HC Deb 30 November 1998 vol 321 cc541-54 3.31 pm
The Secretary of State for Health (Mr. Frank Dobson)

A year ago, I announced our plans for a modern and dependable health service. In February, I announced our proposals to tackle health inequalities. Last month, I set out for the House our plans to ensure that children in care are looked after properly. Today, I am publishing our White Paper "Modernising Social Services", which spells out our proposals to create modern and dependable social services. The White Paper is another step along the road to providing people in every part of our country with high-quality health and social services whenever they need them.

We are determined to have social services that are convenient to use, respond quickly to emergencies and provide top-quality services to those who need them. We do not have such services at present. Despite the efforts of many very dedicated staff, many services are not provided sufficiently conveniently and promptly, or to a sufficiently high standard.

The services are important to all of us. At any one time, up to 1.5 million people in England rely on the help of social services. At some point in our lives, all of us are likely to need to turn to social services for support, whether on our own behalf, or for a family member, a neighbour or a friend. The need for help often arises at a time of personal or family crisis—such as the onset of mental illness, the birth of a disabled child, a family break-up, or a death that leaves someone without the carer on whom he or she had come to rely.

Social services are provided in many and various ways, ranging from meals on wheels for elderly people, to help at home for people suffering from mental or physical illness or removing children from danger. Help may be delivered at home, in a day centre or as residential or nursing home care. It may be provided by councils, voluntary bodies or commercial companies.

As individuals or as families, it is in our personal interest to ensure that good-quality services are available. However, the matter goes wider than that. Any decent society must provide for those who need support and are unable to look after themselves. Moreover, we all benefit if services are provided for those who need them, as we can all suffer if services break down for young offenders or people with mental health problems.

It is in everyone's interest to ensure that services are available, effective and efficient. However, that objective is not being met. Although there are many top-quality services, all too often, social services are failing to provide the support that people in need are entitled to expect.

People who work in social services have a hard job. They have to deal with some very difficult people, often in difficult—sometimes in dangerous—circumstances. They and their managers are often criticised. Some of that criticism may be justified, but often it is not. However, staff have suffered from a major difficulty. Until now, no Government have spelt out what local people can expect from social services or what the staff are expected to do. The lack of clarity has meant not only that, in daily matters, social services cannot easily be held to account, but often that, when something has gone badly wrong, they get all the blame even when others have been at fault.

The Government are determined to change that. We propose to lay down the standards of service that people can expect from social services in every part of the country. Needs vary from one part of the country to another, but the quality of services should not. The new standards should apply to services for young and old, for both sexes and for all ethnic groups, whether they live in the inner cities, the suburbs, country towns or rural areas.

We aim to ensure that people who need social services help are treated with dignity and provided with what they need in a way that promotes rather than diminishes their independence. We want social services to help people to live in their own homes, to do things for themselves and to hold down a job if they can.

We intend to improve the protection provided for vulnerable people by putting in place tough and effective new inspection systems, working to national standards. The new arrangements should make sure that anyone receiving social services help—young or old; living at home or in residential accommodation—is protected from neglect, abuse or exploitation.

Our aim is to raise standards across the board, so that social services everywhere provide top-quality care and attention and are efficiently organised to meet the needs of local people promptly and conveniently.

We will lay down new standards of performance and publish annual reports on what every council has achieved or not achieved. We will set up in each English region a commission for care standards to regulate care services, whether they are provided in people's own homes, through organisations such as fostering agencies or in residential homes. The commissions will cover all services, no matter who provides them. They will have tough new powers and the Secretary of State will have new powers to step in when things need to be put right.

As a further development in our commitment to improve the protection of children, the commission for care standards in each region will include a children's rights officer. Their job will be to inspect children's services to make sure that children are properly safeguarded, that allegations of harm or abuse are thoroughly investigated and that the views of children in care are properly taken into account. They will report directly to the chief inspector of social services any significant evidence that children are not being properly safeguarded. The new children's rights officers will help to make sure that we root out abuse and deliver a better deal for children.

The new arrangements will provide real safeguards for some of the most vulnerable people in our society. Some of what we propose will require changes in the law; some will not. We are taking steps to toughen up the existing system. Councils have been warned that they must not neglect their regulatory functions between now and when the commissions for care standards are set up.

Small children's homes are not currently inspected. We shall invite them to ask to be inspected in the meantime, so that they can start to raise standards, where necessary. I shall advise councils not to place children in homes that have not been inspected.

The standard of social services varies not just between one area and another, but often between two units in the same area. Some first-rate services are provided, but too many are not up to scratch. That has been exposed by recent reports by the social services inspectorate, and in particular by its joint reviews carried out with the Audit Commission. We propose to strengthen the role of the inspectorate and to put more resources into the joint reviews.

We also need to improve the standards of the social services work force. The present professional and training arrangements are not up to the task. We have decided to abolish the Central Council for Education and Training in Social Work. We will replace it with a General Social Care Council. Its job will be to ensure the proper regulation and training of all the social care work force, not just social workers. One of its first tasks will be to develop codes of conduct and practice for all staff, which it and the commissions for care standards will then enforce. It will be given the power and resources to do its job properly.

Many of the most needy people require help from several agencies, including the NHS and other providers of social care. Sometimes the various agencies put more effort into arguing with one another than into helping the vulnerable people whom they are there to serve. We are determined to put a stop to that and we will change the law to make it easier for them to work together for the benefit of local people.

In that and many other aspects of the White Paper, we are making clear that things which are not being done very well at the moment must be done properly in future. Doing things properly does not necessarily cost more than doing things badly. Sometimes it proves to be cheaper as well as better, but the Government recognise that extra funds will be required to implement the wide range of improvements that we have in mind. Over the next three years, as a result of the comprehensive spending review, nearly £3 billion extra will be found for social services—£1.3 billion of that in the form of a modernisation fund to lead the changes that are necessary.

I have already announced that £380 million is to be invested in improving children's services. Today, I can announce that we will provide £750 million to finance the change of emphasis in social services to promote the development of dignity and independence for social services users and carers. An additional £185 million will be invested in mental health services provided by social services and we will shortly announce a more than matching increase in NHS funding for mental health. The modernisation fund will also provide an extra £20 million for staff training.

The extra funding must be spent on the improvements that I have outlined and I am putting in place arrangements to ensure that. The money is for change and improvement. It is being provided on top of general increased funding for social services and additional special grants for drugs projects and work on HIV-AIDS. Taken together, we have provided nearly £3 billion extra for social services over the next three years.

Those and dozens of other proposals in the White Paper are designed to help make sure that local councils, the NHS, voluntary bodies and commercial providers work together to help people live independent and fulfilling lives, increase safeguards for vulnerable people and deliver top-quality services across the board. The proposals in the White Paper will give us modern and dependable social services to match the modern and dependable NHS that we are creating.

I am confident that our proposals will command the support of users and carers, the staff and everyone else of good will.

Mr. Philip Hammond (Runnymede and Weybridge)

I thank the Secretary of State for his statement and for his courtesy in letting me see it in advance. However, I cannot help asking myself why the Government chose today. The White Paper has been trailed since the spring and we are told that it has been ready since the summer. It was extensively leaked in September and the right hon. Gentleman has already had one bite at the cherry in his statement last month on children in care. Now, what a coincidence it is that he has chosen to release his rather predictably entitled White Paper on the day of an important debate on the Government's constitutional proposals—a debate that the control freaks and spin doctors in Downing street would rather not have had and are desperately trying to curtail.

I shall be as brief as the importance of the subject will allow. The Utting and Burgner reports were commissioned by the previous Government. We welcome any effective measures to protect the vulnerable—young or old—from abuse. However, inspection is about more than preventing abuse; it is about ensuring quality and we welcome the level playing field that will be achieved by the establishment of an independent inspectorate for local authority and private and voluntary sector provision alike. Can the Secretary of State confirm that the same standards will be applied identically to both sectors? Can he further confirm whether the inspectors will have power to investigate value for money? Will they be able to close down facilities that offer poor quality at a high cost?

Some local authorities persist in offering direct provision of residential care, which can be 40, 50 or 60 per cent. more expensive than comparable private sector provision. What will he do about the obscenity of high-cost, low-quality care, which some local authorities provide on a captive basis while many of the people who are assessed as needing residential care have to wait on a list to fill dead men's shoes?

Will the Secretary of State assure the House that inspectors will have no power of entry to individuals' private homes? Even the Government who brought us the beef-on-the-bone ban must recognise that a compulsory power of entry to an individual's private home on the sole grounds that he needs domiciliary care is a step too far. An Englishman's home must remain his castle, even when he needs support from social services.

As performance standards will be set and monitored by the commissions for care standards, will the right hon. Gentleman explain how local authorities and councillors will in practice be held accountable, as he said in his response to the Utting report that they would? Will he confirm for the record that the £750 million that he announced today is part of the £3 billion that he announced at the time of the comprehensive spending review?

Does the right hon. Gentleman accept that, in many areas, private and voluntary sector providers are struggling to maintain quality, as local authority social service departments refuse to allow fee increases even at the rate of inflation? Will he require that private providers receive recognition for good practice, such as investing in increased staff qualification levels through premium payments?

In most cases, local authorities are not squeezing private providers because they want to. Does the right hon. Gentleman recognise that whatever he says today about raising standards will be meaningless if the revenue support grant settlement to be announced shortly further savages the budgets of many local authorities in the south-east, where residential care costs are high and rising sharply? Is he happy to see an increasing proportion of social services spending channelled under central control via health authorities, which further diminishes the responsibility of elected local government?

If the need for regulatory reform is so urgent, why has the White Paper been so delayed and why will there be no Bill in this Session? It is no good for the Government to tell us how important reform is; the Queen's Speech has just been delivered and we can judge the Government by their deeds, not by their words. Has not the Secretary of State been one of the losers in the great legislation lottery? The much-delayed White Paper is little more than his consolation prize.

Mr. Dobson

I thank the hon. Gentleman for welcoming our proposals to raise standards and to establish an independent inspectorate to secure those standards. The inspectorate's job will be to ensure that top-quality services are provided everywhere.

Cost-effectiveness will be dealt with as part of the general best-value approach that we will introduce to local government and for which we will be legislating in this Session, as was made clear in the Queen's Speech.

The inspectors will seek to ensure that services are of the same standard, whether they are provided—I thought that I had made this clear in my statement—by councils, the voluntary sector or the commercial sector.

The hon. Gentleman mentioned inspectors of people's homes. We have no such preposterous proposal—it is a manifestation of the fantasies that fill the minds of leading members of the Conservative party. Social services, including voluntary organisations, deliver services—for which the public pay—into people's homes. Some of those services are not up to scratch, so we shall ask people voluntarily to comment on the standard of the services that they are receiving. That is a very proper function for an inspectorate. Nobody will be given powers of entry, or anything daft like that. We want to make sure that where social services are provided to people in their own homes, those services are subject to inspection and checking. That has never happened in the past—something that has been seriously wrong with the system.

On the duties of local authorities and councils, the basic duty—to deliver top-quality services—will lie with the local authorities. That will be their job. We have issued advice to elected councillors on how they can better go about their job of making sure that proper quality services are delivered for children in care and children in need. There will be an inspectorate, but it will not be responsible for the delivery of top-quality services; it will be responsible for checking that others are delivering those services. Private providers should get on with their job of making the necessary provision to the highest possible standards, subject to the regulation that everybody will face.

On channelling money to social services through the NHS, I am glad that we did it. That was one of the reasons why social services and the NHS worked so well together last winter, and I hope that they will do the same again. Frankly, I cannot go to the Prime Minister and the Chancellor of the Exchequer and say that we need co-operation from social services and the NHS to look after people properly during the winter, and then not deliver that. If that has interfered with a few rights, but has meant that a lot of old people have been properly looked after, so be it.

A lot of the powers will be provided for in the best-value proposals, which will be in the Local Government Bill. Some matching powers and duties will be established in the national health service Bill. We are determined to get on with all the improvements as quickly as we can. As I say, I hope that people of good will will welcome them, instead of fantasising about people jackbooting into other people's homes.

Mrs. Llin Golding (Newcastle-under-Lyme)

The Secretary of State's statement will go a long way towards helping the most vulnerable in society. I welcome the introduction of a children's officer. Needless to say, I think that that is a step towards a children's commissioner, for which many in this House have been waiting for a long time. May I ask that the officer be given facilities for publicity on television and radio? In the past, far too many people with knowledge of abuse have turned their backs and walked away from that knowledge. If there is publicity and an officer is appearing regularly on television and radio, people will have less excuse for saying, "We do not know who to talk to or go to."

Mr. Dobson

I very much welcome my hon. Friend's support, because she has played a prominent role for a long time in working to improve the standard of service provided for children, and in campaigning for a national children's commissioner. There are arguments for a national children's commissioner, and there are arguments for our proposal that it would be better done regionally. On balance, we have come down in favour of the regional option. Certainly, I want no one in future—either in social services or in the NHS—to have the excuse of saying, "Well, I knew things were going wrong, but there was no machinery to draw attention to the things that were going wrong." That is unacceptable—we will get rid of it.

Mr. Paul Burstow (Sutton and Cheam)

I thank the Secretary of State for his statement. Liberal Democrats also want action to raise standards of care—wherever and whoever they are being provided by. We welcome the right hon. Gentleman's warm words today about the importance and value of social care workers, in whatever sector. People outside this House will welcome his comments.

The Secretary of State has talked a lot about Berlin walls between health and social care. Why, therefore, does the White Paper fail to put in place a single seamless inspection and regulation agency to cover all aspects of health and social care? Social services are increasingly in the business of rationing care through care charges. How can health and social care services provide a seamless service when the NHS is provided free and universally, but social services are charged for and rationed?

Will the Secretary of State confirm that, if we exclude the continuing commitment to fund community care over the coming years, the allocation from the comprehensive spending review that he has announced today amounts to an increase of just 1.3 per cent. for social services? How does he expect social services to maintain existing care packages, let alone deliver his improvement agenda, when he has clearly failed to secure the resources needed if they are to do the job properly?

Will the Secretary of State also confirm that the modernisation fund that he has announced today will be allocated not on the basis of bidding, but on the basis of need? Where bidding comes into play, money tends to go to those who write the best statements and bids, and not necessarily to where it is most needed.

Mr. Dobson

I thank the hon. Gentleman for his general welcome for what we are doing. I am in favour of breaking down Berlin walls, but the idea that there can be one all-conquering inspectorate to consider everything from the standard of liver transplants to the delivery of meals on wheels is a bit preposterous. I am a great believer in horses for courses, even for inspectorates.

As for allocation of funds, there will be a 3 per cent. increase in real terms next year, and I expect increases on roughly the same lines in future years. The extra money for care in the community has been provided by way of a special transitional grant, and it has been in transition for a long time. The additional number of people in community care who need to be cared for is rapidly falling. The grant will be included in our proposed partnership and other new specific grants. Adequate funds will be available. Let me make it clear that there is no point in providing additional funds unless they will be properly and efficiently spent, and unless there is an inspectorate to make sure that that is happening.

I want allocations to be related to need and I do not envisage that much of the money should be subject to a bidding system. There will, of course, be terrible arguments about the extent of need in different places. No doubt, Sutton and Cheam will prove to be a very needful place in one of our future debates.

Mr. Hilton Dawson (Lancaster and Wyre)

Does my right hon. Friend accept that no actions are more important to improving children's services than those of putting children's rights at the heart of the agenda and of installing the proposed commissioners? May I tell him that he is an absolute hero for doing that, as are his colleagues, the Minister of State, Home Office and the Under-Secretary of State for Health? Will my right hon. Friend assure me that the children's rights commissioners will use the United Nations convention on the rights of the child as their template for practice and action?

Can he tell me what attention his Department paid in preparing the White Paper to the promulgation of the three-year qualification for social work? Does he agree that we must aim to ensure that all staff working in social work and social care are appropriately qualified? Will he assure me that the White Paper, or some future document, will include enabling procedures for staff who want to blow the whistle on low standards in their employing organisations that go against the grain of their training and of the Government' s worthy intentions?

Mr. Dobson

Again, I thank my hon. Friend for his welcome for our proposals and I know that it springs from deep knowledge and professional experience over the years. I am reluctant to accept the role of hero—[HoN. MEMBERS: "Oh."] In all fairness, I must say that the vast bulk of the work in the preparation of the White Paper was done by my hon. Friend the Member for Brent, South (Mr. Boateng), before he was promoted to his new job in the Home Office. I am grateful to him for all the work that he did, and I am sure that the Under-Secretary of State for Health, my hon. Friend the Member for Barrow and Furness (Mr. Hutton), will follow him in the same spirit and with the same commitment.

I am concerned about qualifications for staff, especially social workers. Much social services provision is provided by people who are not social workers, and I want to ensure that they all have appropriate high-quality training, because that will help them to deliver appropriate high-quality services. On the subject of whistleblowing, there is now nothing to stop people blowing the whistle as long as they tell the truth.

Mrs. Angela Browning (Tiverton and Honiton)

Will the Secretary of State expand on his statement with regard to improving the quality of care in people's homes, especially adults who live at home with their parents? I ask the question because, last week, I was with a young man in his 30s who lives with mum and dad. When dad went into hospital, the young man sought the help of social services for someone to come and help to move him, to use the toilet and to get in and out of bed. Social services insisted that a hoist be installed. His preference was for two or three people to come in and help to lift him, and he finally got that by identifying a company that could assist himself. When standards of care in the home are improved, will the individual have a say and be able to express preferences within provision packages?

Mr. Dobson

We intend to do exactly as the hon. Lady suggests. My statement and the documents emphasise our desire to ensure that all services are provided so that those receiving them do so with the maximum dignity and independence. If we are to achieve that, the people involved will have to have a substantial influence on the services provided and that is our intention. That could be an issue for the inspectorate, but the aim of our policy is to ensure that the local authority, or whoever is responsible, treats people with dignity and in a way that promotes their independence. That should be a natural part of the process so that we do not have to rely on the inspectorate to ensure that it is happening.

Mrs. Alice Mahon (Halifax)

I also warmly welcome the proposals. My right hon. Friend will be aware of a continuing inquiry into a children's home in Halifax, in which two of the perpetrators of abuse have been arrested. The independent inspection teams could have made a huge difference to hundreds of children's lives had they been in place during the past 20 or 30 years. Will the children's rights officers actively encourage people to come forward and speak out, anonymously if necessary? If that had happened in Halifax, much unnecessary suffering could have been avoided.

Mr. Dobson

I thank my hon. Friend for her welcome for our proposals. If the children's rights officers are doing their jobs, they will accept any sound information from any source. If anonymity is required, at least at an early stage, they should be prepared to accept that unless remarkable circumstances prevent them from doing so.

Sir Teddy Taylor (Rochford and Southend, East)

Is the Secretary of State aware that Southend-on-Sea council, which has a Liberal Democrat and Labour majority of one, has just decided to close three of our six old folks' homes, because we cannot afford them? We have an appalling problem with bed blocking at our local hospital, because the council cannot take the old people in, and we also have a deficit of £2.5 million in our social services budget. As the Secretary of State said, the people want to know the truth. How will the extra £3 billion be given to local authorities? Will it be included in the local authority support grant that will be announced later this week? Will it be in the form of a special grant, or is it one of those mystical things that might appear in three years' time? Does the Secretary of State appreciate that we have a genuine crisis which is not caused by inefficiency or politics and we need to know how the extra money will get to Southend?

Mr. Dobson

The money will begin to be provided next year—

Sir Teddy Taylor

Next year?

Mr. Dobson

Yes, next year. We are rather a long way through the current financial year. Money will be provided to Southend and everywhere else next year in grants for specific purposes. Although many of the additional funds that I have announced today will be provided in specific grants, others will be provided through the standard spending assessment and the grant formula that will be announced through the revenue support grant system. I make no bones about the fact that if we are to raise standards in the way that we want to, much of the funding must be provided through specific grants, and that is that.

Mr. Jonathan Shaw (Chatham and Aylesford)

I welcome my right hon. Friend's announcements. The proposals for children's rights officers and care commissioners will be given three cheers in the welfare and social work professions.

My right hon. Friend mentioned small children's homes. For far too long, residential social workers have not received the training that they need. As long ago as 1948, the Curtis report said that training was required for people who undertake some of the toughest work, caring for the most vulnerable and violent children. Apart from the specific funds that my right hon. Friend has referred to, what funds will be allocated to improving training for residential social workers?

Mr. Dobson

As I said, there will be an increase of £20 million for training social services staff in addition to the £120 million that is already being spent. Some of that funding is not spent particularly well and it will be helpful if we can redirect funds so that they are better used.

One of the problems in the staffing of residential homes is that for the past 20 years, there has been an emphasis on care in the community being superior to residential care. That is not a party political point; it has simply been the social services fashion, accepted by almost everyone with the exception of myself. That emphasis has resulted in a downgrading of the attention paid to residential care and the training of people who provide it, and residential care has become less attractive over the years. We want to reverse that process and pay more attention to residential care in future. It will, therefore, be one of the targets for our effort on improved training.

Mr. Andrew Rowe (Faversham and Mid-Kent)

As someone who has been fighting for a general social services council for at least 15 years, I welcome that proposal. However, I have two points to make to the Secretary of State.

First, the aging group of frail people who went into residential care with protected rights are now vulnerable to being moved into cheaper homes, which would be extremely painful and disruptive for them. I would be grateful if the Secretary of State could tell me what he intends to do about those people.

Secondly, in the increased partnership between non-governmental organisations and social services departments, there is a serious danger that the local authority departments will try to make the NGOs like themselves in the way in which they deliver services. Having just come from the opening of a new facility in Kent for the National Society for the Prevention of Cruelty to Children, I am conscious of the enormous importance of well-run NGOs continuing to innovate and pioneer services in ways that may be regarded as risky by local authorities.

Mr. Dobson

I thank the hon. Gentleman for his welcome for our proposals for a general social care council. As I said in my statement, it commands the support of people of good will on all sides and no side. The real test of the treatment of aging and frail old people is whether the standard of care is maintained or—preferably—improved. That standard must be applied by whomever is responsible for their care.

I have always been acutely conscious of voluntary organisations' innovatory activities, and I want them to continue. Local authorities always face a dilemma because some novel ways of doing things might be an improvement, but some end up not working. Local authorities have an understandable desire at least to ensure that there is a very good chance that some new provision is more effective than the old one. Generally speaking, we want to encourage innovation, as long as it is not so maverick that it is predictable that it will go wrong.

Ms Helen Southworth (Warrington, South)

I very much welcome the report. I came into the Chamber to harass the Secretary of State about state sector boarding schools. I am, therefore, extremely pleased that they are included in the new protection, along with residential family centres, independent fostering agencies and small children's homes. That is extremely welcome, not just in my constituency, but across the country. Will regional children's rights officers' telephone numbers be made available in those schools and establishments? Will children have access to private telephones?

Mr. Dobson

I thank my hon. Friend for not harassing me. If she has not done so for the good reason that I do not need to be harassed, that is all the more welcome. It was certainly right and proper to extend coverage to state sector boarding schools. We want to cover all aspects of the welfare of children, whoever provides it and wherever it is provided. That seems logical, and I am glad that she is in favour of it. We certainly expect regional rights officers to make themselves known through telephone helplines and all sorts of things. We are, of course, establishing national machinery to back that up. We are trying to provide private telephones. Indeed, many local authority homes, and some voluntary homes, already provide private access to a telephone, and we must extend that.

Mr. John Bercow (Buckingham)

Further to the inquiry of my hon. Friend the Member for Rochford and Southend, East (Sir T. Taylor), will all funding for the new children's services grants be additional to existing Government expenditure? If the answer is yes, will the right hon. Gentleman confirm today what he failed to confirm in the House on 5 November: at no stage will local authority social services standard spending assessments be readjusted downwards to reflect the introduction of those grants?

Mr. Dobson

They will not.

Mr. Bill O'Brien (Normanton)

I join others in congratulating my right hon. Friend on his statement and thanking him for it. Local authorities, such as my own Wakefield city council, suffered for far too long under the Conservatives' unfair distribution of resources, which resulted in a reduction in the provision of elderly and child care in my area. The Tories cut resources allocated for that purpose. Following the launch of the community care charter, will my right hon. Friend extend it in due course to fire protection in old peoples' homes? Three people in my constituency perished 12 months ago because the home was not registered under fire services regulations. We must also deal with the question of elderly people who are denied services because they cannot afford them.

My right hon. Friend's statement goes a long way to ensuring fairness across the board in the provision of community care. There is much to be done to arrest the problems caused by the Tories. Will he consult his Cabinet colleagues on aids and adaptions in the community and care through the health service? I hope that protection can be extended so that we have a super community care programme throughout the country and old people are protected.

Mr. Dobson

I thank my hon. Friend for his welcome for what we propose. Apart from what might be described as the social care and welfare side of the provision of services for old people or young people, or people who are suffering from one form of disablement or another, we certainly need to ensure that we are getting the basics right and that buildings and complexes in which people live are safe and sound. We must ensure that that is done by bringing together all the Government and non-Government agencies in the area to ensure that the very best is being provided.

As I said when we introduced our response to the Utting report on safeguards for children in care, the test must be to ask ourselves, "Would this place be satisfactory for my aging parent or aging relative or relative suffering from disablement?" If the answer is no, people must set about improving things.

Mrs. Jacqui Lait (Beckenham)

I thank the right hon. Gentleman for coming to Bromley this morning to turn the first earth for the new hospital. I also have two questions for him. Does he expect the inspectorate system currently run by councils to be transferred root and branch to the commissions for care standards, or will the two systems run in parallel? Will the commissions for care standards have membership from the independent sector and from the NHS?

Mr. Dobson

The hon. Member is virtually unique among Conservatives in welcoming additional spending on the health service. I suppose it is only reasonable that she should welcome my conducting the sod-cutting ceremony for the building of a £150 million new hospital in her constituency.

We do not intend the two systems to run in parallel. As the commissions for care standards come into operation, local authorities will lose their functions. However, we are making it clear that they must carry out those regulatory functions until the care standards commissions are in place. That is the vital aspect.

We are considering the subject of who will serve on the commissions. We certainly do not want them to be exclusively representative of one group or another. The idea is that there should be ministerial appointments to each of the regional boards, and that they will then employ the professional staff who do the work. It is crucial that the membership of those boards commands the respect of the public and of those providing the services, whether they be in the public, the voluntary or even the commercial sector.

Ms Ann Coffey (Stockport)

I very much welcome my right hon. Friend's proposals to tighten regulation of children's homes. Specifically, I welcome the fact that small children's homes, which at the moment are unregulated, will be invited to offer themselves immediately for inspection. However, may I have his assurance that he will be very tough on those children's homes that decline to offer themselves for such inspection—and on local authorities that have placed children in those homes? As he will be aware, there is considerable concern, especially in the north-west, about standards in some of those homes.

Mr. Dobson

Children's homes with four or fewer children have not been inspected until now, but they will be inspected by law when we have introduced the new legislation. However, I am so concerned about the circumstances in some of those small homes—some are first rate, but others are not—that I am saying that I expect their owners to invite inspection by the existing local authority inspectors, so that they can start raising standards if they need to.

Another party to the process is the local authority or even voluntary organisation that is placing children in these homes. I shall shortly be saying to local authorities that they should not be placing children in such homes unless they have opened themselves for inspection. Those homes that are doing a good job and providing a good service have nothing to fear from inspection. It is the ones that are not doing that that have something to fear.

Mr. Julian Brazier (Canterbury)

May I welcome the proposals for proper outside inspection of children's homes, but ask the Secretary of State what powers the inspectors will have in respect of councils that are actively opposing children in care being adopted? Surely it is desperately sad that with more than 50,000 children in care, barely 1,900 were adopted from care last year, with some councils not allowing one such child to be adopted. What powers will the inspectors have in this area?

Mr. Dobson

We have already issued new guidelines on adoption with a view to trying to promote adoption and encouraging it. In fairness to those who are responsible, there are quite substantial ethical and practical problems about vetting potential adoptive parents. On one hand, we cannot blame the vetting organisation if something goes wrong and, on the other, say that it should not be taking as much time and care as at present. We want to make changes and we want to promote adoption, but it must be safe adoption. It should not lie with any local authority or anyone else to be handing over children to people unless they are absolutely certain that those children will be properly looked after.

Several hon. Members


Madam Speaker

Thank you. We shall be returning to this issue on numerous occasions. I intend to move on now.