§ 11. Mr. Clapham
To ask the Secretary of State for Health what assessment she has made of the implications of removing from local authorities the duty to provide residential accommodation for the elderly; and if she will make a statement. 
There is no such duty. Under the National Assistance Act 1948 the duty is to arrange to provide. Our purpose is to clarify that local authorities may arrange to provide residential care either directly or through contracts with other providers. This matches current practice.
§ Mr. Clapham
I hear what the Minister says, but is that not contrary to the policy that has been set down in previous White Papers, which suggested that care for the elderly should be based on a mixed economy? Is he aware that in Barnsley, one third of all households contain at least one person who is either elderly or disabled and who requires care? Some 12 per cent. of the adult population of Barnsley are informal carers. If the changes are implemented, will the Minister ensure that resources are made available to deprived areas like Barnsley so that adequate care in the community can be provided?
§ Mr. Bowis
It is a matter for Barnsley to organise the very real resources that it has obtained from the taxpayer to meet those needs. If our proposals are accepted, no one will compel anyone to do anything; we will just make things possible.
I think that perhaps Barnsley needs some guidance in view of what the Act requires and what a recent judgment suggested might be required. Barnsley provides no residential care for expectant and nursing mothers, for the physically disabled or for the mentally ill. I do not question that, but I think that it might help Barnsley to have the system clarified.
§ Mr. Sims
Can my hon. Friend confirm that, when an elderly person is assessed as being best cared for in a residential home, it remains the responsibility of the local authority to ensure that that person is suitably placed? Does he agree that elderly people's needs vary greatly and that the private voluntary sector is able to offer a far wider range of accommodation at a more reasonable cost than local authorities have ever been able to provide?
§ Mr. Bowis
Yes. My hon. Friend is quite right: as local authorities have looked for better quality at a better cost when placing people in residential care, increasingly they have looked to the independent sector. It is also true that individuals who are placed in residential care are choosing that sector as they begin to realise their rights under the statutory direction on choice. The only organisation that stands in the way of that choice is the Labour party, and sometimes the Liberal party, in the local town halls.
§ Mr. Hinchliffe
In view of the fact that elderly people from the Minister's constituency were in the High Court last month defending their residential accommodation and that elderly and disabled people were in the High Court again last week defending their care services, what steps are the Government taking to address the serious difficulties currently facing vast numbers of users and carers? The Minister's own figures show that, since the care changes, one third of local authorities have been forced to cut home care, half have cut meals on wheels and more people are now entering institutional care. Is it any wonder that there is a total lack of public confidence in the Government's care policies?
§ Mr. Bowis
No one has required those authorities to cut anything. Some Labour authorities are making a hash of managing their existing resources and they are not exerting the good financial control that is required' of them, not just by the Government and the taxpayer, but clearly by the Audit Commission. The Audit Commission has also pointed out that, if local authorities managed their affairs better, half a billion pounds would be available for front-line services. I cannot understand why, if individuals want to choose between the sectors and if the Audit 147 Commission believes that that is in the best interests of the people who are being placed, the Labour party should reject it because it is the way to ensure good value for money and good services. [Interruption.]
§ Madam Speaker
Order. The House must come to order. It is very difficult to hear those hon. Members whom I have called to speak.