Clause 6 - Co-operating generally

Care Bill [Lords] – in a Public Bill Committee am 9:15 am ar 14 Ionawr 2014.

Danfonwch hysbysiad imi am ddadleuon fel hyn

Photo of Liz Kendall Liz Kendall Shadow Minister (Health) (Care and Older People) 9:15, 14 Ionawr 2014

I beg to move amendment 82, in clause 6, page 7, line 23, at end insert—

‘(f) sharing information and data so as to ensure high quality care and support.’.

Clause 6 seeks to ensure that all the different bodies co-operate with one another to improve care and support. Amendment 82 would ensure that, even when they are co-operating, all such bodies shared information and data to make sure people got the best possible care and support. All hon. Members will know from constituency cases that the different bodies that are supposed to work together often do not share information about the people who are using and receiving services. The amendment would ensure that local bodies worked together to share information where appropriate.

The clause refers to a range of different bodies: councils, NHS bodies, chiefs of police, the probation service and Ministers of the Crown responsible for issues such as employment, training and social security. I want to give a specific example to illustrate my point. Last year, I spoke at an event organised by the Strategic  Society Centre, an excellent think-tank that examines policy in relation to social care. The event was also supported by Independent Age.

The event considered brilliant research on attendance allowance claimants. The Minister knows that 1.3 million elderly people in England currently claim attendance allowance—a non-means-tested means of support to give extra money directly to people who have a high level of need. Some 80% of attendance allowance claimants have a long-term illness associated with heart disease, diabetes, stroke and arthritis. More than half have nine or more mobility problems or difficulties, which is a really high level of need. Despite that, more than a million claimants currently get no help whatever from local council social care services, and fewer than one in 20 get help from NHS community nurses. We know that specialist nurses working in the community can help people with heart disease and diabetes to manage their conditions better so that they can stay at home, their problems do not escalate and they do not end up in hospital.

The Strategic Society Centre and Independent Age rightly highlighted the “missing million” people who have high levels of need, but do not get social care or NHS support when they might really benefit from it. Not only would they benefit, but taxpayers would too if people could be helped to stay living at home rather than ending up ringing 999 and going in an ambulance to accident and emergency.

The research also showed that about a third of attendance allowance claimants are cared for by a son or daughter; 30% by a partner; and 15% by another family member—perhaps a brother or a sister. All that information is held by the Department for Work and Pensions. In other words, the DWP has amazing information about people and family carers who might benefit from up-front help and support.

We have already talked about the fact that carers often do not come forward because they do not think of themselves as carers but as people trying to look after the person they love. We need to do more to identify them, and the DWP has that amazing information. Ensuring that the DWP shares information with local councils and social care would be a brilliantly effective way of getting the shift to prevention that all hon. Members want. I think I might have raised the issue with the Minister before; I am passionate about it. The Government need to get better at sharing information and data.

Has the Minister ever had a conversation with his DWP colleagues about this matter? Does he agree that if the amendment were added to the Bill, Ministers of the Crown would be required to talk to one another and get the issue sorted out? I tabled the amendment to get better care and better value for taxpayers’ money, but it would also require every Minister to do what we all say we want them to do—to work together.

I hope the Minister will accept the amendment. Will he at least tell me whether he has ever had a conversation with his DWP colleagues about joining up the work to get the best outcomes for people and taxpayers?

Photo of Norman Lamb Norman Lamb The Minister of State, Department of Health

I totally agree with everything the hon. Lady said. Attendance allowance is a powerful concept, because it is a direct payment that gives the  individual total power to determine how they spend it in their best interest. The concept should therefore be strongly supported. It was interesting to hear what the hon. Lady said about the session she attended, but there has been a paucity of analysis of the impact of attendance allowance, how effective it can be, and who does and does not get it—some people who are entitled to it do not claim it. Her point about better collaboration was well made, and the Bill seeks to address that issue. Subsection (7)(d) states:

“the Minister of the Crown exercising functions in relation to social security, employment and training, so far as those functions are exercisable in relation to England”.

Co-operation is therefore very much at the heart of the Bill.

The hon. Lady asked about the conversations I have had. I have had lots of discussions with DWP about better collaboration, particularly on mental health and unemployment, but there is great potential for more effective joined-up work. I have not had a specific discussion about that issue, and I will do. That is a very good point, and I am grateful to the hon. Lady for suggesting it. There is a lot we can gain by doing what the Bill tells us we should be doing and collaborating more effectively.

The Government agree that it is paramount for information and data to be shared effectively across organisations, including between commissioners and providers, to aid effective integration, for the purpose of achieving good care. However, we must understand and address the root cause of the current issues with effective information sharing. The Government do not believe that the amendment would help to achieve such a complex and technical goal. There are enormous frustrations about the failure to share information, whether between the Department for Work and Pensions and other parts of the health and care system; providers of health and care services locally, which do not share information with each other; or the commissioner and the provider locally. There are failures of good information sharing all over the place; they need to be addressed and we need to understand why such failures occur and how to unlock them.

This will require detailed work in order to understand how such information sharing can happen effectively, overcoming both technical and cultural barriers. Organisations often work in silos, without thinking about the bigger picture of the care that they are jointly providing to an individual. Officials at the Department of Health are undertaking that work, which I have made clear must be an absolute priority. Integrated care, about which I am passionate, is held back by the barrier of the failure to share information properly between organisations. Often, local organisations put up barriers that do not need to be there; they think that they have to have them to meet privacy requirements, but they end up preventing good care by operating in silos. So I regard this as a high priority.

We have been clear that good data and information sharing is important—indeed, vital—to integrated care, which is why better data sharing between health and social care is included as one of the national conditions  attached to the better care fund. “The power of information” strategy also set out a number of ambitions, including the use of information to drive integrated care throughout the entire health and social care sector, both within and between organisations.

Data sharing is governed by laws on data protection and confidentiality, and we would expect relevant partners to share information where relevant in accordance with the law when exercising their care and support functions to ensure high-quality care and support.

Photo of Debbie Abrahams Debbie Abrahams Llafur, Oldham East and Saddleworth 9:30, 14 Ionawr 2014

I totally support my hon. Friend the Member for Leicester West in her amendment. Is there a particular reason, in terms of the organisations that the Government want to have sharing, why education institutions were not specifically mentioned? That seems to be an omission, again, to consider the needs of young carers in the clause.

Photo of Norman Lamb Norman Lamb The Minister of State, Department of Health

The Bill allows for the sharing of information between departments of an authority—a social care authority would also be the education or children’s services authority, so there should be that co-operation between departments in the authority and, indeed, with the education institutions beyond the authority in the public sector. The hon. Lady makes a good point; I absolutely agree with the spirit in which she is focusing on it. If I can provide her with any further helpful guidance and response I will seek to do so.

Clause 7 provides a specific duty to co-operate in individual cases. Where a local authority or one of its relevant partners requires the co-operation of the other to obtain information relevant to care and support functions, it could request such information and the local authority or relevant partner must co-operate in providing the information, unless doing so would be unlawful or have an adverse effect on its functions.

I hope that I have reassured the shadow Minister that information and data sharing will fall within the scope of the co-operation duties. The amendment is therefore unnecessary, but I completely share her absolute clarity of view that information sharing is essential in order to achieve not only good care, but the most efficient use of resources.

Photo of Liz Kendall Liz Kendall Shadow Minister (Health) (Care and Older People)

I thank the Minister for his response. He understands that information sharing is absolutely essential. I am happy to withdraw the amendment on the basis that, first, the Minister has accepted the general principle and that, secondly, he will go and talk to his colleagues in the DWP about the specific issue of attendance allowance. If he makes any progress on this, will he keep Members updated and will he acknowledge that the issue was raised by the Opposition, and that if he makes any progress, we have, in part, been responsible for that?

Photo of Norman Lamb Norman Lamb The Minister of State, Department of Health

I try not to be tribal in my politics. I have already acknowledged that the point the shadow Minister made is a good one. I am very happy to keep Members informed about any progress that is made, but I commit to entering that discussion with DWP because I think it is worth while doing.

Amendment, by leave, withdrawn.

Clause 6 ordered to stand part of the Bill.