This was published under the 2010 to 2015 Conservative and Liberal Democrat coalition government
Eric Pickles' speech to the National Children and Adult Services Conference 2014.
When I started at Bradford Council 35 years ago I joined the Social Services Committee. Because I was interested in the subject. And the fact, if I’m honest, that no other councillor wanted to be on it.
It was regarded as a backwater. In past 35 years a lot has changed. Now it dominates.
It was the beginning of Care in the Community.
I had an inspirational director of social services, John Crook, who taught me many things:
- how expensive social care was
- and how there was a demographic time bomb in terms of costs
He was right. But above all he taught me that it was not all about money. It was about respect for the most vulnerable.
John died a few years ago.
I hope John would be proud today.
We all want:
- a better way of caring for our ageing population
- a better way of providing services
- a better way of offering them dignity and independence
We all call them the vulnerable.
But they are our parents, our grandparents, sometimes our children, our neighbours, our friends.
People who want our support, but don’t want to be type-cast or wrapped in cotton wool.
Who want a straightforward and predictable way of receiving care, and to avoid excessive fuss and hassle so they can maintain their independence.
Just because you are old you do not lose your humanity or dignity.
Just because you are vulnerable you should not lose your voice.
You have a right to decide when and where you want your care:
- at home
- closer to home
- nearer friends and family
Achieving this is something that people have talked about doing for generations, but they struggled to act.
The Better Care Fund now offers us an opportunity to finally change the way things are done.
Today, with Jeremy, I can announce the first stage of this transformation.
A new national standard of care for the elderly that will begin in April next year.
This new standard will deliver 4 major improvements.
- 7-day social care, which will mean older people can expect the same level of care every day of the week, and don’t need to make unnecessary trips to hospital on the weekend
- a single named professional will join up individual services around peoples’ needs, so they have a predictable and consistent service from 1 person, and don’t feel like they’re being passed from pillar to post
- information will be shared in a better way, so people don’t have to repeat their story endlessly to different professionals
- joint assessments will help assess peoples’ needs quickly and efficiently
It’s a new national standard, but it won’t be a top-down, one-size-fits-all service.
Every area will have their own local plan.
And today I can announce that after months of hard work we have got virtually all of your local plans approved.
We are determined that everyone, everywhere will get quality care.
The £3.8 billion initial investment from our department and the NHS has been boosted by your contributions to more than £5 billion.
So better care is truly a shared achievement we can all be proud of.
We can stand here together and say that – for all the sceptics who told us it wasn’t possible – this programme is on track and set to begin on time.
It’s about joined up government, joined up services and joined up thinking.
The fruit of joint work between health and wellbeing boards across the country, that are made up of local councils and health services, as well as 2 government departments, the NHS, and the LGA.
What is better care?
So what will better care look like?
The most obvious change is we don’t want to see people in A&E who should not be there.
When you are old and vulnerable that’s the last place you want to be.
Better care will mean:
- a better focus on prevention
- fewer people getting ill in the first place
- fewer needless accidents
- and fewer people getting exasperated trying to get the care they need
Above all, it will mean helping people to stay at home when they want to.
Or, when that is not possible, getting home from hospital more quickly and safely.
It will mean giving people the right support, so they can enjoy the level of independence they need, and preserve their dignity and privacy.
This will be a meaningful change in services that people notice, not background bureaucratic tinkering.
Examples of future changes
We can already see how these methods will be put into practice.
Let’s look at 4 examples.
In Pocklington they’re really good at preventing problems before they start.
They’ve prioritised resources to help the elderly stay healthy, active and independent at home for as long as possible.
In Howdenshire they’re helping people get support when and where they need it.
They’ve set up something obvious, but that few areas have.
A single phone number and a rapid response team for elderly people, which applies to health or social care.
In Waltham Forest they’ve gone even further.
Everyone will be given a named professional who’ll be responsible for their care.
It might be a GP, a social worker or a nurse, depending on what’s best for that person, because we don’t want people getting passed around from pillar to post.
In Bath and North East Somerset they’re getting people home more quickly and safely from hospital when they do have to be admitted.
Bringing in charities to help people through the discharge process, from hospital ward to being settled and checked up on back at home.
There will also be a new focus on helping elderly people who want to stay at home for their care.
We need to ensure people are cared for with respect and dignity.
To be honest, in some cases we are talking about people in the last months of their lives.
What could be more important than being cared for well at the very end of your life.
Like a recent case I heard about in a prominent London Borough.
A very elderly woman was admitted to hospital 7 times between January and May.
Those hospital visits did not make a great deal of difference, but they placed her under enormous stress.
She was gravely ill, but she wanted to be at home
Closer to friends, closer to family, with her own comforts and belongings around her.
A joint health and social team came up with a sensible plan to help her stay at home.
So in the final months of her life, despite her health clearly deteriorating, she only went back to hospital twice, when her health took a serious turn for the worse.
She died in November – in her own home.
But the objective was for her to get the maximum out of her final few months.
To maximise her quality of life.
That’s the aim of better care.
That’s the difference it will make.
Everyone deserves to be looked after properly in later life.
Everyone deserves that that extra bit of dignity.
It’s as simple as that.
I’m under no illusion that today’s announcement is just a first step, but it’s also an historic change, and a debt of gratitude is owed to the people in this room who have helped shape the new services for their area.
These improvements will need to continue:
- budgets must be pooled
- costs and pressures on health and social care budgets will need to be managed
- and information must be shared more effectively
But the outcome will be worth the effort.
A better quality of life for older people and care that treats the elderly and vulnerable with respect.
For our parents, for ourselves and for our children.
Today is only the start.
Make no mistake – not all these plans are perfect, there is still work to be done.
But we have a golden opportunity to create a seamless link between health and social care.
For the first time in generations, we have the chance to lay a foundation for something that we can all be proud of.
I look forward to working with Jeremy, and with all of you, and I genuinely believe we can achieve this together.