25/10/2017

0:00:06 > 0:00:13I hope there are points of order, Chuka Umunna?Thank you, can I refer

0:00:13 > 0:00:25you to the debate of the European committee stage in the 7th of

0:00:25 > 0:00:32February, it was a Tuesday, well remembered. The Minister of State

0:00:32 > 0:00:34for exiting the European Union gave a commitment in this house that this

0:00:34 > 0:00:40House of Commons would have a vote on the arrangements of our

0:00:40 > 0:00:44withdrawal from the European Union before our exit from the European

0:00:44 > 0:00:47Union and he said and I caught we intend that the board will cover not

0:00:47 > 0:00:53only the withdrawal arrangements but also the future relationship with

0:00:53 > 0:00:55the European Union, further more I can confirm the government will

0:00:55 > 0:00:58bring forward a motion on the final agreement to be approved by both

0:00:58 > 0:01:04houses of parliament before it is concluded. He then went on to say Mr

0:01:04 > 0:01:09Speaker, and I quote, it will be a meaningful vote, as I have said it

0:01:09 > 0:01:13will be the choice between leaving the European Union with a negotiated

0:01:13 > 0:01:17deal or not. This morning the Secretary of State for Exiting the

0:01:17 > 0:01:24European Union told the relevant select committee that that vote that

0:01:24 > 0:01:27the minister committed to happening before we leave could indeed happen

0:01:27 > 0:01:33after we leave the European Union and as such that is in clear breach

0:01:33 > 0:01:37of the commitment given by his own minister that it will be a choice

0:01:37 > 0:01:41between leaving the European Union with the negotiated deal or not.

0:01:41 > 0:01:44Obviously we will not have that choice if we have already left the

0:01:44 > 0:01:49European Union by the time of a vote. It seems to me Mr Speaker this

0:01:49 > 0:01:52house on the half of the people we represent cannot take back control

0:01:52 > 0:01:58unless we have that vote. Can you advise on what we as a House of

0:01:58 > 0:02:03Commons do about that at best contradiction and at worst false

0:02:03 > 0:02:14impression given to the house?Point of order sir.Very well.They were

0:02:14 > 0:02:24there.We will come to him in a moment, I am saving him up. Point of

0:02:24 > 0:02:27order.I was present at the committee this morning and heard

0:02:27 > 0:02:31exactly what the Secretary of State said and the questions that were put

0:02:31 > 0:02:34to him and I am sorry to have to say that the honourable gentleman has

0:02:34 > 0:02:39misunderstood the situation. Can I explain Mr Speaker that the question

0:02:39 > 0:02:42the Secretary of State had was whether or not he thought that there

0:02:42 > 0:02:50would be an agreement before midnight on the 29th of March 2019

0:02:50 > 0:02:55and he indicated that he thought it might be a nanosecond before

0:02:55 > 0:03:00midnight on that day and he was then asked whether that meant that this

0:03:00 > 0:03:07house would not be able to vote on such an agreement until after the

0:03:07 > 0:03:1229th of March and he said obviously, they will not be able to vote an

0:03:12 > 0:03:14agreement until after the 29th of March if there hasn't been an

0:03:14 > 0:03:19agreement until the 29th of March, that is the point he was making and

0:03:19 > 0:03:24it was perfectly sensible.Providing a bit of extra information to me

0:03:24 > 0:03:29which in one form or another he's been doing for over 30 years,

0:03:29 > 0:03:31greatly obliged. I don't think at this point we need the intervention

0:03:31 > 0:03:36for the honourable member of Wellingborough, but what I would say

0:03:36 > 0:03:41to the honourable gentleman is that put very simply, what he is seeking

0:03:41 > 0:03:51is an assurance that there will be a vote on a final deal before Brexit

0:03:51 > 0:03:54happens, it that if I understand correctly is what he is asking and

0:03:54 > 0:03:58what I would say to the honourable gentleman is that these are matters

0:03:58 > 0:04:06of political debate, he quoted a very clear commitment from several

0:04:06 > 0:04:08months ago, different interpretations have been placed

0:04:08 > 0:04:13upon proceedings in a committee this morning but the honourable

0:04:13 > 0:04:17gentleman, beyond advertising and I don't mean that any pejorative

0:04:17 > 0:04:21sense, Buffon advertising his considerable irritation with what he

0:04:21 > 0:04:27had this morning is presumably keen to ensure he gets what he thinks he

0:04:27 > 0:04:32was promised. He is also presumably keen to get my advice on how to go

0:04:32 > 0:04:37about it and the answer to that is there will be a great many debates

0:04:37 > 0:04:43on European matters in this chamber in respect of the withdrawal bill

0:04:43 > 0:04:52but on many other occasions as well and I absolutely anticipate that the

0:04:52 > 0:04:55honourable gentleman and others will be making the same points,

0:04:55 > 0:05:02repeatedly. That also is not pejorative, repetition as I often

0:05:02 > 0:05:06say is not an unknown or rare phenomenon in the House of Commons.

0:05:06 > 0:05:11People have a point and they tend to return to it again and again and

0:05:11 > 0:05:15again, almost if you will in the spirit of campaigning and that is

0:05:15 > 0:05:18perfectly proper. So there will be lots of opportunity for the

0:05:18 > 0:05:20honourable gentleman here in Parliament and outside as well to

0:05:20 > 0:05:26press his case with the intellect and eloquence that he has brought to

0:05:26 > 0:05:32bear on our proceedings over the last seven years. I keenly

0:05:32 > 0:05:35anticipated his contributions from one side of the argument and those

0:05:35 > 0:05:38of the honourable members for Christchurch and Wellingborough to

0:05:38 > 0:05:43name but two on the other. I would feel that if you will the sequence

0:05:43 > 0:05:48was incomplete unless we heard from the former Europe minister himself,

0:05:48 > 0:05:58Mr Pat McFadden.I am grateful to you, I was at the evidence session

0:05:58 > 0:06:04this morning and listened carefully to what the Secretary of State said.

0:06:04 > 0:06:10He said that Parliament would not be likely to get a vote on the future

0:06:10 > 0:06:17arrangements with European Union until after March 2019. This makes a

0:06:17 > 0:06:22material and significant difference to this house is ability to have a

0:06:22 > 0:06:28meaningful input and a meaningful say on the content of those

0:06:28 > 0:06:33negotiations. So at the risk of repetition following up from my

0:06:33 > 0:06:40honourable friend the member for Streatham asked advice on what this

0:06:40 > 0:06:46house can do to make sure it has a meaningful say and input into these

0:06:46 > 0:06:51most important of negotiations rather than being used as an after

0:06:51 > 0:06:57the fact rubber-stamped. Further to that point of order Mr Speaker?Very

0:06:57 > 0:07:05well. Thank you, as the person who asked the question of the Secretary

0:07:05 > 0:07:08of State. My

0:07:12 > 0:07:16would it not be in order Mr Speaker that if the government had changed

0:07:16 > 0:07:20its position on something of such constitutional significance that

0:07:20 > 0:07:24that change in position should be brought before this house in a

0:07:24 > 0:07:32ministerial statement?It is, the point of order only another matter,

0:07:32 > 0:07:39on this matter? Very well.It seems different members of the committee

0:07:39 > 0:07:43heard different things from the Secretary of State this morning.

0:07:43 > 0:07:49Would it not be better Mr Speaker to wait until we actually have

0:07:49 > 0:07:54published the record of the meeting and then it can be quite clear what

0:07:54 > 0:07:57the Secretary of State did say because I did not hear what the

0:07:57 > 0:08:01members have alleged.Thank you for the honourable gentleman, I know he

0:08:01 > 0:08:06likes to be helpful to the chair and the house. He anticipates me that he

0:08:06 > 0:08:12is right in doing so. There will be a transcript of proceedings and I

0:08:12 > 0:08:19rather imagine that that transcript will be published sooner rather than

0:08:19 > 0:08:25later. I know it will then be subject to the BDI use of colleagues

0:08:25 > 0:08:33on both sides of the chamber and on both sides if I can put it that way

0:08:33 > 0:08:39of the Brexit argument. They will read into it what they wish and

0:08:39 > 0:08:45pursue their cause as they choose. What I will say to the honourable

0:08:45 > 0:08:52member for Felton and Heston is that if there is a material change in

0:08:52 > 0:08:55government policy or intended practice on a very significant

0:08:55 > 0:09:00matter its customary that there should be a statement to the house.

0:09:00 > 0:09:05It would not always be an oral statement but it might very well be.

0:09:05 > 0:09:09The house knows very well that there are means by which to secure the

0:09:09 > 0:09:13attendance in the chamber of a minister if such a statement is not

0:09:13 > 0:09:22offered. The position of the cheer is that they do not seek to take

0:09:22 > 0:09:30sides on this matter, the chair seeks to facilitate the exchange of

0:09:30 > 0:09:34opinion. In addition to all the other debates he might have on these

0:09:34 > 0:09:38matters there will in due course be legislation returning to the house

0:09:38 > 0:09:41and it's a matter of public record there are large numbers of

0:09:41 > 0:09:48amendments which have been tabled to the European Union withdrawal bill,

0:09:48 > 0:09:52at committee stage the chairman of ways and Means will make a proper

0:09:52 > 0:09:57and judicious selection based upon advice and deploying his own

0:09:57 > 0:10:02judgment and that report states that responsibility will fall to me. I

0:10:02 > 0:10:10think members know that I always will, offering the fullest possible

0:10:10 > 0:10:15debate on the widest range of issues pertinent to the bill. So both sides

0:10:15 > 0:10:20of the argument can always feel they have a friend in the chair.

0:10:24 > 0:10:28Mr Speaker I don't know if you recall what you were doing six years

0:10:28 > 0:10:33ago today, I suggest you were recovering from a mammoth session in

0:10:33 > 0:10:38the chair where a backbench business committee debate occurred in prime

0:10:38 > 0:10:43time and 81 Conservative members declined to accept the advice of the

0:10:43 > 0:10:50whips and voted for a referendum on the European Union. How could we

0:10:50 > 0:10:56mark that event and doesn't not sure that backbench business motions have

0:10:56 > 0:11:03an effect on government policy? Well, not for the first time the

0:11:03 > 0:11:08honourable gentleman is right on a matter of parliamentary history and

0:11:08 > 0:11:15precedent. I well recall that debate, it was a very significant

0:11:15 > 0:11:18debate and I am going to vouch it safe to the honourable gentleman

0:11:18 > 0:11:22something he probably did not know. You may not even want to know. But

0:11:22 > 0:11:27he's going to know. That is that I regularly refer to that debate

0:11:27 > 0:11:33amongst others and together with the debate on Hillsborough and a number

0:11:33 > 0:11:38of others as an example of a very significant debate under the

0:11:38 > 0:11:41auspices of the backbench business committee, significant not just

0:11:41 > 0:11:47because of the quality of the debate but because it had an impact on

0:11:47 > 0:11:50public policy. These references are in speeches that I make at

0:11:50 > 0:11:54universities and in front of other for around the country and I think

0:11:54 > 0:12:02most recently at the invitation of the Hannes Arch society. I don't

0:12:02 > 0:12:05suppose the honourable gentleman is such an anorak that he wishes to

0:12:05 > 0:12:08attend to all my speeches on these occasions but I'm giving him the

0:12:08 > 0:12:16highlight. Diana Johnson.Point of order about another issue of public

0:12:16 > 0:12:18policy, the contaminated blood scandal with Sky News today running

0:12:18 > 0:12:23a story about what appears to be a cabinet Coronet in 1987 related to

0:12:23 > 0:12:28the contaminated blood scandal and the consultation having ended last

0:12:28 > 0:12:32week I wonder if you had any indication when the government were

0:12:32 > 0:12:35going to come to the house to make a statement about when that public

0:12:35 > 0:12:38enquiry will be set up as they promised it would be done in a

0:12:38 > 0:12:46speedy manner.The answer is I have received no such indication but the

0:12:46 > 0:12:51honourable lady has raised this matter many times in the house if I

0:12:51 > 0:12:55remember correctly, including on an urgent basis. I seem to recall she

0:12:55 > 0:13:04did so at the tail end of the 2010 - 15 Parliament and on a number of

0:13:04 > 0:13:10other occasions since. The honourable lady is a most versatile,

0:13:10 > 0:13:13experienced and dextrous parliamentarian and knows the

0:13:13 > 0:13:17opportunities open to her and I just have this hunch she is quick to try

0:13:17 > 0:13:21to take advantage of them. If there are no further points of order...

0:13:21 > 0:13:26Perhaps we can come to the ten minute rule motion for which the

0:13:26 > 0:13:30Right Honourable Lady the member for Chipping Barnet has been so

0:13:30 > 0:13:34patiently waiting, ten minute rule motion. Mrs Theresa Villiers.

0:13:36 > 0:13:40Thank you, Mr Speaker, I beg to move that leave be given to bring in a

0:13:40 > 0:13:45Bill to prohibit the expert of live farmed animals for slaughter or

0:13:45 > 0:13:50fattening and for connected purposes. Mr Speaker, the export of

0:13:50 > 0:13:55live farm animals can cause immense, unnecessary suffering to many of the

0:13:55 > 0:14:00animals involved. There is evidence that public concern on this issue

0:14:00 > 0:14:04dates back as far as the 1950s and even further back in the particular

0:14:04 > 0:14:09case of export of horses. Indeed, I'm sure many in this

0:14:09 > 0:14:14chamber will remember the mass protest which featured on our TV

0:14:14 > 0:14:19screens during the 1990s. The key objection to live export of animals

0:14:19 > 0:14:23for slaughter is essentially two fold; firstly some countries in

0:14:23 > 0:14:27Europe have far weaker rules on animal welfare than we do, secondly

0:14:27 > 0:14:32there's a real risk that the rules on transport and slaughter of

0:14:32 > 0:14:37animals which are supposed to apply across the EU will not be

0:14:37 > 0:14:41effectively enforced once the animals leave our shores.

0:14:41 > 0:14:46Figures from the animal and plant health agency show that around

0:14:46 > 0:14:5040,000 sheep are exported from Britain for slaughter on the

0:14:50 > 0:14:54continent every year. The long journeys are stressful for the

0:14:54 > 0:14:59animals and in some cases they can result in suffering caused by

0:14:59 > 0:15:02overcrowding, high summer temperatures and animals sustaining

0:15:02 > 0:15:08injuries en route. Many of these 40,000 sheep are sent to France.

0:15:08 > 0:15:15Regular film reports by the organisation L214 have revealed

0:15:15 > 0:15:19inhumane and illegal slaughter practices in French slaughterhouses.

0:15:19 > 0:15:24In one shocking case, a slaughterman is seen stabbing a knife into the

0:15:24 > 0:15:33eye of a conscious sheep. A report in 2016 by the committee of enquiry

0:15:33 > 0:15:36of the French national, concludes there are serious welfare problems

0:15:36 > 0:15:41in French abattoirs. Mr Speaker, in my view, and in the view of many of

0:15:41 > 0:15:47my constituents, it's not acceptable for the UK to send animals to die in

0:15:47 > 0:15:58such horrendous conditions. 3,000 are exported from Scotland to Spain,

0:15:58 > 0:16:02as regards Scotland, the animals are first shipped to Northern Ireland,

0:16:02 > 0:16:06then they are taken by road to the republic from where they are sent on

0:16:06 > 0:16:11a 20-hour sea journey to northern France, finally they are driven all

0:16:11 > 0:16:18the way through France to Spain. Scientific research indicates that

0:16:18 > 0:16:24young calves are not well adapted to cope with such lengthy journeys.

0:16:24 > 0:16:29Their immune systems are not fully developed and their bodies' capacity

0:16:29 > 0:16:34to control their internal temperature is also limited. That

0:16:34 > 0:16:41makes them particularly susceptible to both heat and cold stress.

0:16:41 > 0:16:43Morbidity and mortality following transport can therefore be high, Mr

0:16:43 > 0:16:49Speaker. Of course, once in Spain, it's

0:16:49 > 0:16:54entirely per misable for calfs to be reared in barren conditions without

0:16:54 > 0:16:59bedding and keeping animals in these conditions would be illegal in the

0:16:59 > 0:17:03United Kingdom where we apply tougher rules than the EU minimum.

0:17:03 > 0:17:09Turning to some of the mechanics of the bill, it's drafted to coverAll

0:17:09 > 0:17:13parts of the United Kingdom, animal welfare is devolved but ex-pores are

0:17:13 > 0:17:18a trade issue and therefore a reserved matter. Whilst the Bill

0:17:18 > 0:17:23would not cover exports whilst the Bill would cover and ban exports for

0:17:23 > 0:17:27slaughter or fattening, it would not prohibit the export of animals for

0:17:27 > 0:17:32breeding because of their higher value breeding animals are generally

0:17:32 > 0:17:38transported in better conditions and so this business does not give rise

0:17:38 > 0:17:41to the same concerns regarding animal welfare.

0:17:41 > 0:17:45Because it only deals with exports, the Bill would not prevent the

0:17:45 > 0:17:50transport of animals from the Scottish Highlands to the mainland.

0:17:50 > 0:17:54An exception is also include in the Bill to allow cross boarder export

0:17:54 > 0:17:58of live animals from Northern Ireland to the Republic of Ireland

0:17:58 > 0:18:03to continue. This is essentially a local trade and aisle seen no

0:18:03 > 0:18:07evidence to indicate the journeys are excessively long. However, the

0:18:07 > 0:18:11exception is framed to try to ensure that the Republic of Ireland cannot

0:18:11 > 0:18:17be used as a back door route to continued live exports from the UK

0:18:17 > 0:18:21to mainland Europe. Mr Speaker, the fear has been expressed that if a

0:18:21 > 0:18:25ban were to be brought forward, there's a risk of challenge under

0:18:25 > 0:18:36the rules of the World Trade Organisation. WTO provide rules on

0:18:36 > 0:18:42trade restrictions, one of which covers public morals. The WTO body's

0:18:42 > 0:18:47ruled that animal welfare matters are capable of falling within the

0:18:47 > 0:18:51public morals exception. For example, the US ban on the import of

0:18:51 > 0:18:57cat and doing fur and the EU ban on seal fur remain in place despite

0:18:57 > 0:19:02both being members of the World Trade Organisations. There are good

0:19:02 > 0:19:07grounds to believe therefore that the UK would be able to defend a WTO

0:19:07 > 0:19:12challenge if it were to be made by showing that the export ban proposed

0:19:12 > 0:19:17in this Bill would be a proportionate response to deeply

0:19:17 > 0:19:23held concerns by many in the public in the UK with strong opposition to

0:19:23 > 0:19:27live exports dating back around half a century.

0:19:27 > 0:19:33Indeed, only recently, the RSPCA delivered a petition with over a

0:19:33 > 0:19:37million signatures to the European Commission, expressing grave concern

0:19:37 > 0:19:42about the suffering caused by poor enforcement of rules on long

0:19:42 > 0:19:50distance transport of animals. Over the years, there have been repeated

0:19:50 > 0:19:55calls for this harsh trade to be brought to an end. I first got

0:19:55 > 0:19:58involved in this issue some 18 years ago when I was a member of the

0:19:58 > 0:20:03European Parliament. But all attempts to ban this trade have so

0:20:03 > 0:20:09far failed. They failed, Mr Speaker, because a ban would contravene EU

0:20:09 > 0:20:15law. In 1992, the Conservative Government then in power sought to

0:20:15 > 0:20:20restrict live exports and refused licences to export sheep to Spain.

0:20:20 > 0:20:24Their decision was overturned by the European Court of Justice on the

0:20:24 > 0:20:28grounds that it would breach EU rules on the free movement of goods.

0:20:28 > 0:20:33Now that the UK has voted to leave the European Union, we have the

0:20:33 > 0:20:38opportunity to make the decision here in this House on whether to

0:20:38 > 0:20:42allow or prohibit the export of live farmed animals.

0:20:42 > 0:20:46But that will only be the case if we leave the customs union and the

0:20:46 > 0:20:50single market, if we do not, we'll remain subject to the restrictions

0:20:50 > 0:20:54that make such a ban impossible today and that provides a further

0:20:54 > 0:20:58important reason to respect the result of the referendum and create

0:20:58 > 0:21:01a new partnership with our European neighbours outside the customs union

0:21:01 > 0:21:06and the single market. The case for a ban has been made

0:21:06 > 0:21:12clearly by a wide ranging coalition of animal welfare organisations,

0:21:12 > 0:21:18including compassion in world farming, the RSPCA, the concern to

0:21:18 > 0:21:22animal welfare foundation and world horse welfare. The Conservative

0:21:22 > 0:21:25manifesto states "as we leave the European Union, we can take early

0:21:25 > 0:21:31steps to control the export of live farm animals for slaughter". This

0:21:31 > 0:21:34Bill, Mr Speaker, provides the Government with an opportunity to do

0:21:34 > 0:21:38exactly that. But we need to deal, not just with the slaughter trade

0:21:38 > 0:21:50but also the export of calf force fattening which can willed lead to

0:21:50 > 0:21:54unnecessary suffering -- calfs for fanning. We shouldn't wait until the

0:21:54 > 0:21:58UK leaves the EU to take action, we should put a prohibition on the

0:21:58 > 0:22:04statute book now to come into effect on exit day as soon as the United

0:22:04 > 0:22:10Kingdom leaves the European Union. Mr Speaker, the time has come to end

0:22:10 > 0:22:15this inhumane cruel and unnecessary trade which has no legitimate part

0:22:15 > 0:22:20to play in modern farming. Exports should took place on the hook, not

0:22:20 > 0:22:25the hoof, and I commend this Bill to the House.

0:22:25 > 0:22:28THESPEAKER:. Thank you. The question is that the Right

0:22:28 > 0:22:31Honourable member have leave to bring in the Bill. As many are of

0:22:31 > 0:22:35that opinion say aye. Of the contrary no. I think the ayes have

0:22:35 > 0:22:43it, the ayes have it.Who will prepare and bring in the Bill?Zac

0:22:43 > 0:22:50Goldsmith, Craig McKinly, Richard Graham, Henry Smith, Caroline Lucas,

0:22:50 > 0:22:54Angela Smith, Kelvin Hopkins, Sir Roger Gail, Kate Hoey, and myself,

0:22:54 > 0:22:58Sir.

0:23:00 > 0:23:05THE SPEAKER:Mrs Theresa Villiers.

0:23:28 > 0:23:29Live animal exports prohibition Bill.

0:23:29 > 0:23:34THE SPEAKER:Second reading what day?2nd February.

0:23:34 > 0:23:41THE SPEAKER:2nd February, 2018. Thank you. We come now to the first

0:23:41 > 0:23:49opposition day motion on social care, to move the motion I call

0:23:49 > 0:23:53Barbara Keeley. Thank you, Mr Speaker. After the

0:23:53 > 0:23:56debacle of the dementia tax, there's been continuing concern that the

0:23:56 > 0:24:00current and future issues about the funding of social care are not being

0:24:00 > 0:24:05addressed. The worries stirred bum I the party opposite during the

0:24:05 > 0:24:10general election are not going to be resolved without a better idea about

0:24:10 > 0:24:14what the future holds for social care -- stirred up by. One place

0:24:14 > 0:24:18people were expecting to hear discussion on this was at the Party

0:24:18 > 0:24:22Conferences in September, but if we thought we were going to hear about

0:24:22 > 0:24:24this in the conferences, by the Secretary of State responsible for

0:24:24 > 0:24:28social care, we were sadly let down. At the Labour Party Conference, I

0:24:28 > 0:24:31talked about the crisis in social care and how it was failing those

0:24:31 > 0:24:40who need care and their families failing unpaid family. People

0:24:40 > 0:24:44needing care and their carers face the greatest impact. Since the party

0:24:44 > 0:24:50opposite came to power in 2010, there are 400,000 fewer people

0:24:50 > 0:24:58receiving publicly funded care. Sadly, over 1.2 million people now

0:24:58 > 0:25:05live isolated and lonely. I will give way.She's raising a very

0:25:05 > 0:25:12important issue. Would she make reference to the Royal Commission on

0:25:12 > 0:25:16long-term care which almost two decades ago recommended free

0:25:16 > 0:25:21long-term care for all, which is where we should be at?

0:25:21 > 0:25:24I thank my right honourable friend and I will be talking about how this

0:25:24 > 0:25:27party will be taking forward proposals on the future of social

0:25:27 > 0:25:33care. We wait to hear from the party opposite what they choose to do. But

0:25:33 > 0:25:36he's right, it's a very driving need now.

0:25:36 > 0:25:40That is a number, the 1.2 million people living with the care needs

0:25:40 > 0:25:44that will rise without an injection of new funding. The lack of publicly

0:25:44 > 0:25:48funded care means that the task of meeting care needs falls more

0:25:48 > 0:25:52heavily on to unpaid family carers. Many carers have to give up work

0:25:52 > 0:25:56because of the demands of caring with a real impact on finances and

0:25:56 > 0:26:00future career prospects. The case for listening to carers and giving

0:26:00 > 0:26:04them more support is overwhelming. We were expecting new carers

0:26:04 > 0:26:08strategy this spring or at the latest in the summer. 6,500 carers

0:26:08 > 0:26:12have taken the time over and above their caring responsibilities to

0:26:12 > 0:26:16respond to the Government's consultation. However, the Care

0:26:16 > 0:26:19Minister told me their responses are now merely going to be taken forward

0:26:19 > 0:26:23into a new consultation on social care.

0:26:23 > 0:26:28Kayleigh Styles is a carer and she's a campaigner for the M & D

0:26:28 > 0:26:32association who contributed to the consultation and who hoped her voice

0:26:32 > 0:26:38would be heard alongside 4 6,500 other carers -- Katie. She told me

0:26:38 > 0:26:42not publishing the national carers strategy has made me extremely

0:26:42 > 0:26:45angry, it sends a message that carers' lives are unimportant, it

0:26:45 > 0:26:49sends a message that Government thinks we can carry on as we are. It

0:26:49 > 0:26:54sends a message that my own time is of little worth. That is a shabby

0:26:54 > 0:26:59way to treat carers. The people who provide more than 50% of the care in

0:26:59 > 0:27:12this country. Yes, I will give way. She refers to unpaid carers and the

0:27:12 > 0:27:18emotional reference to the report in care which allows payments to be

0:27:18 > 0:27:22made to family members to remunerate them for that care. Has she read

0:27:22 > 0:27:27that report and is she willing to look at it in further Dell tail on a

0:27:27 > 0:27:31cross party basis?I'll come on later to how we should proceed,

0:27:31 > 0:27:35whether we should proceed on a cross party basis and how, Mr Speaker, but

0:27:35 > 0:27:39I think the point he makes about carers and family carers is an

0:27:39 > 0:27:45important one. The plain fact of the matter is, there was nothing in his

0:27:45 > 0:27:50party's manifesto for carers, absolutely nothing. We anountsed we

0:27:50 > 0:27:54were going to lift carers allowance to the level of JSA at least --

0:27:54 > 0:27:57announced. That was the only improvement talked about in the

0:27:57 > 0:28:00general election. He ought to turn really to his own minister and party

0:28:00 > 0:28:06and ask them what they are going to do for carers.

0:28:07 > 0:28:12The tone in which she is setting out her remarks I think is very

0:28:12 > 0:28:16valuable, I know she has taken an enormous interest in the subject but

0:28:16 > 0:28:20these debates are very helpful for educating people about the difficult

0:28:20 > 0:28:25issues. The disappointing thing about the motion and I am happy to

0:28:25 > 0:28:28accept we did not handle this issue well in the general election but the

0:28:28 > 0:28:32mistake we made was not being clear about the current system and that is

0:28:32 > 0:28:35why her reference here to what we propose without setting of the

0:28:35 > 0:28:41current system where people can potentially lose all but £23,000 of

0:28:41 > 0:28:43assets I think is something which would have helped contribute to the

0:28:43 > 0:28:51public debate.Mr Speaker we will come onto that, but if the Minister,

0:28:51 > 0:28:54the honourable member wants to get into the mess his party made of this

0:28:54 > 0:28:59the truth is we legislated, we legislated a number of years ago to

0:28:59 > 0:29:04lift the asset floor to hundred and 18,000, what his party did during

0:29:04 > 0:29:11the general election is dropped back to 100,000 and in fact we learned at

0:29:11 > 0:29:14the weekend there was an intention to make it only 50,000 so I think

0:29:14 > 0:29:18you should be clear and perhaps speak to his front bench colleagues,

0:29:18 > 0:29:22what were they trying to do. And then we have heard is a deafening

0:29:22 > 0:29:32silence. We need action on social care now. There are two aspects. On

0:29:32 > 0:29:36the side of the house we have raised many times how fragile the care

0:29:36 > 0:29:43sector is after years of budget cuts from the party opposite. Sergei by

0:29:43 > 0:29:46the Association of directors of adult social services reckons over

0:29:46 > 0:29:52one third of councils have reported closures of and nearly half of those

0:29:52 > 0:29:55councils have had home-care providers handing back contracts.

0:29:55 > 0:30:04Yes indeed.She refers again to local authority care homes, in my

0:30:04 > 0:30:07constituency three superb local authority care homes were forcibly

0:30:07 > 0:30:14closed, effectively by government policy which were loved by the

0:30:14 > 0:30:17residents, with full-time permanent employed trade union staff and were

0:30:17 > 0:30:22supported and applauded by the local health care professionals. They were

0:30:22 > 0:30:29all closed and now we have the private sector which is in crisis.I

0:30:29 > 0:30:35think it's a very important factor that we should bear in mind that the

0:30:35 > 0:30:381.5, 1.45 million workforce in care will have been local government

0:30:38 > 0:30:43employees in the past and will have enjoyed local government terms and

0:30:43 > 0:30:46conditions. We have talked in many times in this house that they are

0:30:46 > 0:30:51now not paid minimum wage, often not paid travel time, very badly paid

0:30:51 > 0:30:58with no pensions in prospect. Yes indeed.As she knows in my

0:30:58 > 0:31:02constituency which neighbours hers we have a real problem as a result

0:31:02 > 0:31:06in recruiting and retaining key workers. Many tell me they can get

0:31:06 > 0:31:09better paid working in the local supermarket than doing the job they

0:31:09 > 0:31:14love. There she not agree that in part because private providers would

0:31:14 > 0:31:17like to pay their staff more but cannot do so because of the

0:31:17 > 0:31:21insufficiency of the value of the contracts they receive from local

0:31:21 > 0:31:28authorities?That absolutely the case, in fact I had a very recent

0:31:28 > 0:31:33meeting with Unison and they told me that in our area in greater

0:31:33 > 0:31:36Manchester one person can be paid more forbidding toppings onto pizzas

0:31:36 > 0:31:42at Morrisons than they can for providing care often for people with

0:31:42 > 0:31:48dementia or who really need it. Yes. The honourable lady talks about the

0:31:48 > 0:31:51squeeze on funding, on that basis would she agree that it would be

0:31:51 > 0:31:55right to asked those who do have the means to contribute more towards

0:31:55 > 0:32:02their social care in the home?I do not agree with that and I think it

0:32:02 > 0:32:07is one of the reasons his party's policy, the dementia tax policy

0:32:07 > 0:32:11fails so badly. To suddenly bring hundreds of thousands of people into

0:32:11 > 0:32:15means testing using their homes was, I can say to the honourable

0:32:15 > 0:32:20gentleman, one of the biggest flaws in the policy has party floated. I

0:32:20 > 0:32:23want to make progress now on the state of care because the fragility

0:32:23 > 0:32:28of the care sector is a key factor. We heard from my honourable friend

0:32:28 > 0:32:33about closures in his area but it is the case that councils are not even

0:32:33 > 0:32:39able to influence this any more because providers and home-care

0:32:39 > 0:32:44providers are handing back contracts. Indeed one in five of the

0:32:44 > 0:32:48councils reported closures in all three services, home-care,

0:32:48 > 0:32:53residential care and nursing home services. There are also serious

0:32:53 > 0:32:58issues with care quality in many areas of the country. The survey

0:32:58 > 0:33:02reported 70% of the councils surveyed had experienced quality

0:33:02 > 0:33:08issues across all three types of care services. It is estimated this

0:33:08 > 0:33:11means 20,000 people have been affected by care quality issues are

0:33:11 > 0:33:15by a change of service due to contract been handed back and we

0:33:15 > 0:33:18know, don't we, that for a person with dementia are continual change

0:33:18 > 0:33:25in the people visiting them is a really big issue. So those arguing

0:33:25 > 0:33:29in favour of cuts and to think about was 28,000 lives affected negatively

0:33:29 > 0:33:34by cuts to local authority budgets. Worryingly the Care Quality

0:33:34 > 0:33:37Commission now report almost a quarter of care services are not

0:33:37 > 0:33:41meeting standards on safety and almost a fifth of services require

0:33:41 > 0:33:46improvement overall. I spoke earlier about how budget cuts mean over

0:33:46 > 0:33:51400,000 fewer people are now getting publicly funded care. Of course that

0:33:51 > 0:33:54means councillors, council leaders and social workers have had to make

0:33:54 > 0:33:57difficult decisions on cutting budgets and support the local people

0:33:57 > 0:34:02in their area. It's a great credit to councils and council leaders that

0:34:02 > 0:34:07so many are continuing to prioritise adult social care in the budget

0:34:07 > 0:34:12setting but the overall position is one of cuts. The real terms loss of

0:34:12 > 0:34:16£6.3 billion to adult social care by the end of this financial year and

0:34:16 > 0:34:20we heard earlier from my honourable friend for Manchester Gorton on the

0:34:20 > 0:34:24level of cuts for the city of man you are. These cuts have an impact

0:34:24 > 0:34:28on staff working in social care... On that point will the honourable

0:34:28 > 0:34:34lady give way? I am grateful. Mr Speaker, the government and HMRC

0:34:34 > 0:34:38have acknowledged that care workers who sleep in giving a loving care to

0:34:38 > 0:34:44those badly in need of it are now entitled to the national living wage

0:34:44 > 0:34:49but as a result a crisis confronts the centre, the final nail in the

0:34:49 > 0:34:54Coughlan for many providers, jobs lost and also a real risk of

0:34:54 > 0:34:57bankruptcy for a whole number of people who have personal care

0:34:57 > 0:35:00packages, does the honourable lady agree with me that the government

0:35:00 > 0:35:05that created this problem should solve this problem and not expect

0:35:05 > 0:35:11local authorities to pick up the bill?I absolutely do agree. I think

0:35:11 > 0:35:18it's very helpful that he has intervened to make that point. This

0:35:18 > 0:35:22issue has been a real cause of worry for many organisations for many

0:35:22 > 0:35:28months. It just goes to the heart of our assertion that people who work

0:35:28 > 0:35:31in care should be paid the minimum wage and should be paid the minimum

0:35:31 > 0:35:35wage when they are working at night which is what sleep ins are. I have

0:35:35 > 0:35:41a constituent who is looking after two households, two affected

0:35:41 > 0:35:44properties, adjoining properties of people and she will not get normal

0:35:44 > 0:35:48sleep during the night when alarms can go off in any part of the

0:35:48 > 0:35:52property and it's not right that all that fixed amounts, not the minimum

0:35:52 > 0:35:55wage, is paid to those people. It's the case that the government must

0:35:55 > 0:36:02find the funding for that decision. I apologise for intervening so often

0:36:02 > 0:36:06but would she not agree, my honourable friend as they have

0:36:06 > 0:36:11hinted at, that we are to have in the longer term at least the whole

0:36:11 > 0:36:16care sector in the public sector provided on the same basis, free at

0:36:16 > 0:36:23the point of need like the National health service?I will come as I

0:36:23 > 0:36:28said earlier to our proposals, I do not want to jump around too much

0:36:28 > 0:36:33more in my speech. Going back to staff working in social care we have

0:36:33 > 0:36:35to think about social workers and it's important we remember not just

0:36:35 > 0:36:40care staff as we have talked about but social workers. A recent survey

0:36:40 > 0:36:43found that less than half of the social workers surveyed felt

0:36:43 > 0:36:47decisions about a personals care and support Rabin led to their

0:36:47 > 0:36:51professional judgment. It's now all about budgets. More than a third

0:36:51 > 0:36:55said they felt unable to get people the care they need and less than

0:36:55 > 0:36:58half of social work role spurt supported to have the difficult

0:36:58 > 0:37:04conversation is needed with people needing care and their families. The

0:37:04 > 0:37:06social care crisis is a direct result of the cuts this government

0:37:06 > 0:37:12has chosen to make. The King 's fund, the health foundation and the

0:37:12 > 0:37:17Nuffield trust have estimated a funding gap of £1.9 billion for this

0:37:17 > 0:37:21year but the extra funding in the budget was only 1 billion so we

0:37:21 > 0:37:26still have a funding gap of £900 million this year. This is why

0:37:26 > 0:37:30Labour pledged extra £1 billion for social care this year the star to

0:37:30 > 0:37:34deal with the funding crisis. However the government has chosen

0:37:34 > 0:37:38instead to put the pressure onto local authorities and hard-pressed

0:37:38 > 0:37:41local council taxpayers to deal with the social crisis which was in

0:37:41 > 0:37:50Downing Street. The lady transferral of care increased by more than a

0:37:50 > 0:37:56quarter putting extra pressure on local councils. But now sadly we see

0:37:56 > 0:37:58government ministers threatening councils with fines and further

0:37:58 > 0:38:03funding cuts to social care if targets on cutting delayed transfers

0:38:03 > 0:38:07of care cannot be met. It's reported that half social services director

0:38:07 > 0:38:13as they surveyed believe their targets on delayed transfers were

0:38:13 > 0:38:18unrealistic. It is barely believable that the government 's response to

0:38:18 > 0:38:21the social care crisis is to threaten to make the situation worse

0:38:21 > 0:38:26by cutting funding for social care even further. Some councils

0:38:26 > 0:38:29experiencing problems meeting targets were even summoned by NHS

0:38:29 > 0:38:33leaders last week to a meeting to review the performance challenges.

0:38:33 > 0:38:38Many different people have said that this approach, blaming and

0:38:38 > 0:38:42penalising local councils and it is not sustainable. The Conservative

0:38:42 > 0:38:46chair of the local government Association said of those warning

0:38:46 > 0:38:50letters now council wants to see anybody stay in hospital for a day

0:38:50 > 0:38:55longer than necessary. These letters are hugely unhelpful at a time when

0:38:55 > 0:38:59local government and the NHS need to work together to tackle the health

0:38:59 > 0:39:03and social care crisis. The president of the Association of the

0:39:03 > 0:39:06directors of adult social services has described the government 's

0:39:06 > 0:39:08actions in making these threats of further sanctions as frankly

0:39:08 > 0:39:15bizarre. David Oliver, clinical boys president of the Royal College of

0:39:15 > 0:39:19physicians said this about the late transfers of care, some of these

0:39:19 > 0:39:23delays are due to systematic cuts to social care budget and provision and

0:39:23 > 0:39:27others are due to a lack of capacity into Canadian health care services.

0:39:27 > 0:39:34He also said attempts to solve the problem through better care fund or

0:39:34 > 0:39:39NHS England have failed. I think interestingly the Chief inspector of

0:39:39 > 0:39:42social care at the Care Quality Commission Andrew Sutcliffe said I

0:39:42 > 0:39:48worry that if people focus on moving people through the system, quickly,

0:39:48 > 0:39:51doesn't mean they will force the discharge of someone old and frail

0:39:51 > 0:39:57into a service we have rated inadequate. We now have a government

0:39:57 > 0:40:01driving the NHS to be obsessed with dealing with the late transfers of

0:40:01 > 0:40:05care are seemingly above all else and this obsession causes further

0:40:05 > 0:40:09problems if patients are discharged without planning for what they need

0:40:09 > 0:40:13outside a hospital. Age UK give an example brought to them. Terry's

0:40:13 > 0:40:18father Richard 85 is in hospital following a stroke, he is ready for

0:40:18 > 0:40:22discharge and assessed as needing rehabilitative care to two home

0:40:22 > 0:40:26visits a day but he was then told there are no services available in

0:40:26 > 0:40:31his area. Terry has been told to get his father out of hospital and to

0:40:31 > 0:40:37look for and fund the care himself. My own local hospital, Salford

0:40:37 > 0:40:41Royal, seems sadly to have similar issues. Last week I spoke to a

0:40:41 > 0:40:44constituent who described her discharge like this: I was thrown

0:40:44 > 0:40:52out of hospital. Having had surgery for an infected bite which caused

0:40:52 > 0:40:56sepsis my constituent was given no discharge summary, no advice on how

0:40:56 > 0:41:00to manage her wind or her recovery. When she struggled to get dressed

0:41:00 > 0:41:03she was told she had to get out quickly otherwise this would count

0:41:03 > 0:41:09as a field discharge. This is a theme we might remember from last

0:41:09 > 0:41:14winter. I want to remind the Minister the British Red Cross top

0:41:14 > 0:41:16then they can manage it in crisis which saw people sent home without

0:41:16 > 0:41:22clothes or into chaotic situations which saw them falling and not been

0:41:22 > 0:41:26found for hours or not being washed because there were no care staff to

0:41:26 > 0:41:32help. Ordering patients out of hospital where there is no Rhys

0:41:32 > 0:41:36Gowman service for them without advice about wounds or recovery or

0:41:36 > 0:41:41to care facility rated inadequate just to meet unrealistic targets on

0:41:41 > 0:41:45delayed discharge is a recipe for an even worse crisis this winter. Yes

0:41:45 > 0:41:55indeed.In East Sussex where I represent the social care and the

0:41:55 > 0:41:59hospital budgets have been merged together and as a result of that the

0:41:59 > 0:42:02accident and emergency is now the fastest improved in the whole of

0:42:02 > 0:42:07England because it is working, would perhaps her local authority were she

0:42:07 > 0:42:13is perhaps consider the same model? My local authority has the most

0:42:13 > 0:42:18advanced example of an integrated care organisation in the country. We

0:42:18 > 0:42:21have already transferred all of our social care staff to work for

0:42:21 > 0:42:24Salford Royal so we have the most advanced model of integration is

0:42:24 > 0:42:29anyway I think and I have just quoted a situation where the

0:42:29 > 0:42:34pressure that's been put onto hospitals because of delayed

0:42:34 > 0:42:37transfers is causing them to treat people like my constituent in the

0:42:37 > 0:42:41way they had. I think members opposite ought to listen to that

0:42:41 > 0:42:44because it is the government and their ministers causing this

0:42:44 > 0:42:49pressure. We now demand is increasing as more people live

0:42:49 > 0:42:53longer with more complex conditions and the number of people aged 75 and

0:42:53 > 0:42:58over is projected to nearly double by 2039. That ought to be something

0:42:58 > 0:43:01to celebrate but instead the government have created fear and

0:43:01 > 0:43:04uncertainty for older people by failing to address the health care

0:43:04 > 0:43:07challenges raised by those demographic changes. Indeed the

0:43:07 > 0:43:11party opposite is spending less money on social care now than when

0:43:11 > 0:43:16Labour left office in 2010. They seem to have no plan to develop a

0:43:16 > 0:43:19sustainable solution to the funding of social care in the longer term,

0:43:19 > 0:43:22they have talked on the other consultation followed by a green

0:43:22 > 0:43:27paper. Furthermore and this is raising real feel rushed that the

0:43:27 > 0:43:30focus has been entirely on the needs of older people without considering

0:43:30 > 0:43:35the needs of the 280,000 working age people with disabilities are

0:43:35 > 0:43:38learning disabilities who are in the social care system. This is

0:43:38 > 0:43:44profoundly short-sighted because now financial pressures on local

0:43:44 > 0:43:48authorities due to the increase in care needs of younger adults with

0:43:48 > 0:43:51disabilities or with mental health problems are greater than those due

0:43:51 > 0:43:52to supporting older people.

0:43:56 > 0:44:00I'm very glad she's mentioned the issue of younger adults. Would she

0:44:00 > 0:44:04not agree that investing in the care that they need will facilitate the

0:44:04 > 0:44:08Government's achievement of its ambition to have more disabled

0:44:08 > 0:44:13people who can work in paid employment, relatively low levels of

0:44:13 > 0:44:16expenditure for care with those people would pay great dividends for

0:44:16 > 0:44:20the Government and the country? That's very much so, I thank my

0:44:20 > 0:44:25right honourable friend for making that point. It's concerning that

0:44:25 > 0:44:29consultations planned or discussions about future policy should actually

0:44:29 > 0:44:34focus so much just on older people when the needs of people with

0:44:34 > 0:44:37disabilities, learning disabilities are so important and we talked in a

0:44:37 > 0:44:41debate last week about learning disabilities. Mr Speaker, Labour

0:44:41 > 0:44:44will fill the policy vacuum which currently exists with this

0:44:44 > 0:44:48Government around social care. Over the coming months, we will consult

0:44:48 > 0:44:52experts to advise us on how we can move from the current broken system

0:44:52 > 0:44:56of care to a sustainable service for the long-term. We will look at

0:44:56 > 0:45:01funding options for social care in the long-term, including wealth

0:45:01 > 0:45:04taxes and employer care contribution, or a new social care

0:45:04 > 0:45:09levy. These experts will help clarify the options for funding our

0:45:09 > 0:45:14planned National Care Service. Our approach will be underpinned by the

0:45:14 > 0:45:18principle of pooled risk, so that no-one faces catastrophic care costs

0:45:18 > 0:45:23as they do now, or as they would do under the dementia tax of the party

0:45:23 > 0:45:26opposite. Our plans are for a National Care Service. They were

0:45:26 > 0:45:30based on a consultation, the big care debate, which involved 68,000

0:45:30 > 0:45:34people. People in that consultation told us they needed a system that

0:45:34 > 0:45:38will support them and their families to live the lives they want, that

0:45:38 > 0:45:41will treat everyone with dignity and respect and that will give them

0:45:41 > 0:45:46choice and control over their care. I believe that those needs still

0:45:46 > 0:45:50remain the same and they will be at the heart of our ambition for social

0:45:50 > 0:45:53care. Mr Speaker, I urge honourable members from all parties to vote

0:45:53 > 0:45:57with us today so that we can set the foundations for a safer, more

0:45:57 > 0:46:02sustainable and higher quality care system for the future and reassure

0:46:02 > 0:46:06those people who become worried about the dementia tax mess of the

0:46:06 > 0:46:10party opposite. I'll give way.I thank the honourable lady for giving

0:46:10 > 0:46:14way. I'm always very impressed with her knowledge in this area. Just to

0:46:14 > 0:46:18clarify, did I hear her say she was considering wealth taxes as a means

0:46:18 > 0:46:24to pay for this? The honourable lady talked about a policy vacuum. I

0:46:24 > 0:46:28would be very interested to hear where the money vacuum is going to

0:46:28 > 0:46:33come from and I was somewhat concerned and I hope she will

0:46:33 > 0:46:39explain it, that a national sort of care system rather puts families

0:46:39 > 0:46:45aside. I'm somewhat concerned to hear that.

0:46:45 > 0:46:48Mr Speaker, I'm obviously coming to the end of my speech. I can

0:46:48 > 0:46:51recommend that the honourable member, if he's interested, reads a

0:46:51 > 0:46:55number of documents. We produced a White Paper for our National Care

0:46:55 > 0:46:57Service, I know it's still available, I advice him to look at

0:46:57 > 0:47:03that. There is no way that we would not include carers given everything

0:47:03 > 0:47:05I've said about carers in this speech, as an important part of

0:47:05 > 0:47:11that. But the burden should not just be dumped on carers, they should be

0:47:11 > 0:47:14partners in care and they should be support sod they have a life of

0:47:14 > 0:47:21their own. It's said about his own Governments, his own party's

0:47:21 > 0:47:24proposals for dementia tax that in terms of the manifesto, that the

0:47:24 > 0:47:30only numbers that were put on that were actually the page numbers. We

0:47:30 > 0:47:36produced a document, this document, funding bring's future, with a fully

0:47:36 > 0:47:47costed manifesto. Yes, he is right to say... I advise him if he has a

0:47:47 > 0:47:52bit more time for reading to go to our manifesto and look how we laid

0:47:52 > 0:47:57out the options. We laid out the options, we didn't get into a mess,

0:47:57 > 0:48:02as the party opposite and try to change it after four days.

0:48:02 > 0:48:06We will take this forward, we will not kick it into the long grass as

0:48:06 > 0:48:10the party opposite is trying to do. No, I'm just going to finish. Our

0:48:10 > 0:48:14motion also asked, Mr Speaker, for action to make sure the care sector

0:48:14 > 0:48:19gets the urgent funding it needs to prevent collapse and it will ensure

0:48:19 > 0:48:23that hard-pressed councils are not penalised for failing to meet

0:48:23 > 0:48:27unrealistic targets for delayed transfers of care.

0:48:27 > 0:48:34THE SPEAKER:The question is as on the order paper, I call the minister

0:48:34 > 0:48:38Jackie Doyle-Price.Thank you, Mr Speaker, I'm grateful for the

0:48:38 > 0:48:43opportunity to answer this debate because I think it gives the

0:48:43 > 0:48:47Government an opportunity to set out exactly where we are in this place

0:48:47 > 0:48:51and it's not, as has been characterised by the honourable lady

0:48:51 > 0:48:54in her opening remarks. She is, as ever, characteristically

0:48:54 > 0:48:58challenging, and I hope to answer some of the issues she's raised

0:48:58 > 0:49:04today. Some of the messages that she's given, I have some sympathy

0:49:04 > 0:49:10with but I again, through my remarks, I hope will reassure her on

0:49:10 > 0:49:14some points. But no speech really should start without paying tribute

0:49:14 > 0:49:20to everyone who works in social care. Everyone from the care

0:49:20 > 0:49:25assistants, managers of the care businesses, occupational therapists,

0:49:25 > 0:49:28social workers, nurses, trusted assessors and the many officials in

0:49:28 > 0:49:32local authority who is organise care packages and adaptations to people's

0:49:32 > 0:49:37homes. As the honourable gentleman's just said, an increasing number of

0:49:37 > 0:49:40people all with the best of motivations to care and we should

0:49:40 > 0:49:45celebrate the work that they do to support those who find themselveses

0:49:45 > 0:49:48in vulnerable situations across our society and I would like all to

0:49:48 > 0:49:52recognise the excellent work that they do. Now, the quality and

0:49:52 > 0:49:58provision of care has been hitting the headlines ever more recently.

0:49:58 > 0:50:01It's therefore reassuring and humbling to see the care and support

0:50:01 > 0:50:05sector respond with such resilience, commitment and compassion. I was

0:50:05 > 0:50:09delighted to see the Care Quality Commission's rated 80% of social

0:50:09 > 0:50:14care settings as good or outstanding.Would the minister on

0:50:14 > 0:50:17that note give way, please. I'll thank the Minister for Raising that

0:50:17 > 0:50:21because I would like madam deputy speak tore say we shouldn't be so

0:50:21 > 0:50:24negative about this area and in the latest report from the Care Quality

0:50:24 > 0:50:29Commission it's said that four out of five institutions are offer good

0:50:29 > 0:50:36or outstanding services. In my constituency of Taunton Deane, I

0:50:36 > 0:50:38recently visited Abbeyfield, the staff are well-paid and loved their

0:50:38 > 0:50:45jobs and the people were very happy there. Somerset Care House, an Cream

0:50:45 > 0:50:48Care recently rated outstanding for its services. I took Jeremy Hunt

0:50:48 > 0:50:52there, relatively recently, and this is kind of old people in Somerset

0:50:52 > 0:50:57need to know they can have and this Government is doing it.I think my

0:50:57 > 0:51:01right honourable friend highlights one of many examples up and down the

0:51:01 > 0:51:04country but we shouldn't be complacent about the 20% that

0:51:04 > 0:51:07require improvement and there will be lots of work that we can do to

0:51:07 > 0:51:11raise the standard there, not least the work that we are doing in

0:51:11 > 0:51:15collaboration with the voluntary sector and the LGA to spread

0:51:15 > 0:51:19examples of good practice and quality and we'll obviously continue

0:51:19 > 0:51:24to do that. We should celebrate other good work going on around the

0:51:24 > 0:51:28country. In Sutton, for example, in just within year, even though the

0:51:28 > 0:51:35number of beds for care homes supported by GPs supported by the

0:51:35 > 0:51:41CCG increased 14%, there was an overall reduction in residents

0:51:41 > 0:51:46attending A&E. They had better coordination of care and in-house

0:51:46 > 0:51:49training of staff and better support for older people actually in the

0:51:49 > 0:51:54homes. It shows that with collaboration, we can get better

0:51:54 > 0:51:57care standards. Social care continues to be a key priority for

0:51:57 > 0:52:05this Government. Yes.The honourable lady's right, none so noble as those

0:52:05 > 0:52:09who care but can I press her on this - the care sector is facing a

0:52:09 > 0:52:14disaster as a consequence of having to pick up a £400 million bill

0:52:14 > 0:52:18because of the confusion in the ranks of Government and likewise in

0:52:18 > 0:52:23that of the HMRC in terms of the entitlement to nose who sleep in to

0:52:23 > 0:52:28the national minimum wage. Can the honourable lady say today that that

0:52:28 > 0:52:34burden which was not the creation of the care sector, that burden will

0:52:34 > 0:52:37not fall upon Local Government but will instead, the funds necessary

0:52:37 > 0:52:42will be met by central Government? Well, the honourable gentleman

0:52:42 > 0:52:47raises an extremely important point and one thatI am very actively

0:52:47 > 0:52:50thinking about. He's absolutely right in the sense that the

0:52:50 > 0:52:54providers have been following guidance which has changed. It's

0:52:54 > 0:52:59clear from our perspective that employers are obliged to meet their

0:52:59 > 0:53:02obligations under minimum wage legislation but I'm very clear of

0:53:02 > 0:53:05the challenge that's giving to the sector and we will work with them to

0:53:05 > 0:53:08develop a solution.

0:53:10 > 0:53:18I'm not used to this, clearly. Turning to the substance of the

0:53:18 > 0:53:21motion, we announced in the Queen's speech that we'll work to address

0:53:21 > 0:53:26challenges of social care for our ageing population and we will bring

0:53:26 > 0:53:29forward proposals for consultation to build widespread support for

0:53:29 > 0:53:33future provision. I'll give way to the honourable

0:53:33 > 0:53:37lady.I thank the Minister for Taking my intervention. At least 60%

0:53:37 > 0:53:42of those receiving social care in the home and 70% of those in care

0:53:42 > 0:53:45home places are people living with dementia and the underfund of course

0:53:45 > 0:53:48social care's meant the burden falls disproportionately on those very

0:53:48 > 0:53:52people. Does the minister agree with me that whatever the system social

0:53:52 > 0:53:57care provided it's unacceptable that those living with dementia and their

0:53:57 > 0:53:59families should be disproportionately affected?I'd

0:53:59 > 0:54:04invite the House to just reflect on what the honourable lady has just

0:54:04 > 0:54:07said because that is exactly the issue we really need to tackle. It's

0:54:07 > 0:54:11very clear there are one in ten people who face very significant

0:54:11 > 0:54:18costs that they have to meet from their own resources. With only

0:54:18 > 0:54:2214,000 ultimately protected. She's right to point out that most of

0:54:22 > 0:54:26those, the vast that swrort of those are people suffering with dementia

0:54:26 > 0:54:29and Alzheimer's. I think we have now reached the time where it's critical

0:54:29 > 0:54:34that we have a consensus about how we address the funding of social

0:54:34 > 0:54:40care so we can address the injustice she's ably highlighted.On that, am

0:54:40 > 0:54:48I right in thinking that under current statute law, from the

0:54:48 > 0:54:55financial year 21-22, a cap of £72,500 will apply and if that

0:54:55 > 0:54:59settlement is to be altered, it will require primary legislation in this

0:54:59 > 0:55:08Parliament?The honourable gentleman is indeed correct. The ageing

0:55:08 > 0:55:11population presents one of the nation's most profound challenges,

0:55:11 > 0:55:15it raises critical questions as to how a society will enable all adults

0:55:15 > 0:55:18to live well into later life and how we deliver sustainable Public

0:55:18 > 0:55:24Services that support them to do so. Will my right honourable friend give

0:55:24 > 0:55:29way on that point. On a spirit of cross party consensus, can I add my

0:55:29 > 0:55:31support to what the honourable member for Stretford and Urmston

0:55:31 > 0:55:36raised which is to make sure that when we bring forward our

0:55:36 > 0:55:40consultation, we do cover something close to 50% of the social care

0:55:40 > 0:55:44spending that's spent on adults with disabilities because I share the

0:55:44 > 0:55:48view that we must make sure they are properly supported and able to lead

0:55:48 > 0:55:51full lives including where able move into work. That's something that

0:55:51 > 0:55:55sometimes gets lost in the debate when we completely focus on people

0:55:55 > 0:55:58towards tend of the their lives, we must deal with everybody, this's a

0:55:58 > 0:56:01really important point the honourable lady made.

0:56:01 > 0:56:05I couldn't agree more and I share my right honourable friend's support

0:56:05 > 0:56:10for what the honourable lady said. I think there's still many

0:56:10 > 0:56:15opportunities to get people with ageing adults with disabilities into

0:56:15 > 0:56:18work. It's challenge that woeful set ourselves a target of getting a

0:56:18 > 0:56:25million more people with disabilities into work. -- it's a

0:56:25 > 0:56:31challenge we have set out. The honourable lady in her opening

0:56:31 > 0:56:34remarks, much of the debate has focussed on the how we care for the

0:56:34 > 0:56:38elderly, but as the honourable lady laically will be aware, support for

0:56:38 > 0:56:42working age adults is becoming an increasingly bigger proportion of

0:56:42 > 0:56:46local authority spending in this area. It's very important that we

0:56:46 > 0:56:50focus on it. I can say that alongside the preparations we are

0:56:50 > 0:56:54making for the consultation in the New Year, we have a parallel work

0:56:54 > 0:56:57stream looking specifically at working age adults because some of

0:56:57 > 0:57:03the solutions will be similar and some of them will be different.

0:57:03 > 0:57:07I thank the Minister for Giving way. It's very important we have got to

0:57:07 > 0:57:10this point today because she should know that very many organisations

0:57:10 > 0:57:15and individuals have been worried for months about this. In the

0:57:15 > 0:57:19Queen's speech, and the talk has been of a consultation around social

0:57:19 > 0:57:23care for older people, but I think that the wording needs to change if

0:57:23 > 0:57:26it's to encompass, as it should, working age people with disabilities

0:57:26 > 0:57:30or learning disabilities. Let's stop the focus on just older people if

0:57:30 > 0:57:33she would stop using it in letters we could have clarity on this, it

0:57:33 > 0:57:37would be helpful. I wonder whether it has to be a separate work stream?

0:57:37 > 0:57:40I think it does need to be a separate work stream because it's

0:57:40 > 0:57:45connected to the desire to get more people into work, but the two

0:57:45 > 0:57:48programmes are working in parallel and, as I said, it's a great

0:57:48 > 0:57:54opportunity today to actually get that on the record. Certainly my

0:57:54 > 0:57:58conversations with voluntary groups in the sector, this has been very

0:57:58 > 0:58:04much a focus of our conversations.

0:58:04 > 0:58:08The reason I think it is important to picking up the point about making

0:58:08 > 0:58:11sure it is separate but parallel is everything about how we are funding

0:58:11 > 0:58:15this one of the really important things is to make sure we do not

0:58:15 > 0:58:18inadvertently put in place any barriers to work were somebody would

0:58:18 > 0:58:22find if they moved into work because of their care would increase to the

0:58:22 > 0:58:29extent they are finding work of no consequence. That would not be an

0:58:29 > 0:58:32issue when it comes to funding care for older people so there are

0:58:32 > 0:58:35different challenges so I think a separate but parallel structure may

0:58:35 > 0:58:43be the one to go for.Again, I agree with everything said and to reassure

0:58:43 > 0:58:46the Honourable lady we will have plenty of opportunity to discuss

0:58:46 > 0:58:50these issues in the New Year because one of the ways we want to progress

0:58:50 > 0:58:54this is by building a real consensus. This is a strategic

0:58:54 > 0:59:00challenge facing us all because not only are we all living longer but

0:59:00 > 0:59:02working age adults with disabilities are living longer and it's a matter

0:59:02 > 0:59:07for celebration. We must do everything we can to make sure we

0:59:07 > 0:59:14can honour all our obligations to them.I am glad we are spending time

0:59:14 > 0:59:18on this subject and I apologise for intervening again, she will

0:59:18 > 0:59:22recognise I am sure that for working age adults it may be that relatively

0:59:22 > 0:59:27modest amounts of care enable them to participate more fully in the

0:59:27 > 0:59:31workplace and in wider civil society. Will she say that this

0:59:31 > 0:59:36separate but parallel work stream will acknowledge that because I fear

0:59:36 > 0:59:39there will be a pressure to look at the most severe and critical level

0:59:39 > 0:59:41of need and that means many people who could work with the most severe

0:59:41 > 0:59:44and critical level of need and that means many people who could work

0:59:44 > 0:59:47with a small amount of help will be shut out from doing so.I have to

0:59:47 > 0:59:56say I could not do that better myself. We can get a lot more return

0:59:56 > 1:00:02by putting, as she says, good value for money measures which will

1:00:02 > 1:00:06support people to live independently and be able to work. Very keen to

1:00:06 > 1:00:10explore those things. I will take one more but I do need to make

1:00:10 > 1:00:14progress.I do appreciate the minister giving way, just on the

1:00:14 > 1:00:19point about getting older with the Minister give me advice on my

1:00:19 > 1:00:23constituent who when her daughter who is quite disabled with epilepsy

1:00:23 > 1:00:30when the mother was retiring she realised she would lose her carer 's

1:00:30 > 1:00:34allowance as she went on to state pension and when she rang HMRC and

1:00:34 > 1:00:38the Department to enquire they said by your age they are normally shoved

1:00:38 > 1:00:42into a home. Could you give me some advice on how I could support my

1:00:42 > 1:00:48constituent?Well I have to say I am not impressed by the tail she

1:00:48 > 1:00:52requires but I would like in to look into that more directly and get back

1:00:52 > 1:00:58to you, thank you. The government has in a more stable footing and

1:00:58 > 1:01:03alleviate short-term pleasures rhythm

1:01:06 > 1:01:10one equipped to meet the challenges of increasing numbers of people with

1:01:10 > 1:01:13care needs. To address these questions the government will work

1:01:13 > 1:01:18with partners including those who use services, those who work to

1:01:18 > 1:01:23provide care and all other agencies to bring forward proposals for

1:01:23 > 1:01:26public consultation. The consultation will consult on a wide

1:01:26 > 1:01:31degree of options to encourage a very wide debate. The consultation

1:01:31 > 1:01:34will set out options to improve the care system and put it on a more

1:01:34 > 1:01:39secure financial footing, supporting people families and communities to

1:01:39 > 1:01:42prepare for old age and address issues related to quality of care

1:01:42 > 1:01:48and variation in practice. It will include proposals with options for

1:01:48 > 1:01:54caps on overall care costs and means tested floors. But it is a

1:01:54 > 1:01:57consultation and the government wishes to approach the future of

1:01:57 > 1:02:02social care in the spirit of consensus. Our consultation is

1:02:02 > 1:02:04designed to encourage a grown-up conversation in order that society

1:02:04 > 1:02:10can rise to the challenge.I am grateful for giving way, there are a

1:02:10 > 1:02:14number of options the government will consider, would the government

1:02:14 > 1:02:17also considered as contained within that report a system of social

1:02:17 > 1:02:22insurance which would provide a sustainable and simple system and

1:02:22 > 1:02:29would deal with some of the points raised about those adults of working

1:02:29 > 1:02:32age, all of that in the scheme providing protection for people who

1:02:32 > 1:02:39are on low incomes as well, it's a system that seems to work very

1:02:39 > 1:02:41effectively and garnered cross-party support in Germany when it was

1:02:41 > 1:02:47introduced.We do want to learn from examples from other countries, I

1:02:47 > 1:02:52would agree with that and the spirit of the consultation, it will be to

1:02:52 > 1:02:55inform a well-informed debate that can establish consensus and in that

1:02:55 > 1:02:59sense we will consider a wide variety of options and not just

1:02:59 > 1:03:01about funding but also about lifestyle solutions and other

1:03:01 > 1:03:09issues. Could I make some progress, I have taken many interventions, I

1:03:09 > 1:03:12apologise.On funding adult social care funding is made with government

1:03:12 > 1:03:19grants, council tax and business rates.Has further help join a

1:03:19 > 1:03:24health care services so people can manage health and well-being and

1:03:24 > 1:03:29live independently in their communities for as long as possible.

1:03:29 > 1:03:32The 2015 spending review introduced an adult social care precept

1:03:32 > 1:03:35enabling councils to raise council tax specifically to support social

1:03:35 > 1:03:43care services by 201920 this could raise up to £1.8 billion extra per

1:03:43 > 1:03:47year for councils. And as a further boost social care the Chancellor

1:03:47 > 1:03:51announced in the budget this year that local authorities in England

1:03:51 > 1:03:55will receive an additional 2 billion for social care over the next three

1:03:55 > 1:04:00years. £1 billion has been provided this year in ensuring councils can

1:04:00 > 1:04:04start to feel more care packages immediately. The additional money

1:04:04 > 1:04:07means local authorities in England are estimated to receive an increase

1:04:07 > 1:04:11in the dedicated money available for social care over the next years of

1:04:11 > 1:04:18£9.25 billion. Statistics produced today show that spending on adult

1:04:18 > 1:04:22social care increased in real terms last year due in part to the precept

1:04:22 > 1:04:29by one and a half percent.I think this is an important point Madam

1:04:29 > 1:04:33Deputy Speaker because it's in our motion about closing the funding

1:04:33 > 1:04:38gap, it was not 1 billion it was 1.9 billion, so there is 900 million

1:04:38 > 1:04:42left not covered which is what councils are struggling with up and

1:04:42 > 1:04:46down the country. She makes a point about extra funding, because it

1:04:46 > 1:04:50falls onto local taxes but though she except there is still this gap

1:04:50 > 1:04:54which means people cannot be paid for the national living wage and we

1:04:54 > 1:04:57are going to struggle all the way through winter and unless there is

1:04:57 > 1:05:03an acceptance that there is that gap and will her party work to close it?

1:05:03 > 1:05:09I don't accept that actually. Let's recognise it has been hard in the

1:05:09 > 1:05:13past, we have made money available in recent years and the local

1:05:13 > 1:05:16authorities have faced challenges but as one local authority leader

1:05:16 > 1:05:20who did to me austerity has been the mother of invention and I

1:05:20 > 1:05:25congratulate local authorities on the very efforts we have made. As

1:05:25 > 1:05:28for the point about the national minimum wage it is enforceable so

1:05:28 > 1:05:34again I don't accept that point at all. That's come from the local

1:05:34 > 1:05:42authority leader. I agree, I agree local authorities have shown

1:05:42 > 1:05:46considerable initiative by implementing savings.Just a final

1:05:46 > 1:05:51point on that, though she except that our government is funding

1:05:51 > 1:05:56social care less now than 2010, she can check that with NHS digital, it

1:05:56 > 1:06:00is less in real terms, does not matter that it has increased this

1:06:00 > 1:06:04year because of the social care levy, it is less. Given the growing

1:06:04 > 1:06:10demographic challenge it is clear why we have this gap.We have made

1:06:10 > 1:06:21£9.25 billion available. Turning now to delayed transfers of care... I

1:06:21 > 1:06:25need to make progress I apologise. On delayed transfers of care this

1:06:25 > 1:06:29government is clear that no one should stay in a hospital bed longer

1:06:29 > 1:06:32than necessary. It removes people's dignity and juices the quality of

1:06:32 > 1:06:39life, it leads to and is more expensive for the taxpayer. I am now

1:06:39 > 1:06:43going to set out in more detail the work we are doing on reducing

1:06:43 > 1:06:49delayed transfers of care. This is critical because he well running

1:06:49 > 1:06:52social care system enables the NHS to provide the best possible

1:06:52 > 1:06:57service. We are clear we must make faster and more significant process

1:06:57 > 1:07:01to free up hospital beds for the sickest patients and reduce

1:07:01 > 1:07:04pressures on overcrowded AMD departments. Last year there were

1:07:04 > 1:07:102.25 million delayed discharges, up 24 and a half percent from the 1.81

1:07:10 > 1:07:13million in the previous year. Just over a third of these delays were a

1:07:13 > 1:07:18tribute to both the social care. The proportion of delays has increased

1:07:18 > 1:07:25by four percentage point to 37%. We have put in place and agile and

1:07:25 > 1:07:28supportive improvement structure and I have been clear on priorities.

1:07:28 > 1:07:33First of all this year 's mandate to NHS England we set out a clear

1:07:33 > 1:07:37expectation that delayed transfers of care should equate to know more

1:07:37 > 1:07:41than 2% of all hospital beds by September. The system has worked

1:07:41 > 1:07:44incredibly hard to agree spending plans and put in place actions to

1:07:44 > 1:07:48make use of additional funding and they deserve real congratulations

1:07:48 > 1:07:52for the efforts which have been made. Since February there have been

1:07:52 > 1:07:56significant improvements within the health and care system, where local

1:07:56 > 1:08:00governments and the NHS are working together to tackle the challenge of

1:08:00 > 1:08:04delayed transfers of care with a wrecker deep crease in month on

1:08:04 > 1:08:09month delayed discharges in April 2017. I must make progress.

1:08:09 > 1:08:18Giveaway!THEY TALK OVER EACH OTHER In early July NHS England

1:08:18 > 1:08:22improvement local government and Association published the definitive

1:08:22 > 1:08:27national offered to support both the NHS and local government to reduce

1:08:27 > 1:08:32delay. This package supports all organisations to make improvements

1:08:32 > 1:08:36and includes the integration of better care fund planning

1:08:36 > 1:08:40requirements of how this and other aspects of the planning process, I

1:08:40 > 1:08:44have limited time and I must get this on the record. A joint NHS

1:08:44 > 1:08:51England improvement and service guidance on him commenting just

1:08:51 > 1:08:54assessors and greater transparency through publisher in a dashboard

1:08:54 > 1:08:58showing how local areas in England are performing against the metrics.

1:08:58 > 1:09:02It also includes plans for local government to deliver an equal share

1:09:02 > 1:09:07to the NHS of the expectation to free up to and half thousand

1:09:07 > 1:09:10hospital beds. This package set out expectations for each local area

1:09:10 > 1:09:16that reducing such delays must be shared endeavour across NHS and

1:09:16 > 1:09:22social care. These expectations are stretching but they are vital for

1:09:22 > 1:09:25people's welfare are particularly over the winter period. We have also

1:09:25 > 1:09:30asked the chief executive of the CTC to undertake reviews of the most

1:09:30 > 1:09:33challenging areas to consider how well they are working at the health

1:09:33 > 1:09:38and social care boundary. Reviews are underway and a further eight

1:09:38 > 1:09:42will be announced in November based on the performance dashboard and

1:09:42 > 1:09:48informed by returns from July. These reviewsINAUDIBLE

1:09:48 > 1:09:58By November identifying the issues and driving rapid improvement.

1:09:58 > 1:10:02Assessment arrangements which can allow more efficient discharge from

1:10:02 > 1:10:05hospital by avoiding gibbet patient assessments by different

1:10:05 > 1:10:10organisations. All areas have submitted plans which include

1:10:10 > 1:10:14trajectories for reducing delays and finally in October we have asked NHS

1:10:14 > 1:10:17England to extend the GP and pharmacy influenza vaccination

1:10:17 > 1:10:24service to include all care workers working any nursing and residential

1:10:24 > 1:10:27care sector. They will be able to access the service through local GPs

1:10:27 > 1:10:32and pharmacy is free of charge. The honourable lady will be concerned

1:10:32 > 1:10:36about the provisions on those who failed to improve and I just wanted

1:10:36 > 1:10:40to tackle head-on the suggestion will be fines. We're not talking

1:10:40 > 1:10:45about fines at all. The money which has been deer will continue to be

1:10:45 > 1:10:52returned by local authorities, I will give way.I am very grateful to

1:10:52 > 1:10:56the minister forgiving way. Leicestershire County Council fears

1:10:56 > 1:11:02it could have £22 million removed from its budget because of fines or

1:11:02 > 1:11:06delayed discharges when the reality is the government have cut their

1:11:06 > 1:11:10funds. The Conservative deputy leader says I cannot think of

1:11:10 > 1:11:16anything more stupid and the Conservative leader says how long

1:11:16 > 1:11:21can we put up with the Secretary of State? That is the reality of the

1:11:21 > 1:11:26policy, what is the minister going to do about it?I reject the

1:11:26 > 1:11:31suggestion will be any kind of fines, the £22 million will be

1:11:31 > 1:11:34returning to spending within Leicestershire but that funding has

1:11:34 > 1:11:38been allocated for a specific purpose and where local authorities

1:11:38 > 1:11:42are not showing the improvement we expect we will work collaboratively

1:11:42 > 1:11:47with them and advise them how to make that money but let me put on

1:11:47 > 1:11:52record exactly what we're going to do. There is significant variation

1:11:52 > 1:11:57in performance across local areas, we do now 31 health and well-being

1:11:57 > 1:12:02roles are collectively responsible for percent of adult social care

1:12:02 > 1:12:06delayed transfers of care. That cannot be right when other local

1:12:06 > 1:12:11authority areas have none. Newcastle has now adult social care delayed

1:12:11 > 1:12:15transfers of care and if they can do it others can too provided we have

1:12:15 > 1:12:19good partnership and good leadership. I have just demonstrated

1:12:19 > 1:12:22the extent to which the government is supporting the best performing

1:12:22 > 1:12:26systems where local government and the NHS are working together to

1:12:26 > 1:12:30tackle the challenge. But we are clearly must make faster and more

1:12:30 > 1:12:34significant progress to free up hospital bed for the sickest

1:12:34 > 1:12:38patients and reduce pressures on our AMD departments. It's right there

1:12:38 > 1:12:44should be consequences for those who fail to improve, or local authority

1:12:44 > 1:12:50areas informing them that if their performance does not improve the

1:12:50 > 1:12:53government may redirect spending. It is not a fine we will direct

1:12:53 > 1:12:57spending and reserve the right to review allocations in the future but

1:12:57 > 1:13:02it's important to note that those allocations will remain with local

1:13:02 > 1:13:06government to be spent on adult social care. It is not a fine, it's

1:13:06 > 1:13:10about making sure public money delivers the outcome is intended for

1:13:10 > 1:13:11it. In conclusion...

1:13:17 > 1:13:22Revising allocations is not a fine. Is that what she is saying? Revising

1:13:22 > 1:13:25allocations, presumably not upwards but downwards, but that is not a

1:13:25 > 1:13:31fine? Sorry, but...Sorry but that is not the case. That money will be

1:13:31 > 1:13:35retain bid Local Government and what we'll be doing, we'll be directing

1:13:35 > 1:13:40spending to achieve the outcome that the money is intended for. That is

1:13:40 > 1:13:42exactly wa we should do at the moment, that's how we establish

1:13:42 > 1:13:46value for money. In conclusion, Madam Deputy Speaker,

1:13:46 > 1:13:50the health and care system's committed staff and managers up and

1:13:50 > 1:13:54down the country working every single day to deliver the best

1:13:54 > 1:14:01outcomes for people. Hard working workforce and leaders clarity on how

1:14:01 > 1:14:06the Government expects the NHS - I've already taken too much time

1:14:06 > 1:14:11actually - I've given the hard working workforce and leaders

1:14:11 > 1:14:18clarity on how the Government reports instrumental in delivering

1:14:18 > 1:14:22high quality care. To summarise, we accept there are

1:14:22 > 1:14:26significant challenges in the health and care systems. That is why over

1:14:26 > 1:14:28the lifetime of this Parliament we are increasing funding in real

1:14:28 > 1:14:33terms. It's not just about money. It's about sharing innovation and

1:14:33 > 1:14:37best practice, it's about integration defining new mod olds of

1:14:37 > 1:14:40care and thinking about a long-term sustainable solution to the care

1:14:40 > 1:14:48system. Most important of all, it's about supporting the weep that work

1:14:48 > 1:14:53in the care system, as well as those with little or none. We are

1:14:53 > 1:15:00committed to all of this. -- the people that work in the care system.

1:15:00 > 1:15:04Before I bring in the holt that speak force the SNP, we have a lot

1:15:04 > 1:15:11of speakers really a lot of speakers this afternoon so after the

1:15:11 > 1:15:15honourable lady for the SNP, I'll be bringing in a time limit of five

1:15:15 > 1:15:23minutes to start with, but that may have been reduced. Dr Fill la

1:15:23 > 1:15:32Whitford.Thank you. We have all seen the figures about people

1:15:32 > 1:15:37getting older -- Philippa. The number of people over 65 is due to

1:15:37 > 1:15:43double, the number of people over 85 will have increased by ten times.

1:15:43 > 1:15:49Yet the number of funded places for care has gone down by a quarter. So

1:15:49 > 1:15:55those two things simply don't match up. What we are seeing is that also

1:15:55 > 1:16:02as the minister mentioned, those under 65, those with disabilities or

1:16:02 > 1:16:06learning libels are also thankfully living longer. But the problem is

1:16:06 > 1:16:10trying to provide that care. Obviously, I tried, as a doctor, to

1:16:10 > 1:16:14do my little bit for people living longer and we shouldn't look upon it

1:16:14 > 1:16:22as a catastrophe. We must celebrate it. But we are all heading there, so

1:16:22 > 1:16:25we need to make sure, for our own vested interests, that those service

1:16:25 > 1:16:29are there for us. We know that a lot of the health you will have in older

1:16:29 > 1:16:34age is laid down in early years, so we are focussing in Scotland on the

1:16:34 > 1:16:39early years collaborative from the baby box for every newborn child,

1:16:39 > 1:16:42the 30 years early learning entitlement, doubling act of

1:16:42 > 1:16:45transport and rolling out through schools what's called the daily

1:16:45 > 1:16:49mile. But you don't get a financial return

1:16:49 > 1:16:54on that for 50 or 60 years, so we also have to invest in our older

1:16:54 > 1:17:00citizens. While in Scotland, we are trying to expand the elective

1:17:00 > 1:17:07services to meet the demands of hips, knees and eyes, the King's

1:17:07 > 1:17:10Funds report rationing of hip and knee joint replacements, we know

1:17:10 > 1:17:15that three quarters of trusts from set strict limits to access cataract

1:17:15 > 1:17:19surgery that someone is in essence losing their sight and certainly

1:17:19 > 1:17:23losing the ability to drive. Half of those Trusts will only fix

1:17:23 > 1:17:29one eye. So what we are doing when you do that is, we are driving

1:17:29 > 1:17:35people into their own homes, driving people into isolation and actually

1:17:35 > 1:17:39increasing their need for care and the speed and age at which they will

1:17:39 > 1:17:46need that care. So it really doesn't make sense. Age UK point out that

1:17:46 > 1:17:51there are 1.2 million people not getting the care that they need.

1:17:51 > 1:17:56That matches almost exactly the one million family carers who're

1:17:56 > 1:18:01actually providing a bulk of care for someone who requires that. In

1:18:01 > 1:18:07Scotland, we have already committed to raising carers allowance from £60

1:18:07 > 1:18:11to match Job Seekers. But that's pretty paltry for someone who in

1:18:11 > 1:18:17essence will be working seven days a week and 40% of them are reported

1:18:17 > 1:18:24not to have had any respite or any break in a year. That is because the

1:18:24 > 1:18:27statutory system isn't supporting them and it is something that needs

1:18:27 > 1:18:35to be looked at. What we are seeing is care homes closing because of

1:18:35 > 1:18:39extra costs brought in by the national living wage and, part of

1:18:39 > 1:18:44that is simply because the price paid is being driven down, as was

1:18:44 > 1:18:48mentioned over half of local authorities are seeing either home

1:18:48 > 1:18:52care providers or nursing and care home providers closing.

1:18:52 > 1:18:58But the thing is, we need to pay people a decent wage, not the

1:18:58 > 1:19:03national living wage, but the real living wage. This needs to become a

1:19:03 > 1:19:08profession that attracts people and retains people. Who is it you would

1:19:08 > 1:19:13like looking after yourself or your mother? Someone who is only doing it

1:19:13 > 1:19:18for six months until they can get something better or someone who

1:19:18 > 1:19:23actually believes in looking after our older population with the

1:19:23 > 1:19:27greatest love, care and dignity possible. We need to put the funding

1:19:27 > 1:19:32in. The minister talked about the better care fund which has indeed

1:19:32 > 1:19:37put extra money in, but at the cost of the new homes bonus in England.

1:19:37 > 1:19:41Local authorities are also being told to build more new houses. What

1:19:41 > 1:19:46is it that they're meant to do? We need to put this on a sustainable

1:19:46 > 1:19:52footing. We also need to address the issue of those under 65. In

1:19:52 > 1:19:58Scotland, our programme for Government includes the commitment

1:19:58 > 1:20:02to under-65s in what will be called Frank's Law in honour of a football

1:20:02 > 1:20:07player from Dundee who developed early dementia. Because we have

1:20:07 > 1:20:14people under 65 with the same needs, with early dementia, MS, motor

1:20:14 > 1:20:17neurone disease, why should your birth date dictate whether you get

1:20:17 > 1:20:25help or not? I will give way.Would my right honourable friend not

1:20:25 > 1:20:30accept that while she paints a Rosie picture of the social care system in

1:20:30 > 1:20:35Scotland, it has serious problems as well. In my own constituency, I know

1:20:35 > 1:20:42of one case where a gentleman was in hospital 150 nights after he could

1:20:42 > 1:20:46have been transferred out because the care package was not there.

1:20:46 > 1:20:52Freedom of Information enquiries have come up with people at 400

1:20:52 > 1:20:56nights in care when they could have been transferred. So will she accept

1:20:56 > 1:21:01that the picture in Scotland is not entirely rosy either?Oh, I totally

1:21:01 > 1:21:07accept the position is not entirely rosy. I've said many times in this

1:21:07 > 1:21:13chamber prior to her being here that we face the same challenges which is

1:21:13 > 1:21:16increased demand, the workforce needs, which will be made

1:21:16 > 1:21:19significantly worse by Brexit, and the fact that money is tight. So we

1:21:19 > 1:21:23face exactly the same challenges and obviously some of those patients

1:21:23 > 1:21:29that she refers to will have had specifically complex needs that were

1:21:29 > 1:21:33struggling to be met. But what we are talking about is that we are

1:21:33 > 1:21:37funding free personal care, not based on means testing. We are

1:21:37 > 1:21:41working towards providing that for under-65s and everything in England

1:21:41 > 1:21:47at the moment seems to be put in to the solution that sustainability and

1:21:47 > 1:21:51transformation plans will bring and yet they have been set backside

1:21:51 > 1:21:56forward where the budget line is the predominant thing and the designers

1:21:56 > 1:22:01have to work backwards. That isn't going to give the desired result. It

1:22:01 > 1:22:05must also be recognised that supporting people at home and in the

1:22:05 > 1:22:09community is desirable in its own right, none of us want to be stuck

1:22:09 > 1:22:14in a hospital, none of us want to be stuck in a care home. If we could

1:22:14 > 1:22:17actually be looked after in our own home, that would be all of our

1:22:17 > 1:22:22choices. But that will not necessarily cut the money required

1:22:22 > 1:22:26by a hospital. The nurses will still be there, the lights will still be

1:22:26 > 1:22:32on. What it might mean is that that bed can be more effectively used and

1:22:32 > 1:22:36waiting times for surgery or other treatments can be achieved. They are

1:22:36 > 1:22:41not achieved at the moment. I saw the issue on the news yesterday

1:22:41 > 1:22:46talking about the inefficiency of operating lists and it was clearly

1:22:46 > 1:22:50said by the former President of the Royal College of Surgeons, this

1:22:50 > 1:22:55comes down to beds. Beds in England have been cut in half over recent

1:22:55 > 1:22:59decades. The problem is, if you can't put your patient in a bed

1:22:59 > 1:23:04before or after the operation, you can't do the operation. That often

1:23:04 > 1:23:07is only discovered the day before and you can't just drum up another

1:23:07 > 1:23:12patient. So we are in a position where there are all sorts of things,

1:23:12 > 1:23:17not just delayed discharges, which are driving inefficiencies within

1:23:17 > 1:23:21the system and the thing that is generating the biggest pressure on

1:23:21 > 1:23:28the NHS has been the cuts in funding to social care that mean that by

1:23:28 > 1:23:322020 there'll be an over £2 billion funding gap in England that has to

1:23:32 > 1:23:38be met. All of us want to look forward to a dignified older age. We

1:23:38 > 1:23:42hope that we'll be independent and healthy. We need to invest in that.

1:23:42 > 1:23:48Yet public health's gone down 5%. We also should we need care, want to

1:23:48 > 1:23:53have care that is dignified and decent. That has to be funded.

1:23:57 > 1:24:02Thank you, Mr Speaker, it's a pleasure to follow the honourable

1:24:02 > 1:24:05lady, I particularly commend her comments on the importance of

1:24:05 > 1:24:07prevention that we mustn't forget. Can I join the minister in starting

1:24:07 > 1:24:12by paying tribute to the wider care and health workforce and of course

1:24:12 > 1:24:17the many, many unpaid carers, family carers and for all that they do. I

1:24:17 > 1:24:21would hike to touch on the forthcoming consultation and some of

1:24:21 > 1:24:26the current and future challenges in the time that I have and, if my

1:24:26 > 1:24:29right honourable friend will forgive me, and the members will forgive me,

1:24:29 > 1:24:32I'll take few interventions because I know many are weight to speak.

1:24:32 > 1:24:36First of all on the issue of the consultation, just to say that the

1:24:36 > 1:24:39health committee yesterday had the pleasure of hearing from members of

1:24:39 > 1:24:43the Lord's committee on the long-term sustainability of the NHS

1:24:43 > 1:24:49and social care. This started out with the remit of talking about the

1:24:49 > 1:24:53NHS but they rapidly realise had the two systems are completely

1:24:53 > 1:24:58inseparable and that we have to consider health and social care

1:24:58 > 1:25:03within separate silos. So my first request to the minister in the

1:25:03 > 1:25:07consultation, because she'll hear this overwhelmingly from the people

1:25:07 > 1:25:10that contribute, that we cannot keep thinking of the systems in

1:25:10 > 1:25:14isolation. Could she please right from the outset make this a

1:25:14 > 1:25:17consultation on the sustainable future funding of both health and

1:25:17 > 1:25:22social care. Now, one of the things that we heard loud and clear from

1:25:22 > 1:25:26members of the committee yesterday was that we need to do more about

1:25:26 > 1:25:32our future planning, that the system for this has been dismal for decades

1:25:32 > 1:25:35and that what their recommendation was, was that we should set up and

1:25:35 > 1:25:40office for health and care sustainability that gives us all

1:25:40 > 1:25:44good quality reliable data, not only about the demographic challenges but

1:25:44 > 1:25:49the future needs of both systems. And so that we can plan ahead for

1:25:49 > 1:25:53the costs we face in a realistic manner. The other thing I would say

1:25:53 > 1:25:57is that too off none this House we have very divisive debates on this

1:25:57 > 1:26:03issue. The challenges are so enormous here in funding future

1:26:03 > 1:26:09health and care costs. The only way that we are going to meet it is by

1:26:09 > 1:26:12both frontbenches and the all members across this House agreeing

1:26:12 > 1:26:17that we need to work jointly to come to solutions because no political

1:26:17 > 1:26:23party has a monopoly on good ideas. We owe it particularly in the

1:26:23 > 1:26:28reality of a hung Parliament, where it's very difficult to pass any

1:26:28 > 1:26:31primary legislation, the only way that we are going to move forward on

1:26:31 > 1:26:36behalf of the people that we all represent and we all want the best

1:26:36 > 1:26:41for, is for us to see the solutions worked at jointly across the House.

1:26:41 > 1:26:45So I hope that that is also the spirit in which all members will

1:26:45 > 1:26:50move forward in this debate and one of cooperation. Because we have to

1:26:50 > 1:26:55fund it properly. I'm afraid there is a funding gap, I absolutely

1:26:55 > 1:27:01welcome the £2 billion pledged but there is a consensus that by the

1:27:01 > 1:27:09time we reach 2019-2020, we will face a funding gap of around about

1:27:09 > 1:27:13or over £2 billion is the estimate for the future. That will have a

1:27:13 > 1:27:16real impact on all those that we represent in this House. So we have

1:27:16 > 1:27:20to fund it properly, not just now in the short-term, but in the long-term

1:27:20 > 1:27:24and we have to come forward with solutions. But it's not just about

1:27:24 > 1:27:29funding. It's about staffing. Planning properly for a wider

1:27:29 > 1:27:33workforce across health and social care. So I very much hope that that

1:27:33 > 1:27:40will also be included in the consultation. Unless we plan ahead

1:27:40 > 1:27:44for our future work forceth force, we are always going to be playing

1:27:44 > 1:27:48catch-up as we do at the moment -- workforce. There are many important

1:27:48 > 1:27:53changes we have seen, for example now in the future, health care

1:27:53 > 1:27:57assistants will be able to train in the future to move forward through

1:27:57 > 1:28:01the apprenticeship roots to become nursing associates then on into

1:28:01 > 1:28:05degree nursing. We know from the Camilla Cavendish's review for

1:28:05 > 1:28:10example that it wasn't just about pay within the sector, it was the

1:28:10 > 1:28:13lack of continuing professional development and training

1:28:13 > 1:28:16opportunities, particularly the ability for us to rotate through

1:28:16 > 1:28:19both the NHS and social care community settings. I think that

1:28:19 > 1:28:22does give an example of how the Government is actually making some

1:28:22 > 1:28:29very positive moves which I do welcome.

1:28:29 > 1:28:33So, as I say, for the consultation I very much hope from the start we

1:28:33 > 1:28:38will see both. I also hope the minister will go further in touching

1:28:38 > 1:28:42not just be sleeping crisis that we face but also some of the many other

1:28:42 > 1:28:47issues that affect my constituents at the moment, those poor example

1:28:47 > 1:28:51who are having their assessments re-examined, disabled young adults

1:28:51 > 1:28:55who face a real change in the support that will be available to

1:28:55 > 1:28:59them and I hope the Minister will meet with me to discuss some of the

1:28:59 > 1:29:07issues that are being raised by my constituents in Kingsbridge who face

1:29:07 > 1:29:10very significant changes to their care. Thank you.Thank you, Madam

1:29:10 > 1:29:14Deputy Speaker, and it is a privilege to follow the Health

1:29:14 > 1:29:17Select Committee chair and I will pick up some of the themes she

1:29:17 > 1:29:23raised. During the election, members opposite were no doubt dismayed that

1:29:23 > 1:29:31their manifesto proposals were dubbed a demented tax, conveniently

1:29:31 > 1:29:35forgetting their death tax assault on Labour in 2015. But whilst some

1:29:35 > 1:29:46of us could be accused of feeling a little schadenfreude, our care

1:29:46 > 1:29:51services desperately need more money to cope. Yet any party that comes up

1:29:51 > 1:29:55with a significant proposal for funding social care risks their

1:29:55 > 1:29:59political opponent trying to do -- trying to destroy them. We could

1:29:59 > 1:30:03carry on like this for yet another parliament and yet another election

1:30:03 > 1:30:07or we could face up to the reality which is that we will only get

1:30:07 > 1:30:12lasting change if we secure a cross-party approach. That is why I

1:30:12 > 1:30:15have joined the honourable member for Totnes, the right honourable

1:30:15 > 1:30:18member for North Norfolk and other select committee chairs in calling

1:30:18 > 1:30:23on the Prime Minister to establish across Ponty -- cross-party

1:30:23 > 1:30:27commission on the future funding of social care. We cannot allow this

1:30:27 > 1:30:33issue to be kicked into the long grass any more. More than a million

1:30:33 > 1:30:37people are not getting the help and care they need. Many end up in

1:30:37 > 1:30:40hospital and getting stuck in hospital for longer. That is no good

1:30:40 > 1:30:44for them and it costs the taxpayer far more. It's not just the people

1:30:44 > 1:30:50who need care who face a daily struggle. 6.5 million people in this

1:30:50 > 1:30:55country now care for an older or disabled relative. 40% of them

1:30:55 > 1:31:00haven't had a break for a year and a quarter haven't had a single day

1:31:00 > 1:31:07away from caring in five years. And what is the result? A third of

1:31:07 > 1:31:12unpaid carers have to give up work or reduce their hours, so there

1:31:12 > 1:31:15incomes are reduced, the cost of benefits increases and the economy

1:31:15 > 1:31:20is denied their talents and skills. The failure to deal with the funding

1:31:20 > 1:31:24problem hasn't just created a care crisis, it has created a crisis for

1:31:24 > 1:31:31families and our economy. So, alongside a significant and

1:31:31 > 1:31:36immediate injection of cash, which we must see in next month's budget,

1:31:36 > 1:31:40three long-term questions must now be addressed. First, what is the

1:31:40 > 1:31:45right balance between the contribution made by individuals and

1:31:45 > 1:31:50their state? Do we leave all of the extra costs of care to individuals

1:31:50 > 1:31:54who are unlucky enough to need it and he may end up seeing all their

1:31:54 > 1:31:59savings wiped out as a result or do we pool our resources, share the

1:31:59 > 1:32:05costs and risks and create a fairer system for all? Second, what is the

1:32:05 > 1:32:10right balance of funding across the generations? The Conservatives

1:32:10 > 1:32:14proposals in their manifesto, I believe, were deeply flawed but with

1:32:14 > 1:32:20the longest period of stagnation in wages for 150 years and rising

1:32:20 > 1:32:24personal debt, I don't believe the working age population can pay for

1:32:24 > 1:32:30all of the additional costs of caring for our ageing population.

1:32:30 > 1:32:35Wealthier older people will need to make a contribution, too. Third, how

1:32:35 > 1:32:41do we get rid of the inequities between the NHS and social care and

1:32:41 > 1:32:46make the fundamental reforms we need to provide a single, joined up

1:32:46 > 1:32:50service and shift the focus of care and support towards prevention? The

1:32:50 > 1:32:54Barker report for the keys thunder rightly calls for a single budget

1:32:54 > 1:32:59for the NHS and social care and a single body to commission services

1:32:59 > 1:33:04locally. It also says we must face up to the deep unfairness that if

1:33:04 > 1:33:08you end up getting cancer, your Cancer care is provided free at the

1:33:08 > 1:33:12point of need on the NHS but if you suffer from dementia, you may have

1:33:12 > 1:33:17to pay for all of your care yourself. Now, these are inevitably

1:33:17 > 1:33:22difficult and controversial questions about the Prime Minister's

1:33:22 > 1:33:27experience during this general election campaign and Labour's

1:33:27 > 1:33:31experience in 2010 simply reinforces the argument that we need a

1:33:31 > 1:33:38cross-party approach. The Government must now act.Thank you, Madam

1:33:38 > 1:33:44Deputy Speaker. It's a pleasure to follow my fellow East Midlands MP,

1:33:44 > 1:33:47the Member for Leicester West. Like many members from across the House I

1:33:47 > 1:33:51was compelled to speak in today's debate because my personal

1:33:51 > 1:33:54experience with the social care system and my deep respect for all

1:33:54 > 1:34:00the people who work in it and contribute to it. For five years, my

1:34:00 > 1:34:05father has been in the care of a nursing home in Keighley. At age 94,

1:34:05 > 1:34:08my dad is still in good spirits but he does have significant care needs

1:34:08 > 1:34:14as a result of a massive stroke in 2012. It is testament to the

1:34:14 > 1:34:18fantastic work of our NHS that we now find ourselves in a position

1:34:18 > 1:34:25where every care home in the country as residents who ten, 20 or 30 years

1:34:25 > 1:34:29ago would not have survived serious health issues such as A stroke,

1:34:29 > 1:34:34heart attack or indeed cancer. However, for governments, this

1:34:34 > 1:34:40success in the NHS can be seen as a double-edged sword. With successive

1:34:40 > 1:34:43administrations failing to adequately prepare our social care

1:34:43 > 1:34:48system for the ageing population and those people living with

1:34:48 > 1:34:53comorbidities. We now talk about adequate preparation. It is not just

1:34:53 > 1:35:00down to adequate funding. We have heard that the Prime Minister -- the

1:35:00 > 1:35:04Chancellor has already announced another £200 million for social care

1:35:04 > 1:35:09for local authorities over the next three years. This rightly

1:35:09 > 1:35:14acknowledges the significant extra pressure on our social care system

1:35:14 > 1:35:20and consequently our NHS is now under and must be welcomed. But we

1:35:20 > 1:35:26heard earlier from some of the party opposite, they seemed to want to

1:35:26 > 1:35:31blame our Government, whereas successive governments going back to

1:35:31 > 1:35:34the opposition when they were in Government as well have failed to

1:35:34 > 1:35:38act. They have failed to act on their royal commission that they set

1:35:38 > 1:35:43up, they have failed to act on their own report and green paper. But as

1:35:43 > 1:35:47my honourable friend for Totnes has indicated, we now have the

1:35:47 > 1:35:52opportunity to effect radical change to the current system as the

1:35:52 > 1:35:54Government embarks on its comprehensive consultation into

1:35:54 > 1:36:01adult social care. I sort of alluded to it, in my view, Britain needs a

1:36:01 > 1:36:05sustainable programme of care for long-term and we need to stop

1:36:05 > 1:36:08thinking short-term. In order to achieve this I would like to explore

1:36:08 > 1:36:15the idea of removing the remit of responsibility from local

1:36:15 > 1:36:18authorities and place it under the Department of Health and so becoming

1:36:18 > 1:36:22the Department of Health and care. This stems from the fact that health

1:36:22 > 1:36:27and social care have now becoming critically -- have become

1:36:27 > 1:36:31intrinsically linked in multifaceted ways. If the two were unified it

1:36:31 > 1:36:35would allow for closer integration of services and a greater

1:36:35 > 1:36:39understanding of what demand there will be full picture need to both

1:36:39 > 1:36:44the circle of care and health perspective. It would also protect

1:36:44 > 1:36:48the social care system from political manipulations, as has been

1:36:48 > 1:36:52a case in Derbyshire at county council level, where the new

1:36:52 > 1:36:56Conservative administration has found itself facing a social care

1:36:56 > 1:37:02bombshell left by Labour. Over the previous four years, despite holding

1:37:02 > 1:37:04around £233 million worth of Derbyshire taxpayers money in

1:37:04 > 1:37:10reserves, they have failed to maintain care homes, such as some in

1:37:10 > 1:37:16my constituency, in order to trot out the same old lines about Tory

1:37:16 > 1:37:19cuts. It is because of the shameful practices that the county council

1:37:19 > 1:37:25must now consider closing the care home altogether because of the

1:37:25 > 1:37:29significant care -- significant repairs needed in order to make it

1:37:29 > 1:37:34safe for residents. I would like to urge the Minister to do all he can,

1:37:34 > 1:37:37local Government pointedly to help the council in Derbyshire to keep

1:37:37 > 1:37:41this much loved care home open. There is no doubt that Derbyshire

1:37:41 > 1:37:47County Council and other county councils and unitary councils face

1:37:47 > 1:37:52more tough decisions over the next five years. And as BMP, I will

1:37:52 > 1:37:59continue to everything in my power to show that our relatives --

1:37:59 > 1:38:02residents remain well provided for for both their health and social

1:38:02 > 1:38:10care needs.Jo plant.Thank you Madam Deputy Speaker for allowing me

1:38:10 > 1:38:15to speak in this important debate. As a member of Parliament for the

1:38:15 > 1:38:19borough with the largest ageing population in greater Manchester,

1:38:19 > 1:38:23social care provision is an extremely important and serious

1:38:23 > 1:38:26matter for my constituents. Consequently, social funding --

1:38:26 > 1:38:42social care funding...

1:38:42 > 1:38:46When factoring in things like increased demand on social care,

1:38:46 > 1:38:52that a local authority black hole rises to 40 million. These funding

1:38:52 > 1:38:56cuts have been met by the local authority, largely by efficiency and

1:38:56 > 1:39:01transformational programmes to reduce costs whilst maintaining and

1:39:01 > 1:39:07in some cases improving standards. However, with the Government's

1:39:07 > 1:39:10proposed supported Housing cap, the Universal Credit roll-out, as well

1:39:10 > 1:39:17as the wage obligations all severely limiting the services the local

1:39:17 > 1:39:22authorities can provide. What we have seen from this Government is an

1:39:22 > 1:39:26attack from all angles on local authorities, leaving them simply

1:39:26 > 1:39:30unable to meet their care obligations. And the beach of local

1:39:30 > 1:39:34authority funding looks even bleaker. The Government has so far

1:39:34 > 1:39:41failed to set out a long-term social care strategy, or how it intends to

1:39:41 > 1:39:45fund local authority provision is after 2020. This leaves constituents

1:39:45 > 1:39:49deeply concerned about the care they will receive and local authorities

1:39:49 > 1:39:54being unable to find any further savings to protect their core

1:39:54 > 1:40:01service provisions. However, as the ageing population begins to require

1:40:01 > 1:40:06services, just as their budgets have been slashed, the opportunity to

1:40:06 > 1:40:09realise further reductions in costs diminishes. Local authorities are

1:40:09 > 1:40:14also very rightly concerned about the restricted care funding which

1:40:14 > 1:40:23could deter third sector people from investing in these services. It is

1:40:23 > 1:40:26unsurprising that within my own constituency, planned projects

1:40:26 > 1:40:32related to the living wage have now been cancelled, care provision

1:40:32 > 1:40:35reduced, resulting in dangerous levels of excess demand in the local

1:40:35 > 1:40:39care sector. Where does this leave people to turn? Either they are

1:40:39 > 1:40:44forced to rely on their remaining savings and their family to meet

1:40:44 > 1:40:47their care needs which puts the burden onto the NHS with patients

1:40:47 > 1:40:53who require social care needs instead sitting in hospital wards.

1:40:53 > 1:40:57Not only our patients not receiving the correct care they require, this

1:40:57 > 1:41:02is an enormous drain on an already stretched NHS resource. This brings

1:41:02 > 1:41:06me onto my final point of this vicious circle, delayed transfer of

1:41:06 > 1:41:11care. Is it any wonder that when local authorities face budget cuts,

1:41:11 > 1:41:20third sector are pulling out of social care, that delayed transfer

1:41:20 > 1:41:25of care is rising at a rate of 25% per year, costing the NHS 173

1:41:25 > 1:41:30million in the last year alone. The social care crisis we face in this

1:41:30 > 1:41:34country will continue to grow until the Government proposes a fair,

1:41:34 > 1:41:40comprehensive and long-term funding strategy. This strategy cannot

1:41:40 > 1:41:44include cuts to local authority budgets, it cannot include any

1:41:44 > 1:41:50additional pressures on the NHS and most importantly, it cannot risk

1:41:50 > 1:41:55straining patients of their life savings as the Prime Minister

1:41:55 > 1:41:59proposed during the general election campaign. That is why I hope after

1:41:59 > 1:42:02this debate the Government will realise the pressure their policies

1:42:02 > 1:42:07are putting on local authorities, care providers and the NHS and

1:42:07 > 1:42:11introduce a national, fully integrated care service that puts

1:42:11 > 1:42:14social care patients burst and fairly funds the care sector for the

1:42:14 > 1:42:21feature.

1:42:22 > 1:42:26I think there is consensus in this House that social care is one of the

1:42:26 > 1:42:30biggest policy challenges that we face and we needed to get it right,

1:42:30 > 1:42:35not just for current elderly people, but also for the point that's been

1:42:35 > 1:42:40made on both sides of the House for working age adults who have

1:42:40 > 1:42:43disabilities and I think it's important in that respect we see

1:42:43 > 1:42:48things to do with social care in relation to things to do with mental

1:42:48 > 1:42:53health of people with learning disabilities. Funding is clearly

1:42:53 > 1:42:57crucially important in this discussion. The Government has

1:42:57 > 1:43:03recognised that in recent times. The budget earlier this year increased

1:43:03 > 1:43:08funding on social care, as well as giving local authorities the freedom

1:43:08 > 1:43:12on council tax precept. I've seen in my borough in Dudley that that has

1:43:12 > 1:43:16had a positive impact on the frontline in adult social care.

1:43:16 > 1:43:20There are two points I want to make in relation to future strategies for

1:43:20 > 1:43:27adult social care. The first one is about structures and the second one

1:43:27 > 1:43:31is about people. Despite positive efforts that have been made, don't

1:43:31 > 1:43:35forget it was in Government and the previous coalition Government who

1:43:35 > 1:43:39introduced the better care fund to given the process of health and

1:43:39 > 1:43:43social care integration, that the picture is still a very fragmented

1:43:43 > 1:43:48one. People have talked about delayed discharges of care. The

1:43:48 > 1:43:52reality is that there is huge variation across the country in

1:43:52 > 1:43:57relation to delayed transfers of care. It's as a result broadly of

1:43:57 > 1:44:01the fact that the process of integration between health and

1:44:01 > 1:44:05social care has only really just begun and we need to move further

1:44:05 > 1:44:09and faster. I agree with the chairman of the Select Committee

1:44:09 > 1:44:15that we should be seeing this debate in the context of seeing the system

1:44:15 > 1:44:20as one system, a health and social care system. We'll only make

1:44:20 > 1:44:26progress if we see it in that right. One thing which I think is important

1:44:26 > 1:44:30is also to think about devolution and the devolved nature of adult

1:44:30 > 1:44:35social care. Currently in Greater Manchester, funding for social care

1:44:35 > 1:44:39and health, has been devolved, it's probably a bit too early to say

1:44:39 > 1:44:43whether or not that has proved to be a success, but I think that there

1:44:43 > 1:44:47are strong arguments to say that if we are to properly reform the system

1:44:47 > 1:44:50of health and social care, we shouldn't be thinking about trying

1:44:50 > 1:44:54to do it on some kind of national scale, as the opposition are

1:44:54 > 1:44:58arguing, I think we should chunk it into smaller bits, to a renal

1:44:58 > 1:45:03national level and perhaps give responsibility to things like the

1:45:03 > 1:45:07West Midlands combined authority and devolved Mayors for adult social

1:45:07 > 1:45:11care. We need a fully integrated system at sufficient scale and the

1:45:11 > 1:45:16regions are the best place to locate that. The second point I want to

1:45:16 > 1:45:21make is about people, other people in this debate have mentioned the

1:45:21 > 1:45:26crucial role of care, people working in the care sector and informal

1:45:26 > 1:45:31carers. People is clearly a massive constraint when it comes to adult

1:45:31 > 1:45:36social care and we need to think very carefully about how we develop

1:45:36 > 1:45:39the care else workforce as we move forward in the future. Other people

1:45:39 > 1:45:44is made the point it needs high levels of professional recognition,

1:45:44 > 1:45:48it needs better career structures and incentives and the objective

1:45:48 > 1:45:51should be that we have people working in the care sector who feel

1:45:51 > 1:45:57that they are working with an equal standing to those in nursing and

1:45:57 > 1:46:03other professions. We should also move towards that objective,

1:46:03 > 1:46:08currently we see health and social care workforces in two separate

1:46:08 > 1:46:13places and we should be perceiving it as a single seamless workforce

1:46:13 > 1:46:16that needs to be developed to cater for the needs of our health and

1:46:16 > 1:46:25social care system. On informal care, we also need to look at some

1:46:25 > 1:46:27potential arguments about statutory rights for people working in

1:46:27 > 1:46:32informal care. They don't have any rights and we need to think about

1:46:32 > 1:46:35incentives because clearly informal carers benefit the economy and

1:46:35 > 1:46:41reduce the costs to the Exchequer. So what we need is to think about

1:46:41 > 1:46:48the future of an integrated social and health care system which does

1:46:48 > 1:46:54require extra funding but funding will only be effective if we achieve

1:46:54 > 1:46:57that fundamental reform of seeing a seamless health and social care

1:46:57 > 1:47:01system capable of responding to the needs of people in the health system

1:47:01 > 1:47:06and those in social care. We'll only achieve that if we take a radically

1:47:06 > 1:47:11different view of what we mean by a carers workforce, how we treat that

1:47:11 > 1:47:15carers workforce, Hoy we also treat informal care. If we get that right,

1:47:15 > 1:47:18we'll make a lot of progress.

1:47:23 > 1:47:27The moral test of Government is how that Government treats those who're

1:47:27 > 1:47:32in the dawn of life, the children, those who're in the try light of

1:47:32 > 1:47:37life, the elderly, and those who're in the shadows of life, the sick,

1:47:37 > 1:47:42the needy and the disabled. These words spoken by Vice-President of

1:47:42 > 1:47:48the United States Hubert Humphrey in 1989 still ring true today. Social

1:47:48 > 1:47:53care should not just be a process of Government. But a moral duty of care

1:47:53 > 1:47:58for each and every one of us. We should make sure that every person

1:47:58 > 1:48:03who is being looked after through social care systems, whether that be

1:48:03 > 1:48:07by a local authority or by a private company, should be able to expect

1:48:07 > 1:48:12the level of care that any of us would expect for our families and

1:48:12 > 1:48:19ourselves one day. Whether someone is rich or poor has a debilitating

1:48:19 > 1:48:24illness or is elderly, every single one of these people deserve to be

1:48:24 > 1:48:30treated with dignity and respect. Money should not be a factor in the

1:48:30 > 1:48:35level of care that someone receives. The Conservative manifesto proposed

1:48:35 > 1:48:40a tax on people who're affected by dementia. Why is it that this

1:48:40 > 1:48:44Government considers people affected by dementia any less worthy than

1:48:44 > 1:48:51those with let's say cancer, diabetes, those who have a stoke?

1:48:51 > 1:48:55Let me repeat myself, Madam Deputy Speaker, what someone is rich or

1:48:55 > 1:49:00poor, has a debilitating illness or is elderly, every single one of

1:49:00 > 1:49:06these people deserve to be treated with dignity and respect. Dementia

1:49:06 > 1:49:12costs the UK economy around £26 billion a year. That is enough money

1:49:12 > 1:49:19to pay for every household's energy bill for a year. It's estimated that

1:49:19 > 1:49:241,330 people in my constituency of Colne Valley have dementia and that

1:49:24 > 1:49:27every three minutes someone in the UK will be diagnosed with the

1:49:27 > 1:49:32condition. Each and every one of us in this

1:49:32 > 1:49:37place have had or will most likely have some kind of experience

1:49:37 > 1:49:42supporting someone with dementia. From a family member or friend, to a

1:49:42 > 1:49:48constituent whose family's contacted us for support. Or to a neighbour.

1:49:48 > 1:49:53Madam Deputy Speaker, let's not ignore the elephant in this room.

1:49:53 > 1:49:58Local authorities have faced crippling cuts to budgets due to

1:49:58 > 1:50:07this Government's austerity-driven agenda. My local council Kirklees

1:50:07 > 1:50:12are currently spending £101.8 million per year on adult social

1:50:12 > 1:50:16care which is 35% of its total budget. Kirklees has had their

1:50:16 > 1:50:23direct funding from the Government cut already by £129 million and a

1:50:23 > 1:50:27further £65 million will be cut in the next few years. In addition to

1:50:27 > 1:50:32this, it's predicted that the number of people in Kirklees over the age

1:50:32 > 1:50:39of 659 will increase by 29% over the next 13 years. With cut to their

1:50:39 > 1:50:42budgets and growing demand, our local councils are struggling to

1:50:42 > 1:50:45make sure the most vulnerable in society are protected and are looked

1:50:45 > 1:50:49after. The Government benches opposite can try and blame the

1:50:49 > 1:50:54social care crisis on local councils, but we all know that their

1:50:54 > 1:51:01hard line austerity agenda is the reason. Madam Deputy Speaker, may I

1:51:01 > 1:51:05return to the first part of my speech. What Vice-President Humphrey

1:51:05 > 1:51:09said needs to resonate with every single one of us in this House. This

1:51:09 > 1:51:14is a moral issue. Finally, Madam Deputy Speaker, I feel that we also

1:51:14 > 1:51:21need to recognise the work that unpaid carers do. In Kirklees, there

1:51:21 > 1:51:25are 45,000 unpaid carers. These family, friends and neighbours are

1:51:25 > 1:51:29often a lifeline to those with long-term illnesses and I hope the

1:51:29 > 1:51:33Government will do more to support these carers.

1:51:38 > 1:51:43Thank you Madam Deputy Speaker. I concur with pretty much everything

1:51:43 > 1:51:47that has been said this afternoon and I, as an MP that recently fought

1:51:47 > 1:51:52a marginal seat, fully felt the pain and the discomfort of the way we

1:51:52 > 1:51:56handled the proposals regarding social care. But, since then I've

1:51:56 > 1:51:59had a number of constituents who've come to me who've lost family homes

1:51:59 > 1:52:06because they've needed to pay for a family member in care. So as we

1:52:06 > 1:52:10know, currently, that amount of money can dwindle right down to

1:52:10 > 1:52:13£23,000 before the local authority can step in and so the manifesto

1:52:13 > 1:52:18plan that set out the fact that we will protect the £100,000 and then

1:52:18 > 1:52:24only the property will be sold after the person passed away, actually is

1:52:24 > 1:52:28welcomed by the people that have come to see me. What often people

1:52:28 > 1:52:31don't realise and I'm surprised the Labour Party haven't picked up on

1:52:31 > 1:52:36this, is that that policy supportlets poorest families, rather

1:52:36 > 1:52:41than those who maybe have greater assets -- supports poorest family.

1:52:41 > 1:52:45I'm a corner MP and we are in a situation where our urgent care

1:52:45 > 1:52:50hospitals are in special measures. Two weeks ago they were put in

1:52:50 > 1:52:54special measures by CQC. The CQC report that also looks at social

1:52:54 > 1:52:59care and the role of the local authority in Cornwall demonstrates

1:52:59 > 1:53:04that in Cornwall, 82 people are in beds in our urgent care hospitals

1:53:04 > 1:53:10due to delayed transfers of care compared to 42% in other comparable

1:53:10 > 1:53:17local authority areas -- 42 people. Cornwall Council's chosen to fund

1:53:17 > 1:53:22social care by half of our comparable local authorities and

1:53:22 > 1:53:26that is according to the CQC report who're clear that funding

1:53:26 > 1:53:31prioritised by the local authority's half of comparable local

1:53:31 > 1:53:35authorities, which has put huge pressure on the NHS budget and the

1:53:35 > 1:53:40budget in Cornwall is actually funding the gaps that social care is

1:53:40 > 1:53:44leaving. In April, the Government gave a further £12 million to

1:53:44 > 1:53:51Cornwall council in order to address this, the transfer of care and £12

1:53:51 > 1:53:57million is promised to 2018-19 and 20. The health system is under huge

1:53:57 > 1:54:03pressure is huism largely due to pressure but we know that care and

1:54:03 > 1:54:08support workers do need and deserve proper pay, pay that does

1:54:08 > 1:54:15demonstrate the work they do, pay 25 that's similar to a health assistant

1:54:15 > 1:54:19in an NHS service. They deserve the extra money, support and training

1:54:19 > 1:54:26that would help them to do their job more easily and more safely. My plea

1:54:26 > 1:54:29to the Government is to do what they can to help Cornwall prioritise

1:54:29 > 1:54:34social care and help them to address the challenges they face in how they

1:54:34 > 1:54:39allocate funding and how they reward those that provide the social care

1:54:39 > 1:54:44services on the frontline. It's very easy for people to always blame the

1:54:44 > 1:54:46Government and that's been a habit of the local authority where every

1:54:46 > 1:54:51time a decision is made it's because of Government cuts but sometimes the

1:54:51 > 1:54:54responsibility must be shared by those in positions of management at

1:54:54 > 1:54:59local level. Local managers must share

1:54:59 > 1:55:04responsibility and I welcome the Government's intention to review the

1:55:04 > 1:55:10social care but I do agree with members that that review must look

1:55:10 > 1:55:14to how we integrate health and social care because currently, a

1:55:14 > 1:55:20weakness in one has dramatic impacts on the other. People this Cornwall,

1:55:20 > 1:55:23people on Scilly deserve the best care. There are people on the ground

1:55:23 > 1:55:28who want to provide that care, but barriers exist there to hinder them

1:55:28 > 1:55:32from doing that. I would ask the Government to work urgent hi to help

1:55:32 > 1:55:37our local authorities address that crisis. -- urgently to help our

1:55:37 > 1:55:41local authorities address that crisis.Almost each day my office is

1:55:41 > 1:55:44introduced to a new case where a constituent and their families are

1:55:44 > 1:55:48facing the harsh and difficult realities of a social care system in

1:55:48 > 1:55:55crisis. However, this is not a crisis borne out of necessity.

1:55:55 > 1:55:59Unfortunately, it's a cruel consequence of an ideologically

1:55:59 > 1:56:02driven cost-cutting agenda in action. A crisis that has been

1:56:02 > 1:56:09created at the heart of Number 10. The Tories have presided over an

1:56:09 > 1:56:14unprecedented attack on social care budgets, some £4.6 billion being

1:56:14 > 1:56:19taken from adult social care budgets since 2010. All this at a time when

1:56:19 > 1:56:24demand is growing. Reports by the King's Fund are clear what the adult

1:56:24 > 1:56:29social care system as it stands is failing older people. Their families

1:56:29 > 1:56:39and carers. It has a funding hole of £5 billion by 2019-20 which if left

1:56:39 > 1:56:43unresolved will continue to fuel the crisis.

1:56:43 > 1:56:46This pattern is also found in my hometown in Sheffield where there

1:56:46 > 1:56:52are now a growing population of over 65s and all with a longer life

1:56:52 > 1:56:55expectancy than ever before. However, Sheffield City Council has

1:56:55 > 1:57:03had its budget cut to the tune of £352 million since 2010 with further

1:57:03 > 1:57:09cuts on their way.

1:57:09 > 1:57:14As a result, councils have had to take difficult decisions. Across

1:57:14 > 1:57:19England, cuts have led to 400,000 fewer people able to access publicly

1:57:19 > 1:57:24funded social care, with one out of eight older people living with unmet

1:57:24 > 1:57:29care needs. The results on people and their families in our

1:57:29 > 1:57:33communities have been harrowing. Once more, the deep cuts inflicted

1:57:33 > 1:57:38by Number ten are not only cruel but are nonsensical and ineffective. For

1:57:38 > 1:57:44example, councils are having to limit the hourly care fees paid to

1:57:44 > 1:57:49providers. However, a case I have had in my own constituency recently

1:57:49 > 1:57:54highlights the doubling negative affect of limited administration and

1:57:54 > 1:57:57care payment resources. My constituent with significant daily

1:57:57 > 1:58:02care needs and the council have struggled to keep up with resourcing

1:58:02 > 1:58:06her complex needs, leaving care providers withdrawing at short

1:58:06 > 1:58:09notice and leaving the council and families of the patient frantically

1:58:09 > 1:58:14trying to find a new provider. The under resourcing of social care

1:58:14 > 1:58:21therefore created your problem of a higher than acceptable turnover of

1:58:21 > 1:58:25providers and councils without the resources to step in effectively.

1:58:25 > 1:58:28This causes much upset and paying for the most vulnerable in our

1:58:28 > 1:58:35society. Another consequence of the deep cut to the level of duty of

1:58:35 > 1:58:40care being paced -- placed on unpaid carers and we know it's generally

1:58:40 > 1:58:44women doing this work. In one place, a granddaughter cared for her

1:58:44 > 1:58:49grandmother for 100 hours per week and when she applied for a care

1:58:49 > 1:58:53package in the hope of receiving some financial support, it took six

1:58:53 > 1:58:57weeks for it to come through -- six months for it to complete. Often,

1:58:57 > 1:59:02carers are left with no support at all. This is not an isolated case.

1:59:02 > 1:59:08In fact, there are 6.5 million unpaid carers in the UK. I am proud

1:59:08 > 1:59:13that in Labour's election manifesto we pledged to increase the allowance

1:59:13 > 1:59:19paid to carers to allow -- align the benefit with rates of the

1:59:19 > 1:59:22job-seeker's allowance. This is a practical solution which also seeks

1:59:22 > 1:59:29to highlight the work that carers do for our communities. Too often they

1:59:29 > 1:59:33are sidelined and their efforts shunned. They need the Government

1:59:33 > 1:59:39for the many, not just the privileged few to stand up for them.

1:59:39 > 1:59:44And crucially the knock-on effects of a social care crisis are felt

1:59:44 > 1:59:49acutely by the NHS. In fact, this year's general election was the

1:59:49 > 1:59:53ultimate litmus test for the social care policies put forward by the

1:59:53 > 1:59:57Conservative Party and the Labour Party. Whilst the Labour Party

1:59:57 > 2:00:00pledged £8 billion to alleviate some of the problems facing social care,

2:00:00 > 2:00:06we also promised to build a new national care service which we would

2:00:06 > 2:00:12implement following cross-party consensus. In a civilised society,

2:00:12 > 2:00:17it is vital that we must all this risk and not let the most honourable

2:00:17 > 2:00:22friend for themselves in old age. Meanwhile, Theresa May launched an

2:00:22 > 2:00:31nasty campaign against older people that we haven't seen in decades.

2:00:31 > 2:00:35Following the U-turn on the dementia tax, the Tories have now turned

2:00:35 > 2:00:38their attention to blaming and threatening councils with vines and

2:00:38 > 2:00:47sanctions.Thank you very much, Madam Deputy Speaker and as part of

2:00:47 > 2:00:50my sort of self-imposed induction into becoming a member of the Health

2:00:50 > 2:00:55Select Committee, I undertake a tour of various places in my constituency

2:00:55 > 2:01:01to understand health and social care better and I think some of the

2:01:01 > 2:01:04concepts of independent living schemes, I think of one opened

2:01:04 > 2:01:08earlier this year by the Queen and Duke of Edinburgh at prior review,

2:01:08 > 2:01:16an independent living scheme in Dunstable, absolutely is a model of

2:01:16 > 2:01:21social care where older people are not lonely, exercise classes can be

2:01:21 > 2:01:24run, there are loads of activities and getting accommodation right for

2:01:24 > 2:01:28the future in the way that Bedfordshire Council have done is

2:01:28 > 2:01:32definitely part of what we need to do. I also visited Orchard Lodge in

2:01:32 > 2:01:38till worth and was struck by the very high standard of care. It's a

2:01:38 > 2:01:43CQC good rated home and I was incredibly impressed by the care and

2:01:43 > 2:01:49dedication of all the staff there. But another home, Rosewood Court in

2:01:49 > 2:01:52Dunstable, a beautiful building with wonderful facilities has closed this

2:01:52 > 2:01:56year because the owners haven't been able to get managers and staff to

2:01:56 > 2:02:01run it and that has caused a huge amount of stress and upset obviously

2:02:01 > 2:02:04to the residents that were there and their families, who have had to move

2:02:04 > 2:02:12them at very short notice. I also met with some care providers in my

2:02:12 > 2:02:15constituency and the conversation that is most clearly in my mind is

2:02:15 > 2:02:20the lady that one -- ran one of them, a former nurse who was in care

2:02:20 > 2:02:26for all the right reasons. She said, I would be too ashamed to go into a

2:02:26 > 2:02:29school to try to attract young people to come into my profession.

2:02:29 > 2:02:35That is not right, we can't have a situation like that. She said they

2:02:35 > 2:02:44need a salary like 16 2000 -- 16,000 to £18,000 per year which isn't much

2:02:44 > 2:02:48to ask for people looking after us in our old age. But travel costs

2:02:48 > 2:02:54also should shame everyone of us in this House. We get 45p per mile when

2:02:54 > 2:03:00we travel on Parliamentary business. Carers are lucky to get 30p. What is

2:03:00 > 2:03:04good enough for an MP is good enough for a care worker and I think we

2:03:04 > 2:03:09need to sort that out. I have also had my constituents raise with me

2:03:09 > 2:03:12the issue of a subsidy for Private places and I don't think that's

2:03:12 > 2:03:18right that some people at the moment pay so much more for the same place

2:03:18 > 2:03:20in order to subsidise local authorities. Constituents also come

2:03:20 > 2:03:24to me wanting to see even more rigour in the quality provided so we

2:03:24 > 2:03:30have real respect for those cared for and real respect for a proper

2:03:30 > 2:03:33career progression for carers themselves. We need to break down

2:03:33 > 2:03:38the division between nursing and social care. Simon Stevens in the

2:03:38 > 2:03:42past has described these as the two great tribes of the health care

2:03:42 > 2:03:47system and often I think a properly regulated way could mean they could

2:03:47 > 2:03:52do more together making them more efficient. I have called for a

2:03:52 > 2:03:56number of things that are going to cost money and we need real honesty

2:03:56 > 2:04:01in this debate, because it will cost, and I am very impressed by

2:04:01 > 2:04:04what I have read in both the community and local Government

2:04:04 > 2:04:09select committee report about social care published in March this year

2:04:09 > 2:04:13and also the House of Lords select committee report on the long-term

2:04:13 > 2:04:18sustainability of the NHS and adult social care. Both of these select

2:04:18 > 2:04:22committees of this parliament in reports published this year point us

2:04:22 > 2:04:28towards what is happening in Germany and what is happening in Japan. In

2:04:28 > 2:04:32those countries, they have mandatory social insurance mechanisms and

2:04:32 > 2:04:38these have been in place for a long time. The German system was put in

2:04:38 > 2:04:41place in 1994. It is not only Germany and Japan that seem to have

2:04:41 > 2:04:45got their act together on funding, it is France and the Netherlands as

2:04:45 > 2:04:51well. It is not a recent problem, it didn't arise in 2010 or 2015, it has

2:04:51 > 2:04:56been with us a long time and parties on all sides of this House have

2:04:56 > 2:05:03failed to grasp the nettle. What I would say to my two honourable

2:05:03 > 2:05:05friend, the ministers on the front bench for whom I have the greatest

2:05:05 > 2:05:09respect, I say there is urgency on this issue, there is a real

2:05:09 > 2:05:14willingness for this to be grasped by our constituents in in a fair

2:05:14 > 2:05:18way, we know there is support for taxes if people know what they pay

2:05:18 > 2:05:22is going to look after them later on and I think some of the social

2:05:22 > 2:05:26insurance systems in Germany and in Japan in particular could point the

2:05:26 > 2:05:31way forward. So what I say to ministers, get on an aeroplane now,

2:05:31 > 2:05:36go to Japan, go to Germany, do the preparatory work so come January

2:05:36 > 2:05:40when we have the green paper we can have some really good ideas to grasp

2:05:40 > 2:05:44the nettle and take this forward and give people the care they deserve.

2:05:44 > 2:05:51Mohammed Yassin.Thank you Madam Deputy Speaker. It's an honour to

2:05:51 > 2:05:54follow my friend from the neighbouring constituency in