§ 1. Ms. QuinTo ask the Secretary of State for Health if he will make a statement on the provision of training for local authority staff in preparation for their responsibilities under the National Health Service and Community Care Act 1990.
§ The Minister for Health (Mrs. Virginia Bottomley)Training for local authority staff is the responsibility of the employing authority. Our specific grant provision to local authorities for the training support programme this year was increased by 25 per cent. to £25 million. In addition, local authorities should be spending at least £10 million of their own resources on training.
§ Ms. QuinIs the Minister aware that many local authorities, including my own in Gateshead, are expressing considerable concern that not nearly enough funds will be available to provide the training that will have to be introduced if community care is to be implemented properly? Will she have urgent discussions with the local authorities on this matter and assure us that the necessary steps will be taken to ensure that recruitment is at its proper level so that community care can become a reality instead of the pretence that it seems to be at the moment?
§ Mrs. BottomleyI assure the hon. Lady that we have had close discussions on the implementation of community care. Only last week my right hon. Friend the Secretary of State introduced a check list to ensure that all local authorities and health authorities are properly prepared for full implementation. Central Government have been playing their part. In the hon. Lady's constituency, there has been a 50 per cent. increase in the amount of money that is available for training social workers and I am pleased that that is being used to train three times as many social and other community care workers this year.
§ Mr. ThurnhamWill my hon. Friend make sure that local authority workers are trained to make the best use of voluntary and independent groups? Local authorities should not have a monopoly on community care.
§ Mrs. BottomleyThis is always a difficult issue for the Labour party, given that one third of its Members are sponsored by the health unions. The Conservative party has traditionally had a high regard for the role of the voluntary sector. We envisage the local authorities being enablers and facilitators in a close partnership with the voluntary sector. That is often an extremely productive way of providing high-quality services.
§ Mr. RookerLeaving the party politics to one side for a moment, may I ask whether the Minister agrees that local authorities welcome the addition to the training programme? There is no question about that. However, exactly when did the hon. Lady warn the local authorities about the full consequences of the reforms for elderly and disabled people? Does she now appreciate that duties that were once the sole province of the district nurse are now being carried out by home carers? I refer to bathing, caring for the terminally ill at home and the application of medication. That work is now being placed on local authority social service departments and on the home care service. Will the Minister explain why those tasks have been transferred from the district health authorities to the social services departments, if not for budgetary reasons?
What will be the full consequences—[HoN. MEMBERS: "Come on!"] Oh yes. These are not party political points; I apologise for that. Where was it was ever specified in guidance from the Department or in regulations that the local authorities had been warned about all the consequences of national health service reforms?
§ Mrs. BottomleyThe hon. Gentleman should address the content of the original Griffiths report on community care. The distinction between health care and social care is one of long standing in the provision of services. To undertake the tasks for which they are responsible, local authorities have this year been given the largest increase for 15 years in the amount that we think that they should spend. They have been given a 23.5 per cent. increase in the amount available for spending. Certainly, the implementation of community care depends on close, effective working relationships between family health service authorities, district health authorities and local authority social services departments. I urge the hon. Gentleman to look at the important check list launched by my right hon. Friend the Secretary of State last week. It addresses precisely the need to ensure that the frail and vulnerable receive a seamless service and do not fall down the gaps between different types of provision.
§ Mr. RoweMy hon. Friend will be aware of how welcome the extra money has been. Can she give us an assurance that the training that is provided is consistent with national vocational qualifications? Can she also confirm that her Department is looking forward to the time when it will be easy to interchange social workers between Britain and other European Community countries?
§ Mrs. BottomleyOnce again, my hon. Friend identifies a matter of great importance. The establishment of national vocational qualifications within social services and health services offers additional flexibility in the 131 provision of care. There has been a substantial—25 per cent.—increase in the amount of money available to the training support programme. Certainly, some of that is being used to resolve the question of vocational qualifications. The subject of interchangeability of qualifications with others in the European Community is one on which I have frequent discussions with members of the British Association of Social Workers and others who represent social workers' interests.