Personal Social Services

HC Deb 26 April 1994 vol 242 cc94-6

9. Mr. Mandelson

To ask the Secretary of State for Health what representations she has received regarding the introduction of charges for personal social services other than residential care; and if she will make a statement.

Mr. Bowis

Local authorities have had a discretionary power to charge since January 1984. In January this year, the Department issued new guidance about the use of these powers and since then seven representations have been received.

Mr. Mandelson

Is the Minister aware that, as a result of the Government's insistence on users paying for services such as home care, day centres and meals on wheels, some of the most frail and vulnerable members of the community must either do without those services or make invidious spending choices between heating or eating and cleaning or laundry? Does he accept that that undermines any true concept of care in the community? Does he further accept that the Government have a responsibility at least to monitor and to assess the impact of those charges in every part of the country?

Mr. Bowis

The answer is no. I do not accept the premise on which the hon. Gentleman makes his assertion. The average charge in Cleveland, the hon. Gentleman's own authority, is 4 per cent. I do not believe that that will cause hardship to anyone who can afford it. I remind the hon. Gentleman that it is entirely up to his authority, which has discretion in the matter, whether to set charges and the level at which to set them. All that we require is that charges are reasonable and reflect the individual's ability to pay. There is no reason on earth why Cleveland council should not exempt people in need or give discounts to those on lower incomes.

Mr. Ian Bruce

Is not the truth that people who might otherwise be forced to enter a residential home and perhaps pay £1,000 a month would like to contribute to the cost of local authority services that enable them to remain in their own homes? That is good value for money and councils should be encouraged to charge where that is sensible and people can afford to pay.

Mr. Bowis

I entirely agree. My hon. Friend is right to say that people who can afford to pay would think it entirely reasonable to be asked to make a contribution to the cost of the services provided to them. If a reasonable charge taking into account ability to pay is levied, that income can bring more benefits to more people in need and raise the quality of the care provided. That must be in everyone's interests.

Ms Lynne

Is not it a fact that a number of authorities throughout the country are introducing charges for community care and that that is the ultimate responsibility of this Government, because of the underfunding of community care? Instead of blaming the local authorities, the Minister himself should take responsibility.

Mr. Bowis

That is quite absurd. The average across the country is under 9 per cent. I remind the hon. Lady about the amount that the Government are putting into community care: in the first year, it was £565 million; this year, it is up to £1.2 billion; next year, it will be £1.8 billion; and the year after, it will be £2.2 billion. If she looks at the top-up that we have been able to incorporate in that for respite and day care, she will see that the Government are backing councils around the country in enabling them to look after people in their own homes, when that is appropriate and when that is what they want.

Mr. John Marshall

Does my hon. Friend agree that the revenue from the charges allows local authorities to expand the services on offer? Those who oppose the charges should tell us which services they would cut or which taxes they would increase.

Mr. Bowis

My hon. Friend is exactly right. It does indeed give councils that possibility. The level of charge depends on the level of cost. Cost depends on efficient delivery of service, and in the partnership between the usually good Conservative councils and the independent sector, which provides better services at lower costs, charges will be lower than those in the high-spending, high-cost Labour authorities.