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Westminster Eye: An insight into the week of politics 13 February - 17 February

This week at Westminster was quieter than normal as the Commons was in recess, but there were still some newsworthy items.

13 February

At the beginning of the week Lord Harrison asked the Government what action it is taking to mark the 2012 European Year for Active Aging. A response is awaited.

Caroline Flint MP, Labour's Shadow Energy and Climate Change Secretary, followed up on her Commons question regarding energy tariff for older people. On responding to reports that the number of pensioners dying from hypothermia has doubled in five years, said: "The energy market has to be made to work better for pensioners and other customers. Complicated tariffs mean too many are overpaying for gas and electricity. That's why Labour has proposed a simple rule for the energy companies - that pensioners over seventy-five be given the lowest tariff on offer, and guaranteed by law if necessary. And to ensure a fair deal for all consumers, we need to open up the energy companies' books so people can see for themselves at what price they buy and sell energy."

14 February

Baroness Bakewell proposed an amendment to the Social Care bill which would lead to the creation of a commissioner for older people. 

"The Commissioner be a single, sympathetic individual, able to speak up directly for the old themselves. They would ideally have a background in caring, and be conspicuously on the side of the old, speaking "for us" to those with the power and money to do something to improve the situation for millions of older people"

Baroness Bakewell

15 February

Lord German asked the Government what proportion of the £648 million allocated for local authority spending on social care that also benefits health in 2011-12 was spent on (1) prevention services, (2) communicating equipment and adaptations, (3) telecare, (4) crisis response services, (5) maintaining eligibility criteria, (6) re-ablement, and (7) mental health.

Earl Howe, the Parliamentary Under-Secretary of State, Department of Health said that the department collected information from primary care trusts in September 2011 to understand how the £648 million transfer was progressing and on which services it was being used. The information suggests that the money is being used on a wide range of services. He added that a full breakdown of this can be found in the National Health Service publication The Quarter: Quarter 2.

The House of Commons is now in recess and returns on 20 February. Health Orals is due to take place on Tuesday 21 February.

Westminster Eye: An insight into the week of politics 30 January - 3 February

Monday 30 January

On Monday Chris Skidmore MP received an answer to his question to the Department of Health on what proportion of finished admission episodes the patient was over (a) 65, (b) 80 and (c) 90 years in each of the last five years. A finished admission episode (FAE) is the first period of inpatient care under one consultant within one healthcare provider. In reply Paul Burstow published a table which showed that FAEs amongst the over 65 age group was 34%, for the over 80 year age group 13% and for the over 90 year age group 2%. The situation in percentage terms had remained fairly static over recent years.

Caroline Dinenage MP had asked what information the Department of Health has received from primary care trusts on plans for spending the 2011-12 NHS social care allocation; which services the money has been allocated to; and what proportion of the money is expected to be spent on older people. She also asked what estimate the Department has made of the difference between the number of people eligible for social care support in England and those receiving formal support from public or private sector agencies.

In his reply Paul Burstow said that his Department collected information from primary care trusts in September 2011 to understand how the transfer was progressing and on which services it was being used. The information suggests that the money is being used on a wide range of services. He said that a full breakdown of this can be found in the NHS publication The Quarter which has been placed in the Library. The Department did not collect information on what proportion of the money is being spent on older people. In response to the second question Paul Burstow said that the Department of Health has not made estimates of the difference between the number of people eligible for social care support in England and those receiving formal support from public or private sector agencies. He acknowledged that unmet need is difficult to precisely define and measure. The eligibility framework issued by the Department seeks to support councils in prioritising funding on those with the highest need. The Government is clear that everyone who thinks they may be in need of care and support is entitled to an assessment, and if this assessment concludes that services are required to meet the person's assessed needs and the person qualifies under the means-test, services must be provided.

Also on Monday Caroline Flint MP asked the Minister for Energy and Climate Change if he will make it his policy to ensure that all people over 75 years old are automatically placed on the cheapest tariff by their gas and electricity supplier. Tracey Crouch MP what recent representations the Department of Health had received on the reform of social care and also what assessment they had made of the effect of changes in funding for social care on (a) avoidable emergency admissions and (b) NHS costs.

On the same day Jim Shannon MP asked what guidelines the Health Minister had issued to care homes on the prevention, treatment and care of fractures resulting from falls by people with osteoporosis.

In his response Paul Burstow said that the Department of Health provides guidelines through the Department's falls and bone health commissioning toolkit. In addition, the National Hip Fracture Database, which audits the care of hip fracture patients, and the Royal College of Physicians' Falls and Bone health audit also apply to all care settings including care homes.

Last week Paul Maynard MP asked what proportion of gross national income is spent on services for the elderly. In answering Mark Hoban said that many public services are shared across groups, for example expenditure on roads. It is therefore not possible to provide a clear split between the proportion of national income spent on any particular age group. However, the Office for National Statistics publishes an allocation of some public services to households in The Effect of Taxes and Benefits on Household Income, 2009-10. This includes an analysis of certain benefits in kind for non-retired and retired households for expenditure in 2009-10.

Thursday 2 February

Tim Farron MP received a reply to his question on what assessment had been made of the effect of the social care system on the financial sustainability of the NHS and what assessment had been made of the prospects for using increased resources for social care to reduce avoidable emergency admissions and NHS costs. Paul Burstow replied saying that effective partnership working and integration are key enablers in delivering against the Quality, Innovation, Productivity and Prevention challenge within the NHS, and supporting improved efficiency within social care. This includes ensuring that people do not stay in hospital longer than they need to.

He went on to say that the Department has put in place practical measures to support social care services, in the context of a challenging local government settlement, and to encourage improved joint working between primary care trusts (PCTs) and local authorities. In 2011-12, £648 million has been allocated to PCTs to transfer to councils for spending on social care services that also benefit health. The Department has been clear that PCTs and local authorities will need to work together closely in order to agree appropriate areas of social care investment, taking account of joint priorities identified by the joint strategic needs assessment for their local populations. Evidence from a survey of PCTs suggests that this funding is being used both to prevent unnecessary admissions to hospital (through crisis response services for example); and to ensure people are able to leave hospital quickly (through intermediate care and re-ablement services for example).

A further £150 million (rising to £300 million in 2012-13) has been allocated to PCTs for the development of post-discharge support and re-ablement services. There is local discretion over how this money is to be spent, but in a letter to the service the Department has been clear that:

"This funding is intended specifically to develop current reablement capacity in councils, community health services, the independent and voluntary sectors, with the objective of ensuring rapid recovery from an acute episode and reducing people's dependency on social care services following discharge".

Finally in addition to these funding streams, the Department announced on 3 January 2012 that it was making a further £150 million available to PCTs, to transfer to local authorities for spending on social care. The Department has set out that this funding should be used to target delayed transfers of care which are attributable to social care services.

David Morris MP asked the Health Minister what steps he is taking to improve the services offered to patients following discharge from an NHS hospital. A reply is awaited.

Mike Weatherley MP received a reply from Minister Paul Burstow on whether he plans to produce a national standard for care homes on the prevention, treatment and care of fractures resulting from osteoporosis and falls. The Minister said that the Health and Social Care Bill makes provision for the National Institute for Health and Clinical Excellence (NICE) to produce Quality Standards that relate to social care, which would potentially include care homes. The added that the Government’s engagement exercise - Caring for Our Future: Shared ambitions for care and support - sought to understand people's priorities for reform to help inform the approach to be set out in the forthcoming White Paper on adult social care. Responses to the engagement in relation to quality welcomed planned work to extend NICE Quality Standards to social care, and highlighted the potential role clinical audit practice might play in driving up quality in the sector. The Government are now considering these proposals before they set out their plans in their White Paper on care and support.

Tim Farron also asked the Chancellor what discussions he has had with the Secretary of State for (a) Health, (b) Communities and Local Government and (c) Work and Pensions on the potential for reform of the funding of social care to result in savings to the public purse across Government. Minister Danny Alexander said that Treasury Ministers have regular discussions with ministerial colleagues on a range of issues. On the funding of social care, the Government welcomed the work of the Commission on Funding of Care and Support chaired by Andrew Dilnot, and committed to consider the recommendations carefully. He added that the Government has been engaging with the care sector to develop and refine their priorities and plans for action, bearing in mind the financial context. They will publish a White Paper on wider social care issues including a progress report on funding reform in the spring.

Hazel Blears MP received number of responses to her series of questions to the Departments of Health and Work and Pensions on what discussions they had held with other Departments on planned reforms to the funding of social care the uses of funding allocated to social services. In responding Paul Burstow said that the coalition agreement set out the Government's clear commitment to reforming the system of social care to provide much more control to individuals and their carers, and to ease the cost burden that they and their families face. This commitment to reform is why the Government acted quickly to set up the Commission on Funding of Care and Support, which published its report in July 2011.

When the commission published its report, Government set out a clear timetable for assessing the impacts of the commission's recommendations, making the necessary trade-offs with other priorities for social care reform, and deciding on the best way forward. The Government has said that it is working towards a White Paper on social care and a progress report on funding reform in spring 2012. The Government remains committed to that timetable.

The commission's report has formed the basis of Government's recent engagement with stakeholders. This engagement exercise examined the impact of these recommendations, and brought them together with other priorities for reform from across the social care system to look at the trade-offs between them.

In addition to the Government’s work with social care stakeholders, the Department is looking in detail at the impact of the commission's recommendations. A full assessment of the recommendations will be included in the progress report, which will be published in the spring. The contents of that report cannot be pre-judged now by commenting in detail on the impact of the recommendations.

On the specific question of the assessment of the use of funding allocated by the Department of Health to social services, Paul Burstow said that local authorities are responsible for decisions on spending on adult social care. He continued that at a national level, the NHS information Centre collects detailed information on Personal Social Services (PSS) expenditure. The spending review outlined an additional £1 billion per annum by 2014-15 to be allocated within the NHS to be spent on measures that support social care. The Department collected information from primary care trusts in September 2011 to understand how the transfer of NHS money was progressing and on which services it was being used. The information suggests that the money is being used on a wide range of services.

Hazel Blears MP had also asked the Secretary of State for Health what estimate he has made of the cost to the public purse of funding for adults no longer able to fund their own social care in each of the last five years. Paul Burstow replied that in the current social care system, people who can afford to pay are required to fund their own social care out of their income and assets. In some cases, people need long-term social care, and some of them will, over time, use up their assets to the point that they qualify for state support to fund their own care. At this point, the local authority will provide them with support to pay for care. The Government do not centrally hold information on how many people spend down their assets and are subsequently supported by the state, nor do we know the total cost of supporting these people.

Hilary Benn MP had asked a series of older people related questions. He asked what estimate had been made of expenditure by each local authority (a) overall and (b) per head of population on social care in each of the last 10 years. In his reply Paul Burstow said that data on local authority expenditure on social care are collected and published by the Health and Social Care Information Centre. Data on local authority expenditure on for 2001-02 to 2010-11 are provided in the tables which have been placed in the Commons Library. Final data for 2010-11 will be published in March 2012.

He also asked questions relating to the spending on Meals on Wheels by each local authority (a) overall and (b) per head of population on Meals on Wheels for pensioners in each of the last 10 years and what the average charge was for Meals on Wheels services in each local authority area in each of the last 10 years. Paul Burstow said that information on the average charge for Meals on Wheels services is not collected centrally. He added that data on local authority expenditure on social care is collected and published by the NHS Information Centre via the National Adult Social Care Intelligence Service online analytical processing tool.  Data, provided by the Information Centre, on local authority expenditure on meals for older people - aged 65 or over - for the years 2001-02 to 2010-11, has been placed in the Commons Library.

Tracey Crouch MP asked the both the Communities and Local Government and Welfare and Pensions Ministers what recent representations they had received on the role of local authorities and the welfare system in reform of social care. A reply is expected early next week.

Ann Clwyd MP asked the Health Minister when he expects to publish his Department's planned White Paper on adult social care.

Next week (8 February) the Health Committee publishes its report into its inquiry into social care.