HC Deb 23 March 1993 vol 221 cc747-8
1. Mr. Matthew Banks

To ask the Secretary of State for Health how she intends to promote the interests of the users of community care services.

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

At the very heart of our community care reforms lies the principle that all decisions about services must reflect the individual needs and wishes of users of the services and of anyone who helps to care for them.

Mr. Banks

Does my hon. Friend agree that one of the most important aspects of the community care reforms is that they put the user and carer at the centre of services rather than the periphery? Under the old system, far too often needs were dictated by the local authority and trade unions. Will my hon. Friend give an assurance that he will take steps to ensure that Labour-run local authorities that have the task of making decisions do so in the interests of users and not in the interests of the local authorities themselves and trade unions?

Mr. Yeo

Extensive precautions have been taken to minimise the risk that any local authority, however doctrinaire or incompetent, can undermine the reforms. We are requiring 85 per cent. of the money being transferred from the Department of Social Security to be spent in the independent sector—on buying from voluntary and private organisations—to ensure that the local authority does not spend it on empire building. We will monitor changes as they take place and we are determined that the best safeguard that anyone can have against users' wishes being ignored is for more Conservative-controlled councils to be elected on 6 May.

Mr. Hinchliffe

What action will the Minister take to promote the interests of those users of residential care who are to lose their £45 per week residential allowance as a direct result of Government policy? If such people go into hospital or go on holiday and are away from their home for more than six days they may lose their place in the home. Will the Minister act to convince users and carers that 1 April is more than just an attempt to reduce the Government's income support expenditure? He can do so by listening to demands for advocacy arrangements, assessment appeals, reassessments and reviews. Is not the Government's total lack of real commitment to change quite obvious from the fact that they discourage the recording of unmet need, which is surely the first port of call for improving community care and genuine reforms?

Mr. Yeo

I am not sure which of the hon. Gentleman's five questions displays the greatest ignorance of the changes that we are about to make. There is no question of any financial saving being achieved in the short term by the policies, as all the money that would have been spent by the Department of Social Security on the higher rates of income support has been transferred to local authorities. In addition, we have added a further £140 million to ensure that they can carry out the assessments. It will be for the local authorities to make the necessary contractual arrangements with residential homes to ensure that the position of people who enter hospital for short periods is protected. We have resourced the authorities to do the job and I have every confidence that the vast majority of Conservative councils will grasp their responsibilities enthusiastically and deliver a high standard of care which meets individual needs.

There is no confusion about unmet need. Decisions are based on an objective assessment of an individual's need. It is a matter for the authority if, for the purposes of planning its services in the longer term, it wishes to keep some record of needs which it would be desirable to meet but which it is not necessary to meet immediately.

Mr. Butterfill

Will my hon. Friend advise Opposition Members to visit Dorset, and Bournemouth in particular, where they can see in action an outstanding example of community care—an example that can serve for the whole of the rest of the nation? That has been achieved by a Conservative-controlled county council which is wholly free of debt, unlike councils controlled by the Labour party.

Mr. Yeo

My hon. Friend is so persuasive that I have had a word with the Secretary of State and she has agreed to pay a visit to Bournemouth on Friday. I am grateful to him for drawing attention to the financial position of Dorset county council. Across the country, expenditure on social services has risen by two thirds in real terms since 1979. In the past three years the standard spending assessment for personal social services has risen by one fifth in real terms. On top of all that, we are transferring a further £565 million to local authorities in England to deliver this new reform.

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