§ 11 am
§ Mr. Ronnie Campbell (Blyth Valley) (Lab)
The topic of this Adjournment debate—the closure of old people's homes—is a sad affair. I shall explain how we reached this point. A couple of weeks ago we learned from the newspapers that the last remaining homes— [Interruption.]
§ Mr. Frank Cook (in the Chair)
Order. Would people leaving the Room do so quietly, please, and conduct their conversations outside?
§ Mr. Campbell
My hon. Friend the Member for Wansbeck (Mr. Murphy) and I were not aware of the closures. The news reached us by way of the newspapers. The Journal in Newcastle reported it first. It was a complete surprise to us. Of course, the trade unions and the work force telephoned our offices immediately. I said that I would meet them on the Friday, as soon as I got back from Parliament. My hon. Friend the Member for Wansbeck, who had a home in his area that was to close, said the same.
That was one of the saddest days I have experienced during my 16 years as a Member of Parliament. When I got to the meeting at the home, all the staff were there, even those who were off duty. They had all come to see their Member of Parliament. There were tears all over the place. They would all lose their jobs. Somebody was on their way from county hall to try to fix them up with jobs elsewhere—that is how far advanced matters were. Even the old people were crying, because some of them had been turfed out of a home a year previously and were very upset by the prospect of being turfed out again. I understand that they were to be placed in private homes. The council was washing its hands of care for the aged in Northumberland.
We were not very happy with the situation or with the council. There was a meeting at county level the following Monday which my hon. Friend the Member for Wansbeck attended—I was away that day—at which there were further developments. Voices were raised and concerns were expressed. The next thing we knew was that the closure plan was withdrawn. What annoyed me more than anything was the statement made by the council leader after the closure programme was withdrawn, because it involved the MPs. It stated:Our two MPs have indicated they will help to get better funding for the council and we and local residents will hold them to those promises.That statement was threatening towards the two Members of Parliament, who were only doing their duty. In fact, as I said, we had not been told of the closure plans. That is the sort of thing we had to put up with.
The statement means that whatever the council closes down next in order to make the required savings of £million, the two local Members of Parliament and the Government will get the blame. I do not believe that we can secure any more funding. I hope we can, but I very much doubt it, because in the past two years the local government settlements have been among the best the council has ever had.
95WH I shall try to express the council's concerns as bullet points, without going through all the rigmarole. We all know what this is about: the council wants extra money. It needs to save£7 million in this year's budget. The council says that the underpin cost pressures in social services are £12 million. That is a lot of money. The council goes on to say that the ring-fenced funding has reduced support for the core services. I know what "ring-fenced" means, and I know there is a lot of funding, but the council does not explain how much is ring-fenced. It has not given us that figure. It simply states that the ring-fencing contributes to the pressure and the debt.
The council also says that 60 per cent. of funding in this year's allocation has to be passported directly to education. Whatever happens, 60 per cent. must go to education, and the rest is for the other services. I do not know how the council works out its budget. The councillors sit round the table and work out the budget in their way, but I am not privy to it. But I was a councillor for 19 years before I came to this place, and I remember one year, when Denis Healey was the Chancellor, he was cutting local government spending.
I was chairman of environmental health in Blyth Valley council in those days, and I remember the leader saying, "We have to make severe cuts. I want you—all the chairmen of the departments—to go back to your departments, get to the base budget and cut all the fat you can find. I want the savings reported back here in a fortnight." So I went to the director of environmental health and we started looking for cuts. We decided we did not need to order paper clips that year, or paper or pencils—we went through the whole list. We were due to go to five conferences— the chairman, vice-chairman, various councillors and the officers—but we decided the conferences were not sufficiently important, so we cut them from the budget.
That is what we did in those days. What do councillors do now? I think they just sit there and say, "What's the biggest expenditure? Old people and the adult training centre." I forgot to mention that the adult training centre was to close as well. We have never seen a budget. We have never heard that they attempted to look at the base budget and cut any fat that there might be. If the county council said to me and to my hon. Friend the Member for Wansbeck, "Look, we've cut the fat. We haven't anything left to cut. We are really at rock bottom", I would have no problem with that. I could get on my knees to my hon. Friend the Minister and say that the council had cut its expenditure to the bone.
However, I have to tell the Minister that the council has not told me or my hon. Friend the Member for Wansbeck that it has examined the base budget and cut the fat, like we did in the old days. I suggest that that is what the council should do, if it has not done so already. There are items of expenditure such as car leasing. I have heard that that involves an enormous amount of money, but I cannot find out the figure. I might have to ask the Minister a question and see whether I get the answer. Another item is conferences. There are conferences all over the place and council members are always away somewhere. There are seminars that they attend. These are all headings. One has to ask for the expenditure under each heading, so that one can add them all up. Then there is training—it must be the best trained county council in the land—and of course there is entertainment.
96WH That is what I call fat, and local councillors—may perhaps not just in Northumberland—should start chipping away at that before they announce the closure of old people's homes and adult training centres. That is only fair to the people they represent, who pay their tax and their rates.
I do not want to take too long, because my hon. Friend the Member for Wansbeck wants to contribute. The Minister says that he needs at least 15 minutes. I want to hear what he has to say, because I want to know how much short the council is and how much we can get off it, if we can get anything at all. The council says it is in a dire situation. I do not think that it has done enough. I have said what I want to say—enough said. The council might take note of my words; it might not. I know the Minister will try his best. I will not blame him if he says he has no money available, but I hope that he has.
§ Mr. Denis Murphy (Wansbeck) (Lab)
I congratulate my hon. Friend the Member for Blyth Valley (Mr. Campbell) on securing the debate. I doubt whether he will be offered coffee and biscuits on his next visit to Northumberland county council, but I await it with interest.
The county council recently concluded a consultation process lasting only two weeks on whether to close three residential care homes—two in my constituency and one in my hon. Friend's—and reviewed, with the possibility of closure, adult training centres in both constituencies. Many elderly and vulnerable people were distraught at the thought of moving out of their homes, where they were loved and cared for.
With my hon. Friend, I met staff, residents and the trade unions. We all agreed to oppose those closures and mounted a fairly good campaign. My hon. Friend and I wrote to every councillor in Blyth Valley and Wansbeck, insisting that they vote against the proposals. The county council has since decided not to go ahead with the closures. I commend it for that, but I question why it felt it necessary to make the announcements in the first place.
When that decision was made, the council put out a press release that was both misleading and disingenuous. The impression was given that my hon. Friend and I had promised that extra funding would be available and that the county would hold us to account for that. I can state on the record that that was never said by either of us. We simply said, as we often do, that if we could help in any way, including with ministerial meetings, we would be happy to do so. The county council agreed to put out a statement correcting its original comments, but I have yet to see it in print.
I want to touch on two or three areas of care that are vital, but also extremely expensive. I urge the Minister to press the county council to work very hard to adopt best practice in all areas of care. In keeping with the majority of local authorities, children's services have experienced major increases in demand over recent years. In Northumberland, there has been a large increase in the number of children with disabilities requiring services—more than 300 additional young people since 2000. An extra 25 young people a year require placements outside the county or in secure accommodation.
97WH Although those numbers are not great, I am informed that a place at a secure unit costs £4,000 a week. Perhaps the Minister can extract from the county council how that massive figure is arrived at. Additionally, each year about 16 to 18 young adults with severe and complex disabilities leave full-time education—they require care services whose cost averages £45,000 a year for each person. That is a total of £750,000 each year.
More pressure is applied to adults' services by the Government's expectation that remaining long—stay residents in learning disability hospitals should be resettled in the community. There are 24 residents in Northgate hospital at Morpeth. They all have complex needs and, until recently, they were expected to stay in hospital indefinitely. The cost to the council of community schemes for those people is over £1 million, plus significant capital costs.
The future of adult training centres is of great concern to my constituents, many of whom rely heavily on them to provide essential family respite and support. For those persons using the centres, they represent a chance to contact the outside world and to enjoy the company of others. Their closure would have a devastating effect on family carers with employment responsibilities, a growing number of ageing carers and those caring for people with complex needs.
Almost 500 people are using the adult training centres and demand is growing year on year. Many service users have indicated a strong interest in finding employment and have been helped through either supported education and employment or social enterprise firms, a number of which operate successfully throughout Northumberland. There is a proven need to expand those services, which makes the call for closure even more alarming.
Those are just some of the services provided by Northumberland county council. My hon. Friend the Member for Blyth Valley described the need to continue with residential care. Pressure on social services increases year on year; the Government recognise that, and have increased the budget year on year to match it. Northumberland county council conceded that it has had the most generous settlement in its history, so I urge the Minister to meet its representatives to determine the truth.
The people in my constituency want to know that their care homes and training centres are safe and have a future. I call on Northumberland county council to assure them on that and on the fact that, whatever decisions it needs to make, it will protect the elderly and the most vulnerable people in our society. The responsibility lies with the county council; it cannot pass it on to anyone else. It has to make the ultimate decision.
§ The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman)
I congratulate my hon. Friends the Members for Blyth Valley (Mr. Campbell) and for Wansbeck (Mr. Murphy) on their contributions. In particular, I congratulate my hon. Friend the Member for Blyth Valley on securing the debate and bringing these issues to the attention of the House. He is keen to have high-quality social services in his area, and 98WH so he should be. He is also keen for the council to get value for money for local council tax payers, and so he should be. I would be delighted to engage with him and my hon. Friend the Member for Wansbeck in any way I can to help to ensure that they understand what is going on, what the Government are doing and what they can do, and what are the responsibilities of the county council.
My hon. Friends both made the point that, ultimately, devolution to local government means that local government is responsible for making certain decisions. It has to stand up and be counted after making those decisions; it cannot try to fob the blame off on Members of Parliament, who have a role to play in approaching Ministers. Ultimately, however, decisions will be made by local government, and it needs to explain them.
To put these matters in context, I want to make a few points about the money that we have given to social services nationally. Between 1996–97 and 2002–03, resources for personal social services were increased by this Government by 20 per cent. on average over inflation. That is an average real-terms increase of 3 per cent. a year. Last year, this year and next, we have done even better, as we have given 6 per cent. more than inflation to local government for social services. That is a huge increase by any calculation.
Next year, total social services resources for adults are set to increase by 8.2 per cent., or £775 million. That includes a 6.8 per cent. rise in formula spending shares as well as extra resources, which have been provided to local authorities to expand the range of community-based social care services, improve services for carers and raise the quality of the social care work force.
Northumberland has benefited significantly over recent years from that extra investment in social services. In 2002—03, the council's total social services resources increased, on a like-for-like basis, by 6.4 per cent. That followed a 7.8 per cent. increase in 2001—02. This year, Northumberland received an increase of 3.9 per cent. in its formula grant, as well as significant increases in the grants paid by the Department of Health. Next year, Northumberland will see its total adult social services resources increase by a further 9.4 per cent. That includes a 7.8 per cent. increase in its formula grant and large increases in its access and systems capacity grant, its carers grant and its training grants.
That means that overall resources for adult social services for Northumberland have increased from £38 million in 1996—97 to £62 million in 2004—05. That is a whopping 62 per cent. increase. My hon. Friend the Member for Blyth Valley acknowledged the generosity of that settlement, and I am surprised that the county council is not joining him by sending letters of congratulation to the Government on the size of that increase. It has done a heck of lot better than most councils around the country—I wish that my council had done that well.
As my hon. Friend said, we have also reduced dramatically the level of ring-fencing on adult social services. In 2004—05, only 2 per cent. of the resources provided for adult social services will be ring-fenced. The council will therefore have the freedom to target extra resources for social services on the areas of social 99WH services that are most in need. I am surprised to hear from my hon. Friend that the council is claiming that somehow, because we have removed ring fences, the pressure on social services is increased. Local councils have been pressing for the removal of ring fences—they believe that they need that extra freedom. It is not a pressure on social services but a freedom for them.
Only a year ago, we finished a full review of the formula used to allocate funding for adult personal social services. As a result of that review, we revised the formula introduced this year. During that review, we looked at the extra cost of providing non-residential care to older people in rural areas because of the extra travelling involved, and as a result we doubled the weighting given to sparsity in the older people's formula. That was a measure for which Northumberland pressed and from which it benefited. Overall, Northumberland gained from the changes made to the personal social services formula this year, so the formula will be frozen for the next few years to allow for a period of stability. All those things were done at the request of Northumberland and have benefited Northumberland.
I should perhaps make it clear that the Department of Health was given a fixed amount for social care by the Chancellor at the time of the last spending review. It covered the period 2003—04 to 2005—06. We have told local government what that money has been provided for and how it will be distributed. I have held no money back, so I fear that I must disappoint my hon. Friends by saying that I have no extra money to give to Northumberland—it has it all, and it has done very well out of it. In no way should Northumberland try to blame my hon. Friends for that. The simple fact is that the money has already gone to the county council, and it has been very well done-by. It has more than adequate resources now to start moving things forward. It should not try to blame Members of Parliament if it must make some tough decisions.
We have given a generous settlement to the council, and the council needs to live within that amount. It needs to consult widely about what is needed locally, and to think long and hard about how it should spend the money that we have given in ways that will provide the best possible services for those needing support—exactly the point made by my hon. Friend the Member for Blyth Valley. I say to both my hon. Friends that I must question whether the council has done that consultation and made that information available, because if two Members of Parliament have not been given the information, what is the likelihood that other people living in the local area have been given sufficient information and consultation on that process?
I have noted my hon. Friend's comments on the passporting of funds to schools, but I would like to point out that education has been well funded and sufficient resources have been provided to enable councils, including Northumberland, to passport the schools funding. Social services funding is separate and is unaffected by the arrangements introduced on education. I also recognise that some of the extra resources that we have provided are required to meet the pressures arising from Government policies such as improvements in inspection, the introduction of the minimum wage and the introduction of criminal record 100WH checks. I am not apologetic about any of those measures, however: we have fully allowed for them in the money that we have provided to councils.
What do those substantial extra resources mean for Northumberland? The council can and should use its substantial extra resources to purchase services at realistic prices, to meet the needs of its residents in any way that it wants. It can increase fees locally, if that is what it needs to do; it can invest in new capacity locally, if that is what it wants to do; it can make the eligibility criteria for social care more generous, if that is what it wants to do; and it can cut the charges that it seeks to impose on people who must contribute to the cost of care at home, if that is what it wants to do. It needs to achieve value for money, however. Wherever it decides to buy care services, it needs to ensure that it is getting a good deal, and that includes where it buys care home places.
I understand that it costs about £35 a week more to keep a client in Northumberland's own care homes than to place that same client in an independent home. The council needs to be certain that that extra cost is reflected in either the quality of care that the client receives or the quality of the home in which the client is placed. It also needs to ask why there are extra costs, and to examine whether those services can be provided more efficiently. It is open to councils, however, to pay a different rate to one provider over another, if, but only if, paying more means that they get more. We want councils to commission the services that they need in an effective way, reflecting best value and the needs of their local community. They must, therefore, carry out a best value review if they have not done so already. Councils should make sure that their services are fair to the people who use them, as service users ought to be at the centre of planning services. Councils have to build person-centred services, and that means new ways of thinking and planning. We must move away from dependency models of care in which "professionals always know best", building a high-quality, well-regulated system that makes independence a real option and puts individuals in control of their own care.
I want to see councils "commissioning for choice" with, at its centre, recognition of disabled and older people as citizens with the same hopes and aspirations for the future as all of us. People want to be able to choose from a full menu of care services: from being able to receive care in their own homes through to extra care housing and residential accommodation. Very few people would choose residential care as one of their first options, and yet so much commissioning activity has been and still is preoccupied with that type of care.
§ Mr. Ronnie Campbell
Can my hon. Friend expand on the other point that I should have raised: the modernising or upgrading of homes? The Government have set a time limit., I believe, whereby all homes must be en suite and up to the standard required by 2007. Is that hard and fast, or is it just a figure?
§ Dr. Ladyman
Certainly, we have set national minimum standards, and we have said that we will review them next year to see whether we have got them right. In any event, we have relaxed the physical standards, so I do not know whether the county council is giving my hon. Friend an accurate picture of what is required.
101WH Certainly, however, I advise and encourage the council and my hon. Friends, if I can help to facilitate matters, to look at best practice emerging from other areas, to see what can be done in care homes. If older people are living in unmodernised homes at the moment, whether they are council-owned or privately owned, they are not getting the level of service that they deserve. Some of the current best practice models of care are fabulous. I commend particularly to my hon. Friends and their constituents the extra care model, which I am trying to encourage throughout the country. In extra care, people live in their own private accommodation—usually a flat, sometimes a bungalow—but with all the care services that they need to be able to live independently on the doorstep, either provided by the council, or, if it is a private setting, by a private provider. Such a model means that people can live independently while still receiving the care that they need. As an alternative to care homes, it is incredibly popular. I advise both the council and my hon. Friends to examine those models, and to challenge themselves to see whether their current services match that best practice, and therefore whether modernisation might be appropriate—
§ Sitting suspended until Four o'clock.