Community Care (Hansard, 16 October 1990)

§ 2. Mr. Illsley
To ask the Secretary of State for Health what representations he has received regarding funding arrangements for the Government's community care proposals.

§ 12. Mr. O'Brien
To ask the Secretary of State for Health what progress has been made on the implementation of the community care proposals contained in the National Health Service and Community Care Act 1990.

§ 15. Mr. Norman Hogg
To ask the Secretary of State for Health what representations he has received from local authorities regarding the Government's proposed changes in the organisation of community care.

§ 16. Mr. Andrew Welsh
To ask the Secretary of State for Health what representations he has received from organisations on the new arrangements for community care; and if he will make a statement.

§ The Minister for Health (Mrs. Virginia Bottomley)
We have received many representations on all aspects of our community care proposals. Those views informed the Government's decision on the phasing of community care and the local authority settlement announced by my right hon. Friend. the Secretary of State for the Environment on 19 July. The implementation of our proposals is 1039 continuing to the timetable outlined by my right hon. and learned Friend the Secretary of State in his statement to the House on 18 July.

§ Mr. Illsley
Is the Minister aware that many poll-tax-capped authorities such as mine in Barnsley are in considerable chaos following the collapse of the Government's proposals for community care? They are having to make cuts of up to £1 milliion and will face further cuts. Has the Minister discussed that in detail with the Department of the Environment to ensure that there will be adequate funding for those authorities next year?

§ Mrs. Bottomley
There is no reason for the hon. Gentleman to blame the difficulties of his local authority on the decision to phase the implementation of the full community care proposals. It is clear that his local authority, and many others, will be able to develop their plans further and improve the management of their services. The fact that his authority has been charge-capped suggests that it could well invest some time in ensuring that it has the cost-effective and efficient services for the community once the policy is fully implemented.

§ Mr. O'Brien
I remind the Minister of the letter that I sent her colleague the Secretary of State on 25 September and the acknowledgement that I received on 28 September. Attached to that was a letter from my constituent, Mrs. June Cadman, who cares for 70 mentally handicapped people, in which she explained the hardship faced by the people in her charge. The letter also contained an appeal for assistance for Leeds city council and Wakefield city council social services department.
Because of the poll tax and the standard spending assessments, it is impossible for local authorities to help private homes. When will the Minister do something to help those people, to sustain those in need of care and attention and to help carers? May we have some assistance, please?

§ Mrs. Bottomley
There is a project under way in the hon. Gentleman's constituency, involving the regional health authority, the housing department and the local authority, for the relocation of mentally handicapped people in the community. I am sure that my right hon. and learned Friend will reply to the hon. Gentleman's letter shortly. There is much to be done in the provision of care for mentally handicapped people and I am pleased that the hon. Gentleman is as concerned as we are to ensure that services for this needy group improve.

§ Mr. Norman Hogg
As the Government did not think that community care in Scotland was worth a statement last July, when they announced the two-year delay, what advice is the Minister giving her right hon. and learned Friend the Secretary of State for Scotland, as there is much difficulty among local authorities in Scotland which are strapped for cash because of Government cuts and the inefficiency of the poll tax? A two-year delay in implementing community care looks extremely optimistic.

§ Mrs. Bottomley
I urge the hon. Gentleman to speak swiftly to my hon. Friend the Minister of State, Scottish Office, who announced on 26 September the full plans for implementation in Scotland. It would be presumptuous of me as an English Minister to make further comment on plans for north of the border.

§ Mr. Andrew Welsh
Where is the caring face of a Government who delay implementation of community care and starve the system of money for vulnerable groups such as elderly and disabled people? What is the Minister doing to bridge the financial gap between social security benefits and the costs of community care, or between revenue support grant and the costs of community care for local authorities? If the Minister tries to implement this scheme on the cheap she will simply create a recipe for social disaster.

§ Mrs. Bottomley
Personal social services spending has increased by 47 per cent. in the past 10 years. That is a substantial increase, quite apart from the extra money available through the social security system. My right hon. Friend the Secretary of State for Social Security has made it clear that he is considering closely the income support questions. This year's settlement for local government would be regarded by my hon. Friends as generous and even Opposition Members would regard it as fair.

§ Mrs. Currie
Is my hon. Friend aware that in Derbyshire the postponement of the community care reforms was met with a great sense of relief, because Derbyshire county council was nowhere near ready and implementation too soon would have put many people's lives and welfare at risk? Is she further aware that the first action of Derbyshire county council in response to poll tax capping was not to cut its administration, its local government newspaper or its publicity, but to cut entirely the grant to the Derbyshire coalition of disabled people?

§ Mrs. Bottomley
That is yet another item in the catalogue of appalling decisions made by Derbyshire county council, which I understand has increased its staff by 8,000 since the Labour party took control. It is clear that many local authorities need those two years. The Select Committee on Social Services made it clear that there is a pressing timetable to implement the changes by next April and I have no doubt that health authorities, voluntary organisations, the private sector and local authorities will need to spend that time training and thinking through the management and cost-effectiveness of their proposals for care in the community.

§ Mr. Thurnham
When considering funding, will my hon. Friend bear in mind the far greater cost-effectiveness of the voluntary sector in providing community care, especially for the mentally handicapped?

§ Mrs. Bottomley
Once again, my hon. Friend leads me to comment on the comments of my hon. Friend the Member for Derbyshire, South (Mrs. Currie) about Derbyshire. Local authorities whose first decision is to cut support for the voluntary sector are thoroughly misguided. The voluntary sector has an excellent tradition of providing care in the community. That is why, for example, we especially identified the voluntary sector to support drug and alcohol misusers in the new specific grant announced by my right hon. and learned Friend the Secretary of State in July.

§ Mr. Bowis
Is my hon. Friend now able to put at rest the genuine worries about funding of those running halfway houses for people coming out of alcohol and drug detoxification units? Without that service, it is difficult for such people to find their way back into a real life in the community.

§ Mrs. Bottomley
My hon. Friend rightly identifies that especially needy group, who are costly in terms of services and who most certainly need a development of provision. He will know that there has been careful discussion with those organisations, which resulted in the specific grant announced in July. We believe that it will be possible for their valuable services to grow and to develop.

§ Mr. Robin Cook
As these will be the last health questions before the uprating statement, can the Minister tell us what hope there is for all those residents on income support who now find that they cannot pay what their private home charges? What does she have to say to those elderly people who have had their personal allowances confiscated, who cannot buy toothpaste or newspapers and who cannot pay for stamps, and who still cannot pay the weekly cost of their home? How can she defend the double standard by which those on income support are put in the shared bedrooms with the poorer services? As it was the Government's decision to delay the community care programme for two years, what do Ministers intend to do for all those elderly and disabled residents who cannot wait until 1993 to pay this week's bill and are likely to be turned out if they try?

§ Mrs. Bottomley
The hon. Gentleman knows full well that matters of uprating are for my right hon. Friend the Secretary of State for Social Security. However, it remains the case that local authorities will continue to make plans for care in the community. We remain committed to a mixed economy of care. It is important that local authorities, voluntary organisations and the private sector provide for the frail and the vulnerable. The hon. Gentleman always speaks as though resources were no object. One has only to consider—I hope that the poor and the vulnerable will do this—the record of the Labour party when in government. There has been a substantial increase in resources. I can make no further announcements without anticipating the comments of my right hon. Friend the Secretary of State for Social Security.