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minutes of the meeting between
SOCIAL SERVICES NORTH WEST
AND THE LOCAL GOVERNMENT ASSOCIATION
SOCIAL AFFAIRS AND HEALTH EXECUTIVE
BOLTON TOWN HALL – FRIDAY, 23 NOVEMBER 2001
Present:
Members
Councillor Morris Bolton (Chair SSNW)
Councillor Keith Knowsley MBC (Vice Chair SSNW)
Councillor Stringfellow Chair LGA Social Affairs and Health Executive
Councillor Case LGA Social Affairs and Health Executive
Councillor Holtom Lancashire County Council
Councillor Roderick Liverpool City Council
Councillor Morley Halton BC
Councillor McInerney Halton BC
Councillor O’Neill Wigan MBC
Councillor Kelly Wigan MBC
Councillor Froggatt Warrington BC
Councillor Bromley Warrington BC
Councillor Trotman Manchester City Council
Councillor Cooley Manchester City Council
Councillor Devine Salford City Council
Councillor O’Hare Knowsley MBC
Councillor Parker Cumbria County Council
Counillor Middleton Tameside MBC
Councillor Heffernan Oldham MBC
Councillor Joynes Oldham MBC
Councillor Gorton Blackburn with Darwen BC
Councillor Candler Stockport MBC
Councillor Phillips Liverpool City Council
Councillor Clare Bolton MBC
Councillor Barlow Bolton MBC
Councillor Murray Bolton MBC
Councillor Howarth Bolton MBC
Councillor Dolan Trafford MBC
MP’s
David Crausby Bolton North East
Ruth Kelly (and colleague) Bolton West
Alison Jack representing
Michael Jack MP Fylde
Officers
J Bremner Local Government Association
A Marsland Knowsley
K Foote Blackburn with Darwen
B Walker Wigan
K. Darragh Salford
A Booth Oldham
M Cooney Bolton
J Pearson Sefton
D Hanley Manchester
P Hewitt SSNW
P J Viggers SSNW
E Trotter SSNW
Apologies:
LGA SA&H Executive members:
Councillor Steve Jones (Sheffield) Councillor King (Norfolk), Councillor Mitchell (Oxfordshire), Councillor Rutter (Gloucestershire), Councillor Wilkinson (Wrexham)
SSNW members:
Councillor Taylor Tameside, Councillor Thompson Rochdale, Councillor Fletcher St Helens
Officers:
S Lightup St Helens, I Davey Rochdale, G Taylor Halton, G Evans Oldham, S McLurg Manchester, D Whitehead Warrington, P Oliver Lancashire, S Pullan Blackpool, A Robertson Bolton, A Shepperd Liverpool.
MP’s:
23 MP’s sent their apologies
1. Opening of Meeting
Councillor Cliff Morris (Bolton), Chair of Social Services North West officially welcomed Councillor Rita Stringfellow, Chair of the Local Government Association Health and Social Affairs Executive; Councillor Pat Case, another member of the Executive and Jeni Bremner, Project Manager for Social Care and Health from LGA Headquarters. Councillor Morris also welcomed to the meeting two leading North West Members of Parliament: David Crausby, Chair of the North West Group of MPs and Ruth Kelly, a Treasury Minister.
This was the second year a joint meeting had been held to enable members of Social Services North West to exchange views with the Social Affairs and Health Executive of the LGA, and to express views and ask questions relating to the local government agenda for social services. Councillor Morris said that Social Services North West had had another successful year. As well as the quarterly meetings, we had promoted seven conferences on a variety of issues, attracting 500 delegates between them. We lobbied Ministers on a number of key matters, and received substantive replies in most cases. We secured representation on a number of key regional bodies, and we have raised the profile of Social Services North West through our quarterly Newsletter and our website, which now receives many regular visitors to our weekly updates.
At our AGM in September, we decided to continue with three key themes: Working with the NHS, Financial Issues, and Quality Protects and children’s issues. We also added a new one: Learning Disability. Each of these would feature in this meeting.
Councillor Rita Stringfellow, Chair of the Local Government Association Health and Social Affairs Executive thanked Social Services North West for inviting her back again for this joint meeting, which this time had attracted attendance by Members of Parliament. There were two powerful issues to be discussed at this meeting. Firstly there was clearly the issue of resources: there was a big gap, especially in Children Services. There had been more funding made available in early October of this year but this still does not "bridge the gap". The impact of delayed discharges was highlighted along with the fact that year-long capacity pressures on NHS and social care resources meant it was not just a seasonal problem. She said that the LGA was continuing to actively lobby Government on this issue. The £300 million additional funding for capacity planning was helpful but did not address the underlying severe financial deficit faced by authorities. Intermediate care is becoming a reality and we need to share best practice. She said there was a huge message that the social care agenda is intrinsically linked with the Health agenda.
2. Working with the NHS
Councillor Morris introduced the theme of Working with the NHS. Our regular meetings with the NHS Executive North West have led to closer understanding and joint working in many areas. Member authorities are working ever more closely with our NHS counterparts at local level, developing joint approaches in accordance with the needs of their communities. We do see this as the essential way forward, and believe that local government must continue to resist any attempts to impose joint organisational arrangements from the centre.
We welcome the emergence of Primary Care Trusts as the key decision-making body for the NHS locally. For most of our member authorities, this will bring about a positive return to coterminous boundaries. As a regional body, we hope to build working relationships with the three new Strategic Health Authorities, as soon as they are formed.
We have also done some joint work with the regional body for Community Health Councils, on the Government's proposals for Involving Patients and the Public in Healthcare. We were unhappy about the proposed abolition of CHCs, but two successive Government documents have brought forward some improvements and we shall do some further work in the region around the latest proposals.
We shall continue to act as partner and 'critical friend' of the NHS at regional level, believing that the users of our services, and their carers, need to experience the health and social care system as integrated and seamless at the point they need it most.
Councillor Candler (Stockport) posed the question about joint funding and the possibility of health using money that should have been used for social care purposes. Given that £100m this year and £200m next year had been allocated by the Government, how had colleagues used this money to address major issues?
Councillor Parker (Cumbria) said in her constituency the Social Services and Health Authority had a joint package to avoid inappropriate admissions, and more care plans had been created in a range of services. The NHS has refused to match funding put in by the local authority and that had made establishing joint funding difficult, but the authority were focussing on joint care planning.
Councillor Holtom ( Lancashire) spoke of the need for close liaison with the ever-changing NHS, and asked that the issue of joint funding continued to be on the agenda for future SSNW meetings.
Councillor Stringfellow explained the criteria for this funding: the £300 million allocated was for local negotiation and decision between local partners. She said that the whole system needed to respond to the challenge of capacity planning: it was important that there should not be any intransigent positions taken up between Social Services and Health colleagues and she asked that the LGA be informed of any serious problems, as if there are problems with health colleagues, this message needs to get through to Ministers. Liaison between the NHS and Social Services was a critical area of work, and it was important to make maximum use of Health Act flexibilities, and to learn from each other and benefit from the skills developing around partnerships.
Councillor Parker said that there were difficulties inherent in having to deal with five Primary Care Trusts (PCT’s) as in Cumbria.
Peter Hewitt (Co-ordinator SSNW ) said we had expressed serious concerns about the abolition of Community Health Councils, but the new arrangements now proposed by Government should now be much more comprehensive and appropriate. SSNW would follow developments closely and liaise with the LGA.
Councillor Stringfellow welcomed this and said that the Minister responsible Hazel Blears, would also welcome any further comments. She concluded by welcoming any comments or consultation documents from the North West on these issues.
3. Financial Issues
Councillor Ken Keith (Knowsley) Deputy Chair of SSNW introduced the topic of finance by highlighting the fact that social services consumes the second biggest slice of local authority resources, and it is our job to see that they are used to best effect. Our experience, year after year, is that the pressure of need, and the costs of provision, can outweigh all the efforts we make to achieve efficiency savings. In general, our authorities respond more than generously to these pressures. The result is that social services spending within authorities, both nationally and regionally, is far in excess of the SSA.
In each of the last two years, Social Services North West has conducted a survey of the financial position in the 22 authorities in the North West. This year, to avoid duplication of effort, we were pleased to gather our information on the same form as the LGA and ADSS national survey. The findings in the region mirrored the national results. Social services authorities are finding it increasingly difficult to meet their statutory obligations. Many expected that they would not have enough money to meet projected demand from all those eligible for help. Across the region, expenditure was expected to be some £21 million (or 1.5 %) in excess of that budgeted for the financial year 2000/01.
We were pleased to note the additional £300 over two years which will come direct to local authorities, though we were less pleased by the reference to bed-blocking. We have also appreciated the personal replies we have received from Ministers John Hutton and Beverley Hughes last year and Alan Whitehead this year. But this does not alter the fundamental underfunding of local authority social services, and we fully support the LGA in continuing to highlight these issues. We are also concerned as to what happens to funding for children’s services when the Quality Protects five year funding span comes to an end.
Councillor Cooley (Manchester) was concerned about the criteria for allocating the £100 million 'building capacity' monies. Were some Authorities being rewarded for under-performing?
Councillor Roderick (Liverpool) said that the nation spent less of its Gross Domestic Product on social care than most European nations, he also cited the shortage of doctors in the country.
Councillor Froggatt (Warrington) said that previous specific grants for community care had now been absorbed into the SSA. Because of increased demand, there was in effect less care for more people. He said that in the recent Joint Review in his area it had been stated that Warrington was well organised and no more savings could be made.
Councillor Bromley (Warrington) commented that foster care and care in residential homes faced market forces and that costs in these areas were increasing, due to the fact that local authorities had no control over private organisations and what they charge.
Councillor Stringfellow responded by emphasing the work the LGA was doing in lobbying for funding for personal social services. She emphasised that this was a major issue for the LGA, which was continuing to lobby hard for additional funding. Many people in social care welcomed many of the Government's reforms, but she said that it would take two terms of office for the Government to reach European standards of health and social care spending. She said the LGA were making progress in highlighting resource issues to Government, and welcomed the fact that the Department of Transport, Local Government and the Regions (DTLR) were contributing £80 million of the £300 million recently provided by Government. This highlighted the fact that local government as a whole was committed to addressing social care issues. In addition to the lobbying activity, there are discussions with the Government about local authorities being able to finance capital spend by borrowing against their assets, but this is still in the process of discussion. The Government has made a clear statement that we need to move toward a European standard of health and social care spend. A clear analysis of what the impact of STG /Community Care money provided has been has been asked for. There is also a wish to minimise the use of children’s residential care.
Councillor Morris added that SSNW are carrying out research on children’s services and Best Value in the Region, and looking at creative ways to provide more effective services.
Anita Marsland, Director, Knowsley said that she chairs the Regional Quality Protects Reference Group, and described the work being done, including the seminar planned for senior officers in children’s services to be held on 28 January 2002.
Councillor Pat Case (LGA SA&H Executive) said that closing homes was not an easy option. A more flexible way of providing payments to foster carers was needed and resources should be available for recruiting highly skill foster carers to care for children.
4. Quality Protects and Children’s Issues
Councillor Frank Roderick said that a huge amount of money, effort and commitment goes into ensuring that we protect vulnerable children from harm, and promote their welfare. Wherever possible this should be with their own family. But when this is not possible, we have a duty to provide the best possible form of alternative care, to meet the needs of the individual child. In recent months, we have revised our directory of high-quality residential services for children, and joined in multi-agency action at regional level to support the Government's Quality Protects initiative.
In our authorities, we have experienced rising demand for services for our children. Also, when an individual child's needs are very complex, it can be very difficult to provide a service locally which meets those complex needs. Member authorities are therefore keen to explore a wide variety of ways of working together, to ensure that we can each meet the needs of all our children in a high-quality and cost-effective way. A number of local partnerships are already developing to provide specialist services on a joint basis; and we intend to see what more can be learned from Best Value reviews in each other's authorities.
We are also working within local partnerships to promote the wider welfare of children and families, right across the public services. Initiatives such as Sure Start are of undoubted benefit to children in disadvantaged communities.
We hope the LGA will continue to press the Government to recognise the underfunding of children's social services, as well as the increasing difficulty of recruiting adequate numbers of suitable trained staff. Nowhere is it more important for central and local government to be working together, than for the future of our children.
Councillor Joynes (Oldham) said there had to be effective and necessary provision within residential care for some children who had been damaged within their own families.
Councillor Parker commented that through initiatives like Sure Start, it had been discovered that more children in need existed and more work needed to be done.
Councillor McInerney (Halton) said that in his area Quality Protects had been very positive and performance indicators were starting to make an impact. These had got people talking to each other about issues and good ideas had been generated. Extra funding was needed but at least people had begun to communicate, and Quality Protects was starting to make a difference.
Councillor Case said that access of children in need to education and health care was a key performance indicator, especially when vulnerable children turned 16.
Councillor Morris said that Quality Protects has had a big impact and ensured that the whole authority had taken on responsibilities as a corporate parent with Health and Education more involved. However, children’s services are still seriously under funded.
Councillor Stringfellow noted all the comments by members and said that Sure Start – which had been a Treasury initiative - was an encouraging example of making a difference through good practice and the involvement of Health and Education. The main aim was to lift children out of poverty. Councillor Stringfellow mentioned the work the LGA were doing as part of their 'Six Commitments' work focussing on support to the 13-18 years age group. She also mentioned the recruitment campaign for social workers that the LGA had been instrumental in developing and securing funding for. A Minister for Children had been appointed: John Denham at the Home Office. She said that sharing ideas and operating on every level was important but there were still huge pressures. After all children only have one childhood and if this goes wrong, there is not another chance to make things right for a child. She was keen that the work being done in the SSNW Region on joint commissioning should be shared with the LGA. She also mentioned a piece of work the Thomas Coram Foundation is doing, trying to identify the driving factors behind the increase in children in need.
5. Learning Disabilities
Councillor Holtom highlighted the newest theme in the Work Programme of Social Services North West, that of Learning Disability. This was partly a response to the new White Paper 'Valuing People', but in truth this Association has held this client group close to its heart for a great many years. During the 1980s and 1990s, the member authorities of this Association worked with our partners in the NHS to provide a new chance for all these people: to live an ordinary life in local communities right across the North West. That process was completed in 1999.
But that does not mean that our task in relation to people with a learning disability is complete. The White Paper 'Valuing People' reminds us how much is still to be done if the four key principles of civil rights, independence, choice and inclusion are to be translated into reality. In September this year we held a joint conference with the Social Services Inspectorate and the NHS North West. Nearly 100 people came together to look at the objectives of the White Paper and the steps which will be taken nationally, regionally and locally to implement it.
There was a moving presentation from some people with learning disabilities, and from some carers, about what life had been like for them. They made it very clear what a difference it can make in their lives when the professionals really listen to service users and carers about what they need and want.
Social Services North West will support member authorities in developing their services to this vulnerable group. We know we need to get better still at listening to their needs, and working with all our partner agencies to ensure those needs are met.
Councillor Clare (Bolton) said it was now a matter of normal good practice in Bolton for people with disabilities to be involved in relevant meetings. It is important that every effort should be made to ensure their effective involvement, by making sure they understood what is to be discussed and how this relates to them.
Councillor Cooley spoke of the Learning Disability Partnership Board and said it was important that representation of users at meetings was not just in a paper exercise, but that such meetings were truly inclusive of users and carers.
Councillor Case echoed these comments about Valuing People and said that the LGA welcomed the approach taken by the Government in relation to services for people with a learning disability. It was particularly helpful that the Government had promoted the setting up of groups for carers and users. This should be at the top of the agenda. She was very pleased that it is a key priority for SSNW and said that the Department of Health needed to be aware of people’s views. Examples of good practice should also be reported to the LGA.
Councillor Stringfellow said that the LGA welcomed the lead that local government had been given for these services. The LGA will be carrying out a telephone survey to find out how the local Partnership Boards are fitting in with Local Strategic Partnerships. Councillor Stringfellow asked Ruth Kelly MP to take a strong message back to Government that the Spending Review projections revealed a shortfall of £20 million in this area. The LGA task groups would put information on the LGA website about examples of good practice.
Councillor Case said there was a danger of middle aged people with learning disabilities living with elderly parents being left unsupported if anything happened to their parents. It was not possible to know at this time the excat numbers who would be in this situation, but social services would have to pick up the responsibility, so we should address the needs of this group of people in good time.
Close of meeting:
Councillor Morris thanked everyone for attending, particularly the MPs and the LGA representatives, and officially closed the meeting at 2 pm
JB/PH/PV/ET
10 December 2001
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