HC Deb 14 May 1986 vol 97 cc828-34

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

11.45 pm
Mr. Alex Eadie (Midlothian)

The subject of the debate—the operation of the board and lodging regulations in Midlothian—is causing great anxiety in my constituency. It is fair to say that that anxiety is widespread throughout the country.

The problem I face as a constituency Member for Parliament arises from statutory instrument No. 613, driven through the House by the Government's majority last year, entitled "Supplementary Benefit Regulations 1985". It is commonly referred to as board and lodging allowances, and I wish to discuss its effect on the elderly in 24-hour care in registered nursing homes.

The problem with payments arose when the Government introduced new restrictions on DHSS payments. We were told that they were aimed at the so-called Costa del Dole—young people living in coastal towns. However, they also set a new limit of £170 a week on payment of nursing home fees.

Even on the later aspect, it is claimed that the order is defective. It is not a new experience for this Government to find their orders defective. Indeed, they have been brought before the courts to be told so.

The bitter experience that I shall relate to the House should give the Minister and his Government great cause for concern. The Minister is aware of the case that I shall describe at this late hour, and the time available compels me to do so in shorthand. It concerns a woman of 95, Mrs. Agnes Scott, formerly resident in Parthhead, Midlothian, but now resident in a nursing home. She is severely disabled and confined to a wheelchair. The medical evidence describes her as frail, suffering from dementia and osteoarthritis, and says that she requires full-dine nursing care. I hope that the Minister will at least have the grace to agree with those medical facts.

I must pay the highest compliment to Mrs. Agnes Scott's grandson, Mr. H. Leonard Scott, who has campaigned for justice for his grandmother. I do so deliberately because he gives the lie to what is abroad nowadays—that children, or grandchildren, show lack of concern for their parents or grandparents. Mr. Scott has been a tower of strength to his mother, who is a pensioner and has been seriously ill. She is worried sick about what will happen to her 95-year-old mother. Lest there be any doubt about the role that she has played in looking after her mother, I want the record to show that for 16 years she cared for her mother until her own health broke down. Only reluctantly, under the pressure of medical advice, did she consent to her mother being cared for in a nursing home. Mrs. Agnes Scott's daughter was in no position to choose any particular establishment for her mother, because she herself had been hospitalised for eight months.

The statutory instrument sets a limit of £170 a week on payments for nursing home fees for the elderly and disabled. I regret to say that I was given deplorable advice by the Minister in a letter. He wrote that charity should be asked to make up the shortfall between the limit and the fees. That was his response when I wrote him about the case of 95-year-old Mrs. Agnes Scott, who has lived in Hilton Lodge nursing home since 1 October 1984. It is suitable for her needs and she is perfectly happy there. If she were removed on the ground of cost, the consequences would be fatal for her. The Minister has had a letter from me to tell him that his charity advice offers no solution to the problem.

In the Minister's letter of 8 April he asserted that Mrs. Scott is in the nursing home that charges the highest fees. My response demonstrates that that is not true. He has been given the figures and I hope that he will concede that the information given in his letter of 8 April is misinformation.

The feature that bedevils Mrs. Agnes Scott's case is that she has a decision in her favour arising from a tribunal decision of 21 February 1986. I shall quote the judgment in its totality because it has a bearing on what I want to say about the regulations. The judgment reads: The Tribunal considered Regulation 9 of the Requirement Regulations and Schedule 1(A) and 2f which gives the figure of £138.60 per week ie the prescribed rate. This prescribed rate is now £170 a week as Mrs. Scott was paying £190 a week prior to 29.4.85 This became the protected rate. The majority held the view that it was her tenancy in the suitable nursing home which was protected and this would take into account any reasonable weekly increase, and in this case the weekly increase of £9.50 a week was reasonable in that it was less than the rate of inflation this was what 'protected' meant in the meaning of the Act and word. To give a fair picture, I should add that the dissenting member held that the tribunal had to take account of what the Act said, not what the tribunal thought that it intended to say. He maintained that the £190 per week was protected, not any subsequent weekly increase, however resonable.

There is no decision in regard to inflation, which reveals the defectiveness of the Act. The adjudication officer has challenged the legality of the tribunal's finding and is appealing to the social security commissioners. The tribunal's decision is frozen, and poor Mrs. Scott and her relatives are left to sweat it out.

Many of my constituents are puzzled. They believe that Parliament makes the laws and that, if a law is defective or in doubt. Parliament hastens to clarify it. If I had more time, I could give examples of defective unfair and unjust legislation that Parliament has remedied. When the statutory instrument was debated in November 1984—it was imposed in April 1985—the Secretary of State for Social Services gave the House the assurance that there was no question of elderly handicapped or disabled people being moved out of their existing accommodation and that their position would be protected.

The Under-Secretary of State for Health and Social Security, the hon. Member for Wycombe (Mr. Whitney), was asked in a radio interview last July whether the limits were not putting on families the onus of paying for nursing homes. He replied: We are definitely not. People are saying that because they are misinformed. The 95-year-old lady has a daughter who is herself on a pension. She cannot maintain her mother. At great personal sacrifice, she has attempted to buy her mother what can be called the basic necessities.

The statements that I have quoted do not tally with the history of the case. Ministers must be held accountable for what they say. It is a serious matter if they have deceived Parliament. The Minister has some explaining to do, although other Ministers should be at the Dispatch Box to explain.

Real compassion for 95-year-old Mrs. Agnes Scott is alive in my constituency, but there is also anger that the Government do not seem to match it. Her grandson asked me whether his grandmother would be murdered by a parliamentay statutory instrument, because that was what it would mean if she were moved from Hilton Lodge. I could not answer the question. Can the Minister answer it tonight? The answer is anxiously awaited by the Scott family, by many other elderly people throughout Scotland and by Age Concern Scotland which reads our proceedings on behalf of its many elderly citizens.

12 midnight

The Parliamentary Under-Secretary for Health and Social Security (Mr. John Major)

I must say immediately that compassion does not merely rest in Midlothian or, indeed, on the Opposition Benches, although I appreciate that the hon. Member for Midlothian (Mr. Eadie) did not suggest that. The welfare of the elderly and the disadvantaged are matters of concern to us all, and I shall seek to deal with the issue.

I am exceedingly familiar with the case from which the hon. Gentleman drew a great deal of his text. He will know that the tribunal judgment is at present the subject of an appeal, and it would be unwise and improper for me to trespass on that matter. I appreciate that the charges relating to other homes are a relatively minor matter, but the hon. Gentleman has slightly incomplete information, and he may find that, for that innocent reason, he has been misled.

The hon. Gentleman will know that it has long been an established practice under both Governments that the details of individual cases of this nature tend not to be discussed on the Floor of the House. However. I am perfectly happy to meet him privately at any time to discuss the matter. He has only to ask for us to have a conversation about the particular details of Mrs. Scott. I make that offer now, as I would have done previously, had he approached me requesting such a meeting at any time in the past.

Mr. Eadie

The Minister should not deceive the House with that offer. I will accept any offer from a Minister to meet and discuss any case. He should be fair to the House and admit that I received an answer to my letter only when I tabled a question asking when I would receive a reply. That does not show any sense of urgency or co-operation on the part of the Minister.

Mr. Major

If the hon. Gentleman wishes to be contentious, I am prepared to meet him. I was endeavouring to make him a realistic, civilised offer because I am not prepared to swap the details of a lady's particular difficulties across the Floor of the House. That would be neither proper nor appropriate and I will not do it, whatever the provocation may be. I am prepared to discuss the matter with the hon. Gentleman, and that was the point that I was making to him.

I must commiserate with the hon. Gentleman about the timing of the debate. As the collective House is aware, although the hon. Gentleman did not mention it this evening, we have been reviewing the supplementary benefit limits for all forms of board and lodging, including those for people in homes and hostels. We shall shortly be announcing the outcome of that review, and obviously, I cannot anticipate it. I must confine my remarks to the present arrangements, although I am acutely aware of the difficulties facing some elderly people, and we have paid special attention to them. I hope that the hon. Gentleman will accept that.

It may be helpful to put the matter in a proper context if I remind the house briefly of the background to the changes we made last year. That was noticably absent from the hon. Gentleman's remarks. Our changes had three aims in respect of both ordinary board and lodgings, to which there was a passing reference, and residential and nursing homes in Lothian and elselwhere.

The first of those aims was to gain control of very rapidly escalating expenditure. I shall return to that point later. The second was to target expenditure more precisely on those in real need, and the third was to help to curb undoubted abuse in some—although. of course, not all—areas. We were also concerned that, with the easy availability of high boarder payments, the benefit system was, in effect, acting as an artificial stimulus to the market, resulting in some cases of exploitation and waste. I emphasise "some", because I am not making a more general charge. It is not a matter of dispute between us that that was a genuine problem—[Interruption.] The hon. Gentleman had a great deal to say earlier. He might do me the courtesy of listening in the time remaining, so that he cannot at some later stage say that I did not respond to his points.

The hon. Gentleman expressed concern about people in homes. That has to be seen in the context of the Government's very good record in recent years. Since the Conservative party took office in 1979 we have enabled many thousands more people to opt for the residential care of their choice, and that is continuing. The hon. Gentleman talked of compassion, but a sharp contrast can be drawn between us and the Labour Government. He did not mention the fact that, under that Government, supplementary benefit was only rarely sufficient to meet the charges incurred by elderly people in homes. I fear that he overlooked that point.

The 1979 supplementary benefits handbook explained just how little could be paid then. Local limits were set by reference to the highest charge a short-term claimant might be obliged to pay to find full board and lodging in commercial establishments of a reasonable standard". In other words, the amounts payable were geared to short-term unemployed claimants, not to the needs of the elderly and the disabled. There has been a material change in that respect.

People in need of residential or nursing care had very little choice at that time. Those who could not pay privately had to rely on local authorities to provide accommodation, or they filled the long-stay wards of National Health Service hospitals. The hon. Gentleman will appreciate that in many cases hard-pressed families felt that they had to cope as best they could in difficult circumstances. I am not tonight arguing that the present system is perfect in all respects. Clearly there are difficulties with it. But, with all its difficulties, the present system is infinitely better than that. That point must be made so that people view policy in the round.

The Government changed the benefit rules so as to open up the option of care in the independent sector. That should be remembered, as it is important to many people in this country. The figures speak for themselves. In 1978, 7,000 supplementary benefit claimants were assisted with their fees in residential care and nursing homes. By 1984, the estimated figure was a six-fold increase, to 42,000. Expenditure has gone up even more. In 1978, £6 million was spent in that area; by 1983 expenditure had reached £105 million and by 1984 it was estimated to be £190 million. That was a quite staggering increase, but it was justifiable, and I hope that 'the hon. Gentleman welcomed it.

It has never been the Government's intention to supplant the valuable role of local or health authorities in this area. Indeed, we are discussing with them how collaboration can be improved. There are grey areas of difficulty between their role and the role of supplementary benefit. I regret, although I understand the point, that a number of authorities took the increases in benefit entitlement as a cue to cease sponsoring claimants in residential care. Nationally, the number of people sponsored by local authorities in private and voluntary homes has been declining although the numbers in homes have tended to increase.

That picture is mirrored in Lothian. In 1980, there were 544 people sponsored in the Lothian area. By 1985, that figure had fallen to 427. I understand that this trend is likely to increase in future. I should reiterate that local authorities still retain their rights and responsibilities in this area—[Interruption.] The hon. Gentleman is always trying to make political points. The situation is precisely the same in many areas in which the Labour party is in control, and he should acknowledge that.

Mr. Harry Ewing (Falkirk, East)

Give us the figures.

Mr. Major

The hon. Gentleman will get the figures if he tables a question. We are discussing Lothian, and nominally at least, the hon. Gentleman is not, as far as I am aware, part of the debate. If he so wished, he could have indicated in the normal way that he wanted to take part in the debate. From the way in which the hon. Gentleman has intervened, it is becoming apparent that the debate has as much to do with party politics as with anything else.

Mr. Eadie

On a point of Order, Mr. Deputy Speaker. I resent the fact that the Minister, in an Adjournment debate granted to an hon. Member, has acted in such an arrogant manner. He has been given 14 minutes out of 30 minutes to reply to the debate. Let us have a little less arrogance.

Mr. Deputy Speaker (Sir Paul Dean)

Order. That is not a point of order, as the hon. Member knows.

Mr. Major

It certainly was not a point of order. It was one of the most ludicrous interventions that I have heard in my few years as a Member of the House. I assume that the hon. Gentleman would like an answer, although there seems to be some question about that.

Mr. Eadie

The hon. Gentleman had 14 minutes in which to reply.

Mr. Major

It is a jolly sight less, with the interruptions and mutterings from the hon. Member for Midlothian and his Front Bench colleague, the hon. Member for Falkirk, East (Mr. Ewing). One begins to wonder whether the hon. Gentleman wants a reply.

Although the changes in the supplementary benefit rules since 1980 brought many advantages, the system did not always work fairly. For example, the amount of supplementary benefit for people in residential care homes varied substantially from place to place—from £51 to £215 a week. Nursing home limits, which, admittedly, were more relevant to Mrs. Scott, varied between £80 and £295 a week. Because limits were set locally by adjudication officers by reference to charges actually levied, they were susceptible to manipulation by the more unscrupulous proprietors. Excessive profits were made at the taxpayer's expense, and value for money was not always given. In other circumstances, the hon. Gentleman would have been the first person to criticise that trend, although he has offered precious little support to the Government in trying to curb it.

No responsible Government could ignore such problems, and last year we took steps to deal with them. We replaced the old local limits with a new, more consistent structure of national limits which varied according to the category of home—for elderly people, those who were handicapped, and so on. The limits operated in progressive steps to meet the anticipated cost of providing an appropriate level of care. The new limits were specifically intended to allow reasonable charges to be met in homes satisfying the registration requirements. Last November, we increased those limits by £10 for residential care homes and by a substantial £31.40 for nursing homes. That was another material fact that slipped the hon. Gentleman's mind when he addressed the House earlier.

The limits for residential care homes now range from £120 to £180 a week. While the limits for nursing homes range from £170—as the hon. Gentleman mentioned—to £230 a week. Those new limits were substantially higher than those they superseded in some places and for a large number of people. In other cases, they were lower. The hon. Gentleman expressed concern about the position of people already in homes charging above the current limit when the changes were made. For those people. we provided unprecedentedly extensive transitional arrangements, which were described not by Ministers but by the Social Security Advisory Committee as generous. People over pension age had their existing level of benefit protected until such time as payment under the new rules became more favourable to them.

That was the extent and nature of transitional protection. It was precisely on all fours with the nature of transitional protection at all times since we have had a social security system—whatever party has been in power. There is nothing novel about the way that transitional protection worked. People under pension age were protected for a year until April 1986 to give them time to make alternative arrangements. There was provision to extend the protected period where exceptional hardship would otherwise result.

In keeping with all precedents under Governments of both parties no provision was made to increase the transitionally protected amounts to meet fresh increases in fees. The hon. Gentleman suggested that that was harsh but, as I said a moment ago, it is not my intention to discuss Mrs. Scott's case across the Floor of the House. In the moments left to me, I reiterate, although I wanted to say much more, that I will be happy to meet the hon. Gentleman to discuss the case and the wider application of the board and lodging rules, if he so wishes. That is an open offer to him.

I should like to say that the Government's intention, in their care for the elderly and the disabled, was to make the transitional protection provision as generous and as flexible as possible. I know that Mrs. Scott's grandson felt differently, but people do retain the same level of protection if they move to another home, although no one can receive more than the actual charge that they are required to pay. The logic of the hon. Gentleman's position can only be that any fees that proprietors choose to impose should be met, whatever their level. I am pleased to put it on record that the hon. Member for Falkirk, East shakes his head. [Interruption.] I did not say that the hon. Member for Midlothian said that. That is the logic of what he said. I am pleased to have it on record that it is not the Labour party's policy that any fee increase of any sort should be met.. That is an important—

The Question having been proposed after Ten o'clock on Wednesday evening and the debate having continued for half an hour, MR. DEPUTY SPEAKER adjourned the House without Question put, pursuant to the Standing Order.

Adjourned at fifteen minutes past Twelve o'clock.