:00:09. > :00:19.Order, order. Urgent question, Barbara Keeley. Thank you. To ask
:00:20. > :00:22.the Secretary of State for Health to make a statement on the crisis in
:00:23. > :00:27.funding in social care and the effect this is having on the NHS on
:00:28. > :00:34.the care of vulnerable older people. Minister David Mowatt. Thank you, Mr
:00:35. > :00:38.Speaker. I think the honourable lady for raising today's question. I
:00:39. > :00:43.think all members of this House will agree that there are few areas of
:00:44. > :00:46.domestic policy which touch on so many lives and is so important to so
:00:47. > :00:55.many of our constituents. I would like to start by
:00:56. > :01:00.acknowledging the work of so many carers who provided excellent and
:01:01. > :01:04.passionate care. I would like to acknowledge the 6 million informal
:01:05. > :01:11.carers who also do so much. Spending on long-term care in our country is
:01:12. > :01:14.more than the OECD average. In particular, it is more than a
:01:15. > :01:20.powerful economy such as France and Germany. I accept that our system is
:01:21. > :01:27.under strain and that pressure has been building for some years. In
:01:28. > :01:34.response, the Government has insured the councils have access to funding.
:01:35. > :01:41.We estimate the increase could be around 5% in real terms. Additional
:01:42. > :01:46.funding comes from the better care fund, the additional better care
:01:47. > :01:53.fund and changes to the precept. To put into place and in force a robust
:01:54. > :01:56.regulatory system between 2014 and early next year, all homes and
:01:57. > :02:05.domiciliary providers will have been re-inspected. 72% by the sea QC as
:02:06. > :02:14.good or outstanding. Powers now exists to ensure closure. These
:02:15. > :02:18.powers are being used. To work with local authorities to ensure that a
:02:19. > :02:22.continuing market exists. In the last six years, the total number of
:02:23. > :02:31.beds has remained constant. There are 40% more riders than in 2010.
:02:32. > :02:35.Finally, the care and health systems, we have seen that those
:02:36. > :02:37.councils which do this best demonstrate far fewer delayed
:02:38. > :02:41.transfers that those who adopted best practice more slowly. Any
:02:42. > :02:48.system would benefit from higher system would benefit from higher
:02:49. > :02:53.budget and social care is no exception. Quality matters too.
:02:54. > :03:02.Today is not a budget statement. Nor a local government settlement. By --
:03:03. > :03:12.I wish to end by thanking the carers who work so hard to make the current
:03:13. > :03:17.system work for so many. That was a disappointment. Before the Autumn
:03:18. > :03:23.Statement, we debated the funding crisis in social care. Not a strain,
:03:24. > :03:25.expressed by local government, expressed by local
:03:26. > :03:28.health and clinical leaders. On this health and clinical leaders. On this
:03:29. > :03:33.site, we called on the Government to urgently bring forward promised
:03:34. > :03:36.funding to address that crisis. The Chancellor did not listen. It did
:03:37. > :03:42.not bring forward any funding for social care. Nor mention it at all.
:03:43. > :03:45.Can the Caird Minister tell us in his response why health ministers do
:03:46. > :03:50.not stand up for vulnerable and older people in this country and why
:03:51. > :03:56.they don't fight harder to get extra vital funding for social care? Over
:03:57. > :04:05.1 million older people in this country have care needs. And as he
:04:06. > :04:11.recognises, and heavier burden falls onto unpaid family. This is made
:04:12. > :04:15.possible by this Government has of the cuts. Can the Minister confirm
:04:16. > :04:19.what is now reported by The Times that the Government intends to dump
:04:20. > :04:26.this funding crisis onto local councils and council taxpayers to
:04:27. > :04:32.increasing the social care precept? The King 's fund has called it
:04:33. > :04:39.deeply flawed because in that least deprived areas could raise twice as
:04:40. > :04:44.much as most are private. -- most deprived. That would widen
:04:45. > :04:49.inequality of access to social care inequality of access to social care
:04:50. > :04:53.across the country. Is it the care Minister's intention to support a
:04:54. > :05:01.solution that widens over quality -- widens inequality and stops health
:05:02. > :05:08.care for older people? The honourable Lady fought the last
:05:09. > :05:11.election on manifesto that said not 1p more for local government
:05:12. > :05:16.spending. That is what she fought the last election on. She has made a
:05:17. > :05:20.statement today and she is against the change to the precept we brought
:05:21. > :05:27.in in the spending review. She talked this morning about taxpayers
:05:28. > :05:34.and council taxpayers having to meet the costs. That rather begs the
:05:35. > :05:39.question, who she thinks is going to be paying for it? Borrowing or the
:05:40. > :05:44.magic money trade? She made the point about the precept. She said
:05:45. > :05:49.that the precept increases inequality is because the councils
:05:50. > :05:53.are able to raise more than others. That would be true if it wasn't for
:05:54. > :05:56.the fact that the additional better care fund is distributed and away
:05:57. > :06:05.which balances that and is precisely what we do. -- distributed in a way.
:06:06. > :06:09.I'll advise the house that there are three urgent questions to be taken
:06:10. > :06:26.today and I want all to be contributed to. I am looking at
:06:27. > :06:31.finishing the U Qs. I hope in looking at coordinating policy
:06:32. > :06:37.across Government, the minister will look not only at join between local
:06:38. > :06:42.health and local government, but also other policies like lifetime
:06:43. > :06:45.homes, a flexible employment policy. All of which will help us deal with
:06:46. > :06:51.these issues. Can he give us some encouragement on this? Thank you. He
:06:52. > :06:55.is quite right. There is a whole raft of measures that need to be
:06:56. > :07:00.taken on informal care. Also the holy grail of better integration of
:07:01. > :07:07.health and social care funding. We are pursuing that vigorously. Thank
:07:08. > :07:15.you. This is the substance of the letter from the health select
:07:16. > :07:19.committee. Not calling for more money, but calling for capital
:07:20. > :07:23.budgets and social care. Because basically the back pressure from
:07:24. > :07:26.social care is actually what is causing the NHS to struggle. I
:07:27. > :07:30.totally agree with the Minister in regards to integration will stop in
:07:31. > :07:34.Scotland, where we have the integrated joint boards, it has
:07:35. > :07:42.brought a change quicker than we would have hoped. Our delayed this
:07:43. > :07:45.discharges are down. This is not something that is easy, it is
:07:46. > :07:51.something that needs to be funding. We have debated the plans which
:07:52. > :07:57.could be that the basis for the future integration for the NHS. All
:07:58. > :08:00.we hear is within those plans, community hospitals being shot.
:08:01. > :08:06.Losing the opportunity to have stepped up and step-down beds. A E
:08:07. > :08:12.being shot and beds within hospitals being shot. This is the wrong way
:08:13. > :08:16.round. STPs could work, but they can't start with a number that they
:08:17. > :08:19.must reach. They have to design themselves around a service that
:08:20. > :08:25.keeps patients at home and keeps them well. She made two points, both
:08:26. > :08:32.of which I agree with. The first is of which I agree with. The first is
:08:33. > :08:40.that in Scotland 9% reduction but it is also true that many parts that
:08:41. > :08:46.have integrated so quickly have also achieved reductions of that or more.
:08:47. > :08:50.She is right, the STP is part of the process. Re-engineering the system.
:08:51. > :08:53.Adult social care and the integration of adult social care is
:08:54. > :08:59.a big part of that. We need to make sure we deliver. Would the Minister
:09:00. > :09:03.agree with me that better integration could be driven by
:09:04. > :09:11.better patient data and help show us where quality practices exist and
:09:12. > :09:16.have just read this best practice? I would agree. I had a discussion with
:09:17. > :09:21.the CQ see on that subject. What is reported. I am hoping that over the
:09:22. > :09:29.next months and years, we can deal with how we do that now. I think the
:09:30. > :09:34.Minister has completely missed the point raised by my honourable friend
:09:35. > :09:40.from the front bench. About the unfairness of asking councils to
:09:41. > :09:50.deal with problem. A 1% rise in council tax in Donk Doncaster rate
:09:51. > :09:57.is 20% less than a raise in the Rye Minister's constituency. Surely that
:09:58. > :10:05.means that the constituents are having more to pay. I would have
:10:06. > :10:12.missed the point, but it takes into account relative need. The Minister
:10:13. > :10:17.will know that following recent events, this issue is something I've
:10:18. > :10:21.taken particular interest in. Saying it is just about money is too
:10:22. > :10:24.simplistic and we have seen a wide variety of the quality of care from
:10:25. > :10:30.homes under the same funding packages. Does he also agree with me
:10:31. > :10:36.that we need to improve things to ensure the concerns are taking
:10:37. > :10:40.seriously? I agree with that. I commend the member with the work
:10:41. > :10:43.that he did with the Morley home in his constituency which had
:10:44. > :10:46.significant issues and now which has been substantially closed down. He
:10:47. > :10:51.is right in saying that the issues there were not principally about
:10:52. > :10:54.money, but about quality and people doing their jobs properly. Does the
:10:55. > :10:58.Minister share the view of the Care Quality Commission that the system
:10:59. > :11:04.is close to tipping point? Does he understand the impact that he has an
:11:05. > :11:07.very many frail, elderly people. Does he not agree that now was the
:11:08. > :11:13.time to bury our differences, come up with a long-term solution? Today
:11:14. > :11:16.is not the day in which we are going is not the day in which we are going
:11:17. > :11:25.to announce the Royal commission on the funding of care into the future.
:11:26. > :11:29.I do agree that it is important that we put care funding on a better
:11:30. > :11:36.structural basis. The honourable member is right to say that. I
:11:37. > :11:42.applaud this Government's commitment the 10 billion pounds to the NHS by
:11:43. > :11:46.2020. Does my right honourable friend agree that social care and
:11:47. > :11:51.health care must be better integrated across the whole country?
:11:52. > :11:54.Somerset County Council sustainability and transformation
:11:55. > :11:57.plan has this at its part. It is a good model. Would you agree that
:11:58. > :12:05.models like this should be copied but must be given the tools? The STP
:12:06. > :12:10.for Somerset is excellent in this regard and she is right to raise it.
:12:11. > :12:13.integration of health and social integration of health and social
:12:14. > :12:16.care is the holy grail of this and those councils and health systems
:12:17. > :12:23.which do it best making huge difference. Is he aware that the
:12:24. > :12:31.local authorities in the court of the past few years have lost more
:12:32. > :12:36.than ?200 million in cuts that have been propagated by the Government?
:12:37. > :12:45.On top of which, they are closing community hospitals and arbiter --
:12:46. > :12:47.when these community hospitals bear when these community hospitals bear
:12:48. > :12:56.the burden of looking after people the burden of looking after people
:12:57. > :13:02.that can't occupy hospital beds? He is right to say that there have been
:13:03. > :13:08.changes to the funding regime. The facts are such as Mosley and St
:13:09. > :13:12.Helens have got virtually no delayed transfers of care. They have got the
:13:13. > :13:20.same budget issues as his own counsel. With an ageing population,
:13:21. > :13:26.a welcome introduction of the national living wage and the
:13:27. > :13:33.expectation on services provided. This is providing exponential growth
:13:34. > :13:43.in the adult care arena. Whilst the council tax cap has delivered... I
:13:44. > :13:50.would urge the Minister to explore other opportunities. I said today is
:13:51. > :13:53.not a spending statement, it is not a statement on a local government
:13:54. > :14:03.settlement either. I will leave it at that. May I say to the Minister
:14:04. > :14:08.it would be a huge mistake to think he can plug the gaping hole of
:14:09. > :14:14.funding with the social have preset is the lead back alone. People who
:14:15. > :14:17.need social care will be least likely to get it by raising council
:14:18. > :14:23.tax. If not today, when will the Minister come to the house with a
:14:24. > :14:29.plan to solve this crisis and help families, K users and the NHS? I
:14:30. > :14:33.have acknowledged that the system is under pressure, but I've also
:14:34. > :14:38.acknowledge that different councils respond that pressure in different
:14:39. > :14:49.ways. For example, next year, 16, 17, Leicester council have increased
:14:50. > :14:56.their budget by 7% in real terms. It is depressing that the Labour are
:14:57. > :15:02.saying things because they did nothing when they were in power. It
:15:03. > :15:05.is important to use fiscal incentives and respected DC LG and
:15:06. > :15:09.the Treasury to encourage the construction of more extra care
:15:10. > :15:18.facilities and also to iron out the disparities of the quality of care
:15:19. > :15:21.delivered between authorities. Yes. There is disparity still in the
:15:22. > :15:24.marketplace and between local authorities and we need to do
:15:25. > :15:33.everything we can working with the CQ seeks to ensure that is
:15:34. > :15:37.eliminated. His statement is totally inadequate for the crisis of social
:15:38. > :15:42.care. The complacency that he shows is totally unrealistic to what is
:15:43. > :15:44.happening in the country and what we require is a very different response
:15:45. > :15:51.than what is given to day. I am than what is given to day. I am
:15:52. > :15:57.tempted to say no, I don't bollards that. I make the point again. I'm
:15:58. > :16:00.not complacent. I understand that this system is under pressure and we
:16:01. > :16:04.acknowledge and accept that. That is not the same as saying that there
:16:05. > :16:07.aren't things that we can do in terms of quality provision to manage
:16:08. > :16:12.it better. That is what I'm trying to do.
:16:13. > :16:18.It is a growing share cost of the key to addressing this challenge
:16:19. > :16:22.will be better integration of health and social care to better manage
:16:23. > :16:25.demand. What funding has been provided to Lancashire County
:16:26. > :16:33.Council to allow the transformation to take place? The better care fund
:16:34. > :16:37.is accredited on the assumption that we will drive that integration. I
:16:38. > :16:41.also make the point that many councils right across the country,
:16:42. > :16:43.not just Lester, have increased and will increase their social care
:16:44. > :16:53.budget in real terms next year. Something like 40%. By 2020 we will
:16:54. > :16:57.see a national shortfall of ?2.6 billion in adult social care
:16:58. > :17:01.funding. If the Government is forcing councils to increase council
:17:02. > :17:05.tax, what percentage would he be expected to increase it by hand what
:17:06. > :17:08.of this percentage increase would go solely to adult social care
:17:09. > :17:14.services, and how would the Government ensure this? Mr Speaker,
:17:15. > :17:21.the Spending Review increased the precept by 2% and that is what we
:17:22. > :17:26.brought in at that time. As I said earlier, this is not the local
:17:27. > :17:33.government settlement and they have nothing to say on council tax. Many
:17:34. > :17:38.people on both sides of the House revealed that the social care system
:17:39. > :17:42.is broken because there are councils involved and the Health Service and
:17:43. > :17:46.all. Would it not be a very good idea if the Secretary of State or
:17:47. > :17:50.Minister could work across the House with goodwill on both sides, rather
:17:51. > :17:56.than this petty point scoring from the other side... No, this is much
:17:57. > :17:59.more serious than politics. We have got to get this right for future
:18:00. > :18:05.generations. Should we not work together and come up with a solution
:18:06. > :18:09.that all sides of the House can on? He is right that this whole system
:18:10. > :18:15.is more important than politics. There is nothing that is more
:18:16. > :18:18.important to more people in terms of the dignity and quality of their
:18:19. > :18:33.lives in getting this right and it is essential that we do that. An
:18:34. > :18:39.eagle! Liveable city council has seen ?330 million cut from its
:18:40. > :18:46.budget since 2010 and 58% of all its money, a further ?90 million has to
:18:47. > :18:51.be found by 2020. Can he say in that circumstance, how it is going to be
:18:52. > :18:55.possible for Liverpool City Council to increase, as we all wish it good,
:18:56. > :19:00.the money that it spends on adult social services when it actually
:19:01. > :19:06.already spends more on adult social care, 146 Milibands, than it can
:19:07. > :19:16.raise in council tax? -- ?146 million. I make the point that
:19:17. > :19:22.Knowsley and St Helens, close to liveable, are virtually no delayed
:19:23. > :19:26.transfers of care and probably some best practice sharing would be in
:19:27. > :19:31.order. I do not want to see a festering sibling rivalry! Angela
:19:32. > :19:34.Eagle. I think it's afraid that you chose the younger role for the
:19:35. > :19:42.older. You did the opposite last time. In the world, we have an
:19:43. > :19:46.above-average older -- average number of older people, but we have
:19:47. > :19:50.a very low council tax base, so we cannot raise council tax to raise
:19:51. > :19:54.enough money to deal with the shortfalls in adult social care. The
:19:55. > :19:59.Minister knows ?5 billion has been cut from social care since 2010, and
:20:00. > :20:05.his better care budget is 3.5 billion. So there are huge issues
:20:06. > :20:09.here. Why was this not mentioned in the Autumn Statement, and what is
:20:10. > :20:16.the Government's response to this ongoing crisis? I made the point
:20:17. > :20:21.already and I will make it again, we acknowledge the precept is uneven in
:20:22. > :20:24.a way when it was announced in the Spending Review, which is why the
:20:25. > :20:33.additional better care fund component is allocated on a basis
:20:34. > :20:40.which remedies that. Jess Phillips. A timely moment to call me. Just to
:20:41. > :20:45.talk to what the Minister says about the remedies. I put in an FOIA about
:20:46. > :20:51.the weekly adult residential rate across every single candle in the
:20:52. > :20:57.country, but Buckinghamshire gets ?615 a week -- county in the
:20:58. > :21:02.country. But Birmingham gets 436 and has to make an additional charge of
:21:03. > :21:06.?55 per week to the residents who live there, who are no doubt poorer
:21:07. > :21:09.than those who live in Buckinghamshire. Does that sound
:21:10. > :21:18.like a discrepancy that is currently being solved by the Government's
:21:19. > :21:22.system, and are grandparents in Buckinghamshire with more than they
:21:23. > :21:26.are in Yardley? The reports in terms of quality from Buckinghamshire and
:21:27. > :21:29.Birmingham are things that we look at rate across a system and we are
:21:30. > :21:34.not finding a geographical variation which is based on the sort of
:21:35. > :21:43.statistics. That is just the fact of the matter. I have heard nothing
:21:44. > :21:46.from the Minister this afternoon to demonstrate that he understands the
:21:47. > :21:55.severity of the situation facing social care. There was a cross-party
:21:56. > :21:57.meeting last week, it was said they needed ?1.3 billion immediately to
:21:58. > :22:04.stabilise social care in this country. They pointed out that the
:22:05. > :22:08.money cannot be raised by council tax increase, and especially because
:22:09. > :22:14.it raises the least money in the areas with the highest need. In
:22:15. > :22:18.terms of council tax increase, this is not the local government
:22:19. > :22:21.settlement. There has already been announced that the additional better
:22:22. > :22:24.care fund will start to deliver more money from next April and the better
:22:25. > :22:29.care fund will deliver more money after that. During the course of
:22:30. > :22:36.this Parliament, there will be a 5% increase in real terms in money
:22:37. > :22:40.spent on adult social care. That is obviously from next April. This
:22:41. > :22:45.year, can the Minister tell me how is it fair that the area I
:22:46. > :22:49.represent, the 19th most disadvantaged constituency in the
:22:50. > :22:54.country, will only be able to raise half of what an area like Kingston
:22:55. > :22:58.upon Thames can raise? We can raise about ?5, they can raise about ?10.
:22:59. > :23:07.How can that be fair for social care? This year, 42% of councils are
:23:08. > :23:11.increasing the adult social care funding in real terms. In terms of
:23:12. > :23:16.the discrepancy caused by the precept, in terms of the
:23:17. > :23:20.discrepancy, it is addressed by the way that we allocate the additional
:23:21. > :23:26.better care fund component and the formula that is used for that. I
:23:27. > :23:31.think the Minister recognises that there is a crisis and I think he
:23:32. > :23:35.recognises that the precept alone will not address that. Does he agree
:23:36. > :23:38.with the former Health Secretary when he said this morning that it
:23:39. > :23:46.was a missed opportunity in the Autumn Statement not to invest in
:23:47. > :23:51.social care? Mrs Pickard, I am not giving the Autumn Statement but I
:23:52. > :23:54.will say again that there is a 5% increase in real terms in adult
:23:55. > :24:00.social care funding during the course of this Parliament and that
:24:01. > :24:08.42% of councils are increasing the budget in real terms this year.
:24:09. > :24:12.Thank you, Mr Speaker. I think the Minister needs to recognise that
:24:13. > :24:16.with cities, it is not just that it can be more difficult for them to
:24:17. > :24:20.raise the money, as we have already heard from colleagues comparing the
:24:21. > :24:24.amount that would be raised by raising council taxpayer as opposed
:24:25. > :24:28.to more affluent rural areas, there are also demographic concerns
:24:29. > :24:32.meaning there are more challenging, it is more challenging to deliver
:24:33. > :24:37.health services in cities such as Bristol. We are already looking at
:24:38. > :24:40.?92 million of cuts that we have defined over the next five years.
:24:41. > :24:44.Can I ask him to come to Bristol to talk to the Mayor and see what
:24:45. > :24:49.challenges we are facing? Cities do have issues with delivering social
:24:50. > :24:55.care but so do rural areas, which quite often have a high proportion
:24:56. > :25:00.of older people, which in itself can absorb a great deal of cost. The
:25:01. > :25:05.truth is, as I have acknowledge, the whole system is under pressure,
:25:06. > :25:09.including in Bristol. We acknowledge that. We are increasing the total
:25:10. > :25:14.spend by 5% during the course of this Parliament. We have heard from
:25:15. > :25:20.honourable friends about the failings of the social care precept
:25:21. > :25:24.model, but what are councils like Kim Butcher, who choose not even to
:25:25. > :25:30.take the meagre resources available? Offered 4% and they took just 2%,
:25:31. > :25:36.leaving the local hospital with 100 85-year-olds with nowhere to go. --
:25:37. > :25:42.councils like Cambridgeshire. That was a decision made by Cambridge
:25:43. > :25:48.Council, and there were a number of other councils like Hammersmith
:25:49. > :25:50.which made a similar choice not to increase the precept and presumably
:25:51. > :25:54.not to feel as though they needed to use the money for adult social care.
:25:55. > :25:59.That is a choice those councils have and it is a choice they must take to
:26:00. > :26:04.the voters. Sheffield is about to lose its last emergency respite care
:26:05. > :26:09.for patients with convex dimension needs. These patients cannot be
:26:10. > :26:12.cared for in the community and people desperately do not want to
:26:13. > :26:16.see it go. Sheffield already has the second-largest better care fund in
:26:17. > :26:20.the country. If today is not the day the Minister to issue a Royal
:26:21. > :26:26.commission, when will the Minister act? Well, I am not aware of the
:26:27. > :26:30.specific issue she has raised in terms of the respite care centre in
:26:31. > :26:34.Sheffield that is on the point of closure, I would be happy to discuss
:26:35. > :26:38.it with her so I understand better. But I'm afraid I can only repeat
:26:39. > :26:47.today is not that they were going announce a Royal commission into
:26:48. > :26:50.funding. Voters in my constituency tell me that they are losing staff
:26:51. > :26:54.to Asda because they cannot compete with pay and conditions because the
:26:55. > :26:59.council cannot commission care at a price that enables them to do so.
:27:00. > :27:02.What will the Minister do to stem this haemorrhaging of care workers
:27:03. > :27:06.from the profession and therefore the haemorrhaging of the provision
:27:07. > :27:12.of care? There is an issue with that and that exists in various parts of
:27:13. > :27:17.the country, and we acknowledge and need to manage it. But we also need
:27:18. > :27:21.to manage the total number of dead is that in the system and the total
:27:22. > :27:26.number of domiciliary providers in the system. The total number of beds
:27:27. > :27:30.is the same now as it was six years ago, the total number of the
:27:31. > :27:41.massively red providers is run about 40% higher. -- domiciliary
:27:42. > :27:45.providers. The Minister congratulated Holton and Warrington
:27:46. > :27:48.councils on being two of the best performing the country on delayed
:27:49. > :27:51.transfers of care and increasing their budgets. But Holton still has
:27:52. > :27:55.a massive shortfall because the precept goes nowhere near that the
:27:56. > :28:01.band of the in the area. The simple fact is this, there is no coherent
:28:02. > :28:06.national strategy on a funding package to solve this crisis we are
:28:07. > :28:11.now facing. The Government is abdicating its responsibility and it
:28:12. > :28:14.will tip over. The honourable gentleman is quite right, I did
:28:15. > :28:16.congratulate Halton and Warrington councils has been those who have
:28:17. > :28:22.particularly low delayed transfers of care. The fact they are doing
:28:23. > :28:25.that in spite of the budget constraints that he mentions
:28:26. > :28:30.demonstrates that this is not just about money, it is about quality,
:28:31. > :28:37.about leadership and best practice. The Chief Executive of Care England
:28:38. > :28:41.has said of the current regime, around 40% of care service will no
:28:42. > :28:44.longer be viable, so a number of services will be lost. When does the
:28:45. > :28:51.Minister intend to do something about this crisis? Mr Speaker, the
:28:52. > :28:55.number of beds available in the system right now is around about the
:28:56. > :28:57.same as it was six years ago. However, there is an issue with
:28:58. > :29:03.managing the financial performance of significant care providers and
:29:04. > :29:08.one thing we brought in two years ago is a robust process led by the
:29:09. > :29:11.CQC, in which they look at the financial performance of the biggest
:29:12. > :29:15.providers to give us warning of issues that might arise. We are very
:29:16. > :29:22.keen on pursuing and making sure that happens. This is a national
:29:23. > :29:27.crisis which this Government has wilfully ignored for years. As the
:29:28. > :29:31.Minister said, there is no issue which cannot be solved by throwing
:29:32. > :29:38.money at it. Is it not time he put his money where his mouth is? I
:29:39. > :29:40.think she paraphrased what I said in my opening statement rather
:29:41. > :29:44.inaccurately. What I said is that money would help with any system,
:29:45. > :29:48.but the issues here are about quality as well, about leadership as
:29:49. > :29:53.well, and about best practice as well. All of those things are within
:29:54. > :29:59.the remit of my job and that is what I am assuming. Everything we have
:30:00. > :30:02.heard today from the Minister seems to fundamentally deny the council
:30:03. > :30:09.tax precept is no solution to the problem. In fact, it exacerbates it.
:30:10. > :30:12.Is he aware that Ray James of the Association of directors of adult
:30:13. > :30:14.social services has said the council tax precept will raise the least
:30:15. > :30:20.money in areas of greatest need, which risks heightening inequality?
:30:21. > :30:24.If that is what the experts in the field are saying, why does the
:30:25. > :30:32.Minister think he knows better? I discussed this and other issues with
:30:33. > :30:36.Ray James often. It is true that the precept, if it was only the precept
:30:37. > :30:40.on its own, would result in an uneven distribution of revenue.
:30:41. > :30:45.Which is why the additional care fund and the money that comes from
:30:46. > :30:50.the additional care fund are allocated using the formula which
:30:51. > :30:53.corrects that.