in and
they sent it to me as well.
Q84 Dr Naysmith: Have you had one
in Bristol?
Mr Behan: Yes we have.
Q85 Dr Naysmith: Have you had one
in the South West?
Mr Behan: We have had four in
the South West. There have been four in every region.
Q86 Sandra Gidley: Some of the regions
are very big though but I think we need to move on. Alexandra
Norrish, can you briefly explain to us the choice that the Green
Paper poses between a fully national model and a part local/part
national model?
Ms Norrish: When we designed the
funding options around the Green Paper and when we were having
the discussions with people last year, one of the big issues that
people told us about was the postcode lottery that meant that
people in different areas received different levels of funding,
and so the Green Paper contains two options around ways in which
you could design the funding system to move towards the National
Care Service and really the question is how national is the National
Care Service? The fully national option involves central government
setting the level of funding that people with a particular level
of need and who need a particular outcome would receive. It is
closer to the Attendance Allowance model in that it would be something
like a national tariff whereby that individual would know that
they were going to receive £200, or whatever it might be,
and then if they move to a different part of the country they
would continue to receive that same amount of money. This ties
into the portability proposals in the Green Paper so essentially
your care is standardised wherever you are. You could flex that.
There would be a formula that would mean if you were in a more
expensive area you would get slightly more, et cetera. That is
the fully national option and the implication of it is that it
would have an impact on council tax. If you are essentially telling
local authorities how much they have to spend on each individual
in their area then it is no longer fair to expect them to be contributing
to that cost through raising their own council tax, so you would
have to reduce the level of council tax and raise more funding
at national level. The part national/part local system is closer
to what we have in the current system and it retains more local
flexibility and retains the ability of local areas to raise council
tax towards their own priorities if they choose to. So what would
happen would be that the individual would still have their assessment
which would be carried out in the same way wherever they were
in the country. They would know they had a right to have their
needs met but then the local authority would be responsible for
identifying exactly how much money that particular individual
was going to get in that local area in order to meet their needs.
The advantage of that is that it gives you the local flexibility.
We have had some people, particularly people working in local
authorities, telling us that in their areas the costs of care
vary literally street-by-street or village-by-village and so the
part local/part national option enables the system to be more
responsive to that whereas the disadvantage of it of course is
that it retains the fact that people would be getting different
levels of funding depending on where they lived which they may
still perceive as a postcode lottery.
Q87 Sandra Gidley: Even if you have
a part national/local model there is still going to be the right
to a national assessment and you mentioned the portability. I
am not quite sure how that is going to work in practice if you
have got these local variations. Is there going to be a points
system for allocating resources?
Ms Norrish: One of the things
we will look at in the run-up to the system is exactly how you
would design that new eligibility system. There are many different
ways that you can run a system of that sort. For example, Attendance
Allowance has consistent national self-assessment right across
the country. Looking around the world there are examples. Japan
does have a points-based system for example and I think France
is based almost entirely on self-assessment, so there is a whole
range of different approaches that you could take.
Chairman: Mr Jerome, welcome to our first
evidence session! I am sorry you have been sat there in complete
silence for one and a half hours now. Stephen?
Q88 Stephen Hesford: Good morning.
I do not know whether these questions are personal or what but
these are the questions. Can you in effect explain yourself, what
is your relationship to the DH? To whom are you accountable? Is
it the Secretary of State? Is it some kind of consortium of quangos?
What is the position?
Mr Jerome: It is the latter. My
role is one created on the back of the Putting People First concordat
which hopefully the Committee knows about in terms of the agreement
between central and local government and other key partners to
actually try and move forward on a "partnership co-production",
is the term but I am trying not to use that one because it is
not a very user-friendly term, in the spirit of working across
the partnership to move the Putting People First agenda forward.
The thinking was that if we can create a role that works particularly
from a sector-led basis (a sector being local government in this
particular case) but accountable, if you like, to a partnership
between local and central government that the sector will be able
to encourage itself on the delivery side to move forward. I am
predominantly working on the local government side to a partnership
of the Local Government Association and the Association of Directors
of Social Services and to the Department of Health but I am not
accountable to the Department of Health; I am accountable to a
consortium of those three organisations and I link to the Putting
People First programme board which is chaired by John Bolton.
Q89 Stephen Hesford: So are you ultimately
accountable then to the Secretary of State for DCLG? Is that how
it might work?
Mr Jerome: No, I am not accountable
to any Secretary of State. I am accountable to the organisations
that could be accountable to two Secretaries of State in fact.
Q90 Stephen Hesford: Targets have
been set in this area. What powers are there to oblige local authorities,
as commissioners and providers, to meet them?
Mr Jerome: If you are talking
about the targets being the ones that we have set out particularly
in the Milestones document that we recently sent to local authorities,
what we are trying to do is to say there is a concordat, we support
this direction of travel absolutely and totally on the local government
and Association of Directors side, and we think it will now be
helpful in terms of creating some pace in terms of progress to
set out some markers that we think local authorities need to work
alongside.
Q91 Stephen Hesford: But in simple
terms what are those milestones and targets?
Mr Jerome: They are milestones
as opposed to targets. It is the definition of a target. They
are not part of the performance regulatory regime, if that is
what you mean, but we are expecting that people will try and meet
those.
Q92 Stephen Hesford: What are they?
Mr Jerome: There are five areas
basically. There is one around engagement and partnership. It
is partly a leadership approach, how well are councils and their
partners, particularly users and carers, engaged in creating this
programme to make clear what the programme is, to be involved
in decisions about the programme, et cetera. We have got another
on investments in prevention and intervention services so that
there is some evidence around the way in which local authorities
are investing in preventative services and targeted intervention.
We have another that is relating to the operating model, if you
like, the system that creates personal budgets for people. I usually
explain that as everybody getting the public sector offer, public
sector money, knows the pound sign associated with that. That
is the personal budget. We have put down a marker on that one
particularly that we want local authorities to hit 30% of those
people who receive council services having a personal budget or
a pound sign by 2011. The other one is around information and
advice, and you have heard a bit about that already, so that there
are clear programmes and clarity about access to information and
advice and actual evidence that there is good access to information
and advice by March 2011. Then finally there is one about commissioning,
particularly with the NHS and other partners, around the sorts
of areas including the efficiencies that arise from that over
the next 18 months of the programme.
Q93 Stephen Hesford: And consumer
resistance to any of your milestones; which is presenting a problem,
if any?
Mr Jerome: I do not think there
is any resistance. There is clearly concern in some quarters about
certain aspects of that. I think the two I would probably pick
out are some people would probably be concerned about their ability
to meet personal budgets targets by 2011 and the other area is
probably in relation to the NHS, how easy it will be to get the
NHS to work alongside local government in that timescale and getting
that matched together. Those are the things that come back to
me most from local authorities.
Q94 Stephen Hesford: Finally, are
you familiar with the Adult Social Care Reform Grant?
Mr Jerome: Yes.
Q95 Stephen Hesford: Is that a factor?
Is that helping?
Mr Jerome: Is that helping? Yes.
That has gone to local authorities and to regions and there are
regional programmes both through the Regional Efficiency Partnerships
but particularly in this case through the Joint Improvement Partnerships
that are chaired generally by directors of adult social services.
They have all got programmes in relation to Putting People First
and there is also money in local authorities. What we know from
our survey last year is that local authorities are using that
productively both internally and externally with providers to
move this programme forward.
Q96 Chairman: Could you just confirm,
is the Secretary of State ultimately responsible for what the
Government call the Social Care Transformation?
Mr Jerome: Well, it is a policy
objective.
Mr Behan: I am not sure whether
you want me to come in, Chairman.
Q97 Chairman: I was asking Jeffrey.
I just wanted a yes or a no to that question.
Mr Jerome: Yes it is and David
can give the answer.
Q98 Dr Taylor: Can I go back to some
of the definitions of terms used by the Government some of which
we have used and heard about already. What do you understand by
"personalisation"?
Mr Jerome: You have heard it already
but effectively it is setting out care and support services around
individual needs rather than always doing it on a collective basis.
That is probably the simplest way to put it.
Q99 Dr Taylor: "Self-directed
support"?
Mr Jerome: Similarly it is a concept
where ideally individual users or their carers will be in charge
of the arrangements that are put around people, bearing in mind
not everybody has full capacity so there are things that you may
need to put in place to assist that.
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