§ 11 am
§ Mr. Nick Hawkins (Blackpool, South)
On 22 November 1995, my hon. Friend the Member for Blackpool, North (Mr. Elletson) was fortunate—in the same way as I have been this morning—in obtaining an Adjournment debate on the subject of social services in Lancashire, which was responded to by my hon. Friend the Member for Battersea (Mr. Bowis), who was then the Minister responsible.
My hon. Friend the Member for Blackpool, North drew attention to the catalogue of incompetence and mismanagement of social services by Labour-controlled Lancashire county council. My hon. Friend the Minister ensured that a report into the position in Lancashire, with particular regard to community care, was made by the social services inspectorate. That report contains some very serious criticisms. In particular, the summary of the report said:Management of the process gave cause for concern … Measures to contain spending and target resources have been unpopular and not always carried out smoothly or equitably across the county … The Council's home care policies give an initial preference to in-house servicesand so on.
Those criticisms were brushed aside by the Labour councillor who chairs the social services committee of Lancashire county council, who bears the staggeringly inappropriate name of Councillor Humble. The one thing that none of us on the Conservative Benches has ever seen from Labour councillors in Lancashire is humility. They are completely unapologetic about all the many sins of commission and omission for which they have been responsible.
Yesterday, as a further sign of how much is wrong with the Labour party in Lancashire, my right hon. Friend the Member for South Ribble (Mr. Atkins) drew attention during Prime Minister's Question Time to the recent revelations in the past few days about systematic fraud and corruption in Labour-controlled Preston council. None of this comes as a surprise to any of us on the Conservative Benches, and all those matters are connected. There is a seamless web of connections between the main Labour-controlled borough councils in Lancashire and the Labour group on the county council.
§ Mr. Robert Atkins (South Ribble)
Is my hon. Friend aware that some of the people mentioned in the auditor's report to which I referred yesterday are members not only of Preston borough council but of Lancashire county council?
§ Mr. Hawkins
As my right hon. Friend says, in some cases they are the same people; in others, for example, there will be a husband on the county council and a wife on one of the borough council Labour groups, or other forms of "partners" that the Labour party so often go in for, with one partner on the county council and another on the borough council. The connections are closest between county hall in Preston and the Labour Lancashire county councillors who run personal empires from there, and Labour councillors on Preston borough council. There is much that is rotten in the state of Lancashire, and all that is rotten is Labour.
914 I now come to the specific effects that this has on the people who are unlucky enough to have to rely on the appalling Labour-controlled county council for care when they need it. What are the details of the huge amounts that Lancashire county council has been provided with—out of taxpayers' money—by the Government to spend on social services? In 1990–91, Lancashire county council had £92 million. By 1993–94, this had risen to £147 million. In 1994–95, it was £169 million—up £22.6 million in one year—and by 1995–96, it was £185 million.
How has Labour-controlled Lancashire county council organised its affairs given those huge amounts? In 1993–94, the county council underspent by £6.3 million. The Conservative group on the county council wisely recommended that that be carried forward. Instead, Labour put it into its general balance for other use—or, more likely, misuse. In 1994–95, the county council found that it had miscalculated so badly that it faced a possible overspend of £14 million. Its response was to withdraw home help services.
§ Sir Mark Lennox-Boyd (Morecambe and Lunesdale)
My hon. Friend should be congratulated on mentioning that point. He will be aware that many of the elderly and others in my constituency have suffered from those cuts. He mentioned the cut in the social services budget of £6 million in 1993–94. Perhaps he will go on to deal with the figures, but I invite him to comment at this stage on the fact that it was also cut by £3 million in 1995–96. I understand that there is a large underspend this year. I find those cuts quite unacceptable and I should be grateful for his comments. Does he agree that the only explicable reason why the county has done this is to build up a war chest for next year's council elections?
§ Mr. Hawkins
My hon. Friend makes an important point. One is bound to be suspicious, in the light of history, of precisely why those sudden cuts were made, and it is our constituents who are suffering. There is undoubtedly political gerrymandering going on with the budgets. I know that my right hon. Friend's constituents have suffered badly. Independent evidence shows that damage has been done in many parts of Lancashire—a point that I shall come to later.
We have covered all of this in the House before, but more scandals continue to crop up. There was the scandalous overspend by Lancashire county council on a new social services home in Bold street, Blackburn. It spent so much on that—about £240,000 to £260,000 for a small number of residents, at a cost of about £26,000 per resident, while there was a vast increase in the budget for social workers—that it became a byword for the incompetence of the social services committee, which refused to use the vastly cheaper but much better provisions in large private sector care homes in Lancashire. Many of the people who provide private care home facilities are members of the excellent Lancashire Care Homes Association, which has done its best to present their case for greater use of their facilities.
The scandal of the hugely expensive home in Bold street, Blackburn came to light because of the diligence of a Conservative councillor in Blackpool, John Woolley, who was presented at a different committee with a large—in his view excessive—claim by a Lancashire county council social worker for a big increase in travel 915 allowances. Councillor Woolley rightly kept digging until he uncovered the whole story. So often, at Labour-controlled Lancashire county council, it is a case of jobs for the boys and jobs for the girls.
The debate grows mostly out of the latest scandal from which some of my constituents have suffered personally. Mr. and Mrs. Gardner of Knaresborough avenue, Blackpool have a son, David, now aged seven. David, sadly, suffers from cerebral palsy and needs a lot of extra care. The Gardners have had a lot of help from charities, especially Scope and the Leonard Cheshire Foundation. Unfortunately, they have been among the many families who have been badly let down by Lancashire county council social services. The biggest problem has been a lack of continuity of care for David. As the Gardners have said to me in their many visits to my surgeries over the past year or more as the case has developed, every time there is a change of social worker, the plans for what the social services department offers to provide seem to change.
The only part of Lancashire county council that seems to work properly and has helped the Gardners is the welfare rights service. I give credit, on behalf of the Gardners and other constituents, to the genuine help that Alun Pugh, Jim Dickson and their team have given, for which they were rightly recently awarded the Government's charter mark.
The Gardners, however, have not been so fortunate with the social services at Lancashire county council. Despite their general practitioner, Dr. Morrison, writing a strongly worded letter to social services at the end of 1995 urging continuity in the care facilities provided for David, the plans have continued to change. There were all sorts of problems with David's speech therapy service, but the most important feature of the case was the proposed changes to the service provided for David at his home.
Frustrated with this long saga, I decided to take up the matter with the Leonard Cheshire Foundation, which was involved in providing much of David's at-home care. The council wanted to withdraw that care and I thought it was important, not only for the Gardners but for so many of those whom we represent in Lancashire, to seek an independent, unimpeachable view from a charitable source about the case and about the general picture of Lancashire county council social services provision.
I was delighted to receive an extremely detailed letter on the subject, from Martin Perona-Wright, director of services in Lancashire for the Leonard Cheshire Foundation. He said:All the staff, Manager. supervisors and care attendants who have been involved with the care of Mr. and Mrs. Gardner's son David, share the considerable concern about the future. Continuity of care and choice by the client appear to be of secondary importance to financial considerations. We operate in Lancashire against the competitive backcloth of a policy which refers every client in the first instance, to their own Home Care service".That is the county council's service. Conservative Members constantly make that precise point and my hon. Friend the Member for Blackpool, North referred to it in his Adjournment debate in late 1995. The letter continues:The Local Authority service—which is not subject to the same rigorous annual Inspection, which the LCF Care at Home Services in Lancaster and Blackpool have recently undergone—can therefore 916 cherry pick the services and clients to whom they wish to provide a service. Charities such as this suffer from lack of continuity—plenty of early morning, evening and weekend work"—in parenthesis, I point out that those are the times when it does not suit social workers to work—but little cost effective continuous Monday to Friday care. Small wonder we are deemed to be expensive!On the specific case, Mr. Perona-Wright goes on to say, on behalf of the charity:If left to this organisation and it were the wish of the Gardners, we would be willing to continue David's care and support, despite the fact we provide a quality of input and care in excess of that purchased by the Local Authority. (What about the principle of direct payment and/or topping up for domiciliary home care services—has either of these practicalities been discussed with the Gardners? The answer is in the negative because neither feature has been adopted by Lancashire County Council Social Services Department!). We have only today"—the letter is dated 22 October—been verbally"—I stress, not even in writing—informed that our services are no longer required from the 2nd November and no reasons have been given for the change.That major charity was given about 10 days' verbal notice that everything was about to change. Mr. Perona-Wright goes on:You might find the attached extracts from the booklet 'Community Care in Lancashire—Your Charter' useful. I have marked those statements which appear to be being breached in this case".
The social services department document, "Information about Community Care Services", contains all sorts of fine words. It states:If it is agreed that you will receive services to help you stay in your own home you can expect:that the detail of the service and the arrangements for its provision will he discussed with you. Your preference is taken into account.As Mr. Perona-Wright says, there was no question of preference in this case. The document goes on to say:that disruption in the established pattern of service will be kept to a minimum.There is no question of social services sticking to that aim in this case. The document goes on:Community care aims to put service users and their carers first. In any dealings with community care services you can expect:to have an opportunity to present your views in any assessment of your needs".
§ Mr. Harold Elletson (Blackpool, North)
Does my hon. Friend agree that social services brochures and documents are unreliable? Does he recall the document that I produced in last year's social services debate which featured my constituent Geraldine Robinson on the cover? She suffers from cerebral palsy and was told that, as a result of Lancashire county council's mismanagement, her budget for domiciliary care would be cut from £700 to £300 per week and that her 24-hour care package would be reduced to only 34 hours of care per week. That is disgraceful.
§ Madam Deputy Speaker (Dame Janet Fookes)
Order. The hon. Gentleman is making a short speech. Interventions, by their nature, should be short.
§ Mr. Hawkins
I am grateful to my hon. Friend and I pay tribute to the way in which he continues to pursue— 917 as all Conservative Members seek to do—the manifold sins and wickednesses of Lancashire county council under Labour. It is extraordinary that both my constituent's case, which I am highlighting today, and the case raised by my hon. Friend involve cerebral palsy sufferers. The Labour group on Lancashire county council social services committee appears to have learned nothing from my hon. Friend's splendid debate, to which many hon. Members contributed, in November 1995.
§ Mr. Atkins
Conservative Members of Parliament from Lancashire are conscious of the importance of this case in raising the profile of the debate. Does my hon. Friend accept that Conservative Members who represent Lancashire constituencies each week come across instances of the council's churlishness, incompetence, downright rudeness and its failure to care about people who need attention? That is a most damning indictment of Lancashire county council.
§ Mr. Hawkins
I could not agree more with my right hon. Friend. About half the cases presented at my surgery each week relate to complaints about Labour-controlled Lancashire county council social services. The real problem is the difference between the fine words in the pamphlets and the actions of the social workers on the ground—the two simply do not match. All the fine words in the world will achieve nothing if the actions do not deliver on the promises.
In Lancashire county council social services documents, one sees not only fine words but political propaganda. I have an official social services document that is supposed to be factual. The document about financial assessment entitled, "Guidelines for Completion of FIN 96", refers to cutting home help services almost overnight—a point that my hon. Friend the Member for Morecambe and Lunesdale (Sir M. Lennox-Boyd) mentioned earlier. In the third paragraph, it states:However, they"—that is, the social services committee—were mindful of the Government under-funding of Community Care".That assertion is not only inaccurate and disgraceful, but political propaganda presented in a supposedly official form about financial assessment. We must continue to highlight that sort of disgraceful behaviour.
I shall complete my quotations from the letter from Mr. Perona-Wright, the director of services in Lancashire for the Leonard Cheshire Foundation. He concludes:I hope these comments will help you pursue the Gardners' case. One would like to see"—as we all would—the interests of individuals—particularly those with disabilities—and their families being of paramount focus. Regrettably in this instance David's best interests appear not to be being served by an unnecessary and enforced change of carer agencies—a change to which no-one, apart from Social Services personnel, appears to subscribe. Please do not hesitate to come back to me if you feel I can be of any further help.I immediately faxed that letter to social services, which picked up one or two minor details in its reply but failed to address the substance of the points raised.
However, there was good news this week for the Gardners, who applied for a review of their son's case. My Conservative colleague, John Woolley, the county and 918 Blackpool borough councillor, presented the Gardners' case at the hearing and he managed to win the review on their behalf on Monday. I pay tribute to his achievement. It was a case of the social services department maintaining its fixed opinion in opposition to the views of the charity that was involved in the child's care and against the interests of the family. The Gardners managed to retain that care only through the diligence of a Conservative councillor. That case is yet another object lesson in the practices of Lancashire county council.
§ Mr. Atkins
The council's reaction to an independent charity is not confined to social services. In education, the county council has refused to accept the existence of dyslexia, and has ignored the specialist, charitable and professional advice of Conservative Members' constituents about children with dyslexia.
§ Mr. Hawkins
My right hon. Friend makes an excellent point about dyslexia, which relates closely to the David Gardner case, because one of his problems was with speech therapy. Under Labour, Lancashire county council constantly lets down the people whom it represents.
I was extremely grateful to my hon. Friend the Minister when, shortly after he took up his new post, he sent us a copy of a letter, which he had sent to the deputy clerk of Lancashire county council, headed:Implementation of Community Care in Lancashire".I pay tribute to the Minister for stressing that it was essential for Ministers to know what action the authority was taking to address the issues covered in a previous letter that had been sent during the summer. The Minister wrote:Those were serious concerns requiring a constructive response. I look forward to receiving a full account of your action plan".It is essential that we keep up the pressure.
§ Mr. Keith Mans (Wyre)
Does my hon. Friend agree that, although Lancashire county council received the Minister's letter asking what it was going to do, there is little evidence that it is doing a great deal? Indeed, rather than doing anything, it is prevaricating and stretching matters out so that none of the recommendations is implemented.
§ Mr. Hawkins
My hon. Friend is right. The purpose of today's debate was to keep up the pressure and to draw attention—as my right hon. and hon. Friends have done—to the fact that Lancashire county council seems to take no notice of evidence from charities, of what people who need care say and of what Ministers or the social services inspectorate say. We have had repeated reports from the social services inspectorate and the district auditor containing savage criticisms of Labour-controlled Lancashire county council.
To emphasise the final lesson to be learnt, I shall use some of the words that were used by another party in the past. Under Labour, do not be old, do not be young and disabled, do not be any age and disabled and do not suffer from cerebral palsy, because all that the Labour party will do is publish fine words in expensive brochures, provide social workers with huge travel allowances and increase the budget for, and the number of, administrators at county hall. The one thing Labour will not do is provide 919 people with care. The country should know that Labour in Lancashire shows what it would be like if the country were ever unwise enough to elect a Labour Government. Do not be old, disabled or young and in need of care, because Labour will provide only glossy brochures and highly paid social workers, but no proper care when it is needed.
§ Mr. Peter L. Pike (Burnley)
I am glad to have the opportunity to speak in this debate and to paint a different picture from that painted by the hon. Member for Blackpool, South (Mr. Hawkins). Whatever the hon. Gentleman's fate may be, he will not be a Member of Parliament representing a Lancashire constituency after the general election. He has chosen the chicken run and has fled Blackpool before he loses his seat at the next general election.
It is a tragedy that every time Conservative Members initiate a debate about Lancashire, all that they do is to attack, criticise and paint an untrue and misleading picture. They know that I am a strong supporter of unitary local government. I would like Lancashire county council ultimately to go, and social services to be provided at borough council level. Having said that, I fully support the work of Lancashire county council. It does an extremely good job, and social services is one of the important services that it provides.
It was regrettable that the hon. Member for Blackpool, South and the right hon. Member for South Ribble (Mr. Atkins) chose to have a totally unjustified go at Preston borough council. Their allegations against Labour councils, including Burnley—their allegations went wider than Preston—were unjustified. I hope that they will repeat some of their remarks outside the House. Whatever the criticisms in the report that was published on Monday, the leader of Preston borough council, David Borrow, and his predecessor, Valerie Wise, are most anxious that any allegations against officers or members of the council are fully investigated, even if they concern activities which took place eight or nine years ago.
§ Mr. Atkins
The hon. Gentleman mentioned me by name and yesterday I asked the Prime Minister a question about Preston borough council. If the hon. Gentleman has seen the independent auditor's report, he will know that the criticism was directed specifically at Preston borough council—I made no allegations against Burnley or anywhere else. Labour councillors and some officers were accused of, among other things, corrupt and criminal practices. I do not care when that was: Labour was in control whenever that took place, and it has cost Preston taxpayers millions of pounds.
§ Mr. Pike
I accept what the right hon. Gentleman says. Conservative Members criticise Labour councils, but they do not make the same criticisms of Westminster council, which has been severely criticised for its actions. I do not condone any wrong actions by Preston borough council, but its present leader and his immediate predecessor have strongly condemned the actions that have been criticised. The hon. Member for Blackpool, South said that this case was typical of Labour authorities, and he made serious allegations. I accept that the right hon. Member for South 920 Ribble yesterday and in his intervention today referred specifically to Preston, so my comment about Burnley did not apply to him.
I agree with the right hon. Member for South Ribble about the welfare rights services, which received a charter mark earlier this year. I pay tribute to Paul Burgess and his team throughout the county, and to Richard Roxburgh, an officer in Nelson, with whom I deal on many local issues. They provide an excellent service to the people of Lancashire.
The hon. Member for Blackpool, South has rightly taken a strong interest in the Gardner case. The individuals involved had a right of appeal. In the latter part of his speech, the hon. Gentleman said that that had been dealt with earlier this week. They exercised their right of appeal, and on that appeal panel were two Conservative and one independent councillor. Under Lancashire county council's system, people are entitled to have their case reviewed by an appeal panel if they are not satisfied with the way in which it has been dealt with. The criticism of the council in that case is unjustified.
§ Mr. Pike
I do not believe that. I think that services are better provided locally. The hon. Gentleman knows that I am strongly in favour of unitary local government, and that it is the Conservative Government who set up the local government review which made a mess of it. It proposed a hybrid solution—the worst possible solution for Lancashire—with Blackpool and Blackburn being taken out. That is a great tragedy. But let us not get side-tracked on to that debate: let us keep our minds on the important issue of social services. Social services and education are the two major services provided by the county council.
The hon. Member for Blackpool, South mentioned the social services inspectorate report which followed a previous debate. In a press release dated 20 June, Louise Ellman, leader of Lancashire county council, said:The Government commissioned this report after a so-called Parliamentary Debate in which no Labour MPs were allowed to speak. The report says that the justification or otherwise for the complaints concerning bias in residential care have not been substantiated.As that press release suggests, the tone of the report was very different from that of the hon. Member for Blackpool, South.
In a later press release, Joan Humble, the chair of social services, said:The Social Services Committee maintains a continuing review of the arrangements for social care services in Lancashire taking account of recommendations made and the guidance provided by the Department of Health and the Audit Commission. This will continue and a clear focus will be kept on the needs of the most vulnerable people in Lancashire's community.
§ Mr. Hawkins
In her press release, which the hon. Gentleman read out, the Labour leader of Lancashire 921 county council, Mrs. Louise Ellman, referred to a "so-called parliamentary debate". What sort of approach is that from the leader of a Labour authority who has been chosen as a prospective parliamentary candidate for Labour, and who aspires to come to the House? We would remember that when the lady became a Labour Member of Parliament, were she to be successful.
§ Mr. Pike
I think that the phrase "so-called debate" is justified when it refers to a debate in which no one is allowed to express a different point of view. The simple fact is that no one was able to express a contrary view in that debate—so it was not a real debate, allowing both sides of the case to be heard.
§ Mr. Pike
No, I will not.
The social services inspectorate undertook an analysis of in-house services, which was published in June. It examined allegations made about community care in Lancashire. The hon. Member for Blackpool, South painted a misleading picture: the report certainly does not constitute the damning condemnation that Conservative Members have tried to portray. It showed that levels of overall service remained comparable with, or higher than, those in similar local authorities; that there was rapid growth in purchasing from the independent sector, at a level exceeding the average for other similar local authorities; that there was rapid expansion in the purchase of domiciliary services from the independent sector, from zero in 1993 to £11 million in 1995; that, in home care services, the growth of the independent sector had exceeded that of the in-house service; that the market share of independent nursing and residential homes in Lancashire had been consistently higher than the average for shire counties and England overall between 1993 and 1995; that, subject to the availability of resources. there was a wide range of choice and flexibility for users; and that the level of resources committed to management and administration was unexceptional compared with that in other counties.
According to the analysis,the report fails to substantiate allegations made that there is any systematic bias towards the use of in-house residential services but instead shows that the Government Direction on choice between public and private sector residential care has been complied with".That view of the report is very different from the view expressed by the hon. Member for Blackpool, South and other Conservative Members.
In-house services are clearly long established, and people still have confidence in them. I have visited a number of private homes: I undertook two tours during the summer recess. Some of them provided an equally good standard of care. I always say that the standard of a home cannot be judged by the carpets, curtains and wallpaper—not that those are unimportant, but I am sure that we all agree that the most important aspects of the care of elderly people are staffing and the attention given to those people. We must make the maximum use of the homes that we have; it would be absurd not to do so.
Let me say a little about charging policy. Lancashire county council has suffered severe financial restraint. Let us make no mistake: because of capping and other financial limitations, and the area cost adjustment—which 922 has caused it major problems—the council has not sufficient money to provide the services that it would like to provide. Finance and Government are responsible for the problems, and the form to which the hon. Member for Blackpool, South referred was entirely justified in pointing that out.
The council was forced to make major cuts. One way of minimising those cuts was the introduction of a charging policy, which reduced the cuts by bringing in some money. The council tried to introduce the simplest and fairest possible system, and the level of charges is comparatively low.
§ The Parliamentary Under-Secretary of State for Health (Mr. Simon Burns)
If Lancashire county council felt that it must make cuts because of a lack of financial resources, why did it underspend its social services budget by £1.94 million in 1993–94? Can the hon. Gentleman also explain to me, and to the people of Lancashire, why it underspent the budget by £3.4 million in 1995–96?
§ Mr. Pike
The Minister ought to be very careful. The hon. Member for Blackpool, South referred to a letter that he had received from the Minister, but the Minister chose to send that letter only to Conservative Members representing Lancashire seats. Why did he not send it to all Members of Parliament? He accused Lancashire county council of being political. I consider it very political of the Minister to choose to write—
§ Mr. Pike
Let us deal with my point first. I am making my speech; the Minister will make his in due course. Was it not political of the Minister to act as he did? He should have written to all of us, to let us all see exactly what he is saying to Lancashire county council.
I know that my hon. Friend the Member for West Lancashire (Mr. Pickthall) will be dealing with these matters, but, in fact, Lancashire county council has used the money that it did not spend, having carried it forward. It believes that it is on target to spend this year's budget; indeed, there is no doubt that that is so. But to criticise a marginal underspend—[HON. MEMBERS: "What?"] It is a very big budget, and the circumstances are extremely difficult when the position is changing all the time.
§ Mr. Pike
What the Minister says is entirely unjustified. In the previous year, there was a £230,000 overspend. Is the Minister saying that that was wrong? Is he saying that the spending of every Government Department is exactly on target each year? We have been looking at the Chancellor's figures for this year. There has been great variation in the public sector borrowing requirement, for instance.
§ Mr. Pike
No, I will not. The hon. Gentleman was not even present at the beginning of the debate—he came in late—and other hon. Members want to speak.
The charges are low compared with those of many other local authorities, with 56 per cent. of service users paying only the minimum rate of £1.55 per week. If the county council had not introduced charges, it would have had to make more cuts. The Minister may feel that the council has sufficient overall resources. That is not true. It needs more financial resources and a greater continuity of budget.
Year after year, the Government change the rules. Year after year, they cut further and cap the county council. Now is the time for the council to ensure that people can receive the services that they want. It will be able to do so when we have a Labour Government who at last recognise the importance of social services and of local government.
§ Mr. Den Dover (Chorley)
It gives me great pleasure to reinforce the views of my hon. Friend the Member for Blackpool, South (Mr. Hawkins) because, in the 17 years that I have represented Chorley, Lancashire county council's social services department has been very uncaring. It has not controlled its budgets. It has not been efficient. In correspondence, it produces all sorts of warm words, but my constituents have been disappointed by its performance, particularly in the past couple of years.
It is unacceptable for the social services department suddenly to impose a respite home on the high-class residential area of Long Copse in Astley village in my constituency. No notice was given. There will be tremendous extra usage of resources, extra traffic and unacceptable noise and disturbance to residents in an area that is unsuitable for such a home. At the same time, I told county council officials that a disused building would have been admirable for the purpose and was within a 924 mile of the council's chosen site. There was a need to do something about the building and to provide—I do not want to stop respite care in the community—facilities where they are needed, not in a high-class residential area. That is typical of the bureaucratic and remote services operated by the county council.
Mention has been made of residential homes and of whether provision for people who need such a service should be made in-house by Lancashire county council or by the private sector. Much of the underspend this year and two years ago occurred because the council was reluctant to place spending in private sector hands.
In that connection, there is a dramatic increase in costs. In-house residential care costs an extra £93 per resident per week, more than in the private sector. That gives rise to a difference in cost of —10 million annually between the public and private sectors and it is one reason why we do not receive best value for money from the council. The standard home care service—domiciliary care—would cost £5 million more if provided in-house rather than by the private sector. That is about £15 million straight away. Compare that with the education spend and the policy statements issued by the Labour-controlled county council in the past few years, saying that there will be cuts in education spending and in the school budgets.
We have heard about the underspending. As in the past, the county council has raised a supplementary rate with no prior notice, which was damaging to individuals and businesses. As they did then, councillors have put the money from underspending into reserves so that, just before county council elections and the probable general election on 1 May, they can show what good, honest citizens they have been on behalf of county council residents and say, "We are going to reduce this and reduce that." I should like to think so. I think that the council will be pressing for that, but let us await events.
It is crazy that, as I said, the county council says, "We need cuts, cuts, cuts in education. We cannot give enough funds to schools," and then calls for an enormous rise of hundreds of millions in the education budget and of tens of millions for education spend in Lancashire.
§ Mr. Atkins
Did not the Leader of the Opposition and the shadow Chancellor of the Exchequer make it clear, as my hon. Friends will recall, that, if there were to be a Labour Government, there would be no extra funds for local government? Why therefore are Labour Members saying that more money should be spent when, if they were to form a Government, they would not be making such provision? It therefore depends on Conservatives and a Conservative administration in the county—if that is what happens—being more efficient.
§ Mr. Dover
I agree entirely, and it is yet another example of Labour saying one thing and doing another, or intending to do another.
If there is not enough money in the county council, why underspend on social services? Why not divert funds to education? Why the enormous brouhaha and cry for an area cost adjustment investigation, and what has that shown? Lancashire is overfunded compared with, say, Cheshire. If there were a change because of the academic and independent research, Cheshire would gain, Lancashire would lose and, guess what, we would be subjected to less education and school spending. 925 The county pressed for the investigation. Now that it has the independent results, it does not accept them or want any changes. It wants the whole thing scrubbed.
We shall see what happens. I hope and am optimistic that the Chancellor of the Exchequer will put education at the top of the spend, as we have in the past with social services and community care. After all, Lancashire started off with the largest community care budget in Britain, and that has been frittered away over the years by inefficiency.
A few months ago, Marylands residential care home on the A6 main road in Chorley was closed. Many of the home's clients had no prior warning. There had been an appeal and a tribunal finding. They rightly telephoned me that day to say, "Why is it that our parents"—or grandparents—"are having to be moved out with no notice?" I should like that to be investigated because it is unacceptable.
As we all know only too well, recently, the home help and care assistance service was massively adjusted by the county council, to the detriment of elderly citizens. I pay tribute to the self-supporting attitude of elderly residents in my Chorley constituency, who are typical of Lancashire and who look after themselves as far as possible, but they need help and assistance, yet that has suddenly been withdrawn.
On 29 August, I wrote to the director of social services to say:I understand that recently you have reversed many of the decisions regarding home helps and care assistance—and I greatly welcome this.I thought that there had been a change of mind, that the county council had realised that it was overspending, had cut here and there and had uncaringly ditched the needs of the elderly. I thought that things were looking up, but no. I received a reply on 10 September from the director of social services, which said:I have not reversed any decisions and neither, to the best of my knowledge, have any other senior officers. Some individuals who had home care services withdrawn or reduced in the past have sought re-assessment of their care needs—as they have always been able to do—and in some cases the social care assessment has indicated a current need for services which have then been arranged. I am aware that this has been described in some quarters as a reversal of decisions but that is not an accurate description, and the number of cases quoted appears to be inaccurate.I thought that my praise and thanks would be reciprocated and that I would receive a sensible reply. Surely to goodness, it should not be up to the media and Members of Parliament to bring about a change of mind by the county council, in the interests of our constituents. The unacceptable situation in which services were withdrawn should never have occurred.
§ Mr. Hawkins
Does my hon. Friend agree that one of the difficulties is that, although—as we all accept—there are some dedicated officers working for the county council, they are constantly constrained when trying to help, by the political direction that they receive from the Labour leadership of the county council social services department, and by the type of policies that led to the unacceptable political propaganda that I mentioned earlier? Even the most dedicated people, who are genuinely concerned about caring, simply are not allowed by their Labour political masters to deliver that care.
§ Mr. Dover
That is borne out by a reply that I received from the director of social services. I said to her, "If you 926 have been underspending this year and for the past two years, you must have built up reserves." She was completely unaware of any reserves, although she is looking into the matter. It shows that the officials are working as best they can, but their political masters are saying, "Do something totally different from what you really want to do."
Another example of the social services department's inefficiency concerns my constituent, Valerie Smith. Unfortunately, about 10 years ago, she lost a child in a road accident, and because of shock and mental disorder, she was in the sad situation of having another child taken away from her. After all those years, the county council suddenly wrote to her to say, "Your child has been adopted." That caused her great mental anguish, because she thought that she had rights of access and that, having proved that she was improving, she could have the child back. She then received that letter and thought that she would not be able to get her child back. However, the council then wrote to say, "Sorry; we made a mistake when we said that your child had been adopted." That is typical of inefficiency in the county council social services.
Cerebral palsy has been mentioned in the debate. Alice Allen, of Chapel lane, Chorley, is six years old and severely disabled from cerebral palsy. The county council social services issued only one orange badge to her family, although her parents work 26 miles apart from each other. Their routine is that one of them will take Alice to the centre in the morning and the other will pick her up at night. Quite rightly, they raised the issue with county council social services, but the response was, "The situation is very difficult. The rules say this and the rules say that." Senior county council officials should use their discretion to be responsive to the wishes of constituents and to issue a second badge in such cases, so that proper care is seen to be meted out to my constituents.
The purpose of the debate is to show that the county council social services department has an uncaring attitude. That is not a sudden development—Labour has controlled the council for the past 14 years—but the situation has been getting worse. It has been a long time since there was Conservative control of the council, and a caring attitude by the council.
§ Mr. Atkins
I am extremely grateful to my hon. Friend. He is providing us with a list of the problems that he and many other Conservative Members are experiencing. Does he agree that the response that we receive from the county council social services department is not always what we would wish it to be, and that a small improvement would make the management of our constituencies and action on behalf of our constituents that much easier?
§ Mr. Dover
I agree entirely. Perhaps it is time for the department to re-examine its arrangement of local offices and to ensure that care is available locally. Occasionally it is necessary to reorganise. I agree with my right hon. Friend that it would be better if we had more local offices, and more local officials controlling what is happening and responding to local requirements.
We do not like raising the issue of problems in social services, but we are pressed constantly by our constituents, in our surgeries and in letters, about them. 927 That should not be the situation. The Government have allocated more than enough money for social and education services, and for all the county and borough council services. We expect high-quality and caring services—particularly social services—and we want to ensure the best value for money. We have not been achieving those goals. I look forward to hearing the Minister's response.
§ Mr. Peter Thurnham (Bolton, North-East)
I congratulate the hon. Member for Blackpool, South (Mr. Hawkins) on his success in obtaining this Adjournment debate, which concerns not only people in Lancashire, but those across the north-west and in the rest of the United Kingdom, and, of course, most people in Bolton like to think that they are in Lancashire. I was grateful to the Minister for agreeing to see a delegation from the north-west, which included representatives from Bolton, on the first day of his appointment.
§ Mr. Elletson
Will the hon. Gentleman tell us what mandate he thinks he has to speak in the debate? He does not represent a seat in the Lancashire county council area, and he betrayed the electors of Bolton—who voted for a Conservative Member of Parliament. Why does not he resign now, fight a by-election, get a proper mandate and then come back to speak?
§ Mr. Thurnham
I will not have any lectures from the hon. Gentleman about my interest in the subjects that we are debating today. Those subjects are of concern not only to people in Lancashire, but to those across the north-west and in the rest of the nation.
§ Madam Deputy Speaker
Order. Each hon. Member is entitled to be heard with reasonable courtesy. I do not expect what almost amounts to barracking.
§ Mr. Thurnham
The Minister was good enough to see me on the first day of his appointment. I was grateful to him for doing that, because a delegation had travelled down from the north-west of England in the expectation of seeing his predecessor. I know that it was difficult for him, because he had had the brief for only a few hours, but the delegation was extremely grateful for the opportunity to see him. Various points were made at the meeting, and detailed letters were sent later, under my covering letter of 9 August 1996.
I shall not detain the House for too long with the points raised at the meeting. Representatives of Galebrook nursing home attended, representing the Bolton Association of Residential Care Homes, and raised several issues, including the difficulty of deciding whether people in need of care should be admitted to hospital if they had been admitted incorrectly.
§ Mr. Mans
On a point of order, Madam Deputy Speaker. I seek your guidance about the subject of the 928 debate. The Order Paper clearly states that the debate is about social services in Lancashire. The hon. Member for Bolton, North-East (Mr. Thurnham) is talking about a specific case outside Lancashire. Is that in order?
§ Madam Deputy Speaker
The hon. Member for Bolton, North-East (Mr. Thurnham) said that the point that he was making was relevant to the debate. I must listen a little longer to confirm that.
§ Mr. Thurnham
If Conservative Members were better informed, they would know that people from Lancashire go to Bolton association care homes. Therefore, the issues that I am raising are of as much concern to people in Lancashire as they are to people elsewhere in the United Kingdom. Such interventions show only Conservative Members' total ignorance of how the care system works. The concerns expressed by the Bolton Association of Residential Care Homes reflect as much on national issues of care as on the concerns expressed earlier in the debate.
Mr. Frank Hessey, from the Lancashire Association of Care Homes, made some points at the meeting, which he set out in a letter of 30 July 1996. I sent a copy of the letter to the Minister. I was a little disappointed to find that it took more than three months to receive a reply to the points raised at the meeting. I had always thought that the Minister was one of the more effective members of the Government, but the delay has shown the difficulty that he has had in mastering his brief. I hope that there will not be such delays in answering correspondence in the future. I also hope that there will be no excessive delays in issuing a White Paper on personal social services. We have been promised that such a White Paper will be published soon, and the newspapers have trailed it as being due in February.
Among the points raised by people from the north-west at the meeting was the need for rights of choice, and information about choice, for people entering care homes. There have been fears that people are not given the proper information, which they should have. I hope that, in the forthcoming White Paper, the Minister will make it perfectly clear that people who are in the process of entering a care home should be given every piece of information necessary for them to arrive at the best decision. We should start by providing proper choice for people going into residential care rather than their being given misleading information.
One of the aspects that is relevant to the debate is the number of judicial cases that have been taken up. The delegation that saw the Minister included representatives of South Lakeland Care Homes Association, who, at the time, had a judicial review pending. I ask the Minister to address the need to reform the law in that respect. It surely cannot be right, when there is so much pressure on care needs, that money is being spent on lawyers' fees in order to argue about the law.
I had a meeting yesterday with representatives of the Carers National Association, who feel that the law is in a mess. In view of pressures on the provision of care, it would be only right and proper for the Government to ensure that the law is properly understood. There should be a complete reform of community care law, so that all those concerned clearly understand it.
929 The Department of Health issued a press release on Friday about rising needs for community care, not only in Lancashire but elsewhere. It said that there was an 8 per cent. rise in the need for services.
§ Mr. Atkins
On a point of order, Mr. Deputy Speaker. Your predecessor ruled a moment ago on a similar point of order that was raised by my hon. Friend the Member for Wyre (Mr. Mans). This debate, about social services in Lancashire, is at the behest of my hon. Friend the Member for Blackpool, South (Mr. Hawkins). The debate is being widened well in excess of the subject that he raised and, as a result, other hon. Members who represent constituencies in Lancashire have been prevented from speaking. Will you rule on whether the hon. Member for Bolton, North-East (Mr. Thurnham) is exceeding the brief?
§ Mr. Deputy Speaker (Mr. Michael Morris)
I have been in the Chair for precisely 60 seconds, and in that time the hon. Member for Bolton, North-East (Mr. Thurnham) has been entirely in order.
§ Mr. Thurnham
The hon. Member for Chorley (Mr. Dover) referred to the pressure on budgets, and to the effect on education budgets as well as social services. The press release issued by the Minister's Department showed that there has been an increase in the provision for home help and home care services of 8 per cent. There have been similar increases in the provision for day care services and other personal social services. Such pressure for the provision of extra services occurs not only in Lancashire but throughout the country.
I hope that next week's Budget will take proper account of the rising need because. no doubt, there will be pressure on education budgets if there is not sufficient funding for personal social services. Local authorities will be faced with difficult decisions about how to balance those requirements if the Budget as a whole does not provide extra funding.
§ Mr. Thurnham
I have no doubt that it would be a coincidence if any authority spent to the penny its exact provision. In avoiding overspending, there is always a possibility of an underspend. What is clear is that there is a great pressure on the budgets generally, and if there is insufficient funding for social services, there will be pressure to reduce spending on education—even if members of all parties agree that education should be a priority.
I hope that the Minister paid full attention to the joint local authorities' submission, which said that an extra £665 million—or 8 per cent. of the total budget—was needed to fund personal social services in the coming year. If that money is not made available, obviously there will be pressure to reduce spending in other budgets at local authority level, just as the hon. Member for Chorley described a moment ago.
The Minister's reply to my letter, following my parliamentary question asking when I would receive a reply, did not address all the points raised at the meeting 930 to which I referred, or in the subsequent correspondence. I hope that he will be able to give full attention to the points that the delegation raised, especially those on cost shunting between health authorities and social services. The Bolton delegation felt that there should be an investigation—
§ Mr. Thurnham
The issues that concern people in Bolton concern people not only in the north-west but in the country as a whole. Many people from Lancashire are in homes in Bolton and, no doubt, people from Bolton go to homes in Lancashire. It is absurd to say that people should not be allowed to go to a home of their choice. Bolton was, of course, in Lancashire for more than 800 years, and 99 per cent. of people in Bolton feel that it should be back in Lancashire. I should have thought that Conservative Members would welcome the prospect of Bolton being returned to Lancashire, as it should have remained in the first place.
The points that have been raised in correspondence with the Minister need a much fuller reply than he was able to give me in his brief letter of 18 November. I hope that he will be able to make further points in the debate, and that the White Paper that is due in February will not be delayed and will address the points very fully.
§ 12.5 pm
§ Mr. Colin Pickthall (West Lancashire)
Following the unnecessary and unwarranted speech of the hon. Member for Bolton, North-East (Mr. Thurnham), I do not have time to elaborate on any of the points that I wanted to make in this debate, which has clearly been called for many reasons, including the usual one of trying to get at Joan Humble, who happens to be the candidate for Blackpool, North.
I want to talk about the issue of overspend. The management letter from the district auditors to county councillors in April said:prudence and accountability have been features of the financial arrangements in the County Council for many years. This tradition of excellence continues despite the challenge of present financial constraints.It is true that, in 1993–94, 4.4 per cent. of the total net budget for social services in Lancashire was underspent and that in the following year, 0.13 per cent. of that budget was overspent. In 1995–96, 1.78 per cent. of that budget was again underspent. Although that is true, the reasons behind it are important.
The budget for Lancashire's social services in 1994–95 was drastically affected by the changes in the Government funding formula for community care, as no doubt the Minister will tell us. The estimated effect at the time was a reduction of £12.8 million for 1994–95. The county then expected a very significant overspend, and equally significant measures were taken by it to avoid that overspend and its knock-on consequences in subsequent years.
The effects of the process were painful and unpopular. It is true that there have been many complaints. Expenditure was squeezed in 1994–95 and 1995–96 and, at the same time, the effect in 1995–96 of the extended non-residential charging policy, which was brought in to counter the expected overspend, was being experienced. 931 The result was a £3.4 million underspend on a net budget of £48.4 million, about which the hon. Member for Blackpool, South (Mr. Hawkins) complained.
At present, the level of undercommitment is about £7 million, but the monthly increasing level of commitments for this financial year means that the treasurer expects that the spending target will be fulfilled by the end of the year. It is important to note in this debate that the underspend on independent sector purchases in 1993–94 was used to ease financial pressure on the same budget in 1994–95, and the same has been true of 1995–96, moving on to 1996–97.
Capping limits have necessitated budget reductions in social services of £19.4 million in the past five years. It is also important to note that Lancashire has exceeded the Government's figure of 85 per cent. of special transitional grant being spent in the independent sector in every year that that target has been in existence. The council also spends 8 per cent. more on social services than the figures calculated in its standard spending assessment.
I must sit down to allow time for the Front-Bench speeches. I suggest to the hon. Member for Blackpool, South that his next Adjournment debate should concentrate on analysing how the Government have managed to find the £4.4 billion that they did not know they had, and about which they were boasting in the press recently. Will he demand that they restore funding to the levels that existed before the cuts and extra charges imposed this year?
§ 12.9 pm
§ Ms Ann Coffey (Stockport)
I welcome the opportunity for a debate on community care, and the comments of those hon. Members who have raised issues relating to the implementation of care in the community, but I do not welcome the personal attacks on Joan Humble. The hon. Member for Blackpool, South (Mr. Hawkins) would be the first to complain if I criticised him in the Chamber without giving him an opportunity to respond. I hope that the Conservative election strategy will not involve using the Chamber to attack the Labour opponents of sitting Conservative Members.
I know that the hon. Member for Blackpool, South is off to the safer Surrey suburbs, leaving the hon. Member for Blackpool, North (Mr. Elletson) to struggle to hold his seat against our excellent candidate, Joan Humble. I do not know whether the hon. Member for Blackpool, South is aware that Surrey county council, where he is off to, wrote to all its private providers last year asking for free places because it had run out of money. I think that that happened at about the same time as he was castigating Lancashire county council for incompetent management of its budget. As he knows, several areas have community care problems.
My hon. Friends have dealt ably and thoughtfully with some of the specific criticisms on resourcing. As the Minister is aware, the problem for many authorities is dealing with issues of entitlement and choice for individuals within a limited budget, often with a fragmented system of health care in which resources are not being used strategically. The case that the hon. Member for Blackpool, South raised illustrates the challenges for local authorities in allocating resources for 932 individual family needs, taking its budgetary considerations into account. The appeal process considers those issues.
A number of cases have been taken to judicial review. That is unsatisfactory for all involved because they all have to hold their breath. Perhaps the National Health Service and Community Care Act 1990 could have been more thoughtfully framed. The consequence is that local authorities are attempting to deliver community care in the absence of guidelines. That is convenient for the Government, because they can blame everybody else, but it leads to unfairness, inequity and a deep sense of frustration for parents whose expectations have been raised. I sympathise with Mr. and Mrs. Gardner.
Conservative Members keep coming back to the issue of in-house services versus the independent sector. The public sector, the independent sector and the voluntary sector all have contributions to make to care in the community. It is unfortunate when they are put at each other's throats. I blame the Government for part of that problem. They seem to prefer to act in an atmosphere of competition and confrontation rather than in co-operation£the only framework within which matters can be resolved.
Conservative Members have said several times that they think that money could be saved by putting all the services in Lancashire into the independent sector, which is cheaper. They repeated that point today, but they also said that the primary considerations should be quality and choice. They cannot have it both ways, although they often try to. Last year, when Lancashire county council closed some of its homes£presumably in response to the pleas of Conservative Members that services should be shifted to the private sector£there was an immediate outcry from those same hon. Members. The hon. Member for Blackpool, South featured in the headline:MP joins battle to save rest homes.Calling for a delay to the closure of one home, the hon. Member for Fylde (Mr. Jack), said:The most important reason for keeping the home open is the strong link it has with the local community.
The chairman of social services said, with great understatement:It is not easy to close down homes.It is certainly not easy, particularly when Conservative Members on the one hand demand that the council does so and on the other hand criticise it locally when it tries to.
§ Ms Coffey
I shall not give way, because the right hon. Gentleman has taken up an inordinate amount of time in the debate. It is sad that our debate on community care is characterised by confrontation, conflict and confusion. That arises from the obsession of the Government and the Minister with what competition can deliver. We need to make changes that reward co-operation.
We support the objective of the 1990 Act: to give people genuine choice, particularly the choice to remain in their own homes. For that objective to become reality, there must be co-operation between the purchasing authorities and the range of providers. We believe that the private, voluntary and public sectors should be able to 933 make their important contributions. To blame Lancashire county council is to try to avoid responsibility for the legislation.
A local council cannot deliver the objectives of the Act by itself and nor can private providers or the health authority. Those objectives can be achieved only through partnership, particularly with carers, on whom we depend. They are the ones delivering community care. There are some excellent examples of good practice, showing what can be achieved by local authorities in spite of the obstacles that are put in their way.
The Minister should congratulate Lancashire county council and give it credit for some of the excellent things that it has done: for negotiating care agreements with four health authorities; for establishing joint planning with 12 NHS trusts; for establishing an intensive home care scheme, which facilitates early discharge from hospital and helps people to stay at home; for the provision of respite and short-term care; for the development of care homes to provide day care and outreach services; for the development of day care among independent sector providers; and for the joint development of dispersed housing schemes in the community.
Such initiatives are important for improving services and should be followed up across the country. There should be clearer guidance from the Department of Health on the approach to community care. Community care plans should be properly monitored by the social services inspectorate and by the NHS management executive. There should be better dissemination of information on cost-effective practices that deliver services in the most helpful way for those receiving them.
The research on social care outcomes recently commissioned by the Minister should have started in 1993. The present system of funding is obviously based on best bidders rather than best bids. I understand why. Without research on what the best bids are, it is difficult to decide which of the schemes put forward is best.
§ Ms Coffey
Yes. The hon. Gentleman should have been aware that that is part of our policy.
People are sick and tired of the present situation. They are sick and tired of the chaos and failure of the community care scheme. They know that things will get better only when there is a Government prepared to lead. No amount of debates will convince the people of Lancashire that the Government are acting responsibly on community care. There is failure in services to children and in services to families. Resources are being wasted because they are not being used in the best possible way. The elderly, the sick and children are suffering. That is a reflection of a Government who do not care. If they cared, they would have got their act together on community care a long time ago.
I look forward to hearing the Minister's response. I hope that he does not simply bash Lancashire county council over the head, but will respond to the wider community care issues that it is facing.
§ The Parliamentary Under-Secretary of State for Health (Mr. Simon Burns)
First, I must congratulate my hon. Friend the Member for Blackpool, South (Mr. Hawkins) on securing this important debate. I am delighted also to see my right hon. Friend the Member for South Ribble (Mr. Atkins) and my hon. Friends the Members for Blackpool, North (Mr. Elletson), for Wyre (Mr. Mans), for Chorley (Mr. Dover) and for Morecambe and Lunesdale (Sir M. Lennox-Boyd) present, as this is an important and sensitive subject.
The provision of community care is a vital function of local authorities. It offers help and an independent lifestyle, where possible, for the most frail and vulnerable members of society. Due to the vigilance and concerns of my hon. Friends in Lancashire, it seems that we now have to have an annual debate in the House on the failings of politically motivated county councillors in Lancashire and the provision of care in the county. It is a sad fact of life that old Labour is alive and well and running Lancashire county council—not new Labour for Lancashire, but neanderthal Labour.
At a time when all local authorities should be calmly and responsibly providing community care for the enhancement and improvement of the lives of those most in need, in Lancashire a highly politically motivated group of county councillors has hijacked all that is good about community care and turned it into a party-political football for the basest of motives. I remind those county councillors that the Government's policies for community care have helped many people in Lancashire—and throughout the country—to maintain an independent life and to receive better support in their own homes when faced with the problems brought about by disability or frailty in old age. Local authorities welcomed that policy and wanted the extra responsibility that it gave them. They must now accept responsibility for the decisions that they are making as they implement the policy. That includes Lancashire.
It might be helpful if I remind Labour county councillors in Lancashire of the words of Stanley Baldwin during the St. George's by-election in March 1931. He said:Power without responsibility—the prerogative of the harlot throughout the ages.It is time that councillors lived up to their responsibilities rather than parroted meaningless platitudes and slogans that do nothing to improve or enhance the quality or provision of community care. I shall explain some basic facts of life to them. The transfer of social security funding through the special transitional grant has resulted in substantial increases in the level of care to people in their own homes, in day services and in the use of care homes to provide the short breaks that are essential for many families. People entering residential or nursing care homes have benefited from the assessment process to identify their needs and match them to a care home of their choice.
The funding arrangements that we have put in place have also resulted in substantial growth of independent sector providers, real progress towards a mixed economy of care, and better value for taxpayers' money. Those are considerable achievements, both in Lancashire and elsewhere, but I have been concerned that the 935 implementation of the Government's reforms has not been as smooth and effective in some areas as we would have wished.
Several of my hon. Friends have today raised matters of serious concern about what has been going on in Lancashire. They also did so last year in a debate initiated by my hon. Friend the Member for Blackpool, North. Those concerns were reiterated today by my right hon. Friend the Member for South Ribble and by my hon. Friends the Members for Blackpool, South and for Wyre. They expressed concern about financial mismanagement and bureaucracy resulting in sudden cuts in services and other problems that Lancashire has not been able to deal with as it should.
§ Mr. Burns
I am sorry, but I do not have time.
My hon. Friend the Member for Blackpool, South mentioned the sad case of David Gardner. I am concerned about that case. I understand that Mr. and Mrs. Gardner's complaint about lack of continuity of care has been upheld, but that Lancashire county council has not yet said what it intends to do as a result. I hope that it will learn from the lessons, problems and stress that the Gardner family had to go through to get to this point. I shall ask my officials to obtain further information about the case and respond in writing to my hon. Friend once we know more from the social services inspectorate about what has been going on.
As a result of the problems highlighted in the debate last year, my predecessor was sufficiently concerned to ask the chief inspector of the SSI to provide a full report on Lancashire. That document confirmed that there was cause for concern about how Lancashire was implementing policy in several respects. Subsequently, the chairman of the social services committee, Mrs. Joan Humble, received our analysis of the problems and was asked to respond with an action plan. Our analysis raised serious issues, which required a considered and constructive response. Mrs. Humble's initial reply did not demonstrate such a response. After time for further and, thankfully, more mature reflection, however, a plan was duly received from Lancashire in September. I have asked the chief inspector of the SSI to monitor and report back to me on the implementation of that plan.
I am concerned to emphasise to Lancashire county council that decisions about the allocation of services should be taken and applied consistently, and with sensitivity to the needs and feelings of service users. The council has responded with assurances that disruptions in the continuity of care, which occurred in earlier years, have now been dealt with and that more effective monitoring arrangements are in place. I hope that that is indeed the case, and I shall be looking for evidence of that when Lancashire's action plan is reviewed.
I am also concerned that changes to the balance of services should avoid unnecessary disruption to service providers. The council has responded with an intention to publish its purchasing policies in a form that will be more readily accessible to service users and providers. Good communication among commissioners, providers and users of services is essential to effective management of 936 local change, and it is particularly important that providers are clear about the intentions of the council in determining its requirements for the future and clarifying how it will use its growing resources to meet those ends and needs.
The funding of community care has featured heavily in this debate, particularly in the comments of the hon. Member for Burnley (Mr. Pike). Total personal social services funding by the Government is a massive £9 billion including the social security contribution. That is a phenomenal amount of money compared with what was being spent in 1990.
I have also heard a great deal of protest from the county council about its inability to manage community care without even more money. When I look at the figures, however, I see an interesting picture. Within the total amount that the Government consider the county council needs to spend this year to provide a reasonable level of service is an element of £156 million for community care, which includes £61 million for its new responsibilities and the community care reforms. That represents an increase in total resources for community care since 1990–91 of 104 per cent. in real terms—over and above the rate of inflation. That means that Lancashire has done even better than the national average, which was a doubling of resources in real terms during that period.
It is for each local authority to set its budget, but given the accusations made by Lancashire, I find it surprising that it underspent in two financial years. It was clear that the hon. Member for Burnley was unable to explain that and the so-called justification offered by the hon. Member for West Lancashire (Mr. Pickthall) made me remain deeply sceptical of the line that he was trying to push.
Given the length of time that I have to reply, I shall not be able to cover all the points that I was prepared to cover. What I will say is that Lancashire is a concern. The SSI has looked into Lancashire. A plan has been drawn up, and it will be monitored with vigour because, as my hon. Friends have so rightly identified in the debate, it is crucial that people in Lancashire are given the best, most satisfactory and most effective care without the worries and disruption that, sadly, they have had to put up with all too often. It is crucial that Lancashire establishes a good rapport and working relationship with the private sector, which plays such an important role in providing help and care for those who need it.
My hon. Friends and others have raised interesting and useful points about how things are going in Lancashire. As I have said, I shall ask the SSI to monitor the situation there closely. In particular, I shall ask the chief inspector to seek further explanation from the council of its financial management and to consider whether further action by central Government is necessary. I do not take that decision lightly, but because of the excessively long-running problems that I have highlighted, it is the least that I can do to ensure that there is better provision of care.
§ Mr. Deputy Speaker
Order. I want to place it on record, for the guidance of hon. Members, that these are Back-Bench debates and that both Front Benches should recognise that the wind-up should not be longer than 20 minutes.