HC Deb 14 April 2000 vol 348 cc669-76

Motion made, and Question proposed, That this House do now adjourn.—[Mr. McNulty.]

2.32 pm
Mr. David Amess (Southend, West)

Social services in Southend are in crisis. That view is not mine but that of the all-party delegation that met the Minister of State, Department of Health, the hon. Member for Barrow and Furness (Mr. Hutton), on 10 January. I was asked to join the delegation, so many of the opinions that I shall share with the Minister for Public Health are not mine, but those of the Labour and Liberal-controlled council. The Minister of State's heart belongs to Southend. He comes from the town and was educated there. [Interruption.]

Mr. Deputy Speaker (Sir Alan Haselhurst)

Order. I am sorry to interrupt the hon. Gentleman, but the hon. Member for Newbury (Mr. Rendel) must not hold a discussion in the middle of a debate.

Mr. Amess

The Minister of State listened courteously to everything that was said in the meeting and I want to share with the House the details and what has happened since. It is no exaggeration to say that a growing number of Southend residents depend on what the Minister for Public Health is able to say today. Unfortunately, the situation has grown somewhat worse since our meeting on 10 January.

Before the meeting, I was supplied with a detailed briefing which I shall summarise. The council budgets to spend overall at the standard spending assessment level. The political complexion of Essex county council has changed and is still in doubt. People often say that things are not as they wish when they take over, and Southend would argue that things were not in a good way when it became a unitary authority. The council says that it is budgeting to spend at SSA level on education in 2000–01. It recognises the budgetary pressures in respect of social services and affords priority to the service by spending above the SSA. I think most Members know how the SSA is calculated, but many of us would argue with the way in which it is calculated. The Government, and the Minister of State specifically, invited representations on that.

The difference between Southend's SSA and projected spending on social services in 2000–01 is approximately £1.5 million, which is a considerable amount. Many people think that Southend is a wealthy area with no social problems; if only that were so. The Government obviously realise that it is not, because they supported the town's bid for objective 2 status. Southend has a growing transient population from London. As a Londoner myself, I do not want to be too heavy-handed with London authorities, but many of their challenging problems seem to be arriving in Southend. Southend argues that it is not being given the resources that would enable it to cope with those problems.

As the Minister will know, having presumably been briefed, the main pressures on our budget relate to learning disabilities and looked-after children. Both show a high level of spending above the SSA. In respect of learning disabilities, an increasing number of service users are qualifying for care as a result of increased life expectancy, ageing carers who are becoming unable to cope, and a perceived high proportion of service users in Southend compared with the average.

Meanwhile, an increasing number of children need to be looked after. As the Minister will know, we have no home in Southend to look after them. I have no easy answer to the problems caused by children who will not go to school. Often they are the children of single parents, who say that they cannot control them. We have no secure residential accommodation for such children.

We are working with South Essex health authority, but we feel that, because we are under-resourced, we cannot chip in and help with its problems. The budget desegregation that led to the redistribution of funds to deal with mental illness left the borough with a further problem: schemes that it inherited did not match the grant allocated by the Department of Health, and there was a shortfall of £52,000.

A number of cuts have been made. During the 18 years of Conservative Government, Labour and Liberal Members of Parliament used to criticise cuts, so I do not think it dishonest of me to share with the House the brief that I have received from the Labour-Liberal council telling me all about the cuts that it has made. Three of our six residential homes have been closed, which has saved £1 million, and a fourth has become a rehabilitation and respite care unit. The children's and young persons' division has been restructured, which has saved £300,000.

There has also been a large increase in home care charges. I have received many letters about that—local residents are facing extra charges for meals on wheels and all sorts of other services. The introduction of a new charging policy, extending charges to day care and other areas in 1999–2000, will apparently raise about £250,000; management has been restructured, and that will save £50,000. The situation is already serious, and, having analysed the projections for next year I believe that they will lead to further cuts.

I had an exchange in the House with the Minister's colleague, the Under-Secretary of State for the Environment, Transport and the Regions, the hon. Member for Stretford and Urmston (Ms Hughes). She obviously does not know Southend as well as I do, and depended on briefing. I do not criticise those who briefed her, but it was slightly disingenuous of her to criticise the council for the under spend of £31,000. When the Minister—who, I know, will not have time to reply to me fully today—looks at the figures, she will see that the money was ring-fenced and the £31,000 could not be used. In any event, it was a drop in the ocean of the overall shortfall.

The Under-Secretary said that the Conservatives could not even be bothered to present an alternative budget, and Labour Members cheered. It was not like that, but one of the problems with being in opposition is that the Government always get the last word, so it is difficult to come off best.

For the following year, the council will have to authorise a number of cost-reduction measures. I am worried that it is keeping a number of posts vacant. The director of social services will have a vacancy factor of £118,000. That is all well and good, but local residents will be very concerned if there are cuts in any key areas.

In its best value review, the local authority identified various savings: there will be independent sector efficiency savings of £89,500; the mental health grant and independence grant will be redistributed, which will contribute a further £57,500; under a review of social services establishment, a senior practitioner will not be replaced, saving £16,000; changes to the reception area of Queensway house and Royce house will save £25,000; equipment store downgrading will save £20,000; a training scheme downgrading will save £24,000, and so it goes on. The headlines will refer to cuts. I do not incite people to write letters, but I would be failing in my duty if I did not represent the views of the local groups that write to me, so umpteen letters will find their way to the Minister's office and to her ministerial colleagues.

Some of the letters that I have received about what is happening on the ground are very worrying. On 31 January, social services introduced a new charging policy for non-residential community care. Instead of a flat rate of £10.85, it was decided to introduce a banded system. Following that new policy, I have had many letters from elderly and disabled constituents whom the council—and perhaps the Government—feels should be able to pay for their non-residential community care. That fear is being stoked up because pensioners are getting only a 75p a week increase.

My hon. Friend the Member for Wood spring (Dr. Fox) is well aware of the terrible problem in Southend. We had a ballot on whether the primary care group should become a primary care trust. Only 31 per cent. of doctors supported it, and doctors cannot be silenced, as we found. The Conservative Government did not try to do that, but we found consultants and doctors extremely challenging. Community care charges will mean a 400 per cent. increase in the weekly bills of local residents. Those people skimped and scraped to put together what they thought would be enough to look after themselves in later life, but it is proving very difficult.

At Southend hospital, 64 beds are blocked, 28 with social services cases. Local home owners are concerned because there is no longer any money for nursing care—it is all residential. I am advised that, as a result of Mrs. Coughlan's case—I know that the Government are appealing against it—any charging would be illegal. A new standard weekly charge of £485.50 equates to £69.36 per day. Private owners are expected to maintain their residents in the private sector on £36 a day. That is ridiculous. They have to maintain higher standards and higher staffing levels on half the amount that the council claims. It is a very difficult situation.

I have had a letter from Southend Rotary Club, which says how upset it is that it seems that the council will not continue to fund Crossroads. I have also had a letter from the treasurer of the Huntington's Disease Association. It is worth quoting. It says that it is disappointed with the treatment we are receiving from Southend Borough Council. First funding for Lulworth Court— which is on the sea front and where residents who are disabled from all over the area enjoyed respite care— was withdrawn causing its closure. It complains about home care charges and says: Crossroads have lost the contract they had in favour of a nursing agency which is hardly the same thing. Crossroads gave a unique service which will now be lost. I have had many other letters from people complaining about that.

I have also had a long letter from Southend Mencap, which has tremendous problems with day-centre charges. It says: We now have the evidence that people in the same Day Centres, receiving the same benefits and receiving the same training programmes, are to be charged by the Southend system but not by the Essex system. How crazy are things when such nonsense can be allowed? Southend Mencap says: We are aware that Government guidance gives local authorities discretion to make charges, with an implied threat that if they fail to do so their SSA could be affected adversely. This is at the root of the problem. I know that some hon. Members may groan about it, but I have had some detailed representations about the situation concerning asylum seekers in Southend. Some hon. Members might say that some constituents are prejudiced, but anyone who knows Southend knows that it is a very caring, Christian area in which to live. Every week, churches raise money for Mozambique and so on, but the council feels that it has an impossible situation to cope with.

Earlier in the year, the council said that it had 447 "nationally assisted" asylum seekers. First, the number in total was between 700 and 1,000. Now it looks as if it is well over 2,000. The Minister of State, Home Office, the hon. Member for Hornsey and Wood Green (Mrs. Roche), is visiting Southend on 9 March, I believe.

The local authority's report goes through all the pressures, not just on schools and on policing but on social services in particular. I know that the Minister will not have time today to reply in detail to the matter, but the local authority is concerned that the grant will not be honored in total. It has had word that the national budget is overcommitted and that grant claims may not be met in full.

There we are. I say it again. It is not the hon. Member for Southend, West saying that social services in Southend are in crisis—we all have better things to do with our time than to keep moaning about things—but the people whom I represent. The plea is coming in particular from councillors in Southend.

I hope that the Minister, if she is not able in the short time available to go into huge detail about the problems, will at least speak to her colleagues. Please, please, please will she do all in her power to help my constituents? 1 represent an ageing population. It is ironic, considering the matters that we have just debated. Life is very precious. All local residents, regardless of their age, are entitled to decent treatment, particularly from social services in Southend.

2.49 pm
The Parliamentary Under-Secretary of State for Health (Yvette Cooper)

I congratulate the hon. Member for Southend, West (Mr. Amess) on securing the debate. I undertake to pass on many of the detailed points that I will not be able to answer in the time available to the Minister of State, Department of Health, my hon. Friend the Member for Barrow and Furness (Mr. Hutton), whom I know he has met before to discuss the issue.

There are substantial numbers of men, women and children in local communities throughout the country for whom the social services provided by local councils are extremely important. The care and support services provided to those people are many and varied, ranging from meals on wheels for elderly people living at home to help at home for people suffering from physical ill health and residential care for vulnerable children who may be in danger at home.

Social services are also significant because of the £10 billion or so of public expenditure incurred annually in providing them. Bearing in mind the demands placed on such services, it is important that we—both local and central Government—obtain maximum value for every pound spent on them. The Government's best value policy aims to ensure that that happens.

The hon. Member for Southend, West has raised some specific concerns about the funding of social services by Southend council, and I shall address as many of them as time allows. I know that he was a member of a delegation from Southend that met my hon. Friend the Minister of State on 10 January to discuss those concerns. First, however, I shall place the funding of Southend's services in context by saying a few words about social services funding generally and the funding that the Government have made available for improving social services.

The Government made the funding of social services a priority in the comprehensive spending review that we undertook two years ago and for which the settlement was announced in July 1998. We guaranteed that for the first time, the funds available nationally would increase in the following three years, so that local councils could plan ahead knowing what resources would be available. In the three years covered by that spending review, social services will receive an additional £2.8 billion, which means an average of more than 3 per cent above inflation each year. That demonstrates in a very real way the Government's commitment to improving those services.

Our White Paper "Modernizing Social Services", published in November 1998, set out what we intend to achieve with those additional resources in partnership with local government. Both the Government and local councils are keen to ensure that the funds provide real benefits for vulnerable people who depend on social services. To that end, last year, we introduced three new grants to promote independence in the community, and another new grant to improve the quality of children's services. We also provided substantial increases in the mental health grant and the training grant, to both of which we attach great importance. Taken together, that is a substantial injection of cash for change, directed through grants and carefully monitored to improve performance.

We are now in the second year covered by the comprehensive spending review settlement, and local councils will receive an additional £492 million for social services, which is an increase of 5.6 per cent. in cash terms, and 3.1 per cent. in real terms.

Those substantial additional resources have enabled us to increase the personal social services standard spending assessments by 5.1 per cent; the quality protects grant for children's services by £45 million, which is an increase of almost 60 per cent; the mental health grant by £13 million; and the training grant by £3.5 million. At the same time, we have maintained the overall funding that we provided last year for the three grants for promoting independence. All local councils, including Southend, are benefiting from those significant increases in resources.

As for the funds available specifically to Southend for social services, Southend's standard spending assessment increased by 10 per cent. last year, and by a further 5.7 per cent. this year, to £34.3 million—well above the national average increase and substantially above inflation. Additionally, there are substantial increases this year in the special and specific grants that we are making available. Last year, they totaled £1.7 million. This year they are increasing by 12 per cent. to about £2 million. I should also emphasise that the increases in provision have been reflected in actual spending by the local council, which increased its personal social services spending by 10.5 per cent. last year, and will increase it by a further 4 per cent. this year.

Overall, therefore, the Government have increased the resources available to Southend for social services by £5.1 million-16.5 per cent—over the past two years, which is a substantial increase well above inflation.

Southend is a new unitary council that took on social services responsibilities when it came into being two years ago. During that time it has made significant progress overall, modernizing through the use of the new grants. Sharpening the focus and impact of the grants has been part of the new performance appraisal arrangements that the Government introduced last year. Like others, the council has been supported and evaluated by social services inspectors and NHS regional officials.

As I speak, a review is being conducted by a joint team from the social services inspectorate and the Audit Commission to establish how well the council and its partners are discharging their social services responsibilities for the benefit of users and carers, and whether they are doing so in the most effective way. Under this Government, such reviews have become important vehicles for stimulating necessary changes. Monitoring, inspection and review in a five-year cycle are the elements of our new system for assessing social service performance.

The House will be pleased to know that this first year's appraisal of Southend council's performance shows that real progress has been evidenced in plans submitted to the Department of Health. That progress covers the quality protects grant for children, which is a quality-directed initiative; specific partnership grant schemes for adults promoting independence and ensuring appropriate discharge from hospital; and the relief of carers in the new carers grant, the aim of which is to allow them more breaks.

In work with children, there has been progress on a number of fronts. Southend submitted a strong second-year quality protects management action plan in January. Fifty of its quality protects targets have been met, despite difficulties in the recruitment of social workers. Each child now has a named social worker and 100 per cent. of cases are reviewed, which is an improvement on last year's performance. More than 20 extra carers have been recruited, and a review of all children for whom adoption is planned has been completed. That ties in with a new consortium that Southend has joined, which has increased the numbers being adopted.

The council has taken the Government's emphasis on its parenting responsibilities seriously. There are new forums for the education and health of looked-after children, and close liaison with the education department. The department has arranged for the secondment of a public health doctor, who has produced a blueprint for how health and social services can co-operate better to give looked-after children more attention. The social services inspectorate has noted that as an example of good practice. Work with adults has produced similar significant progress in a number of areas.

From the performance appraisal it is clear, as the hon. Gentleman said, that Southend has many people with learning disabilities receiving services. The Government are currently giving serious consideration to services for people with learning disabilities. The range and quality of services available to people with learning disabilities, their families and carers can vary widely from one part of the country to another. We are developing a new learning disability strategy. Our aim is to eliminate inconsistencies in service delivery across the country and to ensure that all services reach the level of the best.

Our strategy is to consider a wide range of issues, including services for people with learning disabilities who are living in the community. Work on the strategy is being taken forward in six small groups, each looking at issues related to particular topics—children, health, supporting independence, family carers, work force planning and training, and building partnerships.

Service users are contributing to the work, and the strategy is due to be published by the end of the year. The NHS and local authorities have been asked to prepare joint investment plans for people with learning disabilities from April 2001. That will provide a practical means for implementing the learning disability strategy and an excellent opportunity for the NHS and local authorities to consider how the flexibility in the Health Act 1999 can best be used to improve outcomes for people with learning disabilities.

The hon. Gentleman has expressed concerns about the funding of Southend social services. I am sure that he appreciates the effort being made by the council to focus spending in the positive way that the Government have laid down. The publication of performance indicators by the Department last October has indicated how the council may use its resources more effectively, but it is clear from the performance appraisal that it has engaged positively with the efficiency agenda and made progress throughout this year.

When the hon. Member for Southend, West and his delegation met the Minister of State, my hon. Friend said that he would consider allocating additional mental health funds from the under spend on last year's mental health grant if the authority could make a suitable case. I understand that, because of recruitment difficulties, the authority did not submit a case for additional funds and informed us of an under spend totaling £31,000 from the mental health partnership fund, which was the figure referred to by the Under-Secretary of State for the Environment, Transport and the Regions, my hon. Friend the Member for Stretford and Urmston (Ms Hughes).

The hon. Member for Southend, West referred to asylum seekers. Last month, the Department made a payment of £49,000 to Southend-on-Sea, fully reimbursing the council for the costs that it had incurred in dealing with unaccompanied asylum-seeking children.

The evidence is that in its first two years Southend has made every effort to make proper use of the additional funds made available and the support and guidance provided by the Government. The council has difficult choices to make, but it is not in crisis. It is making strides in delivering cost-effective services, which we are actively monitoring, and my Department will continue to help the council to make the best use of its increasing resources.

Question put and agreed to.

Adjourned accordingly at one minute past Three o'clock.