§ 8. Mrs. FyfeTo ask the Secretary of State for Health when he last met representatives of local authorities to discuss the implementation of the National Health Service and Community Care Act 1990.
§ Mrs. Virginia BottomleyMinisters regularly meet representatives of local authority associations to discuss a range of matters, including community care implementation. They last met them on 16 April.
§ Mrs. FyfeDoes the Minister recall telling the Leonard Cheshire Foundation conference recently that caring and costing are related? If so, what has she told local authorities about community care? More than half the local authorities are having to make cuts in their community service provision and in their grants to voluntary bodies. Those cuts are necessary if authorities are to fulfil their statutory obligation to implement their part of the care in the community policy.
§ Mrs. BottomleyI was honoured to speak at the annual general meeting of the Leonard Cheshire Foundation, which provided an excellent example of care in the community. Perhaps those who were wasting money on the £1.5 million National and Local Government Officers Association's advertisement last week should have paid attention to it. In talking with local authority associations, we are discussing the 23.5 per cent. increase for social services this year, which is in part the result of phase 1 of the community care programme. We have taken the unprecedented step of providing specific grants for voluntary organisations which provide drug and alcohol support as well as introducing a specific grant for the mentally ill. In short, the meetings with local authority associations integrate caring and costing. We make it clear that the Government will support community care and we look to local authorities diligently to implement the policy.
§ Mr. Robin CookHas the Minister grasped the sharp increase in charges that social services authorities are having to make for disabled and elderly people? Is he aware that the average rise in charges for home helps is one third, which is four times the rate of inflation? How many elderly people does the Minister know whose benefit has increased by a third in the past year? Does it not make a mockery of care in the community if elderly and disabled people have to pay for the care that they need?
§ Mrs. BottomleyWhat is clear is that local authorities need to think through their charging policies. As hon. Members will know, Derbyshire, for instance, provides one in three of its elderly residents with a home help, and charges nothing. There has been a dramatic expansion in community services, with an increase of 30 per cent. in the number of day centres for the elderly, an increase of 25 per cent. in the meals on wheels service and a 27 per cent. increase in the number of home helps.
As local authorities implement the community care policies, it is essential that they manage their resources effectively and well. The spending of social services departments has risen by 52 per cent. in the past 11 years. We are already clearly identifying the cost of implementing community care and, in turning that policy into practice, local authorities must ensure that they achieve good value for money.
§ Mr. KennedyWhen the Minister comes out with statements like that about the reality of community care, she seems to pay no attention to the findings of the Radio 4 programme "You and Yours", on which she was interviewed last week. The programme carried out an in-depth analysis of the subject, across the whole country. Does the Minister accept that—according to the clear evidence that emerged from that process, and the direct feedback from those who were involved and consulted, community care is in a catastrophic state because of underfunding and because of the delays to which it has 145 been subjected? Anyone who has talked to those in the local social services departments will inform hon. Members on both sides of the House of that.
§ Mrs. BottomleyAs I hope that all hon. Members will agree, the key issue is that the challenge of caring in the community affects all our constituents as demographic factors change and expectations rise. We must harness the good will of the community to meet those care needs, to provide carers with practical support and to ensure that our provision is truly user-led rather than producer-driven.
Local authorities, health authorities, voluntary organisations and the private sector certainly need the two years that it will take them to phase in community care. We have already made a start with the mental illness and drug and alcohol treatment facilities, the training and the complaints procedure. We look to local authorities to work with us in a constructive partnership to implement what is a popular and very important policy.