07/07/2013 Sunday Politics North West

reform, plus who cares and who pays? Will the integration of our councils

Apology for the loss of subtitles for 2163 seconds

and health services put patients on I am Arif Ansari. Coming up in the

North West... Who cares and who pays? Will the integration of our

councils and health services put patients on a firmer footing?

anybody came here, they are genuine, genuinely interested in the

patients, and that is what it's about, isn't it, really?

And joining us this week the Labour leader of Rossendale Council and

Lancashire County Council Alyson Barnes. And Michael Jones, the

Conservative councillor in charge of Cheshire East. Michael, we had the

Spending Review, have you had a chance to see what the likely impact

will be on your counsel? We think it will have a big impact, about seven

or 8%, and we are looking to absorb that, and I am hopeful services will

not be affected. Deeper than you hoped? You'll macro what we thought

we would get. Alyson? We thought we would sustain a big cut. We had a

51% cut in real terms. And we know, moving forward, that will get

washed, -- worse, possibly by 70%. Difficult times for local

authorities. One area of spending that affect councils is what

opponents call the Bedroom Tax, the reduction in housing benefit for any

spare bedrooms. A new report by the National Housing Federation into its

impact on Merseyside paints a miserable picture of vulnerable

people being put under financial pressure.

The Hoile family did not expect to be cut up in a logical drama. Darren

and Angelina own their own business. They moved to a

four-bedroom social housing property so they are sons could have a room

each. Each of the boys have been diagnosed with ADHD. They are also

on the autism spectrum disorder. There is no way they could share

bedrooms. They do not sleep, up half the night. Knowing their children's

conditions, they never thought they would be affected by benefit

changes, no paying 40% more in rent. We cannot move. There are schools.

Those meet with the boys needs. 26,000 properties on Merseyside are

affected by what has been colder Bedroom Tax. Many people live in

overcrowded conditions, but nearly four times as many are under

occupied. The problem for housing associations is that are not enough

properties for them to move into. So have the wrong type of properties

being built? If we think about 21st century contemporary living, and the

space is needed to live and work in, that points away from very small

cramped accommodation. The report from the National Housing Federation

reports that exposing families have gone into arrears for the first

time. It could cost �23 million over the next year. That is said could

build -- it is said that could build many more homes. The council says

the policy is disrupting community cohesion. Some areas of the city,

there are only three bedroom properties available and nowhere for

those families to downsize. Dumb families are handing the keys back

to landlords and seeing they can no longer afford to live there. -- some

welfare reform driving housing policy and not the housing needs of

the population. What has been the impact for your

counsel, Alyson Barnes, and for people living there? We have not

done a formal evaluation, like Liverpool, and it has been adjusting

looking at their document, because they are demonstrating some of the

concerns we have all had about this Bedroom Tax. But locally in

Rossendale, we are seeing arrears rising and we are also seeing

three-bedroom properties becoming empty and staying that way. One of

the Liverpool Housing associations have seen a doubling of its empty

stock for three-bedroom accommodation. Michael, why support

the principle of this? It is about fairness. But that is the problem.

But has Liverpool built the right houses? I do not think so. You need

to have the right housing stock available, the right offer, the

right structure. As a country, we cannot afford to have housing

benefit doubling to �21 billion. That is a startling figure. We have

to make sure we support those in work, those who can work, those who

cannot work, making sure people go out to work. These are good for

everybody, for the many, and we should support those who cannot.

they are not being supported. We saw them in the film they are talking

about people and vulnerable positions, otherwise they would not

be in housing benefit, being forced out of homes, or having to find more

money they do not have. We want to encourage people into

work, which is the key message behind this, people who can work

should work. In Cheshire East, no one vulnerable should be affected.

If they are, we will pick up the figures. Macro we will pick up the

pieces. Could it be about better skills, could it be about better

interaction? Jobs are on the way. Michael, in the

peace we saw, there was a family in which the parents were both working.

They had three children, a bedroom each and they were being told they

had to effectively downsize. That is not the case of not working, but

this policy hitting them. And we know 66% of people affected by this

Bedroom Tax and actually people living with disability, and

925,000 people stopped claiming disability. That tells you what is

wrong with the system. You cannot have a system giving free benefit

for all. It is not good for the morale of the country. We need a

system rejecting those who truly needed, not just wanted.

understand that principle, but suggest it is not happening and that

people who are vulnerable are being hit, being as to move, downsize into

flats, one-bedroom flats, that do not exist. But we need to build

them. In Cheshire East, we have housing for people, and community

driven housing. We will get them built. All that takes time.

Merseyside speaks about six or seven years. We are looking at similar

timescales. Why have they not been built in the past? You had the money

to build. At the most fantastic time. My information is it is not

economically viable for housing associations to build one bedroom

accommodation at the moment. We clearly need to look at the

financial framework. But maybe feel years under the previous Labour

government? If you look at what is being built under this current

government... I am talking about the previous Labour government. You'll

macro all governments have played their part in this.

all-conference have played their part in this, but housing

associations also building economically viable and bigger

houses. Will Labour repeal the Bedroom Tax? It is unclear what will

be done at the moment. This grassroots pressure to do that. I

would like them to do that. I know many Labour activists would like to

see them do that. The working man and women know that benefit culture

is bad for them. I think you have to be realistic and see what is the

right way. This may not be having the better effect, but it can be

changed and targeted properly. To put it back to the way it was let

people down. Build the right houses, help the needy and those in work

first. But that does not address the issues here and now. We shall leave

that. Among the plans for the Spending review, the Chancellor

promised �3 billion to better integrate health and social care.

Adult social care is a council's single biggest area of expenditure.

Councils are due to spend about �11 billion on at this year. That is

down from �14.6 billion in the year to 2011. The aim is to get councils

and the NHS working more closely to allow people to be looked after at

home, improved patient care and reduce bed blocking in hospital.

Part of the region, including Liverpool, have already started

integrating services. Stuart Pollitt visited one rehabilitation centre

which has just had a make over. You are probably thinking what does

the Berlin Wall have to do with this? Put your right hand on your

left leg... This is an exercise rehabilitation class and an example

of how the imaginary Berlin wall between the health service and local

councils is being broken down. A patient used to be discharged from

hospital, sent home meaning they were now under council care, but the

council may not know much about it, so the patient would probably

struggle and may end up back in hospital, falling between the cracks

of different agencies. People could be Leopard days waiting for

equipment, for the right health care, before the GP got involved. --

could be left for days. It was just jointed in the past. -- disjointed.

John Lennon spoke about being signed by Brian Eckstein. I said what do

you have to lose? June has been part of the Liverpool scene since the

days of the -- the Beatles. Now she is one of many using the Granby hub

in Toxteth. It is a halfway house between hospital and home. I have

been an host, costing a lot of money, not half as good as theirs. I

would give it 100%. They are genuine, genuinely interested in the

patients. It is run by Liverpool community health trust, the link

between council, GP and hospital. Instead of patients begin to several

people, they will speak to one person, to medication going between

both agencies. This thought of tight up is something the Chancellor wants

to see more of. This will help relieve pressures on accident and

emergency, the local government deliver obligations, and save the

NHS at least �1 billion. integration began with a pilot in

Cumbria four years ago. The government now wants all councils to

do the same, so they have pulled budgets and Knowsley and joined

forces in Wigan. Stockport has linked up IT projects. There are

concerns this will not work. worry about the new integrated care

money is that it might not create anything, but create whole new

structures and systems which will come and go, instead of creating and

building on what we know works, which is general practice. That word

integration has been high on the agenda at this week's LGA conference

in Manchester. It is Conservative and Labour Party policy. Partnership

has to be the key thing. If you do not work with other organisations,

you will go under. Is heading home after five weeks at

Bambi. -- is heading home after five weeks at Granby.

You have made a future husband? Maybe. I suppose it is fitting that

are centred built with greater integration in mind has resulted in

just that for some residents. We are also joined now by Professor

Mark Gabbay, a professor in general practice at the University of

Liverpool. Welcome. What is your assessment of this idea? It has been

tested before in several ways. I remember the times when, because of

bed blocking, health services were giving social services money to be

able to move people back home. What we now have is a slightly more

structured way of doing that by having a wraparound approach to

providing holistic care within a primary care setting. So the same

eye they year already been trialled? Yes about 15 or 20 pilots. Including

Cumbria? And the assessment of that scene soon suggest that the patients

did not seem to notice a difference. -- the assessment of that seemed to

suggest. It seemed to help the service providers more. But they did

not seem to carry it on. I think it has only been reporting last year,

so it is a relatively new idea. Evaluation showed that more work

needed to be done to find better ways to do it. The anxiety for the

health services where the money will come from, whether that reduces the

spend in the National Health Service by more effective social care, or

whether in fact effect on the health services such by the transfer of

funds that the health service struggles to meet cost. Michael,

what is your take on this, good idea? Inevitable, it has to happen.

Health is a big part of improvements. We want people to have

helped in the home. A good idea, an essential way to take the pressure

off. The money will come from both sides. NHS has to put money into the

community, driver that way. All of the technology helping as well. I

think it is good. We should go local, community driven, the way to

interact health for people's needs. One are the benefits, do you think?

It is about the person. We have heard about services focused on the

individual needs. I think this will go some way to give us that. And

clearly, the recipient of care, the person at the centre of this, needs

to feel the difference. Andy Burnham announced this week that some Labour

local authorities would go ahead with this whole person pilot.

Lancashire County Council being one of them. How broadly will that work?

I think they will build on work already being done. They have worked

closely with health over a number of years one intermediate care

measures. This is part of building on that. Not looking at completely

changing what they are doing and how they are doing it, but building on

work done already, because that will then help them save on costs. And it

will not incur massive additional new costs in terms of this work.

you have the cash for this? As I said, it is building on what we are

already doing, so we will take this forward naturally. Some of these

measures will save money from both budgets. Michael, the budget has

gone down by about 25%, hasn't it? It is actually going up in my

county, which you would expect in one dominated by an elderly

population. We like that, but it is a pressure. It is a fact of life

people are living longer. The pressure on the NHS, on councils,

will continue. We need to work differently. Pool resources

together, move together, work with GPs. GPs could work with adult care

services. The councils, NHS, GPs, commissioning groups, have to get

together to make this work. It has to go ahead, we have no choice.

do you think will be the financial issues? I do not think this is a

particularly political argument, but about how we cost effectively

provide care for people in their own homes. Liverpool, for example, has

the independent project, part of the Dallas pilot, so they are testing

out the best way to use technology to help people stay in their own

home. It is not a bad idea that we integrate social and health care. I

believe the divide should go. The argument will be how -- who is in

charge of how that money is spent. And maybe the money could be used

for other things, which could cause some problems. Who is in charge? No

always a good question. - always a good question. We have many people

already under trial on telly care. Many are already having a better

quality of life. If we can work with providers to go through and continue

to do that and move to private landlords, it will make things

easier. There are enormous savings we can have to make services better.

To some extent, because some councils have certainly lost a lot

of money in terms of adult social care, is the NHS budget sort of

almost being graded to fill that gap? I think it is much simpler. The

NHS is threatened by people being in there. With an operation, people

stay in hospital far too long. If we can bring them into the community

quicker, get them home quicker, that saves billions. A simple example of

how this can work and should work. And people want to remain in the

Rhone homes. I think this does contribute to the work that we're

doing as to try and bring cost down. It surely should make a contribution

to that. With everyone thinking it is such a good idea, you wonder why

it has not been happening already. My recollection is it used to be the

health service looked after these budgets a long time ago, before it

moved to the councils when she moved to give budgets came in, probably

over 20 years ago, so historically, I think we're just seeing who looks

the budget. -- before it moves to the councils and commuter care

budgets came in. That is a negotiation between social care

staff, health years staff, and cares about the best ways to manage

patient, the members of the public, in their own home. We have huge

problems with inequalities of health. If this can help, we are all

for that. Thank you very much for coming in. Time for the rest of the

weeks news in 60 seconds. The government has been urged to

take action against Tameside General Hospital. The chief executive and

medical director resigned after two critical reviews.

An investigation is underway into high death rates. Another Remploy

factory is to close, this time in Burnley. Esther McVey says the money

is better spent getting equal with disabilities into mainstream work.

A petition is calling on Cheshire West and Chester Council to

reinstate the head of the planning committee after he was removed

following the rejection of plans for a student village on the green

belt. It is not needed, it is unnecessary

and is also unwanted. Ed Miliband came under fire in Prime Minister's

Questions after his aid, the Stalybridge and Hyde MP Jonathan

Reynolds, left the Labour leader's notes in a toilet. And also causing

a stink, legal action is underway after plans for huge recycling plant

in Cheshire were binned. Alyson Barnes, Jonathan Reynolds,

often unwelcome guest, but leaving those notes of Ed Miliband for Prime

Minister's Questions in which we know he was going to defend Tom

Watson, then he did not need to worry, because the following day,

Tom Watson goes anyway. So serious is this problem with regards to

Unite four Ed Miliband and the Labour Party? It is an interesting

distraction, but we all have better things to do. In my view, the Labour

Party ought to challenge this government with much of what it is

doing and not spending its time arguing in public about things that

do not matter to bury people. Michael, a bit of a change to switch

from the Tory party to Labour. -- things that do not matter to bury

people. They want their man. The unions run the Labour Party.

Everyone knows that. I do not think that is true. Unite gave the biggest