What assessment he has made of the effect of changes to local authority social care budgets on demand for health services.

What assessment he has made of the effect of changes to local authority social care budgets on the provision of adequate health and social care services.

The relationship between health and social care budgets is complex. A recent study by the University of Kent has shown that, for every pound spent on care, hospital expenditure falls by between 30p and 35p. The hon. Lady will also be aware that there has been an increase in delayed transfers of care over the past two years, which has resulted in an increase in the number of unavailable hospital beds. Our best estimate of that increase is around 0.7% of total NHS bed capacity due to the increase in social care delays.

It is quite amazing that the Minister is prepared to stand up and accept that there is a crisis in the NHS caused by the lack of social care provision. The crisis in social care means that more and more local authorities are reduced to just washing, feeding and toileting our elderly people. The crisis in residential care means that people from homes are going into the hospitals and choosing to leave the patients with the most complex needs, because they cannot afford the staff to look after them—

Order. I apologise for interrupting the hon. Lady, but we must have a question: one sentence and a question mark, thank you.

There is no comfort for our elderly people. It is not too late for the Government to act. I ask the Minister to look at protecting social care funding. Will he bring forward the £6 billion and the £700 million—

Order. I am sorry, but there is a lot to get through. It is not fair on other colleagues.

It is not fair on the elderly.

Order. I am sorry. I say to the hon. Lady without fear of contradiction that we must spread things out evenly.

I agree that budgets make a difference, which is why we are increasing spending by £7.6 billion over this Parliament, but so do leadership, grip and best practice. Some 50% of all delayed transfers that are due to social care delays occur in 24 local authorities. Many other local authorities have virtually no delays. I recently visited the IASH team—Integrated Access St Helens—in the hon. Lady’s own constituency, which, working with Whiston hospital, has achieved spectacular results and some of the best outcomes in the country. I am sure that she will want to join me in congratulating those responsible.

My local council of Rochdale has had to make cuts of £200 million in the past six years. It has a further £40 million of cuts to implement, which will pile the pressure on our social care budgets. The 2% precept will raise only £1.4 million, which is a drop in the ocean when our total adult social care budget is £80 million. With our hospitals reporting a 70% increase in delayed discharges, I call on the Minister to bring forward the better care fund scheduled for the end of this Parliament so that our social care services can cope now.

As a direct answer to the hon. Lady’s question on the improved better care fund, let me tell her that it will allocated in such a way that the combination of the fund and the precept will address real need. That is what we will be doing during the remainder of this Parliament, starting from April. We spend more on adult social care in this country than Germany, Canada and Italy, but it is very important that we spend it well.

It was good to hear my hon. Friend referring to the University of Kent’s research.

Under the guidance of the vanguards and the sustainability and transformation plan, NHS and social services in Kent are working closer together than ever before, although there is still further to go. Does my hon. Friend agree that it is vital that we overcome the barriers between social services and the NHS so that they operate more as one system, meaning that patients can get the sort of care they need in the right place, preferably at home?

My hon. Friend makes a good point about the success of the vanguard in Kent. Last week I visited the care home vanguard in Sutton, which has achieved a 20% reduction in A&E admissions due to better integration and the sort of things that she mentions as being successful in Kent.

If the Minister watched BBC News last night, he might have seen footage showing the extreme demand for treament in Royal Blackburn hospital’s A&E department and the pressure that it is under. We could point to social care changes but, in reality, the situation is down to the closure of Burnley general hospital’s A&E department in 2008 under the previous Labour Government. What more can we do to support and reduce pressure on A&E departments?

My hon. Friend is correct in so far as two thirds of all delayed transfers of care are a consequence of internal NHS issues, not issues between the NHS and councils. The issue regarding Blackburn and Burnley is part of that.

Recent figures on delayed transfers of care ranked Salford 105th out of 154, with 533 delayed days in November 2016. Sir David Dalton has said that overcrowding at Salford Royal hospital is due to its

“inability to transfer patients safely to an alternative care setting”,

and that changes to social care funding are “urgently required”. Salford Council’s budget has been cut by 40% since 2010, leading to the loss of £18 million from social care budgets. Salford royal hospital, rather than the council, is now providing social care. I know that the Health Secretary respects Sir David. Does Minister accept Sir David’s view about the need for funding changes, or will he continue to find people to blame for cuts inflicted by his Government?

Conservative Members very much respect Sir David Dalton. I remind the hon. Lady that she stood for election on a slogan of not a penny more for local government, so it is entirely inappropriate for her to say different things now. There is now an opportunity in Manchester, through the devolution deal, to integrate care and the NHS more effectively, and I expect that to happen.