HC Deb 22 March 1994 vol 240 cc122-3
5. Mr. Robert Ainsworth

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.

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 six representations have been received.

Mr. Ainsworth

Will the Minister confirm or deny that his Department is operating unofficial guidance whereby it is expecting local authorities to make at least 7 per cent. of their standard spending assessment in charges for non-residential care? Does he agree that that is utterly unfair on local authorities in poorer areas and a tax on the elderly and infirm?

Mr. Bowis

The answer is no. I do not know where the hon. Gentleman gets the 7 per cent. figure from. The charges are long-standing and discretionary and it is entirely up to local authorities whether and to what extent charges are made. The guidelines to which he referred state that charges should be reasonable and should take account of the ability to pay. If he is concerned about the way in which the system is operating in Coventry, I am sure that, as he is a former chairman of finance, he can have a quiet word with his friends who are running the council to ensure that they play the game fairly.

Dame Jill Knight

May I encourage my hon. Friend not to be nervous about making a small charge for these extremely valuable services provided that people can afford to pay? Is not it the case that at present only £1 in £10 spent on the services is recovered? Bearing in mind the fact that every penny of the recoverable sum will be spent on patients elsewhere, is not such a charge a good idea?

Mr. Bowis

My hon. Friend is entirely right. As I said, the charge is discretionary and each council must decide the sort of scheme that it introduces—whether there are flat charges or a scale of charges and whether there are exemptions or discounts. My hon. Friend makes a valid point, however; in fact, 9 per cent. of costs—less than £1 in £10—are recovered through charges, which means that about £69 million is recovered out of a total spend of £815 million. It is perfectly reasonable to expect that modest charges, tailored to the ability to pay, should be made. My hon. Friend is not making me nervous; she encourages me to encourage local authorities to do just that.

Mr. Blunkett

But where does the discretion lie when the Government control the council tax, the distribution of grant and the standard spending assessment and therefore make an assumption of a 7 per cent. charge which, if not levied, would mean that local authorities would have to cut services instead? Is not this very much like the proposed 25 per cent. increase in dental charges—having stung the nation for tax, the Government are now also stinging the nation in charges?

Mr. Bowis

The hon. Gentleman might just look at the figures. He might just remember that, in the current year, the Government are spending £6.4 billion on personal social services. That is a measure of support through the social services to the people of the country. It is entirely at the discretion of local authorities whether and how they introduce charges. If the hon. Gentleman is looking for real discretion that his party could use in local government, may I suggest that he considers the cost of services? Clearly, charges must be related to cost. If efficiency savings are made in the provision of services, the costs are lower. That is why in Conservative-controlled authorities there are lower costs through efficiency savings and why there will probably be lower charges, too.

Mr. Garnier

Will my hon. Friend assure me that those patients who are currently in the Carlton Hayes and the Towers hospitals in Leicestershire, which serve my constituency, will not be moved into the care of the social services department of the county without a proper clinical appraisal of the need for their care?

Mr. Bowis

I can certainly give my hon. Friend that assurance. It is the task of our mental health task force to ensure that such moves are made into adequate residential accommodation, if that is what is needed. I am assured by Leicestershire health authority that the hospitals concerned will not close unless and until that provision is available.