HC Deb 14 June 1971 vol 819 cc193-204

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Rossi.]

11.37 p.m.

Mr. Gerald Kaufman (Manchester, Ardwick)

I am grateful for the opportunity of raising the question of the old people's home of the Little Sisters of the Poor, in Plymouth Grove in my constituency. The Little Sisters of the Poor is a religious order which came to England from France in 1839. The order has established in this country 26 homes for the care of old people.

Two of these homes are in Manchester, one in the constituency of my hon. Friend the Member for Manchester, Openshaw (Mr. Charles R. Morris), which is now, alas, closing because the order lacks funds to remedy basic structural defects in that home in Newton Heath. The other home, St. Joseph's, is in my constituency. Some 126 old people live in St. Joseph's Home and are looked after by 17 of the Little Sisters, working sisters as they are called. Those old people are extremely well looked after. The food is good, the care is devoted and St. Joseph's is not simply a shelter for the elderly but is a home. It is kept spotlessly clean and is full of an atmosphere of genuine concern and affection. It is a Catholic home but people of all faiths are made welcome there. The Minister who is to reply agrees, and has said in correspondence, that there is a high standard of care in the home.

The principal income of the Little Sisters to run the home comes from their own efforts. Some beg for income and in this way raise about £4,000 a year. In addition, there is a fund-raising com- mittee. But the home has no assured income and receives nothing from the State. The Sisters receive no pay of any kind, but out of the money they obtain pay the domestic staff whom they employ. As a home it sounds idyllic.

But St. Joseph's is far from idyllic. It is a large old building. It is 103 years old. The places where the old people sleep are dormitories with curtained cubicles. They are grossly overcrowded. The bath facilities, the washing facilities, and the lavatory facilities are far too limited for the numbers who live there: far too limited, too, for the dignity of those who live there. On one floor in two separate parts more than two dozen old ladies have to share the use of only one bath. Lockers in the corridors are the only places where they can keep their private possessions. In addition, there is a leak in the roof. This has made some of the sleeping accommodation uninhabitable, which has meant greater overcrowding than would otherwise be occasioned.

The Little Sisters of the Poor are themselves more conscious of the defects at St. Joseph's than anybody else. They want to improve the place; they want to reconstruct it to provide modern facilities and decent privacy for those for whom they care. They want to introduce bedsitter accommodation with private toilets and their own washbasins for those living there.

The Little Sisters signed a contract to begin a major reconstruction and modernisation. The financial means for this were quite beyond their own efforts. They cast about to obtain a loan. At the same time they decided to seek Government aid, taking the view—quite fairly—that if the home did not exist, the residents in it would be a charge on public funds and that this would come, on the most conservative estimate, to more than £50,000 a year. The Little Sisters have saved the State millions of pounds through their own efforts. They thought that, as the State now had the power under the Health Services and Public Health Act, 1968, to provide them with finance, the State should be forthcoming.

At this point I should dispose of an argument which has been advanced and which the Minister may have it in mind to advance again tonight, namely, that the new per capita system of assistance of Manchester Corporation is a help to St. Joseph's. This is far from so. It is true that Manchester Corporation at the beginning of 1970 agreed to provide per capita payments for new entrants to St. Joseph's who came from the City of Manchester. Some other local authorities agreed that they would do so, too. These per capita payments were to provide, not for capital costs, but for part of current costs. Still, this was a gain; and the Little Sisters were very grateful for it.

My hon. Friend the Member for Openshaw was in large part instrumental in bringing this about. It sounded marvellous, but I regret to say that it was far from it. To begin with, of the 126 residents in the home only 11 qualified for this per capita payment, six from the City of Manchester. Second, this per capita payment, which sounds so grand, amounts to only 46p a week for each of the 11 who are covered. This, added together, would bring an annual income of £263 and in 16 years this per capita payment aggregated would just about pay for repairing the leak in the roof.

There is a snag. The per capita payment scheme has been in operation for 14 months, but so far the Little Sisters have received not one farthing or one new penny of this money. The mills of municipal treasurers grind exceeding slow.

Therefore, last year the Little Sisters approached my right hon. Friend the Member for Coventry, East (Mr. Cross-man), then Secretary of State for Social Services, and asked him for help. In a letter dated 15th May last year, he replied: I cannot give you a positive answer one way or the other until I get a clear picture of the local possibilities of aid. My difficulty is, of course—as I am sure you will appreciate—that I must take into account not only the very many demands which will be made to me on resources that, however large, are always too small, but also the fact that local authorities have exactly the same powers to help financially that I have. He did, however, arrange a series of meetings, which I attended. At one meeting, on 3rd July last year, the Ministry's principal regional officer told us that the Ministry could not step in until the local authority had refused help. Therefore, we went to the local authority and we had a series of meetings, but I am afraid that they were fruitless.

On 22nd October, at a meeting with the local authority, it was made clear that loans would certainly not be available in this or the next financial year, because loans to independent causes represented a surplus to the authority's needs and there was not this surplus.

On 7th December last year the matter was clinched in a letter from the chief welfare officer of the City of Manchester, who wrote: At their meeting on 9th November, 1970, the Welfare Services Committee resolved to continue their existing policy to make per capita payments to voluntary organisations in respect of accommodation provided by them for Manchester residents in their establishments, but that no grants or loans be made to organisations providing new residential accommodation or replacing existing accommodation similar to that provided by the Committee. This resolution was confirmed by the City Council at their meeting on Wednesday last, 2nd December, 1970. You will appreciate, I am sure, that this resolution has the effect of precluding your making an application to the Corporation for a loan in respect of the project you had in mind. I trust, however, that you may possibly find other means of financing the scheme … By then the Little Sisters had had to cancel their building contract, because the money was not available, but they still wished to proceed with their plans. Recalling what the Secretary of State for Social Services and his principal regional officer had said, they decided to go back to the Ministry which had given a strong indication that once the possibility of aid from the local authority was out of the way it would consider, possibly favourably, extending assistance itself. But as the Little Sisters were ready to make this approach, by an extraordinary coincidence a letter was received from the Department of Health and Social Security which said: I am now writing to say that the Secretary of State regrets that he is unable to give the direct assistance which you seek. It is of course for the Manchester City Council to decide whether or not to help under their powers. However, the Manchester City Council had already decided not to help under their powers. Therefore, we were being sent back to the council by the Ministry which had said that it would consider help if the council decided not to provide it.

We had gone through all that, so I wrote again pointing this out, and I received a letter, dated 26th April, from the Under-Secretary in which he said: … officials of the Department went to some trouble to arrange local discussions to see if a viable solution could be found and in the event Manchester C.B.C. were able to offer some additional help with capitation payments but decided not to make a grant towards the capital costs. Manchester City Council had decided to make no additional help with capitation payments. It had not paid the original capitation payments, and it had certainly not decided on an increase. I know that the Minister gave me this statement in complete good faith, but he was misinformed if he believed that extra assistance had been given as a result of our approaches. If this misinformation played a part in his deciding that the Little Sisters should not be given financial help by the Ministry, this alone is a ground for his thinking again about the matter.

But there are greater grounds for reconsideration in another statement in the Minister's letter to me about the use of Section 64 of the Act. I am sure that in making that statement he did not mean it to be interpreted in an arbitrary or restrictive manner. He said: In order to avoid undesirable duplication of grants for public funds agreement was reached with the local authority associations that use of the Government's powers under Section 64 of the Health Services and Public Health Act 1968 is limited to either assisting with the administrative headquarters costs of nationally operating voluntary organisations in so far as they relate to relevant health and social services, or supporting special projects where there will clearly be results which will be of wide if not national significance. The one thing of which there is no danger whatsoever is the undesirable duplication of grants from public funds", because Manchester Corporation turned us down last year, and therefore the Government are our only hope.

In any case, I should be grateful if the Minister would look further into that statement about new approaches, because on our first approach to the Ministry it was particularly interested in the possibility that St. Joseph's could prove that homes of sizes other than the standard size which the Ministry approves, even very large homes, could be made into real homes with a good atmosphere and individual care. The impression was given to us that St. Joseph's could be a test case in this regard, that the Little Sisters, if given the opportunity, with good buildings and good facilities, could prove that a big home could still be a cosy home.

The Little Sisters work wonders already in a building which in other hands would be institutional, and have done so on a shoestring. These women want nothing whatever for themselves. All they want is the chance to provide an even better life for others. I would welcome the Minister to Manchester to see for himself how the Little Sisters of the Poor are enriching the lives of more than 100 old people, and how the Government could help that work by providing financial assistance.

Therefore, I hope that in his reply the Minister will not give a blank refusal. I hope that if he cannot promise concrete assistance here and now he will at least say that, in the light of the case I have tried to make and the merits—indeed, the virtues—of those involved—he will look at the matter again.

11.53 p.m.

Mr. Charles R. Morris (Manchester, Openshaw)

While not wishing to question the sincerity of the approach to this important issue by the Under-Secretary of State for Health and Social Security, may I impress upon him that already in Manchester we have seen the closure of one of the splendid homes which the order of the Little Sisters of the Poor provided for the elderly within the city. I hope that the Government and the Manchester City Council do not allow the St. Joseph's home to close. The financial provision by the Manchester Corporation in the past has been too little, too late. I hope that we do not miss this opportunity to save this splendid home and encourage this dedicated order in the splendid work which it does for the community in the city.

11.54 p.m.

The Under-Secretary of State for Health and Social Security (Mr. Michael Alison)

I am grateful to the hon. Members for Manchester, Ardwick (Mr. Kaufman) and Manchester, Openshaw (Mr. Charles R. Morris) for raising for discussion tonight the decision by my right hon. Friend the Secretary of State for Social Services not himself to assist the Little Sisters of the Poor with the rebuilding of their home for elderly people at Plymouth Grove, Manchester.

The House already knows that decision and, very briefly, the reason why it was made. But the debate enables us to look at the case in a slightly wider context. I want to place the issue in that slightly wider context because I do not want to leave the impression that we are insensitive to the claims of voluntary organisations and bodies. Successive Ministers, standing where I now stand, for as much as a quarter of a century have pressed the value of voluntary bodies and urged in general terms the development of partnership between them and the statutory services. But the present Government are the first to state a commitment to the ideals of voluntary service as part of their general policy.

Our party manifesto at the last Election contained a specific passage about it, and I stress that we see voluntary service of the sort carried out by the working Sisters, as the hon. Gentleman called them, which is I am sure a proper description, both as an essential complement to the statutory services and as a good in itself—a form of direct participation by the public in public life in the interests of the whole community. I have no doubt that this is reflected in their work and in the striking way in which they set about raising voluntary funds in Manchester.

Over the years we shall be developing the theme of more assistance and partnership in practical discussion with those who are willing to be our partners in terms of mutual help. I have myself been charged with responsibility for develop- ments of this kind, participation and partnership between the statutory services and voluntary services, within the remit of my Department. As far as I know, it is the first occasion on which a Minister has been given a specific responsibility for helping, promoting and encouraging voluntary work.

As a result of that, both I and my colleagues have engaged at every opportunity that has occurred to us in visiting hospitals and any sort of D.H.S.S. establishment in any part of the country, and we have seized every possible opportunity of making personal contact with voluntary bodies. I have no doubt that if I have an opportunity to visit Manchester, which I hope I shall have at some future time, as part of my request to the statutory authorities to let me meet cross-sections of all those engaged in voluntary work, I may have a chance to meet some of the hon. Gentleman's constituents who work with the Little Sisters.

The hon. Gentleman referred to the Health Services and Public Health Act, 1968. This is the general empowering Act and it has fallen to this Government to put teeth into these general powers. When we took office in July, 1970, we found that my Department had grants amounting to less than £200,000 a year on its books as old clients, as it were. Some are of very considerable vintage, venerable in their pedigrees. In November, 1970, my right hon. Friend was able to announce that he would more than double the allocation by 1971–72 and further increase it in subsequent years. I hope that the House will accept that as a token of our mounting efforts in helping voluntary organisations.

Alas, it is not possible under the arrangements for paying Government grant to local authorities to influence their decisions in such matters as assistance to voluntary bodies. They retain very considerable discretionary powers. However, in the rate support grant negotiations with local authorities last year, the Government were able more than to match the requirements of local authorities in the health and welfare fields and thus to open the possibility of greater assistance to local organisations if they chose. It is not for want of resources which the Government are putting at the disposal of local authorities through the rate support grant. We have increased, and we shall further increase as soon as we are able, the resources available in terms of loan sanction which will enable local authorities to provide or to assist voluntary bodies in providing new or replacement homes.

Mr. Kaufman

With respect, the Minister is saying what local authorities may or may not do. This local authority, the Manchester City Council, before the elections—though I do not wish to introduce a party political note—turned us down flat. Therefore, I am not asking what the local authority could do if it wished but what the Government are empowered to do under Section 64 of the Act. I am asking for Government assistance, and not to be told what the local authority can do, since the local authority will not do it.

Mr. Alison

I take the hon. Member's point, but I hope that he will recognise that there is a genuine problem here. It is exactly on this division of responsibility that I hope to elaborate in the few minutes remaining to me.

Where should the responsibility lie? Let me put the matter into perspective for the hon. Member and his hon. Friends. There are more than 1,000 voluntary homes, providing some 25,000 places for elderly people, with which my Department is theoretically engaged. Nearly half of these places are taken up by people to whose maintenance local authorities are contributing under the National Assistance Act. These homes provide essentially a local area service which local authorities themselves would have to provide if the voluntary homes did not. It seems clear that the function of support rests, and ought to rest, with them.

Let us briefly consider the respective powers. Those of my right hon. Friend and of the authorities—the social services departments under the Local Authority Social Services Act—are nearly identical. We may both assist voluntary bodies active in health and welfare either by grant or loan, or by way of recurrent assistance on such terms as appear suitable to us in the particular case. We have therefore to agree how, without being inflexible and bureaucratic, we should exercise our respective powers under Sections 64 and 65 of the Health Services and Public Health Act.

We have agreed—and it seems a reasonable and logical division—that it is the function of the Secretary of State to give such help as seems to him proper to bodies with national scope to enable them to function more effectively, or to foster some experimental development locally which cannot otherwise get under way and which may have national repercussions. It is for the authorities to assist local bodies or projects, or, for that matter, branches or affiliates of national bodies—and the Little Sisters would come into that category, because they have several homes—that operate in their own areas. They can judge the needs and they can judge how wisely public money is spent, for they are on the spot and they have the opportunity to examine closely the actual disposition and the characteristics on the ground of these bodies to whom they make an allocation within their responsibility.

Mr. Charles R. Morris

Time goes by while we are arguing about the division of responsibility and the availability of these homes to care for the elderly is disappearing, for homes are being closed throughout the nation. How can we afford to stand unmoved while local authorities and the Government argue divisions of responsibility?

Mr. Alison

It is not quite so easy as the hon. Member suggests. Manchester itself has been given extra resources. It is the Corporation's responsibility to judge where those resources should be used and only it can make that local judgment. It has to decide whether developing the Little Sister's homes will preclude it from assisting projects of its own with exactly the same purpose, but which it considers to be more in the contemporary interest. It alone can judge. There may be exceptions to that, but this case, for practical reasons, cannot be one.

However greatly enlarged are the resources of the Secretary of State, they are not without limit and demands, however considerable, must have priorities within the national objectives which my right hon. Friend has rightly set and which I have described tonight. I agree that the Little Sisters of the Poor are meeting an important need in Manchester, but the Corporation is well aware of this and it is in a uniquely good position to determine whether there is provision, and it is on the ground to see whether a local home should get the relevant resources for this sort of project.

On policy and practical grounds, therefore, the Secretary of State had no alternative, however regretfully, but to decline to help. I understand that Manchester Corporation has also considered its policy in this matter and is resolved not to offer capital assistance where replacement is necessary, but rather to make provision itself. This must be a matter wholly for the Corporation.

I understand that the Corporation is willing to help the home by contributing to the current costs of accommodating residents from Manchester—and, no doubt, other authorities from whose areas residents originate will help—but it has set its face against a capital grant.

I assure the hon. Member for Ardwick that I shall look into the allegation that the wheels of the city treasurer's department grind exceedingly slow. I shall see whether I can impose a more divine swiftness, or rather suggest a more divine swiftness in this area, since I have no locus standi in that respect. But I take the point that, if anything can be done to expedite bureaucracy, it should be done.

It may be that one of the charitable foundations will be able to help. No doubt, the Little Sisters are exploring these possibilities. I believe that in other parts of the country they have, in fact, had a remarkable response to attempts to raise capital funds. I am sorry that, on behalf of the Secretary of State, I cannot give more practical backing to the sympathy which we both feel.

I understand that at least in theory, from 1st April, 1970, Manchester has undertaken to contribute 46p per resident, and it is thought to be willing to extend this to residents accepted earlier and to increase the amount if audited accounts justify this. That sum appears at first sight to be derisory, until it is recalled that staff costs in a home run by a religious Order are, in the main, nominal. Against the background of the representations which the hon. Gentleman has made, I shall certainly see whether what has been agreed in principle can be realised in practice.

Question put and agreed to.

Adjourned accordingly at six minutes past Twelve o'clock.