Health and Social Services (Co-operation) (Hansard, 2 June 1998)

§ 10. Ms Tess Kingham (Gloucester)
What action he is taking to promote close co-operation between health and social services. [42185]

§ The Secretary of State for Health (Mr. Frank Dobson)
We have made a good start in breaking down the Berlin wall between the national health service and local social services. Last winter, the national health service coped better with emergencies than in any recent year, because of the close working relationship between health and social services, which we promoted, and funded by the extra £300 million that we provided. In Gloucestershire, that included more than £1 million—one fifth of which went on social services to provide, for example, improved out-of-hours service, respite care and holiday cover.

§ Ms Kingham
My right hon. Friend correctly alluded to Gloucestershire, where, last winter, health and social services teams worked closely together to avoid a winter crisis and to prevent patients from having to lie on trolleys in pain, waiting for treatment. However, in my surgeries I receive many representations from carers in the county—especially carers for sick children seeking respite care—who have been frustrated by the previous Government's introduction of fragmentation and competition within the NHS. Can my right hon. Friend reassure those carers in Gloucestershire that the Government will promote co-operation between the NHS and social services throughout the year, so that they can get the vital services they need for sick family members?

§ Mr. Dobson
I can certainly give my hon. Friend that guarantee. It is not that we will be promoting co-operation; we will not tolerate a lack of co-operation.

§ Miss Ann Widdecombe (Maidstone and The Weald)
The right hon. Gentleman has lauded the state of communication and co-operation between the health service and the social services. He will be aware that one of the biggest problems facing social services and the health service is bed blocking. It is impossible to discharge certain patients, because the proper sums of money are not available to social services to care for them. As the right hon. Gentleman is so concerned with proper and constructive co-operation, what will he do to ensure that social services have adequate, identifiable funds to care for those who should not be in NHS beds, and who are thus contributing to the waiting lists which he says he is so concerned to bring down?

§ Mr. Dobson
The fact is that, as a result of the initiatives we took and the extra money that we found, there was greater co-operation last winter between the health service and local social services than at any other time in the past. In the right hon. Lady's own area, as a result of the money that we found, more than 450 extra residential places were provided to get people out of hospital, and more than 400 care packages, as they are called, were provided for people in their homes. That is what happens when people work together. It did not work everywhere, but it did work in the right hon. Lady's area—although she did nothing towards it and has not praised the people who delivered it.

§ Miss Widdecombe
The right hon. Gentleman ought to talk to people in my area. This was a matter of 166 considerable concern to them, and I made representations about it to the trust involved—so he is wrong to say that I took no action, and I hope that he will now apologise for saying it.
I speak not just on behalf of my own area; I have asked the right hon. Gentleman once again a specific question that he will not answer. Can he guarantee that social services—not just last winter, next winter or the winter after that—will have as a matter of course enough identifiable funding to care for people who need not be in NHS beds but who are in them in my area at the moment?

§ Mr. Dobson
The right hon. Lady should know that there was so much successful co-operation between social services and the national health service precisely because I had supplied the funds to the NHS locally; the NHS, in turn, made it a condition of local social services getting the money that they spent it on what we wanted it spent on—in contrast to the traditional Tory system, which was to give local authorities money with no guarantee that it would be spent on the services for which it was intended. That is what we put in place last year. I have freely admitted to our budging our way through the chaos that we inherited. We intend to have in place an altogether better system for the coming winter and future winters—but we will take no lessons from the Tories.