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Westminster Eye: An insight into the week of politics 27 February - 2 March

Monday 27 February

Paul Maynard MP received a reply from the Minister to his question on what proportion of the Department of Health expenditure was spent on services for the elderly in the latest period for which figures are available. In his reply Paul Burstow said that around 40% NHS acute, mental health, primary care and prescribing by general practitioner is estimated to be spent on people aged 65 years and above. Information by age is not held centrally for other expenditure by the NHS. In addition, adult social care is funded by local authorities, through a combination of central Government grant funding and locally-raised council tax. He added that provisional data for 2010-11 shows that local authority net expenditure on adult social care for people aged 65 and over was £7.42 billion. This represents 50.8% of total net expenditure on adult social care.

Simon Hart MP asked the Minister for the Cabinet Office what estimate he has made of the number of people who are full-time volunteers; and how many such people volunteer for 35 or more hours per

Nick Hurd replied saying that data from the 2009-10 Citizenship Survey suggests that approximately 163,000 people in England and Wales volunteered for 140 hours or more in the four weeks prior to interview-equivalent to 35 hours a week or more. Data are not available to determine if such individuals were full-time volunteers.

Andrew Lansley laid before Parliament the Government response to the House of Commons Health Committee's report Public Expenditure.The Committee's report was published on 24 January 2012.

In its statement the Government said that the modernisation and efficiency challenges it is seeking across health and social care are exceptional; ones that are vitally necessary to secure sustainable and improving services. They are also inextricably linked and mutually supportive. These changes are critical to bringing about a modern care system that is fit to deliver the high quality, responsive, personalised services wanted by people today. As a part of these reforms, the Government is protecting funding for the NHS and allocating additional funding for social care.

Tuesday 28 February

On Tuesday Baroness Gibson of Market Rasen received a reply to her question which asked the Government what steps it is taking to reduce the burden of administration associated with volunteering. Lord Wallace of Saltaire replied saying that the Government is determined to make it easier to volunteer and run civil society organisations by cutting bureaucracy. The Government had set up the Civil Society Red Tape Taskforce, chaired by Lord Hodgson of Astley Abbotts, to identify what stops people giving more time and money to civil society organisations. Their report Unshackling Good Neighbours, makes 17 major recommendations that we are taking forward and Lord Hodgson will review progress in implementing them in May.

Baroness Gibson of Market Rasen had asked a further question over making it easier for employers to release their employees to assist in the voluntary organisations in which they have an interest.

The Baroness Wilcox said that the Giving White Paper made clear that the Government fully supports and encourages organisations making time available for employees to volunteer. The Government has also made its ambitions clear with their commitment to turn the Civil Service into a civic service, supporting civil society organisations. This will encourage civil servants to give time by providing them with opportunities to use their skills and using volunteering as a means of learning and professional development both in terms of gaining new skills and experiences and also better understanding of the impact of government policies on the civil society sector. She added that under Every Business Commits, the Government is challenging businesses to take action on priorities including promoting employee well-being and engaging with communities, with Government committing in return to encourage enterprise and reduce red tape to create the best conditions for businesses to succeed.

Wednesday 29 February

On Wednesday Hilary Benn MP asked the Communities Minister what the average charge was for Meals on Wheels in each English local authority in each year since 2000. A reply is awaited.

Tracey Crouch MP asked the Health Minister what assessment he has made of the quality of annual reviews for patients with dementia and what measures he is taking to ensure that people diagnosed with dementia who are receiving anti-psychotic medication receive regular reviews of their progress. A reply is awaited.

Thursday 1 March

On Thursday during the House of Lords debate entitled “International Women’s Day - Motion to take note” on 1 March Baroness Royall of Blaisdon included WRVS in her closing address for the opposition.

"Earlier this week I was privileged to attend a reception for the WRVS which now has 40,000 volunteers but needs more. When one thinks of the WRVS, meals on wheels and hospital cafes and trolleys come to mind. These are important tasks but the WRVS does so much more to help older people stay independent at home and active in their community"

Baroness Royall of Blaisdon

Westminster Eye: An insight into the week of politics 20 February - 24 February

Monday 20 February

At the beginning of the week Paul Maynard MP asked the Departments of Health, Justice and Transport what proportion of their Departments' expenditure was spent on services for the elderly in the latest period for which figures are available. Replies are awaited.

Tuesday 21 February

"That this House expresses concern at the news that the number of pensioners dying from hypothermia has nearly doubled in five years, a period that has coincided with a succession of cold winters as well as drastic rises in energy bills by energy companies; notes that 1,876 patients were treated for hypothermia in 2010-11, up from 950 in 2006-07; further notes that this coincides with an increase in energy costs over the past five years, especially gas, which has increased in price by 40 per cent.; recognises that energy companies' price rises are leaving more and more pensioners in fuel poverty; and calls on the Government to take action to stop energy companies increasing prices to ensure that people are able to properly heat their homes and not be left with the very real threat of serious illness and even death."

Early Day Motion tabled by Greg Mulholland MP

During health oral questions Lorely Burt MP asked what steps the Department of Health is taking to improve the standard of dementia care in hospitals. The Minister of State for Health, Paul Burstow, replied that as many as four out of 10 people in hospital have dementia, and people with dementia stay longer in hospital. He added that Government knows that there is much room for improvement. That is why it has set a new national goal for hospitals actively to identify people with dementia.

Lorely Burt MP asked a follow up over the level of training and development on dementia care in hospitals. He asked what action the Minister is taking to better equip staff to be able to take care of dementia patients in future. In response Paul Burstow said that training is certainly one of the issues highlighted by the audit. The Government is taking a number of steps, including working with the Royal College of Nursing, which has developed an online dementia information resource; working with Skills for Care and Skills for Health to provide a series of training workshops for staff; working with Oxford Deanery to trial a new approach to dementia education and training for GPs; and funding another audit to make sure that Government keeps track of the improvements that it expects to see across the NHS.

Annette Brooke MP appreciated that the Government has allocated additional funding for social care, but asked what more will and can they do in the short term not only to address the current crisis in funding and ensure that funding is used creatively and efficiently locally, but to cater for those with lower-level needs through preventive measures and early intervention. Paul Burstow agreed about the need to invest in early intervention and prevention. In addition to the £7.2 billion that the Government will invest this Parliament, this January it announced an extra £120 million for the remainder of the year to support care services. Furthermore, the Government is funding, jointly with the Local Government Association, work to support councils in delivering improved productivity and sharing best practice to ensure that they deliver improvements to services, and not just cuts.

David Crausby MP asked what recent assessment the Minister has made of the quality of services for older people. In his reply Paul Burstow said that a number of independent audits, investigations and inspections have revealed long standing and unacceptable variations in the standard of care older people receive in the NHS and social care. The Government is determined to root out poor quality care wherever it is found. It has established the National Nursing and Care Quality Forum to work with patients, carers and professionals to spread best practice.

Wednesday 22 February

Shadow Energy Minister Caroline Flint received a reply to her question to the Secretary of State for Energy and Climate Change over how many applications for assistance under the Warm Homes Discount scheme were (a) accepted and (b) rejected in 2011-12. Gregory Barker MP said that the Warm Home Discount scheme requires participating energy suppliers to assist all of those pensioners identified to them by the Secretary of State as eligible for support as part of the Core Group as they receive pension credit guarantee credit only. This year the Government estimates that around 660,000 of the poorest pensioners will be helped in this way. Suppliers are also required to spend a set amount, £153 million this year, on providing assistance to a wider group of low income and vulnerable households beyond the Core Group. This year the Government estimates that around 2 million households will be assisted in total through the scheme. Ofgem will monitor suppliers' spending and ensure they comply with the requirements of the scheme.

On the same day Tracey Crouch MP received a reply to her question to the Secretary of State for Work and Pensions on what representations she has received on the role of the welfare system in reform of social care. Maria Miller MP said that Work and Pensions Ministers have met with their counterparts in the Department of Health to discuss the important role that the social security system plays, and will continue to play in the care and support system for disabled adults and older people, a system which includes social care services provided by local authorities.

Friday 24 February

The figures for the delayed transfers from hospital were released for January 2012. There were 4,195 patients delayed on the last Thursday of the month, of which 2,482 were acute patients. This is an overall increase of around 550 patients from last month. There were 112,381 total delayed days during the month, of which 65,054 were acute. 64% of these were attributable to the NHS, 28% were attributable to Social care and 8% where both agencies were responsible.

The Lords is in recess but returns on 27 February.

Westminster Eye: An insight into the week of politics 23 - 27 January

Monday 23 January

Gareth Thomas MP received a reply to his question to the Cabinet Office on how many charities have closed or de-registered with the Charity Commission since May 2010. Minister Nick Hurd replied saying that 13,517 charities have been removed from the Register of Charities since 1 May 2010. He explained that charities are removed from the register for a variety of reasons. For example, a charity may have ceased to exist or operate, or may have merged, incorporated or transferred its funds to another charity.

Chris Skidmore MP asked the Department of Health in 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 for which figures are available. 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. Replies are awaited.

Dr Julian Huppert MP asked the Secretary of State for Business, Innovation and Skills how much the (a) Medical Research Council and (b) Engineering and Physical Sciences Research Council spent on dementia research in 2010-11. In responding David Willetts said that the Medical Research Council spent £15.6 million in 2009/10. Precise figures for MRC expenditure in 2010/11 are not yet available. The Engineering and Physical Sciences Research Council estimate that they spent £3.5 million in 2010/11.

Caroline Dinenage MP 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. A reply is awaited.

Hilary Benn MP asked the Secretary of State for Work and Pensions how many and what proportion of all adults potentially eligible for council tax benefit are pensioners in each local authority in England. Pensions Minister Steve Webb said that the number of pensioners who were entitled to council tax benefit in Great Britain, 2008/09, was between 3,950,000 and 4,490,000 which is equivalent to between 50% and 63% of the entire population entitled to council tax benefit. For context, the take-up rates of pensioners in 2008-09 were lower than non-pensioners for council tax benefit: pensioners had a take-up rate of between 56% and 64% while non-pensioners had a take-up rate of between 72% and 81%.

Tuesday 24 January

The Commons Health Committee published its highly anticipated report regarding public expenditure.

The Committee said that health and social care must be seen as two aspects of the same service and planned together in every area for there to be any chance of a high quality and efficient service being provided which meets the needs of the local population within the funding available. Best practice should be rolled out across the Health Service and underperforming commissioners held to account.

The report suggested that precious little evidence of the urgency which it believes this issue demands—on both quality and efficiency grounds. It is a question to which the Committee will return in its Report on Social Care.

The report noted that the Audit Commission argued that a key factor in progress towards joint commissioning is the quality of existing relationships on the ground. The Committee was concerned that NHS organisations are giving highest priority to achieving short-term savings which allow them to meet their financial objectives now, at the expense of planning service changes which would allow them to meet their financial and quality objectives in later years.

The report continued that the Nicholson Challenge can only be achieved through a wide process of service redesign on both a small and large scale. These changes should not be deferred until later in the Spending Review period: they must happen early in the process if they are to release the recurring savings that will be vital in meeting the challenge. In the meantime, the Committee was concerned that savings are being made through “salami-slicing” existing processes instead of rethinking and redesigning the way services are delivered.

The overall picture is of a service that is continuing to function by restricting eligibility, by making greater savings on other local authority functions and by forcing down the price it pays to contractors. The scope for further efficiencies is severely limited. The Government’s response to Dilnot’s proposals should set out how a sustainably funded system will continue into the future. The challenge is to continue to provide a meaningful service until a new system is in place.

In spite of Government assurances, local authorities are raising eligibility criteria in order to maintain social care services to those in greatest need. The Committee reported that it was It is deeply concerning that £116m of the £648m intended to be spent through the NHS on improving the interface between health and social care is being spent on sustaining existing eligibility criteria. This suggests that this money (which was intended to support greater integration of services) is in fact being used to maintain the existing system. To the extent that this is true it is a lost opportunity to promote the necessary process of service integration.

ADASS found that 82% of councils are only providing care to those whose needs are assessed as significant or higher. The Department of Health said that the settlement was intended to “hold the position steady” until a new funding system for social care was developed. The tightening of eligibility criteria shows that the settlement is not sufficient to achieve this. Early reports from the Health Service are that the transfer of money from the NHS to be spent on social care has been effective. This is important but the fact remains that it represents just 1% of annual funding for the NHS. There is scope to extend transfers of this kind. The Department of Health should urgently investigate the practicalities of greater passporting of NHS funding to social care.

The Committee’s report into its inquiry into social care is expected in the first week of February.

Paul Maynard MP asked what proportion of gross national income is spent on services for the elderly. A reply is expected shortly.

Wednesday 25 January

Andrew Jones MP asked the Secretary of State for Work and Pensions how much was paid to pensioners as a result of the increase in cold weather payments in winter 2010-11. Steve Webb replied that during the 2010/11 winter season, it is estimated that cold weather payments amounting to £264.4 million was awarded to pensioners. This has been presented in the Autumn 2011 Statement of 29 November 2011.

Gareth Thomas MP received reply from Simon Burns on his question on the steps his Department is taking to measure progress on the implementation of policies supporting the big society initiative. Simon Burns said that the Department of Health encourages and supports the big society agenda. In health care, public health and social care, the big society vision has driven our work to help people take control over their lives, the services they use and communities they live in. He added that the Government is embedding this new approach throughout our proposed health and social care reforms. The vision set out for the national health service, social care and public health puts patients, service users and carers at the heart of services they use and in control of what they access-"no decision about me without me". This is well aligned with a big society approach. He concluded by saying that over the coming years the Department will continue to have a strategic role in the design of the new health and care system. It will be a key shaper and architect and as such will ensure that strategies and policies keep people at the forefront of all that they did, working together with partners and stakeholders to achieve better experiences for all those who interact with the health and care system and help to grow the big society.

Thursday 26 January

Tim Farron MP asked the Department of Health 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. He 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. Replies are awaited.

Hazel Blears MP asked a series of questions of 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.

Hilary Benn MP also 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 ten years. He also asked about spending on Meal 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 ten years and what the average charge was for meals on wheels services in each local authority area in each of the last ten years. Replies are awaited.

Friday 27 January

The Department of Health published its monthly delayed transfers of care figures for December 2011. These showed a decline in both in the number of individual delays and the overall numbers of days compared to the previous month. This was said to be down to usual seasonal variations that occur at Christmas and New Year.