HC Deb 08 December 1992 vol 215 cc676-8
2. Mr. David Nicholson

To ask the Secretary of State for Health if she will make a statement on the latest progress towards the implementation of the Government's proposals for community care.

The Parliamentary Under-Secretary of State for Health (Mr. Tim Yeo)

Good progress is being made by most local authorities in implementing the new arrangements. Where there are difficulties, we are offering help in a variety of ways, including our community care support force.

Mr. Nicholson

My hon. Friend will be aware that there is a general welcome from all parties for the ring fencing of the substantial grant given for the implementation of care in the community. He will also be aware that Somerset has been especially singled out by a recent Audit Commission report for making excellent progress, in collaboration with the health authority, in preparing to implement the proposals. However, is my hon. Friend also aware of a matter about which I am in correspondence with him and other right hon. and hon. Friends, which is that Somerset feels that it has lost about £1.3 million of grant for having followed Government guidelines in giving the private sector proper scope in the administration of care in the community? Do I have my hon. Friend's assurance that he and his colleagues will carefully examine that matter?

Mr. Yeo

I am grateful to my hon. Friend for his welcome for ring fencing, which ensures that the very generous resources that the Government have provided for local authorities to deliver community care will reach their targets. My hon. Friend is a most vigorous champion of the interests of Somerset in all respects. I am, therefore, aware of the particular difficulty to which he alludes. When Somerset county council entered into arrangements to ensure maximum participation by the independent sector in Somerset, it was aware of the likely arrangements for funding the new policy from next April. I shall continue to look into the matter most carefully.

Ms. Jowell

Will the Minister confirm the guidance given by civil servants last week to health service managers that trusts are to be regarded by local authorities as part of the independent sector in purchasing community care? Will he make it clear to the House that he agrees that care for many elderly people will not now be free at the point of use and that their health care has been privatised by stealth?

Mr. Yeo

There is absolutely no question of privatising the health care of any person, whether elderly or otherwise. As the hon. Lady really should know, a distinction has always been drawn between health care needs, which are met free of charge at the point of delivery to patients, and social care needs, for which we have never guaranteed that services would be delivered free. It is proper that all local authorities should make a charge for social services to those families who can afford to pay for them.

I gladly confirm that, as part of our general programme of maximising participation by the independent sector and of giving all local authorities the best opportunity to meet the requirement that 85 per cent. of the transfer funds must be spent in the independent sector, NHS trusts will qualify as being part of the independent sector because they are not controlled, managed or owned by local authorities.

Dame Jill Knight

Does my hon. Friend agree that the Children Act 1989 laid on social services departments the duty to take care of and to watch over children aged 16 who have left care? Is he aware that that is not being done and that children of 16 are not capable of managing by themselves? Will he look into that problem?

Mr. Yeo

I am aware that, in terms of implementing the provisions of the Children Act—which require local authorities to prepare all children, from the day they enter care, for the moment when they leave care, and to befriend children up to the age of 21 after they have left care—and in terms of the powers they have to help children where necessary not only with cash payments, but with advice and general counselling, there has been some variation in the performance of local authorities in the year since the Act came into force.

We are studying the matter and we have a research programme at Leeds university. We are also carrying out a careful survey of all local authorities to see exactly how they are implementing the Act. We shall study the information submitted to us and we shall include it in the report that we make to Parliament in the new year, as required by the Act.

Mr. Hinchliffe

Has the Minister fully considered the implications of requiring a set quota of next year's community care funding to be spent in the independent sector, bearing in mind that independent sector domiciliary care is non-existent in many areas and that local authority domiciliary care faces cuts in 87 per cent. of councils, according to the directors of social services? Are we not in danger of seeing more rather than fewer elderly and disabled people ending up in unnecessary private institutional care?

Mr. Yeo

Absolutely not. I very much regret the fact that the hon. Gentleman continues to adhere to his party's traditional hostility towards the private sector in any form. What the policy will deliver, by replacing the awful alternative of a local authority monopoly in the provision of all social services, is higher standards and better value for money. Local authorities will have to contract with private and voluntary organisations, not only for the provision of residential or nursing home care but for domiciliary and day care services. We have an initiative in hand that is designed to encourage local authorities to work with the independent sector to develop innovative methods of delivering domiciliary care.