§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Chapman.]
9.37 am§ Mr. John McAllion (Dundee, East)I first applied for an Adjournment debate on this topic at a time when the immediate fate of 10 community care projects in Dundee and 23 in Tayside as a whole hung in the balance. Those projects had been brought into existence under the old community programme and had therefore, been fully funded by the Government. They provided a variety of community-based services for some of the most needy and disadvantaged groups in Dundee, including many elderly people.
There were involved projects such as Crossroads in Dundee, which provides a home-care service for the severely handicapped and chronically ill as well as for the carers who look after them. They also involved Kandahar house, Dundee, which provides day facilities for the mentally and physically handicapped and former psychiatric patients, and Menziehill community care project in Dundee, which provides a home visiting and caring service for the single elderly and other vulnerable groups and which plays an important preventive role in keeping people in the community and out of institutional care. Whitfield court playgroup, which provides playgroup facilities for children from an area of multiple deprivation and which also provides educational and training opportunities for the parents of those children was another of the projects. St. Salvador's day care is a day centre for the mentally handicapped adults in Dundee and assists them to become better integrated into the community.
Such projects, along with the Coldside and Ardler community care projects and the adult learning support and agency teams, provided Dundee with a range of vital personal services which were available to vulnerable groups in our city. The initial threat to the continued survival of those projects arose when the Government announced their intention to scrap the community programme from September 1988 and to replace it with the new employment training scheme. The Government's message to the Dundee community care projects was simple: if they wanted to go on, they had to get into the new employment training scheme, which was the only source of funding that the Government were prepared to make available to them.
Of course, such a proposal was impractical and unacceptable to everyone who understood the nature of the projects and who wanted them to continue on the same basis. The Government's case does not bear examination. For example, the Secretary of State for Scotland made much of the fact that the Clydeside branch of Crossroads had already agreed to go into employment training. He singled it out as an example that should be followed by all the other Crossroads schemes. However, the Secretary of State and other Ministers ignored the fact that 47 other Crossroads branches across Scotland had already taken an informed decision not to follow Clydeside's example. The minutes of the executive committee of the Scottish Council on Disability said:
the other 47 had given careful consideration and decided that this employment training scheme was not designed for Crossroad care attendant schemes.1246 Ministers would be better advised to listen to the advice of 47 of the 48 Crossroads branches in Scotland instead of latching on to the one branch that happens to suit the Government's argument.It was not just a matter of the Crossroads care attendant schemes. In Tayside, voluntary day care units at Brechin, Montrose, Forfar and Kinross agreed to enter employment training when the community programme was wound up last year. After five months' experience of employment training, they wrote to the Minister of State with responsibility for education and health, saying that, having had the opportunity to evaluate ET, their blunt opinion was that the system did not work satisfactorily. They pointed out that employment training rules were different from the old community programme rules. They did not allow, for example, for sufficient full-time staff members on the projects. They said that it was difficult to recruit suitable personnel, leading to gaps in the core staff who were essential to the success of the projects. Elderly clients were unhappy with the constant changes in staff, which are inevitable under employment training. The voluntary day care units said that the uncertainty in service provision caused by employment training was discourag-ing private sector support for the projects.
Those schemes had learned from experience that the Government's advice was impractical and that alternatives for ongoing funding were essential if they were to continue to provide the service that they had provided. Fortunately, the 10 Dundee projects and 13 other similar Tayside projects were saved from the bitter experience of the voluntary day care schemes by the minority Labour administration of Tayside regional council. Last September, the council intervened to extend the funding of the projects until the end of this month. The question was: who would provide the funding beyond 1 April?
At that point, I had hoped to raise this issue with an Adjournment debate. Unfortunately, some sharp practice by the Government Whips succeeded in scuppering the final scheduled debate on housing, and with it my Adjournment debate. I am therefore grateful to you, Mr. Speaker, for having allowed me a further opportunity to raise this matter in one of the debates this morning.
Events have moved on in the interim period. On Wednesday 15 March, the policy and resources committee of Tayside regional council unanimously agreed to intervene and to grant an 11th-hour reprieve to the projects. All 23 projects in Tayside will receive continued financial support from the council for six months, beginning on 1 April. The permanent staff members are to be retained in the meantime on their existing terms and conditions of service. Temporary staff will be similarly retained until 30 September or the completion of their 52 weeks, whichever comes earlier. Council officers have been instructed to identify with the care groups their minimum staffing requirements and to report on the feasibility of continuing the projects beyond the six-month period from 1 April.
The Office of the Under-Secretary of State—the hon. Member for Stirling (Mr. Forsyth)—contacted my office during the week to ask whether I still wished to pursue this Adjournment debate following those developments. Of course, the answer is yes. That approach speaks volumes about that Office's deplorable attitude to this affair. The only point that concerned it was that, wherever else funding was to be found to save the projects, it would not come from the Minister or from direct Government 1247 funding. As far as the Minister is concerned, now that Tayside region has stepped in to save the projects, that is the end of the story.
It is, of course, anything but the end of the story because a number of vital questions remain to be answered by the Minister. Why have the Government refused to accept responsibility for funding the projects when the Government alone are responsible for the funding crisis that threatens the projects' existence? Why have the Government failed to respond to the wide-ranging criticism of their suggestion that community care projects of this kind can be accommodated within the employment training scheme? Why do the Government leave regional councils to pick up the pieces when those councils are severely strapped for cash, whereas the Government had a huge budget surplus of billions of pounds which they wasted in the recent Budget in paying back the national debt? What do the Government intend to do about the long-term funding future for such projects in Dundee and elsewhere in Scotland?
The Griffiths report on care in the community has been carefully ingored by the Minister since its publication just over a year ago. The kind of infrastructure of community care that would make possible the transfer of patients from long-term institutional care back into the community is not in place. That is why projects of this kind have developed through schemes such as the community programme. Instead of withdrawing support funding from the projects as the Minister has done, he should have provided development funding through health boards and social work departments to enable the work of the projects to be built on and developed into the sort of community care that Griffiths envisaged.
It is surely ironic that, far from providing additional development funding to councils, the Minister and his friends are hounding councils to cut the resources available to them. For example, had Tayside levied a poll tax of £178 as Scottish Office Ministers advised it to do, instead of the £220 poll tax upon which it finally decided, Tayside region would have had between £11 million and £12 million less to spend on its social work education and other services. Had that happened, not just the community care projects that I have described would have been at risk.
For the moment, the projects have been saved by a council that cares, but their long-term future and the long-term future of community care as a whole remain depressing because of a Government who do not care and will not live up to their funding responsibilities. I hope that, in responding to the debate, the Minister will address the issue of funding for the long-term future of community care projects such as envisaged in the Griffiths report—something that the hon. Gentleman and other Ministers have failed lamentably to do in the recent White Paper. I look forward to hearing the Minister's response.
§ Mr. Ernie Ross (Dundee, West)I congratulate my hon. Friend the Member for Dundee, East (Mr. McAllion) on obtaining an Adjournment debate on a subject which is important to many thousands of individuals and to families and concerned organisations in Dundee and Tayside.
It is important to remind ourselves who is involved in care in the community. We are talking about people whose families find it difficult to look after them and for whom 1248 voluntary organisations have formed groups to provide services that normally would have been provided by the social work department of Tayside regional council or Tayside health board in day care centres or hostels. If the council or the health board had to take on the responsibilities of the voluntary organisations they would have to reduce services in other areas. That would increase pressure on individuals in Dundee and Tayside.
It is important not only to outline the views of my hon. Friend and myself, but to remind ourselves of some of the main players in the drama and some of their comments. I shall spell out the views of those who are supposed to be concerned and of those who are genuinely concerned. On 25 January, the Secretary of State wrote to the chairman of Crossroads (Scotland) saying:
I find it most regrettable that Crossroads organisations have largely rejected Employment Training as a source of funding and I remain unconvinced that other Crossroads organisations could not follow the Crossroads (Clydesdale) example if the will to do so existed. Crossroads (Clydesdale) clearly believes that it has a future operating within Employment Training and I welcome and share that belief. More generally, I remain convinced that caring organisations like Crossroads could provide excellent Employment Training opportunities. I have however to accept that the management of other Crossroads schemes, having assessed what Crossroads (Clydesdale) proposes to do, have decided not to follow that example. That is of course a decision for them.The executive committee of Crossroads in Scotland held a meeting on 23 February, having had time to consider the correspondence from the Secretary of State. The chairman, Dr. Kuenssberg reported that it was totally absurd of the Secretary of State to have said what he did in his letter of 25 January. One branch out of 48 had joined the employment training scheme and the other 47 had given careful consideration and decided that the employment training scheme was not suitable for Crossroads care attendant schemes. He also reported that a number of Crossroads schemes had folded.You represent an English constituency, Mr. Deputy Speaker, and there may be other hon. Members who do not understand the differences between the system that operated for Crossroads in Scotland and that in England and Wales. Ms. Hunt from the Scottish Office said that Crossroads schemes in England and Wales were run very differently, as they were based on funds from health boards and local authorities. It is clear that there were two methods of achieving the caring facility. It was far more beneficial to the Crossroads care schemes in Scotland to use the community programme for funding and looking after those with whom they were concerned.
The community programme in Scotland was far more centred on the caring aspects of the voluntary sector—that is, the sector outside the statutory bodies which have responsibility in these matters. Against that background, the Scottish National Council for Voluntary Organisations had a series of meetings with the Minister of State, Scottish Office with responsibility for industry and employment in Scotland prior to the ending of the community programme to make it clear to him that many of the care schemes would not be suitable to go into the new employment training programme. I put it on record that the association did not say simply that it saw the matter as wholly or only the responsibility of the Government. It offered the Government, and the Scottish Office in particular, a package. It said that if the Department of Employment and the Minister of State 1249 would agree to establish a separate fund under the Department of Employment—on which it put a figure of £1 million—those caring organisations could continue.
Some of the caring organisations have not only invested considerable time in training the carers whom they have used under the community programme, but have built up a great deal of expertise and have gathered together equipment which they used on community programmes. The association's request was simple. It asked not for a continual handout, but for a breathing space of two years and for £1 million to be set aside from the money allocated to employment training. During the two years, the care organisations would be able to redefine their needs and priorities and gather together extra funding. That was not an unreasonable request, but to this day we have had no formal response to it other than the views of the Secretary of State, set out in his letter of 25 January. He said that all the money previously spent on the community programme would now be given to employment training and that, whether they liked it or not, caring organisations had better get themselves into employment training.
That mistake was further compounded when I went to see the Minister of State to discuss the problems of the Menzieshill community organisation. The organisation was formed to provide basic caring services to the elderly who live in the Menzieshill area of Dundee. Simple care was provided such as visiting the elderly, disabled or ill in their homes, collecting retirement and other benefits and doing the daily or weekly shopping—in other words, the type of jobs that we normally associate with home helps. The group also drives the elderly and infirm to the lunch club in the Menzieshill community centre. With the greatest stretch of imagination, one could hardly believe that a person would need to be trained to talk to the elderly and disabled, to take the benefit book to the local post office, to buy provisions from the local shops or to assist people from their homes to the community centre. Even the Minister would find it difficult to say that such tasks could be fitted into employment training.
At a meeting on 2 February, the Minister of State suggested that we had not looked properly at the proposals and that we should look at them again. He believed that we might be able to fit the Menzieshill community organisation into employment training. He said that instead of asking simply for money, I should be prepared to argue the case. I agreed and I went back to the Menzieshill group which agreed immediately to hold discussions once more with officials from the Department of Employment. That meeting has taken place and both sides agree that there is no way that such a service could be included in employment training. As my hon. Friend the Member for Dundee, East said, if Tayside regional council had not stepped in and found the extra money, the Crossroads scheme in Dundee would have ended. That would have added to the misery of the individuals who have enjoyed the benefits of the service.
It is not only my hon. Friend and myself whose words should be heard in this debate. One of the Minister's friends—in the sense that he shares his political views—is one W. Loe CBE, JP, who wrote on behalf of a number of caring organisations, including the voluntary day care units in Kirriemuir, Forfar, Brechin and Montrose. The Kinross day care centre had also associated itself with the 1250 thoughts expressed in the letter. William Low, CBE, JP is not a radical politician in the Tayside area, but even he thinks that the Minister should think again.
I hope that the Minister will show an awareness in his reply of the concern felt by the caring organisations in the Dundee and Tayside area and that the Government are at long last prepared to do something other than mouthing platitudes.
§ 10 am
§ The Parliamentary Under-Secretary of State for Scotland (Mr. Michael Forsyth)I may have many faults, but I do not think that mouthing platitudes is one of them.
The hon. Member for Dundee, East (Mr. McAllion) based his explanation of why we missed the opportunity to debate the matter on a previous Adjournment debate on what he described as "sharp practice" by the Government Whips. I recall that as I waited in the Chamber to discuss the matter, the business moved on, because the Opposition did not choose to speak on previous business, and while I am delighted that we have this opportunity to return to the matter, I think that the blame lay with the hon. Gentleman for not being present rather than with anyone else.
I shall try to answer some of the questions asked by the hon. Members for Dundee, East and for Dundee, West (Mr. Ross). First, however, I will explain our overall policy on community care. We shall be bringing forward proposals for further development of community care in due course, but hon. Members will accept that this is a complex subject, and I do not think that I can say anything definite at this stage about when an announcement is likely to be made.
Before dealing with the circumstances of the community project about which the hon. Member for Dundee, East is concerned, I will say something about the provision of community care nationally. Gross expenditure on the Health Service in Scotland has increased by 34 per cent. in real terms since the Government took office and the planning figure for social work services has risen by no less than 67 per cent. in real terms over the same period. Those remarkable resource increases should be borne in mind in assessing the scope for futher development in community care.
We have heard a great deal about the generosity of Tayside region and how it stepped into the breach. Unfortunately, the hon. Member for Dundee, East did not tell the House that Tayside's grant for the coming year is very substantial. It represents an 11.1 per cent. increase over this year—well above the rate of inflation and the average increase of 9.8 per cent. that authorities have received. Moreover, grant penalties have been abolished so Tayside will receive the sum in full. It is true that Tayside's grant has been abated in the past, but that was the result of overspending and inability to control its financial affairs.
§ Mr. McAllionAs I understand it, the Minister's assessment of the need for social work spending in Tayside is not yet matched by actual expenditure. That is the result of the activities of a Conservative administration, which consistently underspent on social work provision over a long period. Since it came into office, the Labour administration has increased expenditure on social work services every year until this year and it has been penalised by the Minister and the Government for doing so.
§ Mr. ForsythSince the Government took office, the resources made available for planning for social work have increased by 67 per cent. in real terms. The hon. Gentleman is right to point out that Tayside spends less on the elderly than a number of local authorities. That is because of the way in which the Labour group has chosen to allocate the very substantial additional resources made available to the local authority. I would certainly wish to encourage the authority to redress the balance and make more resources available for the elderly from the substantial pool available to it. The background in Scotland has been of substantial additional support for the elderly. There has been a 16 per cent. increase in residential places for the elderly, a 68 per cent. increase in the number of day centre places and an increase of about 29 per cent. in home help provision. That is a result of the substantial resources that the Government have provided for local Government.
§ Mr. McAllionWill the Minister give way?
§ Mr. ForsythNo, I want to make a little progress. I know that the hon. Member for Dundee, East is particularly interested in Tayside.
Primary responsibility for community care provision lies with the local authorities, health boards and housing agencies. The increased resources for the NHS in Scotland have led to a 40 per cent. increase in the number of beds and day places in psychogeriatric provision. National Health Service hospital provision for the elderly in Tayside stands at 26 beds per 1,000, compared with a national average of 24 beds.
The hon. Members for Dundee, East and for Dundee, West referred to the difficulties allegedly faced by care schemes in adapting to the employment training arrangements. We believe that employment training marks a significant development—in our view, an improvement —over its predecessor, the community programme. Employment training is targeted specifically at providing training designed to enhance full-time job opportunities for those taking part in the programme. That means that the Training Agency and local training managers must ensure that individual projects or schemes wishing to be involved in the ET arrangements must show that their activities contain an element of training which will benefit individuals looking for full-time jobs.
Many of the care schemes about which we hear are closely linked to the types of services that local authority social work departments or health boards can often provide at their own hand. It seems to follow, therefore, that the care schemes must be doing work which is relevant to functions already exercised by those statutory bodies.
There are claims—the hon. Member for Dundee, West has touched on them—that inflexibilities in employment training mean a reduction in the independence of individual schemes if they participate in ET. That seems to mean that for fairly small individual schemes it often makes more sense for the local training managers to bring together a number of projects for training purposes because this is the most cost-effective way of monitoring the training element. It is not the Training Agency or local training manager's intention to usurp the proper management responsibilities of individual scheme managers, nor does it mean that the aims or objectives of schemes should be significantly altered or influenced by this administrative arrangement.
1252 A further allegation is that care schemes cannot hope to attract a sufficient number or quality of trainees because of the type of activity and the anti-social hours—that is, weekends—which those schemes often involve. I find it hard to believe that that is an overriding argument against care schemes participating in ET. Local training managers have been flexible in trying to identify and select suitable trainees and terms, and conditions of working have been adapted to suit the needs of individual schemes. The proof of this and of the other points I have made in this connection is that there are care schemes within ET that operate satisfactorily and have not suffered any of the traumatic effects that the hon. Member for Dundee, East and other detractors of ET seem to envisage. Many care organisations in Tayside have successfully made the transition from community programme to employment training. These include, Broughty Ferry community care and Clepington parish church. Indeed, I understand that both these projects are to all intents and purposes identical to Menzieshill. I am sure that the schemes are known to the hon. Member for Dundee, East, as they clearly were to the hon. Member for Dundee, West.
The obstructive attitude of the Scottish TUC and COSLA, including some local authorities such as Tayside regional council and Dundee district council, had an initial adverse impact on the implementation of employment training in Scotland. Many community programme providers were pressurised into following the STUC-COSLA line and declined to transfer to the new programme. Most of the people lost from Government training programmes in consequence reverted to unem-ployment. What does that tell us about local authority attitudes to the plight of the unemployed? Employment training is now progressing well, however, with more than 20,000 places filled in Scotland and more than 500 in Dundee. The national training programme cannot, of course, be revised to accommodate every peculiarity of every scheme. There is enough flexibility and discretion within the programme, and with co-operation and realism on both sides the scheme can be made to fit most circumstances.
The Menzieshill project was formerly funded under the community programme, but since September last year it has relied significantly on grants from Tayside regional council. The project, in common with several others in Tayside, chose not to participate in employment training. I have already set out the Government's views on the wider matter of how care schemes can take advantage of ET if there is a willingness and flexibility to do so.
The hon. Member for Dundee, West mentioned Crossroads. We have been saying to health boards and local authorities that they should use the powers and substantial resources available to them to assist organisations such as Crossroads. We have also been encouraging Crossroads to try to find patterns of operation which will meet the ET rules.
The Menzieshill project is clearly a broad-based community scheme aimed at helping a range of people, including the elderly, with ordinary day-to-day tasks. The original aim of the project was to provide a home visiting-caring service for the elderly, infirm, disabled and housebound within the local housing estate. That is community care in a very general sense, not specifically related to the health or social work services in quite the way that they were addressed in Sir Roy Griffiths' report.
1253 None the less, I can see that for the 300 to 400 people who use or benefit from the project each year, it is a worthwhile venture.
The latest information that the hon. Member for Dundee, West has given suggests that project managers may not be particularly interested in exploring the scope for identifying suitable training elements in their activities and that project representatives see no possibility of ET being able to provide assistance to the project.
The hon. Gentleman said that Tayside regional council agreed earlier this month to continue for a further six-month period its present grant support to a number of community care schemes in Dundee, including the Menzieshill project. I understand that council officers have been instructed to discuss with each of the projects concerned their normal core funding arrangements. The council will then be in a position to assess the budget implications of its providing continuing grant support for those projects on a longer term basis. I very much welcome the positive and constructive approach taken by the regional council in the circumstances, but I must say that it is in rather stark contrast with its outlook on employment training.
The hon. Gentleman seemed to be asking whether that further six-month period would provide a breathing space and whether the Government should consider adjustments to ET more easily to accommodate community care projects. As I have said, I find that difficult to accept in principle, given that a number of projects—and one or two in Dundee which seem virtually identical to Menzieshill —have not found too much difficulty in meeting the ET criteria. On the face of it, therefore, I do not think that there is a strong case to be made for changes in the ET rules, and nothing that the hon. Gentleman has said amounts to new evidence or facts which have not already been considered.
I believe that ET can and will continue to play its part in support of community care projects. I accept that some 1254 adaptation to meet the different needs of ET is often required, but it would be unfortunate if worthwhile projects of benefit to vulnerable groups such as the elderly were to cease, not as a result of practical considerations but because of ideological resistance to ET from local authorities, trade unions and the Labour party.
We have done all that we can to make funding available for community care services in Scotland. It is clear from the organisations and care projects already within the ET arrangement that there is no intrinsic barrier to involvement. I have mentioned two schemes in or around Dundee which carry out the same type of activities as Menzieshill. If, however, schemes are forced to close or to contract significantly because of an unwillingness to look toward employment training for funding, the collective opposition of local authorities, STUC and the Labour party in Scotland must bear their share of the responsibility.
§ Mr. McAllionThe Minister is trying to say that Labour and the STUC oppose the schemes. Does he understand that the Conservative group on Tayside regional council, who originally thought that ET could be used, has reversed its position and agrees that there should be special provision for community projects of that kind?
§ Mr. ForsythRegrettably, the Conservative group is not in power in Tayside region. If the behaviour of the Labour party in Tayside region in respect of ET is anything to go by, I look forward to the day, which may not be far ahead, when the Conservative group is in power as a result of the strong feelings of the electorate about the way in which politics are being used to the disadvantage of the elderly and other vulnerable groups in the community.
The unhelpful background of prejudice cannot detract from the success of ET in Scotland. The voluntary sector is already helping to provide over 10,000 project places —50 per cent. of all ET places in Scotland. Nor can it diminish the high standard of community care development in health and social work that was achieved during this Government's term of office.