§ Order for Third Reading read.9.35 am
§ Mr. Marsha Singh (Bradford, West)
I beg to move, That the Bill be now read the Third time.
I shall try to be as brief as possible, but first I want to apologise to you, Madam Speaker, and to hon. Members as I shall have to leave before the end of the debate due to a pressing engagement in my constituency. Although I have tried to change it, I have been unable to do so. I shall be opening a post office and I cannot get out of the engagement. I hope that you, Madam Speaker, and the House will accept my apology.
My hon. Friend the Member for Ealing, North (Mr. Pound) has kindly agreed to stand in for me and I am grateful to him. However, I cannot see him in the Chamber at the moment; I just hope that he is watching the debate on a television somewhere and will turn up soon.
The Bill is not sexy; it is not controversial and it does not arouse the passions that we have recently witnessed in the House. It is nevertheless an important Bill which will ease the anxieties of older people already in residential care and the many thousands who may need such care in the future. It will enshrine in law their right to keep a proportion of their hard-earned income and savings. Indeed, it is a Bill that may even benefit right hon. and hon. Members, should the need ever arise.
I shall briefly give some background to the Bill. Although there have been rules on capital limits since the National Assistance Act 1948, the current rules came into force in April 1993 under changes introduced in the National Health Service and Community Care Act 1990. The changes in means testing for residential care included rules about both income and capital. Previous limits on capital caused grave and widespread concern and it was in response to that concern that in April 1996 the capital limit was raised, following an announcement to that effect in the Budget statement on 28 November 1995. Those changes were, first, that the level of assets at which people would no longer be eligible for assistance was doubled from £8,000 to £16,000 and, secondly, that the level of capital at which they would start to make a contribution was raised from £3,000 to £10,000.
The former right hon. Member for Kensington and Chelsea, then Chancellor of the Exchequer, said:In this Budget I shall be helping people who are earning and people who are saving. But I also want to help the people who have worked and saved all their lives. Some of them may be unfortunate enough to need care in residential or nursing homes in their old age. If they do, they may find their savings eaten away quickly to pay 1520 for that care. Of course, that is one of the rainy days for which people save. But the balance between the state paying and the family paying must be right.
§ Mr. Edward Garnier (Harborough)
I apologise for interrupting the hon. Gentleman at so early a stage in the debate. I am slightly confused as he referred to the former Chancellor of the Exchequer as being the right hon. Member for Kensington and Chelsea. Will he confirm that he means my right hon. and learned Friend the Member for Rushcliffe (Mr. Clarke)?
§ Mr. Singh
It was my confusion, not the hon. and learned Gentleman's.
As I was saying, the former Chancellor said about the balance being right:If it is not, many prudent people will complain that they are being treated unfairly compared with those who are unable or unwilling to save at all.To help people who have already put money aside, it was recently decided to exempt from VAT some forms of care provided in someone's own home. I now have two important further proposals.First, I intend to exempt from tax the benefits from a range of insurance policies that provide long-term care benefits. We should encourage, not penalise, people who decide to take more responsibility for themselves.Secondly, at present only people with assets worth less than £3,000 are not asked to make any contribution from their capital towards the costs of residential or nursing home care. People with assets worth more than £8,000 receive no financial support from the Government. When applied to care in residential and nursing homes, those limits are far too low.From April, and sooner if practicable, we shall more than treble the lower threshold, from £3,000 to £10,000, and double the upper threshold, from £8,000 to £16,000. That means that people in residential care who have worked hard and saved will now keep more of their own money. It will give many elderly people and their families more financial security and greater peace of mind. But we also want to find more ways of helping people who are now in work or recently retired and want to plan ahead to prepare for their old age."—[Official Report, 28 November 1996; Vol. 267, c.1067.]The next day, the then Secretary of State for Social Security, the right hon. Member for Hitchin and Harpenden (Mr. Lilley) said:One of the main financial concerns facing elderly people is the prospect of needing long-term care. Providing for their needs in old age is, of course, one of the reasons why people save, but Age Concern and others have argued that the capital limits applying to people in residential and nursing care are tougher than the rules for people who stay in their own homes. They have urged us to raise the capital limits for residential and nursing care to those that apply to housing benefit.We are going further than that. We are not just doubling the upper limit to £16,000 but more than tripling the lower limit. Under our proposals, people with up to £16,000 of assets will qualify for state help and people with capital of less than £10,000 will not be required to make any contribution from their capital towards the cost of basic residential care."—[Official Report, 29 November 1996; Vol. 267, c. 1214–15.]
§ Mr. David Tredinnick (Bosworth)
I am listening to the hon. Gentleman with great interest. Will he explain how he has arrived at the new thresholds? It will be 1521 interesting for the House to know whether the hon. Gentleman has talked to the Treasury about this matter, as there are grave financial implications.
§ Mr. Singh
If the hon. Gentleman had listened to what I was saying he would know that those thresholds were introduced by the Chancellor of the Exchequer in his Budget statement in 1995 and by the Secretary of State for Social Security the day after the Budget statement. Those thresholds are not new, but existing ones that were introduced by the previous Government—the money was allocated in the 1995 Budget.
§ Mr. Tredinnick
The hon. Gentleman must forgive me if I did not understand him correctly. What I was getting at was whether the current Treasury team under the new Government had given its part or total blessing to the Bill. It is one thing to look at what the Conservative Government proposed, but there has been a change of Government—indeed, the hon. Gentleman is here because of that change of Government. It is germane to the debate for us to have an understanding of the hon. Gentleman's arrangement with the Treasury as, without that, the basis of the debate is undermined.
§ The Parliamentary Under-Secretary of State for Health (Mr. Paul Boateng)
Perhaps I can assist the hon. Member for Bosworth (Mr. Tredinnick). I shall be making the Government's position clear in due course, but I can say now that we have no problem with the limits.
§ Mr. Singh
I do not have the words to speak on the Bill as eloquently as did the then Chancellor of the Exchequer and the then Secretary of State for Social Security in the debates when the capital and income limits were introduced.
Those changes were welcomed by the whole House and they should have been implemented without any problems, but local authorities began to abuse the rules in different ways. Sefton borough council decided to disregard the limits and adopted a strict rationing regime. Dozens of people were refused assistance—dozens of people had to wait until their assets were below £1,500 before they could receive help they needed. That £1,500 was just enough to pay the funeral expenses. Dozens of people in Sefton were subjected to misery and hardship.
Help the Aged took the matter to judicial review and, to everybody's surprise, the judge upheld the actions of Sefton council.
§ Mr. James Gray (North Wiltshire)
I think that on these occasions fair dues all round should be the case. I hope that the hon. Gentleman will also give credit to Age Concern, which also brought the judicial review to which he referred.
§ Mr. Singh
I shall pay due tribute to Age Concern during my speech.
1522 The judge's decision led to widespread anxiety among older people, their families, their carers and organisations acting for them, such as Help the Aged and Age Concern. Thankfully, the Sefton judgment was overturned in the Appeal Court on 31 July 1997, but there is still a great deal of uncertainty and anxiety among older people and organisations acting for them because of the Sefton judgment.
I am reliably informed that some local authorities are telling people with less than £16,000 to go on waiting lists. Long delays in assessments are leading people to eat into their own assets—assets which were supposed to have been guaranteed by the House—and local authorities frequently refuse to backdate the funding. The process constitutes a form of Sefton by the back door, which is a disgraceful state of affairs. That is why the Bill is necessary.
It is essential that the law makes the position absolutely clear. If our previous guarantees to older people are being flouted, we must legislate. It is essential that, through the Bill, we amend the National Assistance Act 1948. I hope that the Department of Health will go further and ensure that assessment of need is separate from, and precedes, assessment of a person's financial circumstances.
I hope that the Department will ensure that local authorities do not unreasonably refuse to assess someone for community care services and residential accommodation. I hope that the Department will ensure that local authorities do not delay assessments by setting deadlines. I hope that the Department will ensure that local authorities have a duty to carry out an assessment, whether or not care and attention is otherwise available. I hope that the Department will ensure that, once a person is assessed as needing residential care, lack of resources cannot be used as a reason for refusing or delaying care.
§ Mr. Nicholas Soames (Mid-Sussex)
I am grateful to the hon. Gentleman for giving way and I have a great deal of sympathy with the points that he is making. Does he agree that we are talking about a two-sided contract? It is not just that the local authorities should, as he rightly says, speedily undertake those assessments so that old people are able to move to another care regime; local authorities should pay nursing homes and other institutions promptly for the services that they have contracted from them. Some councils do not. I am dealing with such a case in my constituency, where a nursing home has persistently been kept waiting by a county council under a contract arrangement, to the great disadvantage of the people who live there.
§ Mr. Singh
I agree with the hon. Gentleman. I hope that the Government Bill that will set out a statutory right to interest on the late payment of bills will help. If there is a contract, the local authority involved should pay on time. I am sure that the Bill to which I have referred will involve local authorities.
I said in my introduction that this is not a Bill which excites passions, but I believe it should. We should be passionate about the rights of older people. We should be passionate about the fact that older people are being ripped off. We should be passionate also if older people are being denied the care to which they are entitled. Older people should be able to keep the assets that they worked hard to secure and for which they saved hard. Every right hon. and hon. Member may one day be grateful for that passion.
1523 Finally, I thank Age Concern, Help the Aged and the Department of Health for their help and advice and I thank my hon. Friend the Minister for his encouragement. I commend the Bill to the House.
§ Mr. Richard Page (South-West Hertfordshire)
I congratulate the hon. Member for Bradford, West (Mr. Singh) on bringing the Bill before the House. There is a skill in choosing Bills that are available to private Members—ones that will not cause excitement and delay. It is wise to choose a Bill that can speedily pass through the House and take its place on the statute book, especially if it will provide the support and help that is intended.
The hon. Gentleman mentioned passion. I believe that the Bill raises a passionate issue and one for which we should fight. If we cannot help the elderly, who can we help?
§ Mr. Page
There is no dissension between us. I agree with the hon. Gentleman that the Bill fully deserves the support of the whole House. Hon. Members on both sides who have supported the Bill have given us the opportunity to clarify the responsibilities of local authorities towards people who are in need of residential care.
I find it rather sad that local authorities should abuse weaker members of society, but I suppose that Parliament is here to ensure that such people are protected.
§ Mr. Tony Baldry (Banbury)
We should not talk of local authorities as a whole but of Sefton, which at the time had no overall political party control although it had a number of Liberal councillors. Does my hon. Friend agree that it is appalling that on a day when the House will be debating several significant Bills there is not one member of the Liberal party present in the Chamber?
§ Mr. Deputy Speaker (Mr. Michael J. Martin)
Order. Let us concentrate on the matters that are before us and not on who is here and who is not.
§ Mr. Page
That is a matter on which I shall touch lightly when I make some further remarks. I disagree with my hon. Friend the Member for Banbury (Mr. Baldry) to the extent that Sefton is not alone; there are one or two 1524 other councils that are playing the same game. I am sure that if my hon. Friend reads the details that are in front of him this will all become relatively clear.
It is right that people who have a reasonable amount of capital should be asked to make a contribution towards the cost of their care. I do not think that everyone should lie back and rely on the state, saying, "Give me the necessary money." That view was taken by the previous Parliament and I am glad that it is sustained in the Bill.
§ Mr. Soames
I am sorry to interrupt my hon. Friend as he moves into the full power of his oratory. I am sure that he agrees that the Bill is important and that the hon. Member for Bradford, West (Mr. Singh), who I am sure is not moving too far from his place, deserves great credit for introducing it. However, there are many Conservative Members—[Interruption.] I think that of one of my hon. Friends' pacemakers is going off. Let us hope that it is nothing serious. A by-election would be inconvenient for my party at the moment.
There are many on the Conservative Benches who feel that the Bill should have been introduced as a Government Bill. Is it not odd that the Government, when in opposition, were extremely earnest on this issue but have chosen the long, detailed and difficult way of introducing legislation—although extremely competently presented—through a private Member's Bill when the matter could have been dealt with perfectly well in last year's Finance Bill?
§ Mr. Page
For the record, it was not my pacemaker that was going off. Mine is under control.
I can only agree with my hon. Friend. The Bill deals with an issue which should have been dealt with on the statute book earlier. The private Member's Bill procedure is a well-known route but it is subject to the hazards and vagaries of the House, as one or two other hon. Members have discovered on producing private Members' Bills. I am glad that this Bill will not be thwarted by other hon. Members, but will go through the House and on to the statute book. I hope that that process will be as quick as possible. If I may proceed with my speech without the support of my colleagues intervening every 30 seconds we might make some progress.
As I have said, I believe it right that members of the public should make a contribution towards their upkeep as they become older and if they have some resources. It is entirely wrong that some local authorities have cynically attempted to create and exploit the technical language—the hon. Member for Bradford, West referred to this briefly—in sections 21 and 22 of the National Assistance Act 1948 to avoid meeting their justifiable responsibilities. They have chosen to do so until elderly people's savings have been reduced to less than £1,500.
As the hon. Member said, it was the intention of the previous Government, approved by Parliament, that once an individual's capital fell below £16,000, and subject to the level of their income, local authorities should begin to contribute towards the cost of their accommodation and that once that individual's capital had fallen to £10,000, local authorities should meet the full cost. The Bill would ensure that there is no legal loophole that allows local authorities that want to take advantage of the elderly to disregard those requirements.
§ Sir Nicholas Lyell (North-East Bedfordshire)
My hon. Friend says that the Bill would ensure that there will be 1525 no legal loophole. That is one of the things that we have the opportunity to test in the Minister's presence on Third Reading. There is a serious question whether the Bill does not still leave a legal loophole; I understand that if the local authority thinks a person is not in need of care and attention because he or she still has enough money—between £16,000 and £1,500—to continue to pay for himself or herself at home or in some other form of care, the Bill will not bite. Has my hon. Friend had an opportunity to consider that question?
§ Mr. Page
My right hon. and learned Friend makes a valuable point. I hope that the Minister will clarify that issue when he replies. Accommodation today is so expensive that, frankly, it would be only a matter of months before the local authority's decision to take up, instead of avoid, its responsibilities would be thrust upon it. This issue needs to be clarified, not only to ensure that local authorities behave in future but for the peace of mind of elderly people.
When they are young and active, as you are Mr. Deputy Speaker, people have confidence, but when they become elderly and frail they need help and support. They do not need the worry that they could suddenly be in desperate need of support from local authorities or the various bodies that exist to help.
Hon. Members will be familiar with local authorities' claim that they are underfunded. The director of my local social services authority, Hertfordshire county council, wrote to me last October saying that demand from elderly people for services was rising in line with the growth in their number. He was afraid that the county council budget could not cope with the demand. As a result, basic services such as shopping and cleaning help have been withdrawn—despite a huge increase in Hertfordshire's council tax this year of some 10 per cent: it is a Lib-Lab-run authority—so that the authority can concentrate on those who, unfortunately, are housebound or unable to feed and wash themselves.
I am deluged by letters from elderly people who need help and support. Their letters are exceedingly moving and worrying. It is difficult to reconcile the huge increase in Hertfordshire's council tax and the huge cut in its services with the fact that London seems to have survived swingeing cuts. The fact that there might be an election, of course, is pure coincidence, and I must not let anybody draw any inferences from the lack of services in Hertfordshire.
§ Mr. Tredinnick
I am listening with interest to my hon. Friend. What specific concerns have been expressed by elderly constituents? Their main concern is covered by the Bill, but it would be interesting to know whether he has deduced anything in particular from his correspondence.
§ Mr. Page
My hon. Friend tempts me down paths that are peripheral to the Bill. I make the point that the concerns expressed by the elderly in my constituency result from the cut in services and the lack of financial support. I raise this point because it is germane to the Bill. If we cannot get the financing right, we will not be able to look after people properly. I do not want people to suffer cuts in services through lack of support and finance if that can possibly be avoided.
1526 The list of concerns raised by the elderly is long and serious, but if I had to choose one item that is causing most concern it is the lack of home help for people who are unable to look after themselves but want to stay in their own home. If we do not tackle that properly there will be greater pressure on residential homes as more and more people say, "I want to move into a residential home because I can't cope in my own home." That is why the lack of support for home help is most serious and damaging.
§ Mr. Gray
Does my hon. Friend agree that, often, the shortage of social services funding for home care and home help comes about not so much through a lack of central Government funding or a lack of funding from local taxpayers as through incompetent handling of the funds available to the social services department? He will be interested to hear that Wiltshire county council—a Lib-Lab council—spends some £70 to £80 a week more putting people in long-term care homes run by the county council as an ideological preference to the perfectly excellent private homes throughout the county. Does he agree that that is a disgrace and that the net effect is precisely the shortfall in home care that he describes?
§ Mr. Page
I do not want to chide my hon. Friend, but he is trying to lead me into areas about which I have no knowledge and expertise. I have no idea about the way in which his council operates. I have no idea about its policies—just as I have no responsibility for the Liberal Democrats.
I return to the point that I was making. If we do not get our finances correct, greater pressures will be placed on residential homes, and that will mean even greater pressure on the taxpayer. That is why I come back to the sensible, lower-cost support of home help, which has enabled people to stay in their own homes, in their own community, which, ultimately, reduces the bill to the taxpayer. It is a win-win situation. I suggest that my hon. Friend goes back to his council and suggests that this is a way in which costs could be reduced to the greater enjoyment of elderly people.
I shall not go on about the shortcomings of councils—Hertfordshire or any other. I produced the example of Hertfordshire because I know that the arguments of local authorities that cannot meet their full obligations to the elderly because of a lack of financial resources is one with which Ministers in the present Government will become more familiar in the years ahead.
I cannot believe that any local authority can seriously maintain that the capital of an individual in its area should fall below £1,500 before it feels legally bound to offer assistance to meet the costs of residential accommodation.
The hon. Member for Bradford, West referred to the cost of a funeral. I am not an expert on the cost of funerals in Merseyside, but I studied some figures produced by the National Association of Funeral Directors. In parts of the country, a standard burial costs more than £2,000. If the Bill did not address the issue of savings, everybody in Merseyside in this situation would have to be cremated, as the choice of a burial would be beyond them.
The conduct of Sefton metropolitan borough council in trying to insist that people in need of residential care should have their savings reduced to this minute level merits outright public condemnation. It puts its emphasis 1527 on its policy—draining the resources of vulnerable people—above its duty of care. Moreover, it does so on the basis of the argument that possessing capital of more than £1,500 and less than £16,000 means that people might have the means to secure the care and attention that they require.
If that really is the substance of the council's position, it means that it places its accounting position ahead of its legal obligation to help elderly and vulnerable people. Morally, that is a shallow, repugnant argument. Legally, as has been said, the Appeal Court judgment last October showed that that argument is morally and legally bankrupt. The council's defence—that its actions were solely driven by its lack of financial resources and that it had no desire to challenge the law or attack people's savings; that line was taken by the chairman of the social services committee last April—is just not credible. As soon as the judgment of the Court of Appeal went against it, Sefton council's assistant director for older people, Mr. Alan Lewis, told The Independent on 23 October thatyears of financial stringency have paid off and after reviewing our financial circumstances we found we are now able to meet the provisions affecting this particular group of people".Halfway through this financial year there was money to meet the needs for residential care and accommodation that had previously been impossible to find.
The only redeeming feature of the council's response was that it had become willing to recompense the people who had been wrongly forced to pay the costs of residential accommodation. They will be paid back with interest. The hon. Member for Bradford, West mentioned the statutory right to interest. I am not sure that it is a panacea for all late payment, but I am glad that some extra compensation is to be paid to those people. I am not certain how many are involved. The Independent quoted a figure of 70; The Guardian said that 100 people are affected. However many, if it is more than zero, it is one person too many.
Whatever view the council took of the level of funding provided by the previous or the present Government for the community care programme, the effect of its policy decision was to place its assessment of its financial resources ahead of the assessment of the elderly vulnerable people who needed help to secure appropriate residential accommodation. The elderly in Sefton and one or two other places were being held to ransom in an argument between local government and central Government over the funding levels that the latter should provide. I hope that such a case will never happen again. I am happy to support the Bill.
§ Mr. Edward Garnier (Harborough)
I am most grateful to be called today, not least because it gives me an opportunity to talk about a subject that has concerned me for some little while and which I discussed with the Under-Secretary of State for Health when we debated, under the auspices of the Hansard Society, the question of the law and Parliament. I am brought to that subject because the Bill has its genesis in the case of the Crown v. Sefton metropolitan borough council.
It is often said, as much by Conservative Members of Parliament as others I fear, that judges and lawyers are out of touch with the real world. In the case of 1528 Mrs. Blanchard, who was the victim of Sefton metropolitan borough council's community care policy, the Court of Appeal, presided over by the Master of the Rolls, Lord Woolf, reached a conclusion that demonstrated not that the courts were out of touch with the real world but that they were very much in touch with it. I hope that my hon. Friends who have taken a different view to mine—a view that the Minister shares—will from, in the light of maturer reflection and the Master of the Roll's judgment, come to take a more sympathetic view.
§ Mr. Andrew Rowe (Faversham and Mid-Kent)
Does my hon. and learned Friend agree that the chances of judges in the Court of Appeal being in touch are far greater in cases involving people over 75 than in almost any other kind of case?
§ Mr. Garnier
I disagree whole-heartedly. The retirement age for members of the Court of Appeal is 75, so the point that my hon. Friend makes is a bad one. It demonstrates one of the difficulties that we have. It is easy to assume that the Court of Appeal exists in some sort of Gilbertian world in which a lot of geriatrics are finding it difficult to string two words together or reach rational conclusions. If my hon. Friend cares to look, he will find that the quality of the intellects of those who sit on the Court of Appeal bench is immensely superior to that which is demonstrated by the profusion of words to which we sometimes listen in this Chamber. I have to be careful. Here I am trying to persuade my hon. Friend that my argument is good, attractive and worthy of support. The last thing that I want to do is to be accused of being abusive to him. All that I would say is that the premise on which he advanced that intervention was wrong. I hope that he will care to go to "Who's Who" and look up the ages of Lord Woolf, and Lord Justices Roch and Henry. He will find that they are some little way under the age of 75 and even 70.
I congratulate the hon. Member for Bradford, West (Mr. Singh) on his Bill and on choosing a subject which is largely uncontroversial and brings with it a social benefit, unlike some of the other private Members' Bills that we have discussed recently. I dare say that many people in the hon. Gentleman's metropolitan area in the west riding of Yorkshire will feel that he has done them a service. I congratulate him on that. I want to analyse to some extent the decision of the Court of Appeal presided over by the Master of the Rolls last July so that my hon. Friends, who have appeared in greater numbers than Government supporters, can understand why I believe that the relationship between two great limbs of our constitution—the judiciary and the legislature—can be fostered to assist the third limb of our constitution, which is, the Executive, represented most ably today by the three hon. Members on the Treasury Bench—the Under-Secretary of State for Health, the Minister of State, Department of Trade and Industry, and the hon. Member for Tyne Bridge (Mr. Clelland). If that relationship is fostered, the House and the other place will produce and digest legislation in a way that produces better law. I believe that the Bill is a product of a sensible union of view and opinion.
The Master of the Rolls said at the outset of the Sefton case that he identified three main issues. I suggest that those issues applied not only to the facts of that case but to the general area of social policy involved. As the 1529 Under-Secretary of State for Health already appreciates, having practised in the courts and no doubt dealt with similar cases, the case involved three primary issues. The first was whether a local authority, in deciding whether an elderly person was in need of care and attention—in which case it would be required to make arrangements for residential accommodation to be available to her—was entitled under section 21(1)(a) of the National Assistance Act 1948, to have regard to its limited financial resources. That is the big political question to which the Bill attempts to provide an answer that is acceptable to most people.
The second issue that the Master of the Rolls identified was whether if Sefton's limited resources were relevant, they justified the policy that it adopted. It is a policy which many cash-strapped local authorities have to consider. It is perhaps unfortunate for Sefton that it is the first borough council to have caught the attention of the relevant charitable interest groups and that its activities and policy have persuaded a charity to take the matter to court.
The third issue was whether, in determining whether care and attention was not otherwise available to a person, an authority was entitled to take the resources of that person into account, even if they fell below the levels prescribed by the National Assistance (Assessment of Resources) Regulations 1992 for the purposes of sections 22 to 26 of the 1948 Act.
I appreciate that, at the moment, that sounds deeply dry, deeply boring and thoroughly technical, but, unless one understands the foundations of social policy and the legal framework within which it is constructed, it is extremely difficult to understand quite why the Bill promoted by the hon. Member for Bradford, West is a beacon, or perhaps even a lighthouse, for other jurisdictions and other countries.
§ Sir Nicholas Lyell
My hon. and learned Friend may be able to assist the Under-Secretary of State for Health by highlighting a real point in this case. It is not entirely clear to me whether Sefton borough council took into account the fact that it was strapped for resources, and therefore had a policy under which people had to spend their modest capital, down to £1,500, or whether it believed that people with between £1,500 and £16,000 were not in need of care, because they had a small amount of personal resource to look after themselves. Can my hon. and learned Friend elucidate that point?
§ Mr. Garnier
After six or seven years as a Member of Parliament, I have learnt that the Under-Secretary rarely needs help, and when he does, he does not take it. However, I shall try to help with the argument put to me by my right hon. and learned Friend by having a go at explaining what Sefton borough council was doing, which may help with our deliberations. If I get my explanation wrong, I am sure that the Under-Secretary, who is listening with great rapture, will put me right with the assistance of his official advisers.
There has been a great deal of press and other comment on the case. As I understand it, the borough council was applying its policy in a discriminatory way to distinguish, perhaps for financial or other reasons, between what it regarded as real welfare cases involving elderly residents 1530 who had become enfeebled enough to need residential care, as happens with elderly residents in Manchester, in Sheffield, in Bedfordshire or in north Wiltshire, and elderly people who had put themselves in retirement homes in the seaside resort of Southport pre-emptively—before they needed residential care as the Department of Health understands it—and while they were still in relatively good health.
The bulk of Sefton borough council's policy addressed the issue of who was and was not to be assessed as needing residential care. The matter of their capital allowances were a detail of that policy, but it has taken on far greater significance for obvious political and social policy reasons, perhaps because Sefton borough council was insensitive and inept in the way in which it developed, arrived at and presented its policy.
§ Mr. Garnier
I am sure that the Chancellor of the Exchequer has no desire to bankrupt my constituents by imposing an extra 20p a gallon on fuel duty, but that will be the consequence. Any decision maker in national politics, national Government or local government must be taken to have accepted responsibility for, and anticipated the consequences of, his decisions. I cannot acquit the official at Sefton borough council of ignorance or of lack of responsibility for the consequences of his actions or advice any more than I can acquit the Chancellor of the Exchequer, whose colleague the Under-Secretary looks a little puzzled. I dare say that the cost of petrol does not affect his constituents in Brent quite as much as it does mine. I hope that my hon. Friend the Member for South-West Hertfordshire (Mr. Page) will allow me to leave that point hanging for others to pick up.
I am happy that Labour Back-Bench representation in the Chamber has now trebled, and three Labour Back Benchers are present.
§ Mr. Garnier
I am sure that that is entirely right. I offer my congratulations to the hon. Gentleman on his half century this year: we should therefore discuss community care for the elderly with some care.
In the Sefton case, which I was briefly analysing, the—
§ Mr. Deputy Speaker
Order. Perhaps the hon. and learned Gentleman will assist me. We have discussed the background to the Bill at great length, and we must now speak about its content. He has assisted me and given me a grasp of why we are having such a debate on Third Reading, but we have passed from the debate on the background—what is done is done. We are discussing Third Reading, and we should talk about content.
§ Mr. Garnier
I fully understand your point, Mr. Deputy Speaker. Perhaps I may illustrate what I am 1531 doing by giving this example: a tapestry is composed not only of threads of wool, but of latticework through which the wool is woven.
§ Mr. Deputy Speaker
Order. The hon. Gentleman makes my point. The backcloth has been fully explained to me. Now I must look at the tapestry.
§ Mr. Garnier
You are, Mr. Deputy Speaker, a man of great and acute perception. My anxiety is that my hon. Friend the Member for Faversham and Mid-Kent (Mr. Rowe) is not quite as quick as you, and his intervention suggested that further explanation of the backcloth was required so that he would understand the interwoven colours created for us by the hon. Member for Bradford, West, who represents a textile constituency. I shall move on because, if I am not careful, my hon. Friend the Member for South-West Bedfordshire (Sir D. Madel), whose patience may not be as great and accommodating as yours, Mr. Deputy Speaker, may contrive to put me in a community care home.
Rather than wait for my explanation, hon. Members should study the law report on the Sefton case; there is much to learn from it. My hon. Friend the Member for North Wiltshire (Mr. Gray) wishes to intervene, but I first give way to the hon. Member for Bradford, West.
§ Mr. Garnier
The hon. Gentleman is a man of unfailing courtesy, and I fully understand that he has constituency engagements to attend to. I was slightly amused when he said that he had a post office to open and could not get out of it.
§ Mr. Garnier
I send him to Euston station with our good wishes, and trust that by the time that he reads Hansard his Bill will have made the progress that he and its supporters wish for it. I wish him all the best.
I would have made other arguments, but you, Mr. Deputy Speaker, required me to leave them to another forum. Before coming to the second thrust of my argument, I give way to my hon. Friend the Member for North Wiltshire.
§ Mr. Gray
Yes, but my hon. and learned Friend is not being paid by the hour in this place.
I bring my hon. and learned Friend back to the reason why he was expatiating a little on the judgment in the Sefton borough council case. An important point about the Bill highlights the difficulties caused by it not having been considered in detail by a Standing Committee.
1532 The point that the judge in the case missed was Sefton borough council's feeling that certain residents of Southport, being perfectly fit and healthy, did not need its financial support. The point about capital allowances is that they are awarded at the point when social services departments decide that a person needs care and attention that would otherwise be unavailable to him. Sefton borough council feels that, following the judgment, many people could receive support who would not otherwise be considered to need it.
§ Mr. Garnier
That is true, and relates to what I said in response to my right hon. and learned Friend the Member for North-East Bedfordshire (Sir N. Lyell). If people are not assessed as needing residential care, the capital allowances for residential care do not apply. The Bill does not bite on that aspect of social policy. It would bite only in the cases of elderly people who had already been assessed as needing residential care, like Mrs. Blanchard.
§ Mr. Dominic Grieve (Beaconsfield)
The fear that has been expressed in that context is that unscrupulous local authorities might exploit the loophole and fail to assess people at all, or simply not get on with the job. People who fell below the £16,000 threshold would then receive no support from the local authority. Does my hon. and learned Friend agree that, even if that problem cannot be addressed in the Bill, we may have to address it eventually?
§ Mr. Garnier
It may be possible to address it in the Bill if their lordships take up my hon. Friend's point, but, on Third Reading, it is not for us to do more than acknowledge his point and hope that others who take a close interest in these matters—including the Minister—will do what they think appropriate.
It is still possible for a council to save on the cost of caring for elderly people who have put themselves into homes simply by not assessing them as having any needs as defined by statute. The hon. Member for Bradford, West may not have come to grips with that, but the House should do so before the Bill goes to another place. The capital of elderly people could be run down with no more consideration than the council would have for someone aged 30 who was staying in bed-and-breakfast accommodation or an hotel. How councils behave in such cases will depend on their integrity and good will, and on how they make difficult choices about prioritising their resources.
Government is difficult enough for the Conservative party, but we now have a Labour Government who have not made a decision of any complexity or national significance for 18 years except within their own party system. It is essential for us to remind not only the new Government but local authorities of the huge importance of getting priorities right, and having the courage to stand by their decisions when put to the test. I see that the Minister agrees whole-heartedly with my point about the need to order priorities properly.
The Bill illustrates just one aspect of that need. I hope that, if we allow it a speedy passage to the other place and, eventually, the statute book, borough councillors throughout the country—as well as their officials and advisers—will realise that the House is now watching them to make sure that elderly people are not artificially 1533 prevented from gaining access to the care that they so richly deserve after a lifetime of hard work, thrift and saving.
§ Sir Nicholas Lyell (North-East Bedfordshire)
I am grateful for the opportunity to make a brief speech. I welcome the Bill, and congratulate the hon. Member for Bradford, West (Mr. Singh) both on promoting it and on steering it successfully through its stages so far.
The question of how to pay for old age is probably one of the most difficult questions of the day. As people get older, they experience real anxiety about how they would manage if they had to go into a home: it preys on everyone's mind, in connection with themselves or elderly relatives. Indeed, they may worry about how their children will manage in the future. This is rightly a topic for political debate.
I shall not dwell on the distinction between the Government and the Opposition—between the Labour and Conservative parties—as reflected in what is sometimes described as the Chancellor's smash-and-grab raid on pension funds through the abolition of advance corporation tax. In a sense, however, that is part of an overall approach to the subject. It is important to enable people to build up capital so that they can care for themselves, and—here there should be common ground between the parties—to keep at least some of that capital to pass on to their children.
I have a particular insight, as one who was first a junior Minister in 1986, in what was then the Department of Health and Social Security. The Minister of State was one John Major, my right hon. Friend the Member for Huntingdon. At that time, Conservative party policy was to increase the amount of protected capital from £3,000 to the still modest figure of £6,000, which has subsequently been increased to the £16,000 in the Bill. It must be borne in mind that that £16,000 is not wholly protected. When people's capital has dwindled to £16,000, which is probably only about half the value of a modest house—even in Sefton, in the north-west of England—they will still have to pay a substantially higher weekly sum for board and lodging in a residential old people's home.
The Bill aims to resolve what was, frankly, an abuse introduced by Sefton borough council. The ideology of those councillors was different from the ideology that I think prevails today—in the country and, I hope, in the Government, although it is their party which predominates in Sefton. I am grateful to the Government for at least moving that far.
Sefton borough council was saying that it would not provide accommodation for someone who was in need of care and attention because of the frailties of old age until that person's capital had dwindled from £16,000 to £1,500. The Bill seeks to correct that, which is why we welcome it. Let me make a point which, although rather technical, is important. Clarification of it, even on Third Reading, may assist the construction of the Act that this Bill will become, and of national assistance Acts generally. The point was highlighted by the Master of the Rolls when the Court of Appeal had to make a decision in the case involving Mrs. Blanchard.
1534 The point is that, provided that it is clear that an old or disabled person—people may be frail for reasons other than old age—is in need of care and attention, there is no entitlement to take into account the local authority's alleged lack of resources. I accept that local authorities are under pressure.
I think that we can be sure, but I should like clarification on the point that one is not entitled to take into account the fact that a person still has £16,000 and that the amount has not dwindled to £1,500. A person who is down to £16,000 must be careful if he is in need of care and attention. He should not be told that he may spend £14,500 on looking after himself and then make another approach to the authority. Such a loophole seems to exist because the fundamental legislation, the national assistance legislation as amended from time to time, refers to people who are in need of care and attention that is not otherwise available to them.
Of course, money gives freedom and the power to purchase services. Notwithstanding the Bill's intention, it could be said that people could spend their money on caring for themselves, perhaps marginally by upping the amount of private home help. That means that they could put off going into residential accommodation for a long time and, of course, that will prolong the anxiety of the elderly and, in practice, it may force them to deplete their modest resources from £16,000 to whatever figure the relevant local authority—it may not be the one in Sefton—may set. It may not stick to £1,500.
I support the Bill and hope that it will be successful in overcoming the difficulty. I have highlighted the issue, albeit at the 11th hour on Third Reading because it is important to bring it to the attention of the House so that the Minister may comment on it. If we cannot put it right at this stage of the Bill's progress, I hope that the Government will be sympathetic to my point and will use some future Finance Bill or assistance Bill to close continuing loopholes.
§ Mr. Andrew Rowe (Faversham and Mid-Kent)
I fear that I have to join the Bill's promoter in apologising to the House because, if the subject is debated for the length of time that it deserves, I may not be here for the final speeches. I hope that the Minister will forgive me if I have to leave early. One of my local hospitals is threatened with closure and all hon. Members will understand that such a matter requires attention from the hon. Member concerned.
We debate this important Bill against a background of quite alarming figures. The latest population estimates of mid-1996 show that the United Kingdom's population aged over 75 numbered 4,192,000. Of course, a high proportion of people who live until the age of 75 will live until they are over 90. One of the enormous difficulties for Britain's elderly is to have any idea of how long they have to budget for. They have absolutely no way—none of us has—of knowing when the asteroid will hit them, and they cannot know how much money they will need or how to apportion it.
The mean cost of residential care is £275 a week. In my part of the country, that is modest, and it is easily seen that the fear of destitution in old age is acute. Research suggests only 7 per cent. of the elderly are confident that their children will look after them. I think 1535 that they are being unduly pessimistic because Age Concern figures show that we in this nation still look after elderly relatives. However, 90-year-olds have 65-year-old children and, at the age of 65, many people are not in particularly good health. Their capacity regularly to drive long distances to look after a parent who has moved or from whom they have moved is much impaired. Even those children who want to look after their parents are often in no position to do so.
As the Chancellor told us on Tuesday thathalf the population have only £200 or less in savings",—[Official Report, 17 March 1998; Vol. 308, c. 1102.]the demand for publicly provided residential care at the full cost to the taxpayer will rise sharply. I can tell the Minister that, among the plethora of reviews that have been undertaken by the Government, the tangled and now entirely historically based relationship between national assistance Acts, national health service Acts and community care Acts needs to be completely overhauled.
There is something ridiculous about the conflict between the regulations governing people in residential care, those in long-term hospital care or those who are being looked after in the community. For example, a person in a private residential home probably has to pay for medication, but a person in a long-term national health service bed does not, although he may be almost exactly the same kind of person. The anomaly that the Bill tries to correct clearly points up the fact that the way in which we provide residential care needs to be wholly re-examined. Given a sufficiency of respite care and the ability to take it regularly, many elderly people could survive satisfactorily where they would prefer to survive—in their own homes. However, the elasticity of social services provision is so tight that that is now difficult to provide.
I also view with considerable concern the explosion in child care. Whatever my personal views about the sense of paying people to look after other people's children and denying the parents the kind of income that would allow them to look after the children themselves, which would be much better for them, the pool of carers from whom the elderly would expect support will be drained by an explosion in exactly the same kind of people being recruited into the rather more appealing task of looking after children. That will cause considerable anxiety to everybody in the field, and I hope that the Government are taking that on board.
There is another enormous difficulty and a real conundrum. For the past 75 years, we have encouraged people—by mortgage tax relief and a host of other devices, intended and unintended—to view their homes as their principal stock of value. That is not the case in many other European countries. In many countries of mainland Europe, people rent accommodation and keep their savings in some other form, but in Britain the biggest store of value is in the home. Many people have bought their houses with the specific intention of having them as stores of value against a rainy day, but when the rainy day comes, they have become so emotionally attached to what they no longer call a house but now call their home that they are deeply resentful of any suggestion of moving out.
§ Sir Nicholas Lyell
My hon. Friend raises an interesting sociological point. That was not always the 1536 case. My grandfather, who could probably have afforded to buy a house, never did and always rented accommodation off a large landowner, which tended to be the Harrow Trust or something of that nature. Such a system left people with free capital to look after themselves, which was much more effective than tying it up, as we tend to do now. Perhaps we should not be so ideologically attached to putting so much money into our homes and should try to encourage people to go in a different direction.
§ Mr. Pound
On a point of order, Mr. Deputy Speaker. Although I realise that the accommodation arrangements of the ancestors of the right hon. and learned Member for North-East Bedfordshire (Sir N. Lyell) are of extreme interest to him and his immediate family, what remote relevance has that to the matter under discussion?
§ Mr. Rowe
I of course accept a rebuke, Mr. Deputy Speaker, but the fact is that the Bill seeks to set right an anomaly and, as my right hon. and learned Friend the Member for North-East Bedfordshire (Sir N. Lyell) has pointed out, there is some doubt about whether it will succeed in preventing local authorities from introducing various forms of informal rationing, which will be just as deleterious as the form of rationing that Sefton council introduced.
I am green with envy about this measure because I have never yet won any of the ballots in this House. I have given up subscribing to the national lottery on the basis that my experience in this place suggests that I shall never win anything anyway. I have never had a private Member's Bill in all my time here, so I am deeply envious, but the fact is that, although this is a useful tidying-up measure, the Government have to get a grip on the issue at its heart and have a real shake around because, otherwise, we will not succeed.
I give one further example. One of the reasons why local authorities are under such pressure that they behave as Sefton council behaved is local authority planning restrictions. Many of my constituents, and I myself, frequently applaud such restrictions but, when confronted with a particular dilemma, we start wondering about them. They make it difficult for 60-year-olds who want to look after their 80 or 95-year-old parent to adapt their home in ways that would allow the parent to come and live with them.
That is partly because polices such as the green belt—policies of which I am largely in favour—make it difficult to allow extensions to houses, but also partly because there is a residual, inappropriate anxiety among local authorities that, somehow, by improving their home in that way, members of the younger generation are enhancing the value of their houses, and should not be allowed to do so. That is a real difficulty.
The other great pressure on local authorities is that many of them, as we have heard already from many interventions today, have an extraordinary ideological hostility to private care provision. Quite honestly, the way in which local authorities of that persuasion delay assessments, so that a care home has to carry two or three empty beds, when it may be only a six or seven-bed home 1537 anyway, until it gets very near to ruin, or the way in which they manipulate the lists in other ways in favour of their own care provision, is an absolute scandal. It all goes back to the core problem: we have a set of contradictory views about the value of people providing for their own care.
§ Mr. Gray
Is that not particularly disgraceful when county council homes cost significantly more than the private homes that they are competing with, as is the case in Wiltshire? It is even worse when, as in Wiltshire, the county council announces that, ideologically, it is determined to continue to use its own homes unless those homes are sold. Even if they are then sold, they can be sold only to non-profit-making organisations. Is that not a disgrace?
§ Mr. Rowe
It is a disgrace and it should be made absolutely crystal clear that local authorities that behave in that way are diminishing the number of people whom they can afford to look after and so depriving needy people of care.
There is a real difficulty because people who have been frugal and provident all their lives and who want to provide for their own care and well-being in old age, are terrified of the future. If we cannot do anything else, I hope that the Under-Secretary, the hon. Member for Brent, South (Mr. Boateng), will be able to give us some assurance—when he has stopped his private conversation—that, beyond the narrow confines of this Third Reading, the Government are seriously addressing the tangle that leaves so many old people, who have done all the things that we applaud in trying to create savings for themselves, in a state of fear, confusion and, in many cases, pretty miserable living conditions.
§ Mrs. Eleanor Laing (Epping Forest)
I congratulate the hon. Member for Bradford, West (Mr. Singh) on introducing the Bill, which I thoroughly support. The one point on which I disagree with him is that he said that 1538 people do not deal with this subject with passion. On the contrary, at the Conservative party conference a few years ago—
§ Mrs. Laing
My hon. Friend is absolutely right. I made a passionate speech on this very subject. I found at the party conference that the vast majority of Conservative party representatives throughout the country entirely agreed with what I said. Therefore, I know that I must have been right. It was an excellent example of how democracy works in the Conservative party because, only a few months later, the then Chancellor of the Exchequer announced the changes in the appropriate legislation, which were outlined so well this morning by the hon. Member for Bradford, West. On that day, I urged the then Chancellor to change the limits that are applied when the financial situation of an elderly person is assessed in examining whether their long-term care should be funded by the state, or whether they should have to pay for it themselves.
Although I had the full support of the many thousands of Conservative party members who were there on that day in Blackpool, and the support to a certain extent from the then Chancellor who made those changes, the great importance of this subject to the lives of almost every family has not been fully recognised. It is unfortunate that there is a need for such a Bill, but the hon. Member for Bradford, West is brave and courageous in introducing it.
The need arises because of the disgraceful attitude of certain local authorities that have continued to employ a policy of envy against people who have worked hard, saved and built up their resources, which they are entitled to retain to pass on to their families. It is sad that some local authorities continue to disregard the wishes of the people in their local communities who elected them. Unlike my hon. Friend the Member for North Wiltshire (Mr. Gray), I can commend my local council—Essex county council—on its attitude—
§ It being Eleven o'clock, MR. DEPUTY SPEAKER interrupted the proceedings, pursuant to Standing Order No. 11 (Friday sittings).