Constitutional reform

Asked if the Prime Minister thought fixed-term parliaments were a good idea, the PMS said that the Prime Minister set out his priorities for constitutional reform in his speech last week.

Put that the Government seemed to have been working on constitutional reform for some time, the PMS said that it was a dynamic process and the Prime Minister stated last week that the Written Constitution would have a consultative element to it.

Asked about the Government’s remaining legislative programme and which bills had priority, the PMS said that it was the Government’s intent to make as much progress as possible with the remaining bills and that the Government would not embark on any bill if it didn’t think there was a reasonable chance of making progress with it. Ultimately it could come down to the “wash-up session”, which was at the end of a Parliamentary session, and allowed the opportunity to get approval for any outstanding bills, with the support of opposition. All these pieces of legislation were important and the Government would not put anything forward if it wasn’t a priority. All the remaining bills were at different stages of the parliamentary process and so they were not comparable.

Afghanistan

Asked about what the Defence Secretary had been saying about current operations in Afghanistan, the PMS said that the Defence Secretary and other senior figures at the Ministry of Defence had over the last few days been talking about Operation Moshtarak. This operation was not yet underway and part of the process was alerting the local population to the fact that this was about to happen.

The staff, including a school cleaner, a catering manager, an IT specialist and a teaching assistant, received special ‘support staff awards’ from the National Association of School Business Management after they were nominated by their fellow staff and pupils.

On Tuesday, the winners celebrated their achievements with a behind-the-scenes look at Number 10, where they met the Prime Minister’s wife Sarah Brown.

The Prime Minister said:

“Support staff work incredibly hard behind the scenes to ensure schools across the country run smoothly. They play an important role in school life and have made a valuable contribution to improving the standard of education which is now at an all time high.

“These winners are highly respected, esteemed and appreciated by their colleagues and pupils. These awards give rightful recognition for their hard work and I’m very pleased these staff are having their day in the spotlight.”

Read more about social care reform on the Department of Health website (new window)

Read the transcript:

Moderator says: Phil Hope has just arrived at Downing Street and will begin answering your questions shortly.

Phil says: Hi, I’m Phil Hope, Minister for Care Services. I am delighted to be here today to answer your questions on the future of the care and support system and I hope to answer as many of your questions as I can.

Mark Edgecombe: Hi Phil. Can you clarify something for me? I’m always puzzled about the definition of ’social care’ as opposed to ‘health care’. What is the difference between them given that both types of care are the cause of the same illness? Thanks.

Phil replies: Hi Mark, you’re right that there can be confusion about what counts as social care and what counts as healthcare. As you know, healthcare is medical care provided free at the point of need through the NHS which is funded through general taxation, but social care is the support given to people to help them with everyday living such as help with dressing, washing and eating. This is provided by local authorities, voluntary organisations and the private sector to people at home or in residential settings and is a means tested system.

P Stevenson: I have a relative that through illness cannot care for herself yet has to pay for the care she receives, the illness is not cancer or a heart condition as the care is free but dementia, please could you provide an explanation for this discrimination

Phil replies: Dementia is a very cruel disesase but we know we can help people to live with this condition for many years.  People with dementia may have healthcare needs which are provided for through the NHS, e.g. for drug treatment and social care needs which are provided for through the social care system and which, depending on your income, may have to paid for by the individual themselves. We are currently considering a major reform of our care services to create a national care service which is fair, simple and affordable. I recently published our National Dementia Strategy which aims to improve the way that people are diagnosed at an earlier stage with earlier intervention and support.

fred williams: Why are you and your government making disabled people poorer by taking away the Attendant Allowance to feed the NHS. Disabled people need that allowance to live. Disabled people are the poorest in the country and you want to make them ever poorer.

Phil replies: Fred I can assure you that we are not taking away anyone’s Attendance Allowance. If we reform the care and support system to create a National Care Service, then all people receiving Attendance Allowance at the time of reform will continue to receive the same level of support. There will be no cash losers. However, we think there is a good case for combining our care and support systems to create a better system for everyone for the future.

Nicola Lloyd: How are these new initiatives going to be funded with an already overstretched NHS?

Phil replies: Nicola this is a really important question because we have an ageing population, there will be more demands upon the system and we estimate there will be 1.7 million more people than today by 2026. That’s why we are proposing to create a National Care Service in which more people are given help to live independently in their own homes, there is more investment in care services to prevent people going into hospital and residential care and there is more integration between health and social care services so that people receive better quality care and we get the best value for money from the huge investment that we are now making in our health and social care services.

Deirdre Krymer: Will users who do not want personalised budgets be able to retain direct service delivery?

Phil replies: Deirdre, the short answer is yes. The longer answer is that everyone I’ve met who receives their care through a direct payment or a personal budget has really been enthusiastic about the control and choice it gives them over the kind of care that they receive. I would like to see everyone have the choice of a personalised budget in the future and ensuring that services are tailored to meet the specific needs of individuals will be at the heart of our new National Care Service.

Phill: Hi, I am a graduate and have been looking to find a job in social care since last summer but everywhere is asking for experience. I have tried getting in as a volunteer but there aren’t many places and I am worried that such a placement will affect my job seekers allowance. Any recommendations?

Phil replies: Phill, I think it’s great that you want to join our social care workforce. We are very keen to attract new people into a career in caring and we are launching today a major new recruitment campaign to attract more people into the caring profession. This includes graduates, people leaving school or college and people wishing to make a career switch from their exisiting job. For more information do visit our website. I would encourage anyone who wants to get experience of caring to join the huge number of volunteers who already do a fantastic job in our care services. Please check out with the advisors at Job Centre Plus if you have any concerns about any effect of volunteering on your allowances.

Natalie Williamson: What exactly will be available to service users in the reablement package proposed in the Personal Care at Home Bill? If adaptations and telecare are assessed to be integral in enabling an elderly person to remain at home through the reablement package how do the government propose to deliver these services in six weeks? As there is no clarity in the consultation on this it is impossible to determine the impact of this bill on existing services, including the work currently being undertaken by home improvement agencies who are already delivering reablement in a variety of ways. If we take it that telecare and adaptations are not included as part of the reablement package but rather, the reablement package identifies the need to provide these services and individuals are then referred on to other service providers,the potential implications of the delays this will incur in terms of reducing the care needs of these people needs to considered. For example, would a person waiting for an adaptation receive free personal care (providing they meet the eligibility criteria) whilst they were waiting for the adaptation to be completed?

Phil replies: Natalie, I think it’s really important that people get help with living independently and safely in their own homes, particularly if they have recently had an operation. We call this reablement care. I call it getting back on your feet. This is something that the Prime Minister spoke about enthusiastically yesterday and is a key part of our Personal Care at Home Bill. It will include adaptations and telecare in your home if that’s what you need. I would like to see the excellent practice that exists in some parts of the country repeated everywhere so that everyone has the chance to receive a reablement package tailored to their needs.

Phil replies: Natalie, I think it’s really important that people get help with living independently and safely in their own homes, particularly if they have recently had an operation. We call this reablement care. I call it getting back on your feet. This is something that the Prime Minister spoke about enthusiastically yesterday and is a key part of our Personal Care at Home Bill. It will include adaptations and telecare in your home if that’s what you need. I would like to see the excellent practice that exists in some parts of the country repeated everywhere so that everyone has the chance to receive a reablement package tailored to their needs.

Linda: what plans are there for social inclusion for physically disabled adults.

Phil replies: Linda, I think it is absolutely essential that all adults with care needs can live the life that they want to live and be able to contribute to and be a full part of their community. This for me is a fundamental principle that will underpin the new National Care Service.

Tracie Noon: the job of carer will need to be made more profesional if more dementia suffers are to be cared for in thier homes what will be put into place to make sure this happens, Im a scheme manager of a sheltered housing and see what effect poor carers have on dementia sufferers.

Phil replies: Tracie, I believe that informal carers play a vital role in giving support to people with social care needs. We published our ten-year Carers Strategy in 2008 and an early area for action was to improve the amount and quality of respite care for people who take on the role of caring for a loved one. Our future National Care Service will have carers and families at its heart to ensure that people who carry out this important role are given the support they need. The paid care workforce is now around 1.5 million people and we are taking forward a new strategy to raise their skills and give them the support they need to do their very demanding job as well as possible. From this April, the Care Quality Commission will be introducing a new registration scheme for all providers to ensure that minimum standards of care are provided for people at home and in residential care.

Gerry: Is is fair to those older people who have the greatest needs, i.e. those in residential/nursing care, that they will have to pay for personal care whilst those in their own homes, with less needs, will get it free?

Phil replies: Gerry, everyone I talk to says that they want to live for as long as possible in their own homes rather than go into residential care. Our Personal Care at Home Bill will provide free care for those people in the most need living in their own homes. It is these people who have often run down many of their savings already who have the most needs and for whom their family is providing a lot of care and support. We think it is right to give more help to people in these circumstances and to reduce the numbers of people who might have to go into residential care as a result. This new measure is an important step towards creating a National Care Service.

Paul Clarke: Question: It seems we will continue to have an ageing population for some time. Are we being bold enough in planning for the longer term care consequences this presents?

Phil replies: Paul, you are right to identify the challenge of an ageing population where we will move from four adults of working age to every pensioner now to two adults for every pensioner by 2026. There will be 1.7 million more adults needing care in the future. I see an ageing population as an opportunity, not a threat, as we will have more people with knowledge, skills and experience who can make an active contribution to a fairer society. But fundamental reform of our current care and support system will be needed. That is why we will be setting out our plans for creating a National Care Service that rises to this challenge. While we have improved elements of the system in the past, the time now is for fundamental and wholesale reform.

janet McCarter: Most people would agree that free personal care is the ideal - but how will it be paid for, as the cost is likely to increase year on year.

Phil replies: Janet, the question of funding personal care is crucial both now and for the future. The costs of providing free personal care at home for those in most need is estimated to be £670 million with part of this (£420 million) coming from the Government and the rest from efficiency savings across local government. For the longer term, we need more radical reform and we will be spelling out our proposals on this in the near future. Free personal care for people in most need in their own homes is one of the building blocks towards creating a new National Care Service.

K Wheeler: What is going to happen to the very cost effective Attendance Allowancel This will be greatly missed if it is scrapped as would appear to be the case

Phil replies: I know that many people are concerned about the Attendance Allowance so let me say again that if we reform the care and support system, anybody receiving Attendance Allowance at the time of reform will receive the same level of cash support. There will be no cash losers. We think there is a case of bringing together some benefits such as Attendance Allowance and care funding to deliver a better joined up service. So we are not scrapping Attendance Allowance as some have claimed, but I believe we can provide better care and support for the future.

Claire Wood: Hi I have a very serious condition and I’m caring for someone with Dementia but we live together, we’re mother and daughter. Will she have to sell her home to pay for her care? Where does that leave me as this is my home too.

Phil replies: Claire, one of the big unfairnesses that people feel about the system at present is that they have to run down their savings or sell their homes to pay for their care. It’s a system that has existed since 1948 when the National Health Service was created and is long overdue for reform. We want to create a new National Care Service that is fair, simple and affordable. I would like to see a system in which people who have worked hard, saved up and bought their own house do not have to worry about losing their inheritance to pay for care costs.

Jasmine Warwick: I’m concerned that in the midst of going through a vitally important consultation on future social care funding, the Prime Minister announced his intention to offer free personal care. This discouraged participants in the consultation and has made me feel that all that work was not worthwhile because you are going ahead with your own decision regardless of what we might have said. At least let us see the results of the consultation.

Phil replies: Jasmine, I believe it is right that as well as drawing up long term plans for fundamental reform of the whole system we should take action now to help those in most need. Over the last few years we have been developing a number of key changes to improve the care system as building blocks towards a new National Care Service. Putting People First, which is a £500 million programme of funding for local government to transform local care services, our Carer Strategy, the Dementia Strategy and Valuing People Now - our strategy for people with learning difficulties - are all steps towards our long term goal which is a National Care Service. Offering free personal care to people in most need in their own homes is another key building block and in particular will help more people to receive packages of reablement care in their own home.

I am sorry but I have to go now. I hope I have addressed many of the different issues that so many of you have raised. It has been really helpful reading the concerns and thoughts that you all have and I am confident that as we bring our plans forward for creating a National Care Service you will see the commitment we have to creating a fairer system and better quality for all. If you would like to read more about any of these issues please visit the website. Thank you all for taking part.

Mr Brown met Prime Minister Borissov on Monday for wide-ranging discussions.

A spokesman for the Prime Minister said the two leaders had a “warm and constructive” 45-minute meeting.

On the European economy, Gordon Brown and Boyko Borissov agreed on the need to drive forward economic reform and to promote job creation and growth in the region.

The two countries also agreed to intensify UK-Bulgarian cooperation on energy and climate change, the economy, and security issues.

Bulgarian Prime Minister

The Prime Minister’s Spokesman (PMS) said that the Prime Minister had a warm and constructive meeting with Prime Minister Borissov of Bulgaria yesterday evening. They had a wide-ranging discussion including Afghanistan, where the Prime Minister welcomed Bulgaria’s increased troop levels, and the European economy, where the two leaders agreed on the need to drive forward economic reform and create jobs and growth. There was agreement to intensify UK/Bulgarian co-operation including on energy and climate change, the economy and security issues.

Cabinet

The PMS said that the Prime Minister spoke at Cabinet about Northern Ireland and acknowledged the decommissioning of weapons by the INLA and other groups, which was a significant step forward. The Prime Minister congratulated the Secretary of State for Northern Ireland on his efforts.

There was then a discussion on Afghanistan led by the Prime Minister, including contributions from the Foreign Secretary, Defence Secretary and Secretary of State for International Development. Operation Moshtarak was about to begin, which was being led by Afghan forces. The Prime Minister emphasised the fact that this was the first time the Afghanistan army had been at the centre of operations.

This was followed by a discussion on migration led by the Home Secretary, who would be making a major speech tomorrow.

The Chancellor then gave a debrief on his visit to the G7 over the weekend in Canada. He spoke about the domestic economic situation and said that other surveys were consistent with the economy coming out of recession, and pointed in particular to investment figures and growing of businesses.

Jim Murphy gave an update on the planned visit of the Pope to the UK this year. This was a historic visit and had the status of a State visit.

Pope visit

Asked if the visit would be post-election, the PMS said yes, although a specific date had not been confirmed and it would be for the Vatican to do so.

Economy

Asked how concerned the Prime Minister was about the economic problems in the Eurozone and if he would be meeting President Sarkozy this week to discuss the issue, the PMS said that the problems in the Eurozone were a focus of attention, but given we were not in the Eurozone it was not something that we would be specifically involved in. The Prime Minister would no doubt have brush-by time with President Sarkozy in Brussels this week but there were no current plans for a bilateral.

Asked if any other bilaterals had been planned, the PMS said no; the meeting in Brussels this week was informal and fairly short so as yet no bilaterals had been planned.

Asked if the Prime Minister was concerned about contagion from problems in the Eurozone, the PMS said that it was not for the UK to make comments about the Eurozone for obvious reasons.

Asked if the Prime Minister was concerned by the resignation of the Financial Services Authority (FSA) Chief Executive, the PMS said that the Prime Minister endorsed the words of Adhair Turner; Hector Sants had given outstanding service and leadership throughout the last three years. Mr Hants himself had said that he came in to do a specific job for a specific amount of time.

Asked if the Prime Minister was confident of finding a successor to Mr Sants before the election, the PMS said that there was a notice period and there would be an orderly succession but it was best to speak to the Treasury for details.

Put that retailers were suggesting that the month of January, largely due to the weather, had been one of the worst for many years, the PMS said that the weather was not under the Prime Minister’s control. There was no doubt that the extreme weather conditions had affected retail sales in January, but the Prime Minister and Chancellor had both been consistent in saying that we expected recovery to return at the turn of the year.

Wright Review

Asked if the Government would endorse all the proposals from Wright and if they would be put into law, the PMS said that a Written Ministerial Statement had been laid this morning about this. It had always been the case that the Government was very supportive of the Wright recommendations and the question now was about the process by which they could be put to the House and voted through.

Alternative vote

Asked why the Prime Minister thought that the alternative voting (AV) system was such a good idea, the PMS said that the Prime Minister believed that there was an umbilical cord that linked MPs with their constituencies and of the various voting systems this was the one that best protected the relationship between the MP and his/her constituents. If AV was to be introduced then we could ensure that every single MP returned to the House had at least fifty per cent of the votes in his/her constituency.

Asked if the Prime Minister was confident that the vote would go through tonight, the PMS said yes.

Asked how confident the Prime Minister was that this would become law before the election, the PMS said that if the vote went the right way tonight then it would go to the Lords and would then follow the usual process. Time was tight but we would hopefully start the process tonight of being able to see it effected as soon as possible.

Product placement

Asked about the Written Ministerial Statement on product placement, the PMS said that this was being led by Ben Bradshaw; there had been a consultation process and we were setting out plans today to allow television product placement in a way that balanced commercial interests and peoples’ concerns.

Notes for Editors

Christopher Foster (aged 56) studied theology at Westcott House, Cambridge after lecturing in Economics at the University of Durham. He served his first curacy at Tettenhall Regis, Wolverhampton in Lichfield diocese. From 1982 to 1986 he was Chaplain at Wadham College, Oxford and curate of the University Church of Saint Mary with Saint Cross and Saint Peter, Oxford. He was Vicar of Southgate in North London for eight years and also Continuing Ministerial Education Officer for Edmonton Area. From 1994 to 2001 he was Canon Residentiary and Sub-Dean of St Albans and he has been Suffragan Bishop of Hertford since 2001.

He is married to Sally and he has two grown-up children.

NHS PFI

Asked what the Prime Minister thought of claims that the NHS was facing a £63 billion bill for PFI hospitals that are only worth £11billion, the PMS replied that we did not recognise the way the figures have been presented. It is inappropriate to add up annual fees and compare them with the capital cost. The unitary fee includes maintenance and in many cases services such as catering, cleaning and portering. As the Department of Health have said thanks to PFI the Government has been able to undertake the biggest hospital building programme in the history of the NHS, opening the one hundredth scheme in October 2008.

Lobbying

Asked what the Prime Minister thought of proposals to tighten the rules on lobbying, withdrawing the Ministerial pension of anyone breaching the rules and doubling the waiting period before Ministers can take jobs related to their portfolio, the PMS said that the Government has brought in tight regulations covering Ministers who leave Government and go in to the private sector. These are subject to regular review.

EU

Asked what the Prime Minister hoped to achieve to in relation to the Eurozone at the informal Brussels Summit, the PMS replied that the focus of the meeting will be economic reform and climate change. The Prime Minister will present his proposals for jobs and growth for the European economy. Asked if the problems of Greece will be discussed, the PMS said it is an informal summit and the discussions will be at a broader level about jobs and growth.

Expenses

Asked if the Prime Minister has bowed to pressure to withdraw the whip from the MPs charged in relation to the expenses, the PMS said that was a matter for the Labour Party.

The UK teams travelled to Haiti shortly after the devastating earthquake struck in mid-January.

• Read more about the appeal on DEC’s website
• Read more on DfID website

The magnitude 7.0 earthquake has killed more than 200,000 people and left more than a million people in need of aid.

The UK teams were involved in medical and search and rescue operations in Haiti.

Firefighters from the International Search and Rescue Team were in Haiti for just over a week, rescuing three people and treating eight seriously injured people.  Sarah Brown also met the firefighters involved in the rescue of a two-year-old girl trapped under rubble for three days.

The 63 guests were taken for a tour of Number 10, visiting the Cabinet Room and state rooms.

Earlier today, the Prime Minister said he was “thrilled” that the single released in support of the Haiti fundraising effort, reached number one in the download charts.

All of the money raised from the sale of the single will go to the Disasters Emergency Committee.