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Meg Munn MP - Sheffield Heeley's voice in Parliament | Welcome
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Care Bill [Lords]

Tuesday, December 17, 2013

During a debate in the House of Commons Meg gave the following contribution.

Meg Munn (Sheffield, Heeley) (Lab/Co-op): Members on both sides of the House agree that we need to reform and improve how we provide care to those who need it. In the words of the Law Commission, our current legal framework is a complex and confusing patchwork of legislation that is in desperate need of modernisation.

However, the premise on which part of the Bill is based is simply outdated. It tries to focus the debate on residential and nursing care costs, which directs our view of care on to issues of the previous century when this should be a Bill for the landscape of the 21st century.

Only a small percentage of older people need to be in residential or nursing care and, thankfully, most of them for only a relatively short period at the end of their lives. Most people want to stay in their own homes if they can. Consequently, it is right to develop care services that make that happen, such as ExtraCare homes, whose options for meals and support for residents can change as their needs change.

Our care system is there not just for when people hit crisis point; it should be preventive, ensuring that those who need moderate care and support can receive it in their own homes. Yet, as we have heard time and again in this debate, because of the Government’s savage cuts to local authority funding, 85% of local authorities now provide care only to those whose needs are assessed as substantial.

If the level is also set at substantial in relation to the proposed national eligibility criteria in clause 13, people with moderate care needs will continue to be ignored. Their needs will inevitably move to severe, which will mean even greater cost to both the individual and the state. My hon. Friends have given examples of that.

As has already been said, the vast majority of care in this country is given by family and friends, who provide not just physical care but emotional support. Most do so willingly, but many would benefit from some support through the provision of low-level services, such as a sitting service to allow them time to themselves, or a cleaning service to allow them to concentrate on providing more personal help. Put simply, a small amount of support for those whose needs are at a lower level would lever in a large amount of care by families, who would also be enabled to continue to provide support over a longer period, so saving on much more expensive services.

Robert Flello: On the theme that my hon. Friend is developing, quite a lot of carers are almost borderline in their need for care themselves. What is her view of the fact that without that extra bit of support for carers’ needs, there may be the double hit of two people needing care from the state?

Meg Munn: My hon. Friend is absolutely right. I managed care services when, not the previous Government but the one before that, brought in health and social care services. Within the first six months, we found that every single person who ended up in residential care did so because of carer breakdown, as the carer was not getting support. That is why this support is such an important part of what we should deliver.

Care services must be personalised: they have to be about choice, as well as need. If we are to make such personalisation a reality, we need further integration of our health and social care services. The duty on local authorities under clause 3 to promote the integration of care and support with health services does not go far enough in that respect.

Indeed, a recent survey of health and wellbeing boards found that most local authorities have not identified integrated care as a priority. Clearly, we must do more to drive forward the development of integrated care. Without such an approach, we will return to the days that I remember well, when there were fruitless arguments about whether a service such as bathing was required on social or health grounds.

The integration of health and social care services is crucial to ensure that we provide carers with sufficient support. As a patron of Sheffield Young Carers, I feel privileged to have seen at first hand the selfless role that even very young carers undertake in our communities, and they should be valued.

As has been said by the right hon. Member for Banbury (Sir Tony Baldry) and my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), the Bill places a duty on local authorities to have regard to the importance of identifying carers, but that is not good enough. Some 80% of carers have contact with a health care professional, and it makes absolutely no sense to leave the NHS out of the duty to identify carers.

That matter is especially worrying as regards young carers, who quite often need a lot of support. The Children and Families Bill will strengthen young carers’ rights by providing that when a child is identified as a young carer, the needs of everyone in the family should be considered. That of course presupposes that young carers will be identified in the first place. If we do not place a corresponding duty to identify carers on health authorities, we risk young carers falling through the gaps, and we cannot continue to leave them without support.

My remarks would be somewhat lacking if I did not refer to the funding or, perhaps more accurately, the lack of funding that underpins our social care system. The proposals outlined in the Bill primarily concern redistributing the costs of care, and they will not bring any extra funding into the system.

Bill Esterson: My hon. Friend is making an absolutely crucial point. Does she agree that unless investment in social care is made now, it will end up costing far more in the cost of the NHS, as well as that of social care? It is the lack of ambition, as well as the lack of finance, that is really disappointing in what the Government are introducing in the Bill.

Meg Munn: I agree. The demand for services is now greater than ever. Our social care system is being cut to the point of breaking. As has already been discussed, should the proposed health funding reallocation for clinical commissioning groups be implemented, the situation will only get worse. South Yorkshire is due to lose 150 million by April 2014. That is staggering given that, under the proposals, other parts of the UK that already have better health outcomes and longer life expectancy will receive an increase in funding. This Bill seeks only to ration scarce resources; without a completely different approach, we will fail to meet proven need.

As a former social worker, I welcome clauses 42 to 47, which introduce a duty on local authorities to make inquiries when they suspect that an adult is at risk of or is experiencing abuse or neglect. Yet no duty is placed on care providers to report suspected abuse or neglect to the local authority. The Government contend that the present guidance is sufficient, but I disagree. In the light of Winterbourne View and Mid Staffordshire, we cannot afford to have such gaps in protection.

A recent Care Quality Commission report stated that our Accident and Emergency departments see 500,000 elderly victims of neglect. I am therefore far from convinced that enough has been done to address the issue.

Where victims of abuse are imprisoned in their own homes by a perpetrator who denies access to adult safeguarding staff, there are no current legal means by which access can be achieved. An amendment was tabled by the noble Baroness Greengross in the other place to enable a social worker to apply for a court order to access an adult at risk. Between now and the Committee stage, will the Government reflect on that matter and introduce something to address that gap?

The Bill is an opportunity for much-needed reform of our health and social care system, but in its current form it does not make the changes that we need. For that reason, I fully support my right hon. Friend the Leader of the Opposition’s reasoned amendment.

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