This is the text of a speech Sir George made in Westminster Hall:
Sir George Young (North-West Hampshire) (Con): It is a pleasure to follow the hon. Member for Eccles (Ian Stewart), who spoke movingly about the challenges that confront his constituents. His constituency could not be more different from mine; his is an inner-city seat in the north and I have a rural seat in the south. However, the fact that we both face the same problems makes the case that the Minister needs to answer even more powerful.
I congratulate my parliamentary neighbour, the hon. Member for Romsey (Sandra Gidley), on securing this timely debate, as it is in the shadow of comprehensive spending review 7. For some reason, the CSR will not be debated in the House—instead, we have rather more fragmented debates in Westminster Hall—but it sets the parameter for social services expenditure over the next three years.
More than half of those hon. Members who are here took part in a similar debate earlier this year in the context of residential care. Everyone who spoke in that debate made the point that social services were under extreme pressure. The right hon. Member for Oxford, East (Mr. Smith) said of this “complex and crucial” area of care that it was
“under enormous pressure because of demand and constraints on resources even as they are increasing.”—[Official Report, Westminster Hall, 17 January 2007; Vol. 455, c. 316WH.]
My hon. Friend the Member for Beverley and Holderness (Mr. Stuart) spoke about the problems in residential care, and my hon. Friend the Member for Eddisbury (Mr. O'Brien) spoke about the absence of a long-term strategy for funding care, a subject to which he may want to return.
In that debate, I asked for a step increase in funding for social services to eliminate its historic underfunding and a realistic baseline to be provided from which we could move forward. In his reply, the Minister—I welcome him again this morning—gently rebuked us for not noticing in the last pre-Budget report that
“the Treasury identified social care as one of the great challenges facing this country and one that we have an obligation to address.”
He went on to reassure us that
“We are arguing forcefully—I shall not reveal the details in this debate—with the Treasury about the importance of a good settlement for social care under the comprehensive spending review.”
He then said:
“We need a new deal to reflect a new settlement in the demographic realities of the 21st century.”—[Official Report, Westminster Hall, 17 January 2007; Vol. 455, c. 332-32WH.]
He was right. This morning, we have an opportunity to assess the Minister’s performance, as set out in CSR7, against those statements.
The average real-terms increase in public spending over the next three years in the comprehensive spending review is 2.1 per cent. Against that benchmark, who are the winners and who are the losers? The biggest loser is local government, at 1 per cent., narrowly below the Home Office at 1.1 per cent. No way is that a good settlement. No way is that the new deal that the Minister held out earlier this year.
The third biggest winner, after the Department for International Development and the Cabinet Office, which are both small Departments, was NHS England. That disparity in treatment under the Government between health and social services underlines my point. Although the NHS has had a 90 per cent. increase in funding since 1997, if schools are exempted—they are now directly funded by the Government—local government has received only 14 per cent., and the largest service provided by local government is social services.
I understand the political imperatives. Ministers have direct responsibility for the NHS, whereas social services fall to local councillors. How tempting it must be for Ministers to pre-empt for themselves the lion’s share of the CSR for the services for which they are accountable and let councillors take the rap for social services. It is understandable, but it is wrong. The extra 1 per cent. for the NHS, announced with a flourish by the Chancellor a fortnight ago, should, if one believes in joined-up government, have gone to the under-funded social service authorities rather than the NHS.
Ian Stewart: Does the right hon. Gentleman not accept that his comments, pointed as they are, would be more pertinent if we were starting from now? All the statistics that I and others have cited have been built up over the past 30 years. It is important to recognise that.
Sir George Young: I am grateful to the hon. Gentleman, who may have made a valid point. He might like to consider what happened from 1992 to 1997, and see whether there was a disparity then in the treatment of the two. I hope, in return, that he will extend the gentle criticism that I have made of his Administration, that there has been a disparity—in my view, an indefensible disparity—since 1997. Even the 4 per cent. comprehensive spending review increase for the NHS is aimed much more at hospitals than at assisting the NHS to move resources into the community. Had it been the other way around, one could have had a greater partnership with the county councils, who know the communities and have good links with them.
The Government have allowed adult services a growth of 1 per cent., but they expect councillors to increase direct payments, to invest in prevention so that people can remain independent, and to phase out the use of NHS accommodation for people with learning disabilities and to help them live independently in the community. Adult social services are struggling to cope with their current responsibilities. It seems a Herculean task to respond genuinely to the challenges that the Government have laid before them with such resources.
The Minister must know what is going to happen. As the hon. Member for Romsey said, eligibility thresholds will have to be raised, care will be rationed for the most vulnerable, preventive work will be cut back, and charges will be increased or introduced—and the council tax will take the strain. If the Minister believes that health and social services are key partners in the welfare state, he will know that they need to be given roughly comparable resources. If one needs help, one is not interested in whether it comes from social services or health; one
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simply wants the services to which one is entitled. Policy for the past 20 years has focused on breaking down the barriers between the two—promoting joint commissioning, joint assessment, and the rest. If they are to be key partners, they must be more equal. They both need to bring something to the table.
I shall pass over the demographic clock that is ticking in Hampshire, as it is in Eccles and elsewhere—the needs of young adults with learning disabilities coming up from children’s services demanding and expecting large care packages, and parents with offspring with a learning disability who themselves are ageing.
Consultation is about to begin on the Green Paper. It will, of course, be important, as it will offer a potential overhaul of the funding of social care. However, it will not help during the next three years of the spending review. No additional resources have been added to help with the demographic pressure and the other pressures that are on adult services nationally. My county council will get less grant than others, because it is a floor authority; it will have to make economies in other services and raise the council tax to make up the difference.
I leave the Minister with a final question. Is that it? Will there be, at some point during this Parliament, an opportunity to revisit the three-year settlement announced for social services, so that we can get them a squarer deal?