§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Kirkhope.]12.28 am
§ Mr. Greville Janner (Leicester, West)
I am pleased to have the chance to ask the House to listen to the plea of the residents of Simon lodge, in my constituency, and to those of residents of other old people's homes in the city of Leicester—in areas represented so ably by my hon. Friends the Members for Leicester, South (Mr. Marshall) and for Leicester, East (Mr. Vaz). Those homes are threatened with closure; their residents are likely to be evicted, and it is a disgrace that they are to be forced out of their homes as they approach the autumn, and, indeed, the winter, of their days.
It was Charles de Gaulle who said that life was a great voyage whose end was shipwreck. The proposal to close down the homes means that the lives of elderly people will be wrecked, and the only reason is money. This is placing money—profit and cost—above all other considerations, and it is placing the quality of life at the bottom of the pile of care.
I appeal to the Minister to use his considerable influence to prevent this from happening. Leicestershire county council is one of those unhappy bodies that are hung: it has more Conservatives than members of any other party. Unless the Minister intervenes, they will vote in favour of throwing out the residents of Simon lodge; and giving them the choice not of staying where they are, but of going to whatever private homes—or, possibly, other public homes—they wish to go to. That is a choice that they do not want, because they are contented where they are.
The Social Democrats hold the balance on the council. I have privately appealed to them to join their Labour colleagues in saying, "No: we will not allow this to happen.- Whether they will do so, we shall see. The committee that will make the decision meets on Wednesday. I can tell its members that neither residents, nor their families, nor their supporters, nor their friends, nor the voters in the city of Leicester, will forgive them if they vote with the Tories to close Simon lodge.
Why is this happening? Some of us saw the Minister, who has been good enough to stay up so late to be with us, the other day. Producing the brief that he had received, he told us bluntly that there was concern about the provisions for health and hygiene in the homes. I contacted Brian Waller, who is director of social services and performs an excellent service for the public. I asked him whether there was any fear about the health and safety of my constituents in Simon lodge. He replied:On the question of health and hygiene and the kitchen improvements, while there are no urgent shortcomings which would cause the Environmental Health Officer to be seriously concerned, the survey work which was carried out showed that the kitchen and other facilities in this 21 year old home need to be siimilicantln, upgraded to modern standards.I have been to the home many times. I can testify that it is a place where people are happy and well cared for; moreover, it is a decent home on which a great deal of money has been spent. It is clean and well decorated; it is the sort of home where there is a perfectly adequate building, but where what really matters is that people are cared for: The staff have an affection for the residents and look after them, and the residents want to stay.
771 I put it to the director of social services that this was a home where people were well looked after, and where there was no risk to health. When I spoke to him, he told me frankly that there was no concern about any threat to the residents at present. I pointed out that there would be hazards to health if there were unhygienic circumstances. That must be attended to now: it was not a question of closing the home. He said that there was no such threat.
Of course there is not. It is an excuse. What the authority is really saying is that it wants to sell the place. But we know that a Conservative council wants to buy it. This is not what was described in this afternoon's debate as creeping privatisation: it is galloping privatisation at the expense of elderly people, and that is wrong. It is not what was described in the press as "back-door" privatisation. It is front-door privatisation through the main entrance of Simon lodge, and it is intended to drive out the people who want to stay in that home. They will have to be moved to private homes. Well, there are some very good private homes in Leicester, but there are also some that are not so good.
The Government say that those people should have a choice. If that is the case, they should be able to choose to stay where they are and not be driven out simply because the home will have to he upgraded some day. Many other places will need to be upgraded one day. Even places that are not residential homes will have to be upgraded some day. For example, the Palace of Westminster needs upgrading. I asked at Question Time today why the facilities for the staff of this place are so bad, and I was told that those facilities were to be upgraded. However, that does not mean that this place will be closed down and people will be driven out now.
Closing the home is wrong, and totally lacks compassion. It is unfair to push people out. We are not dealing with the privatisation of a utility such as gas, electricity or water. We are dealing with a home where people live, where they have a good quality of care and life and where they want to stay.
One old lady at the home, whom I will not name, is 92. She has been in the home for 22 years. The people at the home do not want to tell her what is happening, because they fear that to do so would be the end of her. We are dealing with human beings, not with pieces of furniture. No doubt the Minister will claim that it is a matter for the county council, not for him. I cannot advise the council to listen to the Minister. However, the Minister is a cunning, shrewd, intelligent operator, and he knows that Leicestershire will not forgive him if he allows the home to close.
The case is simple. Some money needs to be spent on Simon lodge, but it is a good home in which people want to stay. People live there in a happy, contented, comfy environment, and it should remain open. The care of the elderly means looking after them and keeping them in their own homes where possible. If places like Simon lodge become elderly people's homes, they should be kept open. I appeal to the Minister, and through him to the council, not to close that home but to allow the people living there to continue their good lives in that excellent and happy place.
§ Mr. Keith Vaz (Leicester, East)
I thank my hon. and learned Friend the Member for Leicester, West (Mr. Janner) for the privilege of addressing the House on this issue. As he said, we met the Minister last week. This is a unique occasion, as this is the first time that I have seen all the three Members who represent Leicester together on an issue to defend the elderly people of Leicester.
This is one of the saddest debates in which I have taken part—[Interruption.] I am sorry that the Minister is laughing, because this debate is serious. It is also sad because of the way in which elderly people in Dale house, Simon lodge and elsewhere are being treated by the county council as a result of the Government's policies.
I pay tribute to Ben Edmunds, the chairman of the campaign committee at Dale house and to his other supporters who came to London last Thursday and accompanied me to Downing street and to Buckingham palace, and who also joined my hon. and learned Friend the Member for Leicester, West and my hon. Friend the Member for Leicester, South (Mr. Marshall) at our meeting with the Minister.
We want to dedicate the campaign to the memory of Mike Preston, the local county councillor in Humberstone who died only a few hours after launching the campaign and petition to save Dale house. We had hoped that the memory of Mike Preston would live on in Dale house, and we hope, even at this late stage, that Dale house and the other homes will be saved.
If the Minister had cared to visit Dale house he would know that that home provides excellent care. It has excellent members of staff, and the residents want to stay there. At our meeting last week, the Minister said that he did not regard elderly services as a priority.
§ The Parliamentary Under-Secretary of State for Health (Mr. Stephen Dorrell)indicated dissent.
§ Mr. Vaz
The Minister said that, and we disagreed with him. We think that it is the most important priority. The elderly people of Leicester need homes such as Dale house, Curzon house and Simon lodge. They are their homes. For people such as Nellie and Tim, two residents who wish to live the rest of their lives in such homes, this matter has come as a traumatic shock. Two of the residents have died since the horrendous proposals were announced.
At the end of a previous debate, the Minister said that to govern was to choose. He provides no choice for the residents of Dale house. He gives them no opportunity. They must either go into a private home or move their home. The Prime Minister, at the end of his speech to the Conservative party conference, said that the theme for the 1990s was the power to choose and the right to own. Those citizens are too old to be able to own, but they should be given the right to choose to remain where they want to remain.
All we want is the money which Parliament should have given the local authority—the £8.7 million that is required as a result of the National Health Service and Community Care Act 1990. I was a member of the Standing Committee which considered that legislation—the Minister was not. By providing that money, even at this late stage, those three homes can be saved. I urge the Minister to place his county before his party and allow those people to remain there.
§ Mr. Jim Marshall (Leicester, South)
I apologise for the poor quality of my voice. It is caused by the bug that is going around. I am sure that it has not been generated by the Minister.
I also pay tribute to my hon. and learned Friend the Member for Leicester, West (Mr. Janner) for arranging this Adjournment debate. This is the first time in the four years of this Parliament that the three Leicester Members have been present as a group to urge a coherent policy on the Government. That shows what we and our constituents feel about the closure of the three elderly persons' homes in Leicester.
We must realise that this matter is about resources. Those three homes have been threatened with closure, because, unless they close, the other elderly persons' homes within the county of Leicester cannot be brought up to a standard which would satisfy Government regulations. Those three homes—Curzon home is in my constituency —are being sacrificed because the Government are failing to provide sufficient resources to enable them to remain open.
The Minister is a Leicestershire Member of Parliament. At a stroke, he can remove the threat to those three homes. He can remove the threat that the residents feel, of being dispersed to other public or private sector homes in the country. At a stroke he can allay the fears of residents and of their relatives, who are equally concerned about how their dependents will be cared for in future. I urge the Minister, as a compassionate person as well as a Minister of the Crown—there are occasions when those two roles are incompatible—to exercise discretion and ensure that Curzon home and the other two homes remain open.
§ The Parliamentary Under-Secretary of State for Health (Mr. Stephen Dorrell)
I should begin by apologising to the House that I have to weary it with my opinions for a second time in an evening.
I understand the natural concern that arises in any case where it is proposed that an elderly persons' home should be closed. I understand it particularly in this case because two of the three Leicester Members came to see me last week—the third sent his apologies; he was in Leicester at the time—to argue the case with me. I understand the problem also because I read the local newspapers in Leicester and I am well aware of the background to the case and the concern that has been aroused locally as a result of the proposals which the county council is due to consider on Wednesday.
However, quite apart from the fact that I have read the newspapers and that the hon. and learned Gentleman has come to see me, it is obvious that any closure involves the disruption of elderly people's lives, which is something that we should all like to avoid. There is no argument between us on that, and I understand the concern that the case has aroused.
It is also important that I should make my status clear in this matter. This issue has to be decided by Leicestershire county council, not by the House or Ministers in the Department of Health or in any other Department in Whitehall. There is an important distinction between the social services world and the national health service world. If we were talking about an NHS hospital and a contested proposal to close it, the 774 matter would ultimately be decided by my right hon. Friend the Secretary of State for Health. It is the tradition in the Department of Health that in such circumstances the Under-Secretary has quite a large input into the decision that is ultimately to be made by the Secretary of State. There would be an appeals system against a proposal to close the homes in question if they were part of the NHS, but they are not—they are the property of the Leicestershire county council.
It is absurd to suggest that every decision that falls to be made by a local authority should in some sense be held, either directly or indirectly, to be the responsibility of a Minister of the Crown. The purpose of local government is to ensure that not every decision in our society is taken by one of the 85 Members of Parliament who are Ministers of the Crown. We have local government to spread decision-making through the community and to have a more plural system of decision-making. One cannot accept the logic of that system if every difficult decision is then appealed to Ministers.
I repeat that this is a decision for Leicestershire county council, not the Government.
§ Mr. Vaz
The Minister will recall that, during the passage of the Children Act 1989, the Government provided extra resources for its implementation. Why will he not provide Leicestershire with the extra resources necessary for the implementation of the National Health Service and Community Care Act 1990?
§ Mr. Dorrell
I was coming to resources later, but I will deal with them now. The Government have seen a substantial increase in the expenditure incurred by personal social service departments. In fact, since 1979, such spending has risen by 51 per cent. in real terms. It is absurd to say that no extra resources have gone into social services care—
§ Mr. Dorrell
Leicestershire county council is responsible for the allocation of its social services budget. It is within the discretion of the county council whether it uses the social services budget for this purpose or for some other social services purpose.
The speech of the hon. Member for Leicester, East (Mr. Vaz) also showed at the very least a misremembering of what I said when he came to see me last week. He suggested that it was my view that care of the elderly was not a priority. That is not my view. My view is that the Government are quite right in the world of social care to pursue the policy that we have described as a "mixed economy of care". We made it clear repeatedly in the "Caring for People" White Paper, if nowhere else— incidentally, at least until today, I thought that that White Paper represented a bipartisan policy—that, in the world of social care, we do not believe that it is necessarily right for the public sector to take upon itself the exclusive obligation to provide social care.
There is an important distinction between our approach to health care, where we have repeatedly made it clear that we have no intention of privatising or of seeing an existing public health institution moved into the private sector, and our approach to social care, where we have said exactly the opposite and where we have repeatedly made it clear that we think that the private sector has an important 775 role to play. Indeed, we have welcomed the role that it has played in the growth of residential places for the elderly over the past 12 years.
The first point about government policy, as carried out by local authorities, is that we are in favour of a mixed economy of care of private and public sector provision side by side. The second point is the most salient in the current dispute in Leicestershire. We do not think that it is any longer defensible for the public sector to provide residential places for the elderly against different quality standards from those which the public sector insists that the private sector observes. I should have hoped that all three hon. Gentlemen would welcome the fact that the public sector is committed to ensuring that all public sector residential care homes for the elderly meet the same standards as we have required for some time from private sector provision.
§ Mr. Janner
Recognising that the public sector homes need upgrading, why will the Minister not make available the resources which the county council needs to do so? Is it not inevitable that, as a result of resources being taken away from it, the county council is forced to run down the public sector so as to drive people into the private sector?
§ Mr. Dorrell
That is precisely the same point as the hon. Member for Leicester, East made. In response to him, I pointed out, as I do in response to the hon. and learned Gentleman, that expenditure on personal social services over the past 12 years has risen by 51 per cent. in real terms.
§ Mr. Dorrell
I do not know the figure for Leicestershire offhand. Leicestershire is not out of line with the national picture. There has been a substantial increase in the resources available for social services provision. I was going through the key points of the Government's policy as discharged by local authorities. A third point is relevant in this case. We have repeatedly said that, where a change in the provision by a local authority is planned, the management of that change must take account of the welfare of the residents of the homes in question. In this case, it clearly means that, if there is a policy to close a proportion of county council homes, there must be a transitional plan which respects the legitimate interests and wishes of those who live in those homes today.
The Government's policy has been carried through successfully since 1979 and has resulted in a dramatic increase in the number of residential care places available for care for the elderly. The hon. Member for Leicester, East alleged that care for the elderly was not a priority. Far from it. The policy has resulted in a dramatic increase in provision over 12 years. The combination of our change in the rules on entitlement to DSS benefit and our encouragement of private provision has seen the number of residential care places in Leicestershire available for use by the elderly rise by 49 per cent. since 1979. Public and private sector provision have existed alongside each other, with the growth principally in the private sector. That was deliberately because of the policy of a mixed economy of provision for social care that I described.
We recognise that the delivery of that policy had one significant defect—that it provides too great an emphasis on residential care and inadequate provision for 776 domiciliary and other support services to reduce the demand for residential care. That is one of the major factors that has led us to propose the changes in community care provision which will come into force in April 1993. Until tonight, that was a bipartisan policy supported by both sides of the House. However, it seems that there is a weakening of support on the Labour Back and Front Benches for the principles of community care.
Clearly, if and when the community care policy is carried out—the social services have a clear responsibility under those provisions to manage the demand for residential care within their budgets against the identified needs of elderly people—it will tend to ensure that a larger share of that resource is used for domiciliary and residential support, daycare facilities, respite care and a full range of proper care for the elderly. Other things being equal, it will also tend to depress demand for residential places.
Against that background, Leicestershire county council has homes below the standards that for some years it has been demanding of private sector providers as well as vacancies in its homes.
§ Mr. Dorrell
I am advised that there are about 200 vacancies in the public sector in Leicestershire. There is a total provision in the county of just over 1,800 places, of which 200 are vacant.
Thirdly, against the background of community care, the prospect is that demand for places in residential care will not grow as fast in the years ahead as in the past.
Against the background of those three salient facts— homes below standard, existing vacancies and the fact that future demand is unlikely to be buoyant—it does not seem unreasonable for the council to plan to improve the stock of its homes, financing that improvement by a reduction in the total number of places provided. The National Health Service and Community Care Act was passed only two years ago and it has been explicitly the responsibility of local authorities to manage this provision, so it would be absurd of the Government now to seek to second-guess the details, home by home, of carrying out that policy.
The cost of bringing the three homes mentioned in this debate up to the standards required in the private sector is £255,000 for Dale house, £235,000 for Curzon house and £236,000 for Simon lodge. To bring all three homes up to the standards required in the private sector requires costs sigificantly above the average of homes in Leicestershire, which stands at £198,000.
If the county council plans to reduce its provision to bring supply into balance with demand, it is not unreasonable for it to concentrate its reductions on the provision in the city of Leicester, which is where the alternatives are in most plentiful supply.
I simply do not accept that this is the result of Government policy. Expenditure on social services has risen by 51 per cent. since 1979. The management of those resources is in the hands of the county council, and it is to the council before Wednesday night that the hon. Gentlemen's representations are properly addressed.
§ Question put and agreed to.
§ Adjourned accordingly at two minutes to One o'clock.