HC Deb 12 December 1989 vol 163 cc833-5
6. Mr. Cohen

To ask the Secretary of State for Health what representations he has received on the White Paper on community care; and if he will summarise the views expressed.

11. Mr. Alfred Morris

To ask the Secretary of State for Health what representations he has received on the community care White Paper.

The Minister for Health (Mrs. Virginia Bottomley)

We have received several representations following publication of our White Paper "Caring for People: Community Care in the Next Decade and Beyond." Most have expressed a general welcome for our proposals.

Mr. Cohen

Have there not been many protests about the proposal to privatise care for the elderly? Are the Government not about to treat home helps in the same way as National Health Service cleaners, by undercutting the low-paid and penny-pinching in the service that they provide? Why is it that the care of the elderly and the disadvantaged is acceptable to the Government only if it makes a profit?

Mrs. Bottomley

Unlike Opposition Members, the Government have no obsession about the ownership of services to help the elderly and the frail. We are establishing a framework of care for the next decade and beyond. Individuals want their needs to be properly assessed and choice of provision. Wherever possible, they want to stay in their own homes. We want resources to be used effectively and properly, high standards to be maintained and choice and dignity provided to those who need care.

Mr. Alfred Morris

Will the Minister clarify the Government's intentions regarding section 3 of the Disabled Persons (Services, Consultation and Representation) Act 1986, which was so ably promoted by my hon. Friend the Member for Monklands, West (Mr. Clarke)? Also, if in the words of the White Paper, promoting choice and independence underlies all the Government's proposals", will the Minister accept amendments to the National Health Service and Community Care Bill to allow local authorities to pay disabled people to employ the personal assistants they so often need to preserve their independence? If the Bill becomes law, just how much are the Government prepared to spend on community care during its first year of implementation?

Mrs. Bottomley

The existing provision for disabled people will be unchanged by the introduction of our proposals for care in the communiy. What is important is that all people will have their needs assessed before care is provided.

As for the hon. Gentleman's second point, the key aim is to provide effective care and to make plans in collaboration with health authorities. The local authorities have been given the responsibility to provide care in the community. They will be required to produce and publish their plans. But it is important that they should work closely with health authorities to ensure that disabled people, whom the right hon. Gentleman has championed so greatly over the years, receive the services that he and I wish them to have.

Mr. Nicholas Winterton

Does my hon. Friend accept that it is a crying shame that community care proposals have been tagged on to a Bill that relates to the NHS, when community care relates mainly to local government? Will my hon. Friend, and my right hon. and learned Friend, consider ring fencing community care expenditure so that it is not lost within the general expenditure allocated to local government?

Mrs. Bottomley

I resent my hon. Friend's comment that these matters are being "tagged on" to the end of the National Health Service and Community Care Bill. In my view, they are extremely important proposals. The Bill provides an ideal opportunity to establish our plans for those who need health care alongside the plans for those who need social care—a group that my hon. Friend, too, has championed greatly over the years.

As for my hon. Friend's question about a specific grant, the key point is that we want to establish local accountability and flexibility. We want to promote diversity according to local needs and opportunities. If my hon. Friend is concerned that local authorities may not arise to the opportunity and the challenge, I point out to him and to others that this is a moment for which they have long waited. Local authorities will be entrusted with these responsibilities. They will be required to produce and publish their plans. We intend to ensure that they deliver everything that my hon. Friend and I wish them to deliver.

Sir Michael McNair-Wilson

Does my hon. Friend agree—

Hon. Members


Mr. Speaker

Order. The hon. Members who have just come in should realise that it is bad form to walk in front of the hon. Member for Newbury when he is asking a question.

Mr. Skinner

Send them to Sardinia.

Mr. Speaker

Order. Settle down please.

Sir Michael McNair-Wilson

Is my hon. Friend aware that voluntary bodies such as the Children's Society are disappointed that the provisions of the NHS and Community Care Bill do not consider the needs of carers and users of the services, and that there is no scope for the incorporation of review and complaints procedures in the current draft of the Bill? Does my hon. Friend intend to add those to the Bill at a later date, or will she bring forward a code of good practice that will be published after the Bill becomes law?

Mrs. Bottomley

I urge my hon. Friend to look at the White Paper again, because explicit mention is made of the needs of carers, and the important part that they play. We are working closely with voluntary organisations and local authority associations so that when we bring forward a code of practice they will give the recognition to carers that he and I want them to be given.

Mr. Tom Clarke

Will the Minister take a second opportunity to reply to my right hon. Friend the Member for Manchester, Wythenshawe (Mr. Morris), who asked a specific question about the Disabled Persons (Services, Consultation and Representation) Act 1986? How many people have made representations supporting the full implementation of the Act, and how many of them supported sections 1, 2 and 3 which give rights to consumers and carers? Or do the Government take the view that community care is everybody else's responsibility—the independent sector, voluntary organisations and carers—but not theirs?

Mrs. Bottomley

The Bill offers a major step forward for carers and consumers of services. We have made it very clear that an assessment will be required before care can be provided. We are turning our backs on the old system, in which the provision of resources was often irrelevant to the needs of the individual. Frequently, under the system it was more likely that residential care was provided, rather than the domiciliary care that is often more appropriate, and more in line with the dignity of the individual. Our measures move on from the disabled persons Act, but we shall continue to review it. The Bill will be a major step forward, and will provide an opportunity to hear the views of consumers and carers.

Mr. Thurnham

Does my hon. Friend agree that we do not need ring fences in community care, but we need the local authorities to concentrate on their responsibilities, and to bring down the ring fences that stop voluntary bodies, such as Crossroads, playing a full role?

Mrs. Bottomley

One of the difficulties with ring fences is that they tend to lock services in a historical framework. We want collaboration and innovation, with various agencies working together to ensure that a better service is provided for the frail and the disabled.

Rev. Martin Smyth

Will the Minister kindly tell us what plans exist to increase the number of occupational therapists in the community? There is already a shortage in hospitals, and if more people are to go into community care, will more also be required in the community?

Mrs. Bottomley

I can say that there has been a substantial increase in the number of professionals involved in the provision of care in the community in recent years. I anticipate that we shall also need an increase in the number of occupational therapists.

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