In regard to eligibility, the hon. Member for Worsley and Eccles South asked about portability. It is one of the 76 recommendations in the Law Commission report.
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In the “Vision for Adult Social Care” that we published last November, I said that we are minded to progress the idea of portability in assessments. There is further debate to be had about how we translate that into portability of outcomes and services, and that is one of the issues that we are considering in the White Paper.
As I have said, we have a mixed picture across the country. It does not bear out the simplistic formula of “less money equals more cuts.” Age UK and WRVS are publishing a report which I will read with interest when it comes out. An illuminating report was published in September by Demos and Scope, which looks at how disabled people have been affected by budget changes in local authorities. We might expect to find that the biggest cuts in front-line services are made by the councils that face the most dramatic cuts in their income, but that is simply not the case. Demos’s report suggests that there is no direct cause and effect. The councils that it applauds for coping the best have not enjoyed the most generous settlements, and they are not concentrated in the most affluent areas. Rural and urban areas and rich and poor areas are found in equal measure at both the top and bottom of the table.
There are tough choices to be made in every town hall as well as in every part of Whitehall and in the national health service, but we need the choices to be smart, too, Places such as Tameside have invested in re-ablement services that help people back to independence after a period of illness and ultimately reduce their care needs. Tameside estimates that that saved it £2.3 million, which it then reinvested. Somerset county council has commissioned a number of projects that use volunteers to help people with low and moderate care needs to run their own groups, form friendship circles and keep in touch with activities available in their local community.
The West Sussex-based Carewise service was recognised by Which? magazine as a model of best practice. It helps older people who pay for their care to plan their futures. Planning, which is all too often absent, has been a theme of the debate. The organisation ensures that people get good financial advice. We are talking about improving services through integration, which is another important theme of the debate as is the use of personal budgets. Those budgets are now being rolled out through the trail-blazer pilots for direct payments for social care, for personal health budgets and for personal budgets in respect of Supporting People. Such changes begin to give the individual the opportunity to have a Total Place approach to the way in which they use resources and allow resources to be used to best effect.
When I went to Knowsley last year to see what was being done on integration, the most powerful aspect of the approach used was the fact that it involved thinking about “the Knowsley pound.” And in Torbay, which I also visited, the approach there was to look at everything through the eyes of “Mrs Smith.” It may not be appropriate in every community to look through the eyes of a “Mrs Smith,” but in Torbay it was thought appropriate. Officials in Knowsley and Torbay made the leap in the approaches that they took to see money not as theirs—to be held within the boundaries of their institutions—but as their community’s money, to be spent wisely on behalf of
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their community. That is the essential ingredient in delivering effective use of public money in times of austerity.
That brings me to the case for reform. Despite the funding challenges, there are steps that councils are able to take now to improve social care services and I hope that they will take those steps.
I will talk about reform in detail. I have been in the House for 14 years, so I am now entitled at least to have a sense of déjà vu about this debate, like some other Members who have been in the House for a long time. However, I think we are at a different stage in the debate. We are building on the work that has been done—the listening that has happened and the engagement that has taken place—over many years. Indeed, in framing the terms of reference for Andrew Dilnot, we set him the task of looking at everything that had been done in the past 13 years to ensure that we did not just reinvent the wheel and that we learned from what had been heard already. I am keen that we continue to do just that.
I am also keen that in this debate we address a very important issue about understanding, which is the issue about the nasty little secret at the heart of social care. It is a secret that we MPs all share and know about, but seven out of 10 people in this country do not know about it. It is that social care is not free and in fact has never been free. At the moment, we are in a situation where people look at the proposals that Andrew Dilnot has put forward and he is judged not against the standard of the reality of our experience of social care, which has been so well described in this debate, but against a fantasy of social care that is free, just as the NHS is free. All of us in this Chamber and all of us who have an interest in reform in this sector need to ensure that we do not allow that fantasy to get in the way of judging Andrew Dilnot’s proposals fairly.
That is a key part of how we can ensure that we make progress in this area. Indeed, it is key because of the catastrophic costs that people face. Those costs have been touched on by my hon. Friend the Member for Southport (John Pugh), and by the hon. Members for Lewisham East (Heidi Alexander) and for Luton North (Kelvin Hopkins). They talked about the anger that people feel that they have saved, worked, invested in their lives and been thrifty, only to have it all snatched away at the point that they are in need of support from the system. That issue of fairness is part of what we asked Andrew Dilnot to look at.
I want to make two more comments before I sit down for the concluding speech. There has been talk about the cap, about whether it does anything for carers and about changing the way that the system works. I want to make a suggestion that people need to think about. The cap has to be metered. People have to enter the system and then move towards the cap. The way that we design the meter is the way that we incentivise prevention; the way that we design the meter is the way that we build carers in and respect and value what they contribute. I hope that people will think about that in the weeks remaining before we conclude our process of debate and deliberation, leading up to the White Paper next year, because that is one of the ways in which we can redesign the system to be a system that is about supporting what people can do, that is about enabling communities to support people and that is about enabling families to contribute in the way that they want to.
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My final comment is that I have found this debate to be very helpful and a useful airing of the issues. I hope we shall continue to debate these issues in Parliament and continue to have the debate in the community. But it is not just an open-ended debate; it has to be a debate that is closed and that comes to conclusions. That is what the White Paper is about. The White Paper is the conclusion of 14 years, as far as I am concerned. It is about how we get to the next stage.
I was asked about legislation. Let me just say that it is well above my pay grade to be the one who announces what will be in the next Queen’s Speech; I probably would not be a Minister for much longer if I were to do that today. However, when the decisions are made we will have looked at this process and the White Paper outcomes, and I hope we will be in a position to legislate at the earliest opportunity. Social care has languished and rested in the “too-difficult-to-do” box for far too long. We are the Government who are committed; we see the urgency and the need. I hope that together we can get the cross-party lead that results in the changes that are long, long overdue.
5.24 pm
Sarah Newton: Thank you very much indeed for calling me to speak, Mr Bone.
This has been a really interesting debate and I am very grateful to the hon. Member for Lewisham East (Heidi Alexander), my hon. Friends the Members for Stourbridge (Margot James), for Banbury (Tony Baldry) and for Stroud (Neil Carmichael), the hon. Members for Luton North (Kelvin Hopkins) and for Worsley and Eccles South (Barbara Keeley), my hon. Friend the Member for Meon Valley (George Hollingbery), the hon. Member for Leicester West (Liz Kendall) and my hon. Friend the Member for Southport (John Pugh) for their contributions. There were numerous very helpful and constructive interventions from colleagues who had to join the debate in the main Chamber or go back to their constituencies.
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I think I speak on behalf of us all when I say how much I welcome the tone of the Minister’s response, the commitment to producing the White Paper in April and his clear desire to wrestle with this issue to ensure that it does not disappear into the “too-difficult-to-do” category. He also showed a clear desire to work with all parties and to continue to listen to the concerns of the chairs of the all-party groups, who come from all parties represented in the House, in further dialogue and debate while he and the Government develop their White Paper.
Although we cannot do it in the format of today’s debate, it would be very helpful to hear the Minister’s response to the specific request made by the hon. Member for Leicester West about the nature of the cross-party negotiations that were proposed. That would give us all a great deal of confidence that there was a proper process in place to achieve cross-party support before the White Paper is produced, because that cross-party support would indeed enable the White Paper to have the best possible chance of becoming legislation at the first opportunity, which would allow the Government to start to address these issues.
I thank the Minister for his words of encouragement and I thank everybody who has participated in the debate. And Mr Bone, it will not surprise you that I am sure that as a result of this debate, and because of the number of Members who were not able to get to Westminster Hall to speak in the debate that they really wanted to speak in, you and the rest of the Backbench Business Committee will receive another request to have a further debate on this vital issue in the main Chamber, probably in January, when the work of the Health Committee, which is examining the area of social care funding, is completed and when the Minister has had opportunities to have further cross-party discussions. Thank you, Mr Bone.