HC Deb 10 November 1981 vol 12 cc511-6

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

10.15 pm
Mr. Robert J. Bradford (Belfast, South)

I wish to speak about the charging and assessment procedures for the admission of old people to statutory residential homes in Northern Ireland. I have three points to make. However, first I should like to thank you, Mr. Speaker, for allowing me to change the subject of tonight's Adjournment debate. Originally another subject was submitted.

I acknowledge the tremendous work done in statutory residential homes by the staff. I do not wish to detract from their commitment to duty. On behalf of my constituents who are concerned about the assessment and charging procedures, I wish to state how much they appreciate the work of the staff.

I shall describe the history of the problem. In the past eight or nine months a number of constituents have approached me about the high charges levied in respect of their parents and loved ones who have been admitted to the homes. The charges vary from a small amount to the exceedingly high sum of £95 a week. The charges average about £75 a week.

My constituents are also worried about the lack of information available to the old person who is admitted. The Minister has said in correspondence that care is taken to acquaint old people with the charges. However, some constituents are willing to confirm—and I believe them—that old people have been taken into homes without the level of charging being made clear to them or to their relatives.

Old people are faced with charges which can be as high as £95 a week. They cannot afford to meet such charges unless they sell their home. A person's sole home is disregarded for the purposes of assessing supplementary benefit. That is not the case with admission to statutory homes. Therefore, there is an area of unfairness and a need to ensure that old people who have to be taken into full-time care are not treated in a less generous tay than whose who apply for supplementary benefit and continue to live in their own homes.

In many cases the children of old people have sustained them by direct contribution, not only financially but by bringing them into their own homes from time to time. They have enabled the elderly to maintain their investment—that is, their own small residential homes. When the old person hopes to return that generosity and care by leaving the home to the loved ones, if he is taken into a statutory residential home and cannot meet the charges—which range up to £95 a week—the area boards deprive him of his ability to do so.

The Minister said in his letter that no one in statutory old people's homes had been taken to court to enforce payment of such a debt. I do not disagree with that. However, although the area boards have not enforced the sale through the courts, they have occasioned the sale of some of those homes. I can cite two examples of that from the voluminous correspondence I have received.

Some people in statutory homes pay a relatively small amount. Another person, who has perhaps been careful with a small amount of money and acquired a dwelling worth about £7,000 to £9,000—which is not a great deal of money—is forced to sell that home to meet a higher charge because the value of the home has been included for assessment purposes. That is manifestly unfair.

While pursuing the matter during the past eight or nine months I have corresponded not only with the Northern Ireland Office but with the relevant Department. The Minister in a letter dated 5 October gave a small glimmer of hope when he said: A joint central and local government working group on personal social services charging policies, which reported in 1980, considered fully the treatment of the family home in the assessment of charges. Amongst other things, they suggested that some of the difficulties might be overcome by increasing the capital disregard"— which is a good idea— and by disregarding the capital value of the former home and assessing only any income it produces. I believe that that is an excellent idea. The letter continues: These options are still under consideration and decisions on them will be reflected in new regulations on charges for local authority residential accommodation which are being prepared. The Minister came to this slightly disappointing conclusion: Generally, however, it is unlikely that we should wish to depart from the discretionary elements of charging arrangements lo the extent of debarring authorities from taking into account the value of property when they consider the circumstances appropriate. Some discretionary powers are at the disposal of local authorities and they are clearly outlined in the memorandum of guidance. However, none of the paragraphs in the memorandum of guidance meets the problem with which I am trying to grapple. The law on assessment charging should be brought into line with the supplementary benefit legislation, which precludes any consideration of a sole residential home.

I have a number of questions to ask the Minister. When he has time, perhaps he will reply in writing. How many elderly persons' sole homes are being included for assessment in the Province? I believe that there are enough to warrant concern but not enough to inhibit the Government, on grounds of expenditure, from taking action. How many elderly persons have been informed that their properties must be sold to meet past costs incurred during their stay throughout the years? That figure would help us to convince the Government that changes are needed.

What time factor would render the board's claims on properties invalid because an elderly person had already signed over the house to a loved one or left it to that person in a will? I have read the document carefully and paragraph 26 appears to deal with that question but imprecisely. It says that, if one deprives oneself deliberately of an asset, one will be assessed as if the asset were still available. I do not believe that the boards would wish to be as crass and cruel as that. There must be a cutoff point before which, if a house was assigned, willed or put in trust, there would be no claim on that property. Does such an attitude prevail or such a facility exist?

Will the Minister comment on the Government's attitude to the 1980 report referred to in the letter of 5 October? I hope that we are not too late in having the debate. I hope that the Government are still open to suggestions. While it would be helpful to raise the disregard level, justice would be done to elderly people entering homes only if the sole residential property were disregarded. The only exception should be where income is earned from the letting of that property. I accept that that should be taken into account but not the value of the property.

I should be grateful if the Minister would say whether there is still time for him to add his weight to the argument and discussion about this important issue that may still be taking place in Cabinet.

10.29 pm
The Under-Secretary of State for Northern Ireland (Mr. John Patten)

I am glad that the hon. Member for Belfast, South (Mr. Bradford) has raised this important topic. I thank him for his kind words about the staff in old people's homes throughout the Province. They work hard on behalf of us all. I was rather sad when the original motion for tonight's Adjournment debate, which concerned staffing levels at the Purdysburn hospital, Belfast, was withdrawn. It would have given the hon. Gentleman the opportunity to praise the DHSS in Northern Ireland for the vigorous way in which it has approached staffing problems within that hospital. Staffing levels have been increased in recent months to 720, which has brought overall staffing to 63 nurses per 100 beds. That is considerably better than the ratio which obtains in Scotland, which has long been recognised to be the leader.

Mr. Deputy Speaker (Mr. Bernard Weatherill)

Order. I am genuinely sorry to interrupt the Minister. He must reply to the debate, which does not involve hospitals.

Mr. Patten

I apologise, Mr. Deputy Speaker. I was led astray by myself. I shall direct myself to the eventual subject of tonight's Adjournment debate—namely, the admission and charging policy for statutory residential homes in Northern Ireland. That will not prevent me on another occasion from returning to the interesting subject that the hon. Gentleman was kind enough to raise earlier.

The hon. Gentleman has taken the opportunity to add to some suggestions that he made earlier this year about the way charging and admission policy in the Province in old people's homes works against the interests of certain well-defined sectors of the community. He gave an interesting radio interview this morning on the issue that occasioned this debate. I am grateful to the hon. Gentleman for giving that interview, as he has enabled me to be better prepared than otherwise I would have been to answer the debate.

I must set the hon. Gentleman's suggestions in the overall context in the Province of the expenditure that we make every year in providing places for old people in residential homes. The cost of providing such a place in Northern Ireland is about £100 a week. That is broadly similar to the cost of similar provision on this side of the water. The total annual cost of running residential homes in the Province is about £16 million. Our social welfare system was introduced in 1948 and it has never been said that the costs should be met only by the State and not by contributions from residents. We receive about £4 million in charges that are met by those who are paying for their residence in the homes.

If we accept that the charges should be waived entirely—I am sure that the hon. Gentleman is not arguing that that should be done—we must accept that the level of provision in the Province must be greatly reduced. I am sure that the hon. Gentleman shares the pleasure that I derive from the fact that over the past eight years the number of places in old people's homes in Northern Ireland has increased by about 50 per cent.—that is, by about 1,100 places. That represents a major improvement. It is a fine achievement. I am sure that the hon. Gentleman will agree with that.

The economic cost of providing a place in these homes may be about £100 a week, but the majority of residents pay substantially less than that. The average charge throughout the Province is about £25 a week, About half the residents pay the statutory minimum. That is a uniform sum that is applied throughout the United Kingdom of about four-fifths of an old person's pension. The remainder goes to the individual residents so that they may have some money of their own. It is sometimes referred to as pocket money. I do not like that term. It is money of their own that they may spend as they want. We should not think of it as pocket money.

A few facts and figures may help us to examine the hon. Gentleman's very well presented and well argued case rather more closely. About 10 per cent. of the residents in these homes pay the full standard charge. As I have said, about half pay the statutory minimum charge. It is probably among the remaining 40 per cent., who pay on a sliding scale between the statutory minimum and maximum, that some of the problems to which the hon. Gentleman drew attention occur.

As I understand it, the hon. Gentleman is particularly concerned about the method of determining the charges to be met by residents, especially when it concerns occupation of a house which the resident owned prior to entering the home. In the Province, as here, most people tend to enter these homes permanently or for fairly long stays. If they have previously lived in a house of their own, they must vacate it on entering an old persons' home.

As the hon. Gentleman will be aware, the method of computing a person's income in this situation is very similar to the manner in which it would be assessed under the supplementary benefit scheme which is standard for the whole of the United Kingdom. The situation in Northern Ireland is exactly the same as that which obtains in England, Scotland and Wales. There is nothing peculiar about the system which operates in the Province.

There will, of course, be cases in which individual residents realise when they enter the home that they will spend the rest of their lives there. This does not apply to all of them, as some old peoples' homes provide a valuable short-stay respite, perhaps for a year or so, while domestic problems are sorted out by individual pensioners' families. Nevertheless, the majority tend to go into the home for the rest of their lives. When they do so, many of them decide to realise the value of their property and to help to meet the weekly charge from the interest received on the proceeds of the sale.

I put it to the hon. Gentleman that in Northern Ireland, as on this side of the water, when people decide to sell their houses to produce that kind of income, this is very little different in true logic from the situation in which a person moving into the home of a son or daughter or other relative decides by exactly the same token to sell a house and invest the proceeds in order to help the son or daughter who, after all, has accepted responsibility for the care and well-being of the old person. It is a theoretical argument, but I think that in true logic there is little difference between the two situations.

Mr. Bradford

The subtle distinction is that the son or daughter would not insist that the parents part from their money. It would still be available for the old person in the family home. That is not so in a statutory home. The Minister has forgotten that under the Ministry of Social Security Act 1966 and the relevant supplementary benefit orders a statutory home is not assessable. That is the difference and the difficulty.

Mr. Patten

I am grateful for that intervention as it allows me to point to the fact that in reaching decisions of this kind families doubtless sometimes have to take rather hard decisions, just as individuals must. I do not believe that the decisions which families sometimes have to take are at all different from the State-provided institutional framework within which individual old people have to decide whether to sell their homes.

On this subject, there is little that I can add to what I wrote to the hon. Gentleman on 6 July. There has been a fair amount of quoting from letters, but it is worth reminding the hon. Gentleman of what I said. I wrote as follows: If the applicant for Supplementary Benefit is living in his own house its value is disregarded but the value of other property is taken into account. The resident in an Old People's Home has, however, ceased to live in his former house"— that is the difference— and the Board will take its value into account in the assessment of resources. In cases where he is unlikely to return to the house and no dependant is living in it the Board may advise its sale to realise income for personal use. If the Board's advice is not accepted a debt is likely to build up. I have, however, had inquiries made over the last five years and … not one person in a statutory old people's home has been taken to court to enforce payment of a debt of this kind. Nor would one expect such an event to happen in the humane and excellent administration of old people's homes in the Province.

As the hon. Gentleman pointed out, the whole question of charging is at present subject to a review by a working group in England, and the Department for which I have ministerial responsibility in Northern Ireland has been keeping in close touch with developments. Any changes that are recommended will be closely examined by the Department of Health and Social Services in Northern Ireland, because there is parity of provision between regulations throughout the United Kingdom.

The hon. Gentleman's comments tonight will not be ignored. He correctly said that it would be better for me to reply in writing to the four questions that he posed. I shall do that, but before writing I should like to impress on him that the health and social services boards in the Province make every effort to be humane and understanding in their dealings with such cases. The general policy is—I look forward to evidence on this from the hon. Gentleman—that no pressure is put on anyone to dispose of his property. If the evidence is there, let it be forthcoming; let it be produced in writing. If a legitimate debt accumulates it would become a charge against the person's estate and would be eventually discharged when the estate is wound up after the person's death.

I shall write to the hon. Gentleman in detail on the four points that he raised. I hope that he will not take it as a back-handed compliment, but I congratulate him on the constructive way in which he put forward his argument in detail. It contrasted very well with statements that he made in the Province earlier this year. For example, on 12 June 1981, it is reported in the press that he said: I accuse the Government of State theft in depriving the elderly who enter old people's homes of their property by making them sell their houses to pay for their stay in State care. That sort of comment raises totally unnecessary and unfounded fears in the minds of old people and contrasts poorly with the constructive way in which the hon. Gentleman put forward his views tonight, for which I am grateful.

Question put and agreed to.

Adjourned accordingly at eighteen minutes to Eleven o'clock.