Private Nursing Homes (Hansard, 18 April 1995)

§ 4. Mr. Orme
To ask the Secretary of State for Health what was the total number of residents in private nursing homes in (a) 1979 and (b) 1994. [17574]

§ 5. Ms Janet Anderson
To ask the Secretary of State for Health what was the total number of residents in private nursing homes in 1979 and 1994. [17575]

§ The Parliamentary Under-Secretary of State for Health (Mr. John Bowis)
In 1993–94, the total number of occupied beds in private nursing homes was 143,748. It was the first year for which this particular statistic was collected.

§ Mr. Orme
Is the Minister aware that there is a great deal of anxiety and fear among elderly people because of the closure of local authority premises and the extension of the private sector where proper safeguards have not been developed by the Government? Will he bear in mind the fact that it is his responsibility to stop such closures and to ensure that local authority provision is properly funded?

§ Mr. Bowis
It would be difficult for local authorities to close the nursing homes to which the question refers as there are none. The question is about private nursing homes, which provide good quality nursing care for those who need it. I should have thought that the right hon. Gentleman would welcome the fact that increasingly people are able to find comfort and privacy and somewhere where they can take their own belongings and receive the care that they need. The increase in the number of nursing homes around the country shows that a great many people have been choosing this form of residential care provision in addition to those who have been placed there by the health service.

§ Ms Anderson
Is the Minister aware of the deep public concern about the growing number of elderly people who are being forced to sell their homes and use their life savings to pay for residential and nursing care, often of a dubious quality? Does he agree with the Sunday Express that this can be described only as a tax on care? Will he tell us where in the Conservative manifesto at the last election this new tax on the elderly was mentioned?

§ Mr. Bowis
Perhaps I might remind the hon. Lady that there has been no change in charging policies for people going into residential care. Since 1948, when Aneurin Bevan and Beveridge started the welfare state and the national health service, there has been a division between NHS care, which is free at the point of delivery and paid for by the taxpayer, and the social care that is provided for individuals. Where appropriate, that is topped up, formerly by the income support system and now by community care.
If the hon. Lady does not think that that is the right policy, I suggest that she has a word with Sir Gordon Borrie, who chaired the Labour party's Social Justice Commission and who reminded the country that the 6 Labour party could not afford to ask the taxpayer to pick up the bill. Does she, and do members of Labour's Front Bench, support Sir Gordon Borne or not? The electorate would like to know.

§ Dame Jill Knight
Is it not the case that any old person who needs care and who does do not have any money will get that care absolutely free? Many of us believe that it is not outrageous to expect an elderly person who has money—often quite a considerable sum—to make some contribution to the cost of their care.

§ Mr. Bowis
My hon. Friend is right. Nobody who has a low income or is on income support will have to pay towards the cost of care. Those who can afford it are invited to make a contribution to the care. My hon. Friend will recall the continuing care guidance that we issued recently, reminding the NHS that it continues to have responsibility for continuing health care, whether it is provided at a person's home, in a nursing home or in a hospital and that, wherever it is, it will be free.

§ Dr. Spink
Can my hon. Friend confirm that a very vibrant independent nursing home sector has led to an overall increase in places available to people who need long-term nursing care? Does he deplore the actions of county councils such as Essex, which is not placing people in the independent sector?

§ Mr. Bowis
My hon. Friend is right. He need look no further than the independent Audit Commission, which made it very clear that although community care as a whole has got off to a very good start around the country, better use could be made of resources if there were better financial controls in social services departments and if, as my hon. Friend says, better use were made of provision in the independent sector of residential and domiciliary care services.

§ Mr. Hinchliffe
Has not the most obvious consequence of the privatisation of care been the result—I shall start again, Madam Speaker, I am sorry. I am not feeling very well today. Has not the most obvious consequence of the privatisation of care been the wholesale revival of the out-moded institutional model, simply because it is the most lucrative form of care from a business point of view? Once again, by putting ideology before common sense, are not the Government now considering privatising even the inspection of care?

§ Mr. Bowis
I am sorry to hear that the hon. Gentleman is not feeling well. I hope that he feels better soon.
He is not correct and I am sure that, on reflection, he will consider himself to be incorrect in referring to the privatisation of care. When the national health service contracts with nursing homes for the provision of residential care, it is doing no more than what it does when it contracts with general practitioners. Both are in the private sector. Both are providing services to the NHS which are free to the patient at the point of delivery.
If the hon. Gentleman is really concerned about the care of individuals, I suggest that he looks at this week's Laing and Buisson survey, which reminded the House that the Labour party's policy of a national minimum wage would put up the price of care—

§ Madam Speaker
Order. I must ask for brisk answers from Ministers. We are making no progress whatever today, our first day back.

§ Mr. Harry Greenway
Does my hon. Friend agree that care in the community ensures that people stay in the community and out of nursing homes as long as they are fit to do so? Is that not the right policy and does it not help people?

§ Mr. Bowis
Yes. One of the purposes and aims of community care is to enable people who wish to do so and are able to do so to remain in their homes, supported by a package of care. All the independent surveys of community care conducted in its early months show that that is precisely what is happening. Innovative packages of care are being provided. Of course, we also need a range of provision in residential care, to which the independent sector can contribute so much.