Local Government Finance

Part of the debate – in the House of Commons at 5:13 pm on 22nd February 2017.

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Photo of Marie Rimmer Marie Rimmer Shadow Minister (Work and Pensions) (Disabled People) 5:13 pm, 22nd February 2017

I led St Helens Council for many years and was a councillor there for 38 years, so I know a little bit about local government. The council has a fixed grant settlement for four years. It is also subject to the production of an efficiency plan that is accepted by the Department for Communities and Local Government. That would not always be a great task, because it is an efficient council—it is well run and manages its finances well. It has 10-year grant reductions of £90 million by 2020—a reduction in grant support of 75%, or £511 per person.

St Helens Council and St Helens clinical commissioning group have a very strong joint working relationship. Indeed, St Helens was awarded the first council partnership scheme and it was the first to have a public-private partnership. We have very strong working relationships, and this has enabled jointly agreed priorities for the use of the better care fund on social care and health. St Helens is the leader on integrated adult social care and health.

It was with pride that I asked a former Health Minister to visit Whiston hospital. It was the current Under-Secretary of State for Health, David Mowat who undertook the visit and he was amazed by what he saw there. The work it does is unbelievable. In fact, St Helens and Knowsley Teaching Hospitals NHS Trust has just won the out-of-hospital tender for providing district nursing, community matrons, treatment rooms, adult continence services and outreach and reablement teams. That will lead to even more integration, with the hospital out in the community.

The commissioning process has begun for telemedicine in care homes. There will be 30 pilot telemedicine units in care homes so that the elderly will not need to go to A&E. They will have 24/7 access to a senior nurse who will be able to help them in the care home. Many older people who turn up at A&E are from residential and care homes that do not provide nursing care. If they are taken seriously ill during the night, they have to be admitted to A&E. The pilot will cut those numbers.

A falls response car was piloted in December and it worked over the Christmas and new year period. It meant that 40% fewer elderly people who had had a fall went to A&E. Patients were able to access services more rapidly, including a handyman service, occupational therapy equipment and clinical nurse support within two hours. They were in their own homes and they stayed there. Integrated access to social care is superb—there is no doubt about it. People who are not fit to stay at home but not bad enough to go to hospital can go to a centre for few days, perhaps when their family are away.

St Helens Council, the clinical commissioning group and the hospital work really well together, but that is not the only answer. Whiston hospital is still short of beds and we still do not have enough money for social care, even though we will get just under £1 million from the cut to the new homes bonus. That is useful, but it is not the answer to everything. We continue to work together.

Local government is the most efficient part of government, and it is unfair that it has to bear the hardest burden. Despite everything that is thrown at it, it is resilient and has a committed workforce. The way in which they are abused is shameful.

Even given all the joint working and integrated care, elderly people are still languishing in Whiston hospital. Some people have to go to hospital in the end, because they are really poorly. Some are waiting to go to a residential or care home, whose staff sometimes have to assess up to five people for one place. It is inevitable that they will choose the least complex case, because, as my hon. Friend Mr Betts has touched on, the most complex cases require a lot more staff. Yes, we want the living wage, but the homes are not receiving money and they do not have the staff, so the most complex cases are left languishing in bed.

Some years ago, we surveyed our elderly people—anybody over the age of 55—asking them whether they wanted to spend their old age in a residential setting or stay at home. Every single one who lived in a residential home said that they wanted to stay there. They did not want to go home because they were settled, but they did not have the support they needed. We set up a successful programme to fund the residential homes to provide care. Sadly, we now have dozens of homes because we are all living much longer, with much more complex needs, so the funding problem is not going to go away. Each one of us can look forward to a much longer life, but we will have complex needs. Let us make sure that the necessary services are available.

The county works well together to provide efficient care and other services, but every single service is being cut. It was a pleasure to follow James Heappey, who seemed to have been listening to what is going on in my area. We proudly built those services. All local governments are proud of the services that they have built. Those services are not there for frivolous reasons; they are there because the public want and appreciate them, but every single one of them is being looked at.

I am sorry to say that every care package will be revisited, because the funding will not be available. The director of social care in Liverpool, a neighbouring Merseyside authority, is resigning because the funds are simply not available to deliver services. Every single director in the area is saying that we are, sadly, coming to a time when all we will be doing is feeding people, getting them out of bed, washing and toileting. That is not what our elderly people deserve. They deserve dignity and care. They have given much to society, and our society should be looking after them.

I have listened carefully to the Secretary of State, and I plead with him to do his best. I think that he is listening. We need to keep people happy, because if they are happy, they will stay healthy for longer. We need to keep children happy, but youth services are going. It is a crying shame that facilities such as refuse collections, park rangers and golf courses are going. We tell people that they need to stay happy, energetic and healthy, but all the services that have been provided are going.