HC Deb 14 March 1995 vol 256 cc676-8
3. Mr. Denham

To ask the Secretary of State for Health what steps she intends to take to improve residential care for the elderly.

Mr. Bowis

Our inspection regime ensures that local authority-run homes are inspected against the same standards as are expected of independent sector homes, and we have now applied citizens charter principles to both. Standards also of course benefit from the statutory direction on choice, which gives residents the right to choose their home.

Mr. Denham

Is the Minister aware of the anger and fear felt by elderly people whose homes, life savings and partners' pensions are confiscated to pay for residential care? Is he aware that, as the Southern Daily Echo has pointed out, those who can plan ahead and pay legal fees can avoid high charges, while others cannot? Is it not clear that residential care is now a national lottery in which frail elderly people are losing control of the type, quality and cost of the care that they need?

Mr. Bowis

What is certainly clear is that such comments do nothing but undermine elderly people's confidence in the excellent care provided by residential care and nursing homes throughout the country—and, indeed, by social services departments and health authorities working together.

If the hon. Gentleman knows anything about the matter, he will know that there have been no changes in the principles of charging for social care since the founding of the welfare state in 1948. What was good enough for Beveridge and Aneurin Bevan—and, more recently, for Sir Gordon Borne in the Labour party's own Commission on Social Justice—should be good enough for the hon. Gentleman: while of course people must look to the costs of their own social care, their health care will continue to be free at the point of delivery. That includes residential care.

No one, but no one, risks the eviction of his or her spouse from the home because of charging policy, as some have suggested. That is specifically excluded, as is the eviction of any dependent relative, and the spouse's normal standard of living will also be taken into account.

Mr. Rowe

Is my hon. Friend aware of the admirable plan of Kent's director of social services to involve local communities much more closely in residential homes? Does he agree that such a clear use of the voluntary spirit should be encouraged, and will he do his utmost to encourage those admirable ideas?

Mr. Bowis

Yes. We should involve all the relevant agencies in the planning of social care, including social services departments, health authorities, GPs and the voluntary sector—and, of course, users and carers themeselves. My hon. Friend is right to point out that volunteers can play an important part in the provision of services: they can back up the statutory agencies, and many can gain great benefits themselves from supporting others.

Mr. Hinchliffe

Given that the Government have cut 50,000 local authority care home beds, and the Department of the Environment's current proposal to remove the statutory requirement for local councils to provide their own care homes, will the Minister explain how his concept of choice applies to elderly people who choose to enter local authority care homes?

Mr. Bowis

Would that some of the local authorities that are run by the hon. Gentleman's party gave individual residents and potential residents real choice. Real choice is informed choice, not just the choice between two local authority homes.

If a local authority believes, as many do, that it can secure better quality at a better price from the independent sector, that will be good for residents and taxpayers. I should have thought that the hon. Gentleman would have the grace to welcome it.

Dame Elaine Kellett-Bowman

Is my hon. Friend aware that Lancashire has many excellent county and privately run residential homes? Is he further aware that it costs £93 a week or, in total, £10.8 million more to keep people in county-run rather than private sector homes? Should that matter not be looked into so that that £10.8 million could be spent in other ways?

Mr. Bowis

My hon. Friend is right. As I go around the country and see the excellent provision by the independent sector, which is scorned and spurned by some local authorities for ideological reasons, I consider the cost of that provision and I notice, as my hon. Friend says, the savings that could be made. That could provide better quality and, very often, better comfort for individuals, and leave more money to be spent on people in need. Where hon. Members see such a waste of money, I hope that they will unfailingly send the details of it to the district auditor so that it can be considered in his assessment of value for money in local government.