First Standing Committee on Delegated Legislation
Local Government Finance (England) Special Grant Report (No. 42) on the Promoting Independence: Partnership Grant for 1999-2000 (HC 301)
Thursday 15 April 1999
[Mr. Nicholas Winterton in the Chair]
4.30 pm
The Parliamentary Under-Secretary of State for Health (Mr. John Hutton): I beg to move,
That the Committee has considered the Local Government
Finance (England) Special Grant Report (No. 42) on the Promoting
Independence: Partnership Grant for 1999-2000 (HC 301).
The Chairman: With this it will be convenient to
consider the Local Government Finance (England)
Special Grant Report (No. 43) on the Promoting
Independence: Prevention Grant for 1999-2000 (HC 302),
and the Local Government Finance (England) Special
Grant Report (No. 44) on the Promoting Independence:
Carers Grant for 1999-2000 (HC 303).
From the sound of the activities on both sides of the
Committee, this is clearly going to be an enthusiastic and
committed Committee.
Mr. Hutton: The total amount of grants that we are
discussing today is £293 million. The partnership grant is
worth £647 million over the next three years, of which
£253 million will be spent in the current financial year,
£216 million in 2000-01 and £178 million in 2001-02.
That is all new, ring-fenced money.
The prevention grant totals £100 million over the next
three years: £20 million this year, £30 million in 2000-01
and £50 million in 2001-02. That, too, is new, ring-fenced
grant money.
The carers grant totals £140 million over the next three
years: £20 million in the current year, £50 million in
2000-01 and £70 million in 2001-02.
All three grants are financed from the new resources
secured in the comprehensive spending review, details of
which were announced by my right hon. Friend the
Chancellor last July. Social services was one of the areas
that was given priority by the Government as a result of
the comprehensive spending review. We increased the
resources available to social services departments by
6.3 per cent. in 1999-2000. For the first time, we have
guaranteed that national resources for social services will
increase in real terms for each of the following two years,
enabling social services departments to plan ahead in the
knowledge that there will be increased funding. In fact,
social services will receive almost £3 billion more in total
over the next three years, which is an average of 3 per
cent. more than inflation in each year.
The resources that we are making available for these
grants are in addition to any resources that local
authorities have received in previous years. They are the
first social services grants to be made available in the new
era of extra cash in return for outcomes. The grants are
part of the new modernisation fund created for social
services and will be used as a lever for modernisation
throughout all adult social services. We are determined to
ensure that they are used by local authorities to improve
the services that they provide to the people in their
communities.
Our guidance to local authorities about the grants states
clearly that for planning purposes, authorities can assume
that the allocation method for the grants in years two and
three will be the same as for this first year. However, as
with this year, the allocation of special grants to local
authorities will ultimately depend on parliamentary
approval in the year in question.
The partnership grant is a key element in our strategy
to develop partnership working between health and social
services and to break down the "Berlin walls" between
the national health service and local authorities, thus
improving the services that individuals receive. Local
authorities will be required to plan and to agree with their
partner health authorities how the grant will be used to
promote the independence of people requiring their
services.
The grant represents a significant injection of new
money into the system to ensure that the partnership
agenda is properly delivered. However we want to ensure
that the agenda becomes part of mainstream activity for
local authorities and the national health service, so the
amount of new money represented by the partnership
grant reduces over the three years as the new ways of
working become embedded in the culture of the new
national health service and local government.
We have made clear our intention to promote
partnership working between the national health service
and local authorities on many occasions. The national
priorities guidance, for example, set for the first time
priorities for the health service and for social services.
Crucially, we included joint priorities, including the
"promoting independence" priority, and key shared
objectives for both parties. The White Paper entitled "The
new NHS: Modern, Dependable" made clear our intention
to break down the "Berlin walls" between the health
service and local authorities the legal and financial
barriers which, for far too long, have prevented agencies
from working effectively together to provide the best
service for individuals.
We published in September last year our proposals for
taking this forward in the discussion document
"Partnership in Action". The proposals were universally
welcomed. And in November, we published the social
services White Paper which took forward this agenda, not
least by announcing the new partnership and prevention
grants that we are considering today.
However, we are not content with simply making
policy statements. The challenge for all of us is to
translate that policy into concrete benefits for our
constituents. We are legislating for the proposals in
"Partnership in Action" in the Health Bill, which had its
Second Reading two days ago. As well as legislating for
the operational flexibilities proposed in "Partnership in
Action" , the Health Bill includes a new strengthened and
broadened duty of co-operation for NHS bodies and local
authorities. It also requires health authorities to draw up a
strategy for improving health, involving all local partners,
including voluntary organisations. We have consulted on
new performance assessment frameworks for the NHS
and for social services which, for the first time, will
include joint outcome indicators for both those key
partners.
So we are creating the structures to enable NHS bodies
and local authorities to work better together; we are
creating the means by which we can assess how
effectively those incentives are being used to improve
services; and, through the partnership grant, and the other
two grants that we are considering today, we are providing
the necessary resources to enable social services
departments to enter into meaningful and beneficial
relationships with their NHS partners.
The aims of the partnership grant are to foster
partnership working between health and social services in
promoting the independence of adults needing community
care services. That will help local authorities to achieve
the objectives for adult services set out in the social
services White Paper and in the objective on promoting
independence in the national priorities guidance.
The key condition for the grant is that local authorities
must draw up a plan in partnership with the health
authorities in their area which sets out how the additional
money will be used to meet these important objectives.
The plan must include proposals in a number of key areas,
such as joint assessment for individuals, joint procedures
for hospital discharge and better rehabilitation and
recuperation services. If social services and health
authorities work together in those areas, we know that
there are important benefits for individuals. People are
helped to stay at home, rather than be admitted to hospital.
They can be discharged from hospital to their own home
rather than a residential or nursing home. Vulnerable
people, in particular, are better able to receive services
where and when they want them, because agencies are
working together to meet the needs of the individual.
The requirement for a joint plan goes with the grain of
the developing partnership agenda. Health authorities and
social service departments have already been working
together to produce joint investment plans. They are
setting out the resources that they intend to invest and
how they propose to develop services for specific client
groups. In the first year, such plans have been required
only for services for older people, but many health and
local authorities have used the opportunity to set out plans
for the development of services at the interface for all
client groups, not just older people. In these cases, there
is already an established plan which can be used for
setting out how the partnership grant will be used. Even
where local partners have focused on older people in their
joint investment plans, they will have in place the
arrangements for working together which will enable
them to draw up plans for using the partnership grant
without having to establish new mechanisms, so the
partnership grant will create an impetus for partnership
working as well as providing new resources for that
operation.
I would like to draw the Committee's attention to two
important elements of the joint plan. First, we have asked
local authorities to provide information on the
contingency plans they have made with their health
partners to deal with additional pressures on their services.
That will be especially important over the next winter.
Secondly, we have, in the guidance on the partnership
grant, suggested that authorities might use the partnership
grant money to continue projects that has been funded
using the additional resources that were provided to the
NHS to cope with additional pressures over the winter.
Much of that money was used in partnership with social
services departments, and the Select Committee on
Health, in its recent report, noted how effective those
schemes had been. We hope that the partnership grant will
be used to ensure that that good work continues.
The partnership grant is not simply a continuation
of the old special transitional grant. This is new money
for new purposes. It represents a new start in funding for
innovative working. Unlike the old STG, there is no need
for arguments about whether the grant money has been
incorporated into SSAs in the following year because, for
the first time, we have introduced certainty into funding
for local authorities, social services spending. The CSR
settlement is for three years. Each authority will know
what money is available for it over the next three years.
The money in the partnership grant will more than
adequately cover the costs of additional clients who would
previously have been funded from the STG, but the STG
was not the best way of providing funding. It was divisive,
in that it created two separate funding streams for
community care clients. We now want authorities to
consider the totality of resources available to them from
the new grants and SSAs. Clients do not care whether
they are funded from mainstream budgets or from an
earmarked grant; they care about whether they get the
right services at the right time and when they are needed.
The generous overall settlement in the CSR should allow
authorities to develop new services and remove barriers
to joint working. That must be better for all community
care clients.
The Partnership Grant will be paid in 12 equal monthly
instalments. Local authorities are asked to submit a joint
plan for use of the grant money by the end of May and,
where requested to do so, we will work with authorities
to help them develop their joint plans. But all the
indications are that the experience of developing joint
investment plans has given the vast majority of authorities
a head start. We have issued guidance on how the grant
should be used and will monitor closely the extent to
which it is used to improve outcomes for service users.
We want to be able to take the experience of those who
have made best use of the new money and share it so that
improvements are made to services in every local
authority area.
As for the prevention grant, we have made clear our
intention to put a new emphasis on helping people to
achieve and maintain independence wherever possible.
The grant forms part of the special effort to achieve that
objective. It is focused specifically on encouraging local
authorities to take a strategic approach to preventive
services for all adult clients groups and to use their
resources in a targeted way to support people who have
been assessed as being at risk of losing their independence
and those who are able to benefit from lower-intensity
services, which prevent or significantly delay admission
to residential or nursing home care or to hospital. The
grant is aimed also at helping people to gain or re-enter
employment and to enhance their quality of life by so
doing.
The grant is to be used to begin to restore some of
the balance that has been lost between high-intensity and
low-intensity domiciliary services and to help local
authorities to develop preventive strategies. Those must
be developed in partnership with other agencies, such as
the health service and those responsible for transport,
leisure and housing.
The grant will have conditions attached. The primary
condition is that the entire grant must be used only for
the purposes of non-intensive community care services,
including the costs associated with the administration of
such services, within the financial year 1999-2000. The
secondary condition is that authorities must develop
a preventive strategy and, by 29 October 1999, provide a
written plan that is agreed with relevant health authorities.
The strategy should cover the three years to 2001-02 and
set out three things. The first is the preventive strategy,
which should demonstrate that authorities have worked in
partnership with health authorities in their area and
involved relevant organisations in drawing up the
strategy. Secondly, it should show how they intend to
implement the strategy, and include the indicators that
they intend to use to monitor their progress towards its
implementation.
Thirdly, it should make clear how much of the grant
they intend to spend on non-intensive services.
The services on which the grant can be spent focus
specifically on lower levels of intervention for those
people who, on the basis of proper risk assessment, are
likely to benefit most from such services in terms of
preventing deterioration in their independence. The grant
stipulates that at least 75 per cent. must be spent on
additional services. Those are services that are either new
to the authority, or which are being provided to more
people than previously. Although we full acknowledge
that some resources will have to be spent on preparing the
preventive strategy and the plan, it is important that the
majority of the grant money is spent on additional
services.
The success of the preventive strategy will depend on
the involvement of other relevant agencies, so we are
issuing guidance on the development of a preventive
strategy and a social services inspectorate report
identifying examples of good practice policies and
processes.
We expect authorities to devise means of measuring the
progress that they achieve. In doing so, they will wish
to take note of the proposed indicators for performance
assessment contained in the document "A New Approach
to Social Services Performance" , which is currently the
subject of consultation.
Finally, I shall deal with the carers grant. We know that
almost all carers need some help and support to enable
them to continue to care. That is why, as part of our
strategy for carers, the Government are making available
to local authorities a new special grant to allow carers to
take a break from caring. The carers special grant is
intended to enhance provision of community care
services. First, it will allow carers to take a break from
caring by stimulating greater diversity and flexibility of
provisions. Secondly, it should promote greater awareness
in local authorities of the need for services in their area
that are more responsive to carers' needs. Thirdly, the
grant is intended to enable carers and their organisations
explicitly to be involved in work by local authorities on
the appropriateness of current provision and the
possibility of greater diversity.
For those reasons, we are attaching two conditions to
the carers special grant. The primary condition is that the
entire grant must be spent on community care services for
people assessed as needing local authority services who
live at home and who regularly receive substantial
amounts of care from informal carers. That will enable
the carers involved to take a break from caring. We intend
the services provided to support carers in their role,
relieve carer stress, enable them to continue to provide
care, promote their social inclusion and maintain their
health, including mental health. In providing those
services, local authorities must work in partnership with
the NHS, and should take account of relevant
recommendations in the carers national strategy report,
"Caring about Carers" .
The secondary condition attached to the grant is that
local authorities must provide the Secretary of State for
Health with a written plan by 29 October. First, it should
set out their expenditure during 1998-99 on the provision
of community care services aimed at enabling carers to
take a break from caring, and the nature of that provision.
Secondly, it should contain an assessment of need for
community care services aimed at giving carers a break
from caring and proposals for a programme of change and
development to diversify and to enhance their provision
of those services. That information should reflect the
views of users and carers as well as indicators used by
the local authority to monitor progress. Thirdly, local
authorities should set out in the plan proposals to
introduce or improve procedures for the involvement of
carers and local carers' organisations in their planning on
how the grant money should be spent during the
three-year grant period. Finally, the plan should state the
percentage of the grant money to be spent on additional
services. At least 75 per cent. of the grant should be spent
on such services.
The Government are committed to providing better
support for carers than has often been provided in the past.
My hon. Friend the Member for Brent, South
(Mr. Boteng), now Minister of State for the Home Office,
led a recent Government-wide review of measures to help
carers as part of the Prime Minister's national strategy for
carers. The objectives of the strategy was to bring together
across Government a range of new initiatives designed to
address carers' concerns.
Social services will play an important part in providing
much of the practical help needed to assist carers in
maintaining their vital caring role. The grant will provide
resources to help them carry out their role, and forms a
central part of our strategy for carers.
In conclusion, social services are too important to be
neglected. The Government are giving them the attention
that they deserve, and we will work in partnership with
local government and other stakeholders to ensure that
everyone in our society can benefit from services fit for
the next century. The social services modernisation fund,
of which the three grants form a very substantial part, will
be a lever for modernisation throughout all social services
activities and spending. Through the modernisation fund
and wider increases in social services funding we are
providing resources to match the plans outlined in the
social services White Paper.
We have therefore shown our commitment to
improving social services, and have made available
substantial additional resources. The special grant reports
provide for the distribution to local authorities in England
of additional funds totalling £293 million for 1999-2000,
to assist them with the important work at which the grants
are aimed. They show our clear commitment to achieving
improvements in the delivery of social care and in the
way in which social services and the NHS work together.
Most important, however, they provide vital new
resources to bring about improvements in the services that
people receive. I commend the special grant reports to
the Committee.
4.50 pm
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