Domiciliary Care (Hansard, 26 April 1994)

§ 3. Lady Olga Maitland
To ask the Secretary of State for Health what is her estimate of current total expenditure by local authorities on domiciliary care; what was the figure in 1979; and if she will make a statement.

§ The Parliamentary Under-Secretary of State for Health (Mr. John Bowis)
Gross expenditure by local authorities on domiciliary care in 1991–92 was £3,111 million. This is the latest figure available. In 1978–79, the figure was £611 million.

§ Lady Olga Maitland
I warmly congratulate my hon. Friend on those excellent figures. Does he agree that the elderly deserve the highest standards of care in their homes, and that they deserve flexibility, choice and respect for their dignity? Will he confirm that he will continue his drive to develop the community care policy programme, also paying attention to the residential care afforded by local authorities? In particular, will he condemn Labour-controlled Lambeth and Islington councils, which have an appalling record of abuse of the elderly and vulnerable in their care?

§ Mr. Bowis
My hon. Friend is quite right. The fact that we are spending 38 per cent. more in real terms on services for the elderly this year than we were four years ago shows that we are putting into practice our commitment to looking after the elderly in the community. My hon. Friend is also right to criticise some of those Labour London boroughs which seem incapable of doing the same. If Charles Dickens were around today, he would recognise the conditions in some parts of Labour London. He would not understand the nuclear-free zones, but he would understand the neglect, incompetence and misery that sum up Labour London.

§ Mr. Hinchliffe
But has not any expansion of domiciliary care been achieved largely thanks to the efforts of Labour-controlled councils which, unlike the Government, have a clear political commitment to developing alternatives to institutional care? If the Government believe in domiciliary care, why do not they drop the dogmatic requirement that councils spend the bulk of the care grant in the so-called independent sector? Directors. of social services are telling me that that requirement is forcing people unnecessarily into expensive residential care placements. Why do not the Government put the needs of users and carers before Tory party dogma?

§ Mr. Bowis
I should have thought, after all this time, that the hon. Gentleman would at least understand that the transfer element in the special transitional grant relates to residential care which, before, was all spent in the independent sector. He should also recognise the considerable growth, shown by the figures that I gave my hon. Friend the Member for Sutton and Cheam (Lady Olga Maitland), in the domiciliary care provided by local authorities around the country. He should stand up and pay tribute to the councils and directors of social services who have made that possible—thanks to the resources given by this Government. Resourcing for social services, including community care, has increased from £3.6 billion to £6.4 billion in four years. That is what has made the growth possible, and the trend will continue under this Government.

§ Mr. Sims
But does not what my hon. Friend has just said completely contradict the Opposition's forecast that community care would not work because the resources would not be made available? Does my hon. Friend know of any local authority that has been unable to carry out the community care policy because of insufficient funds? Is not the truth of the matter that the policy is successful?

§ Mr. Bowis
All the surveys of community care undertaken since it came into being one year ago this month show that there has been steady progress throughout the country. None of the surveys has shown any problem over resourcing. The problems that have arisen have been due to dogma on the left of the political spectrum, which has stopped local authorities benefiting from the input of the independent sector into the care of people in need.