Community Care (Hansard, 4 May 1993)

§ 1. Mr. Mark Robinson
To ask the Secretary of State for Health what assessment she has made of the progress of the community care reforms in Somerset; and if she will make a statement.

§ The Parliamentary Under-Secretary of State for Health (Mr. Tim Yeo)
Our new community care arrangements came into operation in all parts of the country on 1 April. It is now for local health and social services authorities to make full use of the enormous opportunities that those arrangements present. Our monitoring showed that authorities in Somerset were well prepared to take advantage of those opportunities for the benefit of both users and carers.

§ Mr. Robinson
Does my hon. Friend agree that Somerset was one of the best prepared counties in its plans for implementation of the community care programme? Would he also agree that that is a good reason to re-elect the Conservative-controlled authority on Thursday?

§ Mr. Yeo
My hon. Friend has put his finger right on the point. As we would expect, the excellent Conservative-controlled Somerset county council is taking its new and substantial responsibilities extremely seriously. Only by re-electing that Conservative council can we hope to preserve user choice, continue to raise standards and, above all, get the best value for money out of the enormous increase in resources that the Government have given Somerset—a 22 per cent. real increase over the past three years in the personal social services standard spending assessment and, on top of that, a special grant of £5.8 million for comunity care.

§ Mrs. Dunwoody
Is the Minister aware that, far from benefiting from care in the community, the shire counties are already discovering very directly that there are real problems? Is he also aware that some private firms are charging £25 a head for information about private homes? Is that what he means when he speaks about endeavouring to improve patient care?

§ Mr. Yeo
I am certainly aware that some councils, such as the Labour-controlled Derbyshire county council, are failing to co-operate with the independent sector, refusing to consult with independent providers of community care because of their dogmatic insistence that these services can be delivered only by a public sector monopoly. The Government will not tolerate that from shire counties or anywhere else, and Labour-controlled councils that are continuing to cling to out-of date dogma must heed this warning now.

§ 2. Mr. Jacques Arnold
To ask the Secretary of State for Health what assessment she has made of the progress of the community care reforms in Kent; and if she will make a statement.

§ Mr. Yeo
As I said earlier, our new community care arrangements came into force on 1 April in all parts of the country. They present substantial new opportunities for local health and social services authorities. Our monitoring of preparations in Kent showed that Kent 3 county council was one of the best prepared of all authorities to take full advantage of those opportunities for the benefit of users and carers.

§ Mr. Arnold
Is my hon. Friend aware that in Kent care managers have been in place for three years and that Conservative-controlled Kent county council has developed an excellent database in co-ordination with the general practitioners to ensure that individual packages for the people who need care are properly in place? Is this not an example of what Conservative-controlled Kent county council has done, and should not that example be followed throughout the country?

§ Mr. Yeo
I am glad to say that my hon. Friend has also put his finger right on the point. I gladly join him in paying tribute to the superb policies of Conservative-controlled Kent county council under its excellent chairman of social services and her fine team of supporting officers.
My hon. Friend mentions one of the many fields in which Kent county council is leading the way. There is one more—that council's co-operation with the independent sector. Kent county council is funding Age Concern to take over the running of many of its elderly persons' day centres. Such co-operation between Kent county council and the voluntary sector clearly gives the lie to Opposition assertions that the Government's insistence that the bulk of the special transitional grant must be spent buying services from the independent sector—[interruption.]

§ Madam Speaker
Order. I would be obliged if the Minister would address the Chair. Not only can I not hear him but his remarks cannot be heard publicly when he turns in that way.

§ Mr. Yeo
I apologise, Madam Speaker.
Let me conclude by saying that that co-operation between the voluntary sector in Kent and the county council gives the lie to Opposition claims that the Government's insistence that the bulk of the special grant must be spent purchasing services from the independent sector perpetuates the residential model. It clearly does not.

§ Mr. Hinchliffe
Bearing in mind the fact that, under the Government's bizarre system for distributing community care funding, Kent receives money that should have gone to other areas, notably the London area, because the funding is sent where people have gone to in the past rather than where they come from, does the Minister feel that Kent will be in a position to improve its performance in providing home care, given that, according to the Chartered Institute of Public Finance and Accountancy league table, it is 28 out of 32 in terms of county councils, with Labour Derbyshire county council coming top?.
Does it not say something about the financial crisis facing local authorities in the implementation of the community care changes that Kent, with all its financial advantages, has to make savings of around £2 million in the current financial year?

§ Mr. Yeo
So far from making savings in the current financial year, apart from a proper insistence on efficiency, Kent was recognised, even by The Guardian on 30 March, as one of the councils that were substantially increasing expenditure on personal social services—as one would 4 expect, because Kent received an increase of 7 per cent. this year in its personal social services standard spending assessment.
The hon. Gentleman speaks of a bizarre distribution method. We are recognising need by our distribution formula. That is the purpose of the policy—to allow authorities to respond to needs. That is why the inner-London boroughs receive almost three times the money per head of population that the shire counties receive.

§ Mr. Wolfson
While I welcome my hon. Friend's positive comments about Kent, may I ask him to keep a particularly close eye, as the policy develops, on two sectors? The first is the development of care for the mentally ill, and the second is the services being offered by rehabilitation centres for alcoholics and drug offenders, which have been used to drawing clients from all over the country but which, under the new system, may find that more difficult?

§ Mr. Yeo
My hon. Friend has already mentioned to me privately his concern with facilities for the mentally ill. I look forward to visiting his constituency soon to open a new resource provided by the independent sector in the shape of MIND. As to the provision of services for drug and alcohol abusers, my hon. Friend will be aware that we have set up special monitoring arrangements to examine closely the effects of our new policies during the first three months on the providers of those services and the access that those who need them should continue to have.
A number of county councils, including Conservative-controlled Hampshire and Surrey, have set up ring-fenced allocations from within their special transitional grant to ensure that specialist services for alcoholics and drug abusers continue to be fully utilised. In the case of Hampshire, I know that the sum that has been allocated is greater than the sum that would have been available had we gone ahead with the original intention to ring-fence money at the national level.