:00:00. > :00:00.is very unfair on back answers. And not taking points of order now, they
:00:00. > :00:07.will come after the questions and statements, we will save the
:00:08. > :00:14.honourable lady for later in the day. Urgent question, Barbara
:00:15. > :00:22.Keeley. Does the minister share my deep concern about the state of
:00:23. > :00:26.adult social care... For giving me. She needs to ask the minister for
:00:27. > :00:30.the statement on the matter and then she follows with substantive when
:00:31. > :00:38.the minister has given his substantive. Could the minister
:00:39. > :00:43.respond on the CQC report on the state of adult social care and
:00:44. > :00:49.issues on funding social care? Take two. There are few things more
:00:50. > :00:54.important to any of us then the ways in which the oldest and most
:00:55. > :01:01.vulnerable are cared for. Let me paid tribute to the 1.4 million
:01:02. > :01:05.people in the social care sector who support vulnerable people in
:01:06. > :01:10.difficult circumstances. I am proud we have done more than any
:01:11. > :01:14.government to improve social care, introducing a tough system of
:01:15. > :01:19.rating, new qualifications and standards to make sure everyone
:01:20. > :01:26.receives high quality support. I am heartened that today's report shows
:01:27. > :01:30.even in times of fiscal pressure, 79% of adult social care services
:01:31. > :01:35.are good or outstanding that it is impossible to ignore the pressure of
:01:36. > :01:40.our ageing population and advances in medicine. We have seen the
:01:41. > :01:46.numbers of over 65 is increased by 1.2 million and today's report shows
:01:47. > :01:52.in some areas it is unacceptable that standards are below those
:01:53. > :01:57.expected by care users. This Government view social care as a
:01:58. > :02:01.priority, which is why the spring budget announced an additional ?2
:02:02. > :02:08.billion to councils to spend on adult social care. This means
:02:09. > :02:15.councils will have access to ?9.25 billion, funding enough to increase
:02:16. > :02:19.social care spending in real terms. Later this year we will consult
:02:20. > :02:28.widely on the future of social care to put it on a stable footing. The
:02:29. > :02:35.minister updated the House on Monday, last year there were 2.25
:02:36. > :02:41.million delayed discharges, up from the previous year. No one should
:02:42. > :02:48.stay in a hospital bed longer than necessary, it removes people's
:02:49. > :02:51.dignity, leads to poor health and outcomes and is more expensive.
:02:52. > :02:58.Since Burberry there have been improvements in the health system
:02:59. > :03:02.with a record decrease in delayed discharges, but we must make faster
:03:03. > :03:07.and more significant progress in advance of next winter to free up
:03:08. > :03:11.beds for sickest patients and reduce pressures, which is why we have
:03:12. > :03:17.introduced measures to support the NHS, this guidance includes
:03:18. > :03:24.guidance, a performance dashboard, dance for the Government and NHS to
:03:25. > :03:30.deliver to free up hospital beds and CQC reports. We will consider a
:03:31. > :03:35.review in November of 2018 allocations of funding provided at
:03:36. > :03:38.the spring budget for areas that are poorly performing. The budget
:03:39. > :03:40.funding will remain with local government to be used for adult
:03:41. > :03:48.social care. I thank the Minister for that
:03:49. > :03:52.response, but I really must ask him if he shares my deep concern about
:03:53. > :03:57.the state of adult social care highlighted by the report of the
:03:58. > :04:01.Care Quality Commission today. Some 3200 care services were rated as
:04:02. > :04:06.requires improvement, the other 340 rated as inadequate. What means some
:04:07. > :04:10.92,000 vulnerable people are receiving poor care, and some 10,000
:04:11. > :04:15.people are receiving inadequate care. The picture is even worse in
:04:16. > :04:20.nursing homes, with one in three receiving the poorest ratings. Does
:04:21. > :04:24.he share my concern about safety, with one in four care locations
:04:25. > :04:28.failing on protecting people from abuse or avoidable harm? That means
:04:29. > :04:31.thousands of vulnerable people not getting the scribe medicines, being
:04:32. > :04:35.ignored when they ask for help or having enough time for their home
:04:36. > :04:40.care visits. On this side we have repeatedly raised the damaging
:04:41. > :04:44.impact of Ajit cuts with over ?5 billion cut from social care since
:04:45. > :04:48.2010. Does he now see that this has caused the crisis in care staffing
:04:49. > :04:52.which is at the heart of the poor care being reported? Or staffing
:04:53. > :04:57.levels and start trading are key factors in those providers with the
:04:58. > :05:00.poorest ratings. In his written ministerial statement earlier this
:05:01. > :05:06.week, the Secretary of State suggested that the ?2 billion
:05:07. > :05:10.allocated to local councils to which the Minister has just referred will
:05:11. > :05:13.now be dependent on performance against delayed transfer of care,
:05:14. > :05:18.and some councils could lose funding that they have already planned to
:05:19. > :05:21.spend. As the Minister accept that threatening local councils with the
:05:22. > :05:24.loss of planned funding could actually lead to the worsening of
:05:25. > :05:29.the quality and safety issues highlighted today? With social care
:05:30. > :05:34.in crisis, this is not the time to be threatening joint working with
:05:35. > :05:39.local councils, so willingly reversed that threat, and will he
:05:40. > :05:41.match the Labour pledge of an extra ?8 billion for social care,
:05:42. > :05:51.including an extra ?1 billion this year? I thank her for that response.
:05:52. > :05:54.I fear this is a subject that was obviously much discussed during the
:05:55. > :05:59.general election, and will be greatly discussed during this
:06:00. > :06:06.Parliament. Nobody is making any threats. The Government is very
:06:07. > :06:10.supportive of the best performing systems where local government at
:06:11. > :06:14.the NHS are working together to tackle the challenge of delayed
:06:15. > :06:18.transfers of care. In November, depending on performance, we have
:06:19. > :06:21.said we will consider a review of the allocations of social care
:06:22. > :06:25.funding provided this year for areas that are poorly performing. This
:06:26. > :06:29.funding will all remain with local government, as I said, to be used
:06:30. > :06:33.for social care. Obviously we recognise that there are real
:06:34. > :06:36.pressures in the system. That is why we responded as we did, and I think
:06:37. > :06:40.her party were pleased with that at the time for the additional ?2
:06:41. > :06:44.billion for social care in the budget this year. And of course we
:06:45. > :06:48.have also given councillors the chance to raise the council tax
:06:49. > :06:54.precept, and my authority has done that, and I think that has been well
:06:55. > :07:01.received. Just turning to the actual report, I think it would be easy to
:07:02. > :07:05.just dock all of this, which, dare I say, I hope we can conduct this in a
:07:06. > :07:10.spirit of sensible debate, because people out there working in this
:07:11. > :07:15.system, people who want to pass the mum test as it was said this
:07:16. > :07:18.morning, want us to do that and are watching this closely. Of course it
:07:19. > :07:20.would be easy to bury our heads in the sand, but should we just
:07:21. > :07:29.remember that without this vigorous inspection ray -- regime, a lot of
:07:30. > :07:32.the problems that happened when her party was in Government wouldn't
:07:33. > :07:37.have been heard about, so we only know about this because of the
:07:38. > :07:44.inspection regime that has been put in place. The CTC found a number of
:07:45. > :07:48.things in its report -- the CQC found a number of things in its
:07:49. > :07:52.report, and we will die just that in the years ahead. It found that adult
:07:53. > :07:58.social care sector performed best in her caring services were. 92% were
:07:59. > :08:04.rated good and 3% rated outstanding, so we can kick this around all that
:08:05. > :08:06.we like, but that is why this report today shows exactly why we
:08:07. > :08:12.introduced the inspection regime that we did, and it is that that is
:08:13. > :08:16.uncovering the care that is good, and that is also uncovering the care
:08:17. > :08:19.that is not, which is where we want to help and support local
:08:20. > :08:26.authorities to make sure it improves the people that we represent. Mr
:08:27. > :08:30.Speaker, it is concerning to note from the CQC's state of adult care
:08:31. > :08:40.report that staff turnover rates have risen from 22.7% to 27.3% in
:08:41. > :08:43.the three years to 15/ 16. Will the Minister meet with me to discuss the
:08:44. > :08:48.important role that supporting skills and opportunities for career
:08:49. > :08:52.progression can play in reducing turnover, improving morale and most
:08:53. > :08:55.importantly improving the quality of care that people receive? And will
:08:56. > :08:59.he visit my constituency to see the excellent joint working that is
:09:00. > :09:04.being done by the trust and South Devon college to do just this? I
:09:05. > :09:08.think my honourable friend knows that I will be in the vicinity of
:09:09. > :09:12.her constituency at some point over the next few months, and I would
:09:13. > :09:17.like to take her up on her offer. I wish her well and had current
:09:18. > :09:22.campaign. Workforce is obviously critical to this. Adult social care
:09:23. > :09:25.is a rapidly growing sector. 165,000 more social care jobs than there
:09:26. > :09:29.were in 2010. It is imperative that we get the right people into the
:09:30. > :09:32.right jobs resulting in an improved quality of care and the services we
:09:33. > :09:36.all want to see. We are working closely with our delivery partners
:09:37. > :09:40.to improve the level of skills for adult social care workforce, and we
:09:41. > :09:44.are making the profession more attractive with the introduction of
:09:45. > :09:48.the National living wage, up to 1.5 million people in the social care
:09:49. > :09:51.sector are expected to benefit, a policy which I might point out has
:09:52. > :09:56.only come in as a result of this Prime Minister and this Government.
:09:57. > :10:03.If I could just point out that the same report gives 92% good and 3%
:10:04. > :10:07.outstanding on caring, and that comes down to the commitment of
:10:08. > :10:12.staff, who sadly have not been given a breaking of the 1% cap. What has
:10:13. > :10:16.been raised is the safety issue, with one in for failing to provide
:10:17. > :10:20.safe care, and that comes down to workforce and funding. Brexit
:10:21. > :10:26.threatens workforce because as the honourable member says, there is a
:10:27. > :10:32.one in four turnover. Funding has reduced to 9%, and that is something
:10:33. > :10:34.that has to be tackled. So does the Minister recognise that one in five
:10:35. > :10:39.emergency admissions could avoided if alternatives were provided, and
:10:40. > :10:43.while the measures are different in Scotland, delayed discharges are
:10:44. > :10:47.falling while they are rising steeply in England?
:10:48. > :10:52.So will he get rid of fragmentation, and in the SDP reorganisation, look
:10:53. > :10:56.at real integration of health and so? I thank the honourable lady for
:10:57. > :11:00.that, and yes, I said at the very start of my response that the 1.4
:11:01. > :11:04.million people who work in this country's social care sector are the
:11:05. > :11:07.people that we should be saluted today, and the families who support
:11:08. > :11:12.them, as well, because they are in and out of this setting all the
:11:13. > :11:16.time. I'm grateful that she responded, I did also say that the
:11:17. > :11:19.caring side of this sector does not surprise me that that came out as
:11:20. > :11:27.one of the good bits in this. On the point that she makes about keeping
:11:28. > :11:34.people out of the setting, absolutely, and that is what the SDP
:11:35. > :11:42.process is about. We are one NHS, and it is one public sector, so this
:11:43. > :11:48.is about the NHS, and getting it delayed transfers of care right, but
:11:49. > :11:52.it is also about the whole STP process which works across the NHS,
:11:53. > :11:54.in my area Hampshire it works closely with Hampshire County
:11:55. > :12:01.Council, and it is about one system response, and she is right to point
:12:02. > :12:06.it out, as usual. Mr Speaker, it is vital that we improve those adult
:12:07. > :12:10.services that are failing and falling behind, but letters not lose
:12:11. > :12:14.sight of the fact that most adult social services were of high
:12:15. > :12:20.quality, and many were improving, and four out of five of adult
:12:21. > :12:25.services were good or outstanding. We all know that there is a looming
:12:26. > :12:28.crisis in social care, and that is why the Chancellor announced a ?2
:12:29. > :12:40.billion further investment in that area. Could the Minister say, is
:12:41. > :12:45.that starting to show some results? The CQC have completed their
:12:46. > :12:51.ratings, and the prop portion of providers announced as good or
:12:52. > :13:01.outstanding has increased, it was 72% previously. It also worth noting
:13:02. > :13:06.that the CQC say that there are improvements. There is a challenging
:13:07. > :13:12.element to this report to say, which we don't hide from and we don't
:13:13. > :13:15.shirk, which is why we set up the inspection regime, but it wouldn't
:13:16. > :13:18.be right or fair to people in the sector or to people relying on the
:13:19. > :13:23.sector to say that everything is going to hell in a handcart, because
:13:24. > :13:28.I don't believe it is. I hope the Minister would agree that these
:13:29. > :13:33.widespread failures of care are intolerable in a civilised society.
:13:34. > :13:36.And does he share my view that we will have to confront the need to
:13:37. > :13:40.increase taxes to ensure that we have an efficient and effective and
:13:41. > :13:46.compassionate system, and would he embrace a cross-party approach to
:13:47. > :13:49.come up with a long-term settlement? I thank the right honourable
:13:50. > :13:53.gentleman for that, and as a respected former care Minister, of
:13:54. > :13:57.course I want to work with any members in this House who have any
:13:58. > :14:05.sensible suggestions. In terms of taxation, that is a matter for the
:14:06. > :14:09.Chancellor, but the challenged areas of care, that is why we have picked
:14:10. > :14:14.up as the Secretary of State said earlier this controlled areas ready
:14:15. > :14:21.for review, and we have developed those from the dashboard criteria.
:14:22. > :14:26.We will be giving them every possible support, as we do with the
:14:27. > :14:30.inspection regime, and we will be doing the same for hospitals. I'm
:14:31. > :14:38.very happy to meet with the right honourable gentleman, and if he
:14:39. > :14:45.hadn't asked, I would have offered. If the plan of the Government is to
:14:46. > :14:47.reduce the pressure is on adult social care, can my honourable
:14:48. > :14:50.friend explain why the clinical commissioning group is proposing to
:14:51. > :14:53.close down the centre Leonards Community Hospital which provides
:14:54. > :15:01.really good services at the moment, and is approved by the community? I
:15:02. > :15:07.can't go into the detail of that, and I suspect my right honourable
:15:08. > :15:10.friend knows that, but there will be an STP process in his area, and that
:15:11. > :15:18.will have to come up with proposals that meet the reconfiguration
:15:19. > :15:26.criteria. There were four areas to be met, there are now five, the
:15:27. > :15:29.fifth is around patient safety, and any reconfiguration or change of
:15:30. > :15:33.service in release into that have to be considered in that round.
:15:34. > :15:37.THE SPEAKER: The Minister has just elevated the honourable member for
:15:38. > :15:41.Christchurch to the Privy Council, of which is not a member. Whether
:15:42. > :15:45.that was inadvertent on the part of the member or a gentle hint to the
:15:46. > :15:50.power that be remains to be seen. Would only be a modest elevation for
:15:51. > :15:57.summary of his experience. Thelma Walker. Will the Minister agree with
:15:58. > :16:03.me that it is time we looked at bringing the social care sector back
:16:04. > :16:05.into public ownership to remove the profit-making aspect of looking
:16:06. > :16:12.after the most vulnerable in our society? Yes, Mr Speaker, I have no
:16:13. > :16:15.advance knowledge of the future career prospects of the honourable
:16:16. > :16:28.member for Christchurch, but I'm sure it is a matter of time before
:16:29. > :16:33.he is a Dorset knight! I don't think what the sector needs right now is
:16:34. > :16:36.rationalisation, and if I may just say once again, the answer to every
:16:37. > :16:45.challenge in our public services is not public ownership. Visiting a
:16:46. > :16:52.stick constituent at home last week, I discovered that he had had dozens
:16:53. > :16:55.of carers, many of whom delivered excellent care, but he was concerned
:16:56. > :17:01.about the sheer numbers of different carers that he had had. What could
:17:02. > :17:04.my honourable friend say about proposals or plans that we have to
:17:05. > :17:09.ensure that people receive consistent care from as few carers
:17:10. > :17:19.as possible? Because that benefits both carers and patients. When you
:17:20. > :17:21.look at the primary care and the named GP policy which was a step
:17:22. > :17:25.forward, that is something that we should aim for in this sector, and
:17:26. > :17:30.maybe that is something that will come out in the consultation later
:17:31. > :17:31.this year, and I feel certain that my honourable friend will be
:17:32. > :17:52.responding to that. THE SPEAKER: what an array of
:17:53. > :17:57.riches! Thank you, Mr Speaker. This Government has pushed a national
:17:58. > :18:00.crisis onto a hard-pressed local council and hard up local residents,
:18:01. > :18:05.forcing council tax rises that barely cover the minimum wage
:18:06. > :18:12.salaries that are paid to carers. He says that the precept is welcome. I
:18:13. > :18:14.asked, by who? The precept is welcomed by local authorities who
:18:15. > :18:20.wants to get extra money into their social care system. I understand the
:18:21. > :18:23.honourable lady wants to play politics with this, but as I said in
:18:24. > :18:33.my response, I do honestly think that we can do better than that. I
:18:34. > :18:37.have found the CQC inspections of struggling care homes to be a useful
:18:38. > :18:41.way to make sure that improve the care people get, but is he now
:18:42. > :18:43.confident that the CQC is sufficiently resourced and skill to
:18:44. > :18:49.carry out inspections on a timely basis?
:18:50. > :18:56.Yes, I think the CQC does a fantastic job and its students back,
:18:57. > :19:01.who members will have heard this morning on the media, was right when
:19:02. > :19:07.she talked about social care services leading to meet the mum or
:19:08. > :19:12.dad test because I have ageing parents like members of this House
:19:13. > :19:17.and the mum and dad test is what we want because we want, when they go
:19:18. > :19:24.into adult social care, we want them to feel they are as well looked
:19:25. > :19:29.after as we could do so ourselves. Loneliness can be extreme in
:19:30. > :19:35.housebound adults and mental health issues like depression can be high
:19:36. > :19:39.but unrecorded, so will the Government ensure a holistic
:19:40. > :19:44.approach to social care including key indicators of mental health and
:19:45. > :19:49.well-being? She makes a good point and these are the sort of issues we
:19:50. > :19:56.discuss in the consultation this year which she is welcome to take
:19:57. > :19:59.part in. What is the status of what was the announced government policy
:20:00. > :20:11.that the deal not cap will be implemented in the financial year
:20:12. > :20:17.2122? So... The Prime Minister has been clear about the importance of
:20:18. > :20:21.tackling this issue, she said we look after 2 million more over 75 is
:20:22. > :20:27.in the next ten years and have to find a sustainable way to care for
:20:28. > :20:32.older people. We will consult on proposals like a limit on the amount
:20:33. > :20:38.of people can be asked to pay, with the objective to get the widest
:20:39. > :20:42.possible consensus. Whether he regards that is satisfactory or not
:20:43. > :20:51.is for him to decide but it is the uncertainty is getting. Did the
:20:52. > :20:55.Minister see the recent destruction -- dispatches programme featuring a
:20:56. > :21:00.care home which had shocking levels of care? If large well-known
:21:01. > :21:06.providers like BUPA are caught putting profit before patient carer,
:21:07. > :21:11.what can the Minister do to make sure smaller providers are not doing
:21:12. > :21:16.the same I did not see that programme but I shall look out for
:21:17. > :21:22.it. We can put in place that toughest assessment and inspection
:21:23. > :21:27.regime that we have and that has come from the Secretary of State, it
:21:28. > :21:32.didn't come from the previous government so we can make sure there
:21:33. > :21:36.is rigorous inspection to root out poorly performance services and that
:21:37. > :21:45.is the same in his scan the truancy and in mine. With an increase and
:21:46. > :21:48.ageing population, does the Minister agree it's cynical to pretend there
:21:49. > :21:56.is a financial solution which doesn't involve difficult decisions
:21:57. > :22:02.in and across generations? I do and there were many disappointing things
:22:03. > :22:07.for me about the recent general election but one of the more
:22:08. > :22:13.disappointing things, being serious, was stabbed the debate around the
:22:14. > :22:17.future of adult social care was reduced to using the words dementia
:22:18. > :22:23.tax, which I think that this sector, architecture once, public life and
:22:24. > :22:29.this parliament and enormous disservice. I think we do need to
:22:30. > :22:33.have a grown-up debate around this solution and that is quite we will
:22:34. > :22:41.bring our proposals for consultation. This week marked the
:22:42. > :22:45.sixth anniversary of the deal not commission report into social care
:22:46. > :22:51.yet this Government is no closer to finding a solution. Can the Minister
:22:52. > :22:58.say why his government have waited six years and failed to take any
:22:59. > :23:03.action to solve the crisis? Honestly, I'm being tempted into
:23:04. > :23:09.politics. The Labour Party had 13 years in government to sort out the
:23:10. > :23:17.social care assistant, it never did. It was in the manifesto in 1997, a
:23:18. > :23:24.Royal commission in 1999, a Green paper in 2005, they said it would be
:23:25. > :23:28.sold in 2007 and then there was another green paper. I think
:23:29. > :23:34.lecturers from that side of the House about wasting time on this
:23:35. > :23:38.subject are for the birds. The Minister made an excellent point
:23:39. > :23:44.about the years of field opportunities on the other side, and
:23:45. > :23:47.during those years 40,000 people per year were forced to sell their homes
:23:48. > :23:55.in their lifetimes to fund their care. He is one of the most
:23:56. > :23:59.disappointing things about the discussion around this subject in
:24:00. > :24:04.the last few months is that the current situation is hardly perfect,
:24:05. > :24:10.if it was we wouldn't be debating it and if it was easy to solve we would
:24:11. > :24:15.have solved it years ago and the last Labour government would have
:24:16. > :24:21.sold it. There is extensive interest and I would like to accommodate it
:24:22. > :24:25.all that we have another urgent question to follow and then business
:24:26. > :24:29.questions, so can I ask colleagues to be good enough to pose single
:24:30. > :24:39.sentence pithy questions and I appealed to the Minister to provide
:24:40. > :24:43.comparably pithy replies? In my constituency we had an appalling
:24:44. > :24:48.case of abuse in a small private care home which resulted into prison
:24:49. > :24:53.sentences. What will the Minister do to raise standards in small private
:24:54. > :25:01.care homes? I cannot comment on that case but if she writes to me about
:25:02. > :25:06.it I am happy to look into it. I welcome the CQC inspection of care
:25:07. > :25:09.homes because it is helping drive up standards and highlight problems but
:25:10. > :25:14.many older residents say they want to stay in their own homes for
:25:15. > :25:23.longer. What is the Minister doing to help make that happen? That is
:25:24. > :25:27.why I said this is out one system solution and we need the NHS to work
:25:28. > :25:32.under league transfers of care that we need local authorities to work
:25:33. > :25:36.with us, which is what better carer fund is about. It is better for
:25:37. > :25:41.people to be cared for in their home but that is not always possible, so
:25:42. > :25:45.we need a long-term solution which is doesn't just deal with
:25:46. > :25:51.residential but domiciliary care, which is why we try to introduce
:25:52. > :25:55.that debate. Liverpool City Council spends more on adult social care
:25:56. > :26:05.than it can raise in council tax, yet still has more of a cut to make
:26:06. > :26:12.and pays a low level of fees as a consequence. Can he give assurances
:26:13. > :26:15.to the House that councils like Liverpool will not be further
:26:16. > :26:24.disadvantage 20 rolls out the extra funding to improve the situation?
:26:25. > :26:31.Councils have access to at total of ?9.25 billion funding for social
:26:32. > :26:35.care as a result of the measures introduced by this Government,
:26:36. > :26:40.enough to increase spending by real terms, and the UK spends more on
:26:41. > :26:44.long-term care as a share of GDP than other countries including
:26:45. > :26:53.Germany, Canada and the United States. I would say gently to the
:26:54. > :26:58.Minister the only reason the Labour Party was able to mention dementia
:26:59. > :27:03.tax was because the Conservative Party have put something stupid in
:27:04. > :27:08.their manifesto and really, this is far too important a matter for party
:27:09. > :27:14.politics. With the Minister agree we need the social care system is
:27:15. > :27:23.broken and we need a cross-party agreement of how to move forward? I
:27:24. > :27:30.do think we need a cross-party, cross-country solution to the
:27:31. > :27:35.long-term funding of adult social care, which is why we started a
:27:36. > :27:39.debate during the election campaign and why we need a proper
:27:40. > :27:45.consultation which will come online this year. He is right, this is far
:27:46. > :27:55.too important for the of party politics. Thank you, Mr Speaker. Of
:27:56. > :27:59.the care homes requiring improvement, on the inspection 13%
:28:00. > :28:03.still required improvement and 5% had deteriorated, so what action is
:28:04. > :28:10.the Minister taking beyond inspections to improve standards
:28:11. > :28:15.that is a fair question, that is why I said through the dashboard we have
:28:16. > :28:20.picked 12 most challenged local areas for review. The reviews will
:28:21. > :28:26.cover providers and commission of services looking at the interface
:28:27. > :28:29.between general and primary care and include an assessment of the
:28:30. > :28:34.Government is in place for the management of resources. That is
:28:35. > :28:39.quite those reviews are being put in place because we're not just
:28:40. > :28:43.pointing the finger and saying you were bad, we want to support areas
:28:44. > :28:49.to deliver the care we are getting in the majority of areas.
:28:50. > :28:54.Improvements in medicine have enabled people to live longer but we
:28:55. > :29:03.also want to live more healthily. We know reducing loneliness, improving
:29:04. > :29:12.activity and investing will help to reduce the need for social care. I
:29:13. > :29:16.thank her for that, although I am not the carer minister I am the
:29:17. > :29:21.public Health Minister and that is why we have brought those subjects
:29:22. > :29:25.together because we want to see a healthy population across-the-board
:29:26. > :29:30.and I'm pleased she mentioned the loneliness commission, although it
:29:31. > :29:34.started before she entered this House, it was started by Jo Cox and
:29:35. > :29:41.did some good work that is being taken forward in this Parliament.
:29:42. > :29:45.Bearing in mind that carers in Northern Ireland save the NHS some
:29:46. > :29:52.4.6 billion rising to 32 billion across the UK, Terrace super ride
:29:53. > :29:57.for the elderly and disabled, can the Minister outlined how he intends
:29:58. > :30:01.to fund more respite places to enable families to have a break
:30:02. > :30:08.which lets them keep on caring long-term? I will look into that, I
:30:09. > :30:12.am sure members across this post take part in carers week each year
:30:13. > :30:18.and it is there that you meet the staff who work in the system but the
:30:19. > :30:24.people who day in day out do not have the life they would like to
:30:25. > :30:28.have because they have caring responsibilities and often young
:30:29. > :30:32.carers in our kids seas do that in credible work and we should all make
:30:33. > :30:39.it clear thank you to those people for their work. The extra money in
:30:40. > :30:43.the last budget for social care is helping Kent County Council provide
:30:44. > :30:48.more people with access to care especially at home, but the cost of
:30:49. > :30:53.social care will keep going up. Does the agreed we need an honest
:30:54. > :30:59.conversation about how we fund that growing cost fairly across
:31:00. > :31:03.generations? Yes, and this is no different to the conversation were
:31:04. > :31:07.having around every other funding of social services and it is easy to
:31:08. > :31:13.take to the streets and asked to spend more, I think the leader spent
:31:14. > :31:18.the national debt ten times over in his response to the Queen's Speech
:31:19. > :31:23.and that is why we need a proper debate around long-term funding
:31:24. > :31:28.because it can come out of general taxation but we need a debate as to
:31:29. > :31:33.how much we can afford to do well funding other public services and I
:31:34. > :31:38.don't notice us being short of requests to increase money into
:31:39. > :31:44.other services. Can I have that honest debate, then I think the
:31:45. > :31:50.Minister has to accept the decisions of his government have fuelled the
:31:51. > :31:54.social care crisis in this country. My council as the third most
:31:55. > :31:59.deprived in the country, has had the 17th highest cuts to its budget
:32:00. > :32:05.including ?14 million taken out of social care and the social care
:32:06. > :32:09.precept was not raised the amount of money it would in wealthier areas,
:32:10. > :32:15.so can he accept some responsibility for the mess we are in? Governments
:32:16. > :32:21.of all colours have delivered us to this place but has this Government
:32:22. > :32:31.put more money into the system? Yes, did we put more in the budget this
:32:32. > :32:36.year? Yes. We spend more on long-term care than other countries
:32:37. > :32:42.including Germany, Canada and the mass of the economy of the United
:32:43. > :32:49.States. As the Minister knows there are around 2.8 million adults over
:32:50. > :32:55.the age of 65 in receipt of informal or formal social carer, so can he
:32:56. > :33:01.confirm that despite the pressures, the CQC report shows the proportion
:33:02. > :33:09.of carer services rated good or outstanding is increasing indeed I
:33:10. > :33:14.can. We introduced the new system of CQC inspections for the reasons I
:33:15. > :33:18.said, we introduced the certificate for a healthier assistance from new
:33:19. > :33:27.standard to clarify what Axel Pons Spike, we brought in new terminal
:33:28. > :33:30.offences of neglect, these are all happen under this Secretary of State
:33:31. > :33:39.that never happened before. The care sector is a significant
:33:40. > :33:43.employer in my constituency and able are being lost to other sectors. I
:33:44. > :33:47.listened carefully to his remarks but I would arch that he is more
:33:48. > :33:53.ambitious in supporting the sector to recruit more people and build on
:33:54. > :33:56.career pathways between health and social care to encourage people who
:33:57. > :34:01.want to do these jobs to try to do them. I thank her for that. That is
:34:02. > :34:05.a sensible question. As I said earlier to one of my honourable
:34:06. > :34:11.friends, this is a rapidly growing sector. They were all not sensible.
:34:12. > :34:15.It is imperative we get the right people. Yours was marginally more
:34:16. > :34:20.sensible. It is imperative we get the right people into the right
:34:21. > :34:24.jobs. It is important working with organisations to improve the level
:34:25. > :34:27.of skills and it is important, as I mentioned the National living wage,
:34:28. > :34:32.which people in this sector are expected to benefit from. We have
:34:33. > :34:37.the highest proportion of over 85-year-olds in the country and they
:34:38. > :34:46.tend to be not well off and their major asset is their property. Can
:34:47. > :34:49.the Minister make sure that in welcoming a grown-up debate that any
:34:50. > :34:54.sustainable solution recognises that people who work hard, paid their
:34:55. > :34:57.dues, looked after their families should be appreciated and not
:34:58. > :35:01.penalised having done so. Yes, I thank him for that. I said we would
:35:02. > :35:05.consult on detailed proposals later that year and that would include a
:35:06. > :35:10.capital floor and an absolute limit on the amount people can be asked to
:35:11. > :35:17.pay. They are the critical to pillars that must go together. More
:35:18. > :35:21.care homes are faced with closure if they cannot get access to migrant
:35:22. > :35:25.workforce is. What steps is the Government going to take to ensure
:35:26. > :35:28.that migrant workers who are happy to work in our care homes and
:35:29. > :35:34.provide excellent standards of care are still going to be able to come
:35:35. > :35:37.to the UK after Brexit. The Secretary of State has been clear,
:35:38. > :35:42.including at oral questions earlier this week, that we see the migrant
:35:43. > :35:47.workforce is as critical to the NHS. By which we mean, in patient care as
:35:48. > :35:54.well as the social care system and we went to see those protected. This
:35:55. > :36:02.is a constituency issue raised to me across is late and delayed discharge
:36:03. > :36:07.has also been prioritised. The Lib Dems on the council chose back in
:36:08. > :36:11.February not to support ?27 million more to go to the county's social
:36:12. > :36:16.care budget. With the Minister highlight that some parties...
:36:17. > :36:23.Action but simply failed to make the difference when they can do locally.
:36:24. > :36:27.My neighbour and honourable friend is a champion of our constituency
:36:28. > :36:32.and I represent part of the borough as she knows. It surprises me what
:36:33. > :36:36.she says but I am sure she will be pointing that out as part of the
:36:37. > :36:43.national debate in the months leading up to next May, when I think
:36:44. > :36:48.there are borough council elections. In March the select committee agreed
:36:49. > :36:53.a report on adult social care. We called for significant extra funds
:36:54. > :36:56.in the short and medium-term. In the long term we said a lasting solution
:36:57. > :37:01.would only be found the cross-party working. The Minister agrees that in
:37:02. > :37:04.principle. With the confirm that the consultation is going to embark on,
:37:05. > :37:12.you'll engage with the opposition front bench and other parties. -- he
:37:13. > :37:16.will engage. You will inform them of the consultation and approach with
:37:17. > :37:22.an open mind and involve the select committee in the consultation as
:37:23. > :37:26.well. I will confirm that there will be the widest possible engagement
:37:27. > :37:30.across this house, across the sector and the select committee, which she
:37:31. > :37:36.may or may not be in charge of the next few weeks. I have visited many
:37:37. > :37:41.nursing and care homes and my constituency and met committed and
:37:42. > :37:45.caring care staff. Does the Minister agree with me that the inspection
:37:46. > :37:48.system introduced by this Government, which is finally shining
:37:49. > :37:54.a light on poor care and driving up standards? Yes, I do. As I said at
:37:55. > :37:58.the very start, as we are coming to the end, I think the fact we have
:37:59. > :38:05.this inspection regime is a good thing. Of course for families and
:38:06. > :38:08.people in the system themselves, that is important. I think actually
:38:09. > :38:12.fully staff in the system as well. They want to know we are giving the
:38:13. > :38:17.best possible care and they are benchmarked giving the best possible
:38:18. > :38:21.care. It is as important for the staff as for the punters, for want
:38:22. > :38:31.of a better word. Finally spotted me, Mr Speaker. Worryingly, age UK
:38:32. > :38:34.recently described care homes... Does the Minister believe it is
:38:35. > :38:42.acceptable to force people to take these risks? I did not catch a
:38:43. > :38:44.question but I do not think the honourable member is easily
:38:45. > :38:49.overlooked in any forum. Maybe she would like to write and speak to me
:38:50. > :38:55.afterwards and we will pick up that point. There is somebody after the
:38:56. > :39:00.honourable lady. So she need not develop a complex about the matter.
:39:01. > :39:06.Somebody has to be asked and on this occasion, nevertheless with the very
:39:07. > :39:10.cheerleaders position, it is... Some local authority areas are
:39:11. > :39:15.undoubtably better than others when it comes to joining up social care
:39:16. > :39:19.departments with the NHS. Does my honourable friend agree with me that
:39:20. > :39:23.we need to see a greater focus on sharing best practice where it
:39:24. > :39:29.exists? Yes, I do agree with my cheery honourable friend. There is
:39:30. > :39:34.so much... This is the great praise to finish. There is so much great
:39:35. > :39:39.practice going on in the sector and the report highlights that today. We
:39:40. > :39:44.should celebrate that, as we do, as we learn from it, as the well. While
:39:45. > :39:47.picking out those areas that need support in order to improve the care
:39:48. > :39:59.they are giving. Thank you. Order, urgent question. Margaret Greenwood.
:40:00. > :40:03.Secretary of State for Work and Pensions for his plans to close job
:40:04. > :40:04.offices and the