HC Deb 04 May 1999 vol 330 cc693-6
10. Dr. Lynne Jones (Birmingham, Selly Oak)

What measures he is taking to improve the regulation of residential care. [81818]

12. Ms Sally Keeble (Northampton, North)

What measures he is taking to improve the regulation of residential care. [81820]

The Parliamentary Under-Secretary of State for Health (Mr. John Hutton)

We intend to establish eight new independent commissions for care standards to register and inspect all residential care homes, nursing homes, all children's homes and other care services. We are also developing national regulatory standards in relation to the provision of care and we shall ensure that those standards are met. Those measures will provide stronger protection for vulnerable people in residential care and other care settings, and provide a more coherent and consistent regulatory framework.

Dr. Jones

I welcome the proposals to improve the consistency of care standards, but one of my concerns is that, after years of Tory Government constraint on capital investment, many local councils, such as Birmingham, are facing unacceptable delays in bringing the physical conditions in their residential homes up to their own registration standards. That is forcing them into privatisation deals against the wishes of residents. Will my hon. Friend ensure that adequate capital resources are made available to local authorities so that we can honour our commitment to pensioners to put a halt to Tory policies that have forced councils to sell off old people's homes?

Mr. Hutton

I am aware of my hon. Friend's concerns; we have discussed those issues on the Floor of the House on previous occasions. I am sure that she would agree, however, that the main issue for all hon. Members is to ensure that, right across the spectrum—whether in private care, independent care or local authority care—there are consistently high standards in the quality of care. That is the real issue—not who is providing that care. We made those policies extremely clear in our modernising social services White Paper.

However, I point out to my hon. Friend and to the House that the recent local government settlement provided record new resources for social services—more than £523 million of additional resources this year. We are keen to encourage social services departments to explore new, innovative ways of packaging and financing the provision of residential care. That is the best way to meet what our constituents want—better care, better standards and better provision.

Ms Keeble

I welcome the proposals for the commissions; I hope that they will lead to a substantial improvement in the care of people in all sectors—private, independent and council. However, will my hon. Friend give me assurances on three questions? First, could the commissions look at personal living allowances, which, in some homes, are used to supplement costs instead of going to people so that they can pay for personal expenses? Secondly, can there be provision for lay visitors, or advocates, for people in homes, and can such visitors have right of access, to supplement inspections? If people are concerned about a particular issue, there would be someone in whom they can have confidence to take it up, and that person would have right of access to the home. Thirdly, could the commissions consider the particular needs of ethnic minority people in care? Often, skin care, diet and so on are not properly provided for, especially in the case of children and elderly people. Will my hon. Friend give me assurances on those three matters?

Mr. Hutton

We are considering the whole issue of personal living expenses—the personal living allowance—as part of our wider response to the recommendations of the royal commission. We shall announce some proposals when that consideration has been completed.

My hon. Friend asked a specific question about the provision of services for ethnic minorities. It is up to local authorities to ensure that there is a balanced range of provision to reflect the needs of the local population. That is very much the responsibility of the social services departments.

As for complaints procedures and the role of independent advocates, there are already requirements for proper complaints procedures to be in place in every local authority in England and Wales. We envisage that one of the responsibilities of the new commissions for care standards will be to ensure that those procedures are working properly—that will fall four-square within the remit of the new commissions.

Mr. Tim Boswell (Daventry)

Does the Minister accept that, although there are certainly merits in a greater degree of consistency in the regulations for residential care homes, that presupposes that there is a residential care home sector to be regulated? Homes in both the private and the public sectors face the impact of the working time regulations and the national minimum wage, in addition to the general course of inflation, because they are major employers. In those circumstances, does the hon. Gentleman not find it odd that, for example, Northamptonshire county council—the county of the hon. Member for Northampton, North (Ms Keeble) and myself—can offer only an additional 2.5 per cent. to providers? That is totally inadequate to maintain that service.

Mr. Hutton

I am sure that the hon. Gentleman will agree that it is most important for workers in this sector to have the same basic employment entitlements as anyone else. I am sure that he is not arguing—although perhaps some of his right hon. and hon. Friends are—that the minimum wage legislation and the basic entitlements to statutory rights at work should not apply in care homes. That would be a most unfortunate position for him to adopt. We have given local authorities a record amount of resources this year. Later in the summer, we shall produce some proposals to try to improve the commissioning process—whereby local authorities purchase care from the independent and private sectors. However, it is wrong—even by implication—to suggest that there is a crisis in the independent care home sector. That is not so. That sector continues to grow and expand.

Rev. Martin Smyth (Belfast, South)

We recognise the importance of the private, independent and voluntary sectors in residential care, and welcome the Government's commitment to improve that care to the highest standards. To what extent are such homes regulated in respect of dealing with waste, both clinical and other, bearing in mind that it has an impact on the economy and on health care, and that, as I understand it, residential homes outstrip the national health service in terms of the amount of waste that they generate?

Mr. Hutton

I am afraid that I do not have any specific information to enable me to answer the hon. Gentleman's question today, but I shall be happy to correspond with him. One of the strong advantages of our proposals is that the new commissions for care standards will bring together both regulators from social services departments and inspectors from health authorities, so that we have a proper spread of expertise located within the regulatory and inspection bodies. That is a significant step forward and, as I said, I shall be happy to correspond with the hon. Gentleman in more detail on the technical questions that he raises.

Mr. Bob Blizzard (Waveney)

Residential care home owners in my constituency have raised with me their concern about the inconsistency of some of the inspectors who currently operate through local authorities: they feel that, often, the judgment of the facilities in their home depends on which inspector turns up. Therefore, although they welcome the new commissions, they are concerned that some of those inconsistent inspectors might simply reappear with a new title. What can my hon. Friend say to those people to assure them that there will be greater consistency under the new arrangements?

Mr. Hutton

I can tell my hon. Friend, and he can pass the message on to care home owners in his constituency, that the issues he raises are precisely why we are intent on developing proper national regulatory standards. We have received from the Centre for Policy on Ageing specific proposals on which we intend to consult nationally in the near future. Through the combination of clear national standards and an improved regulatory and inspection mechanism, we shall overcome some of the problems that my hon. Friend raises. Of course, the final decision on which inspectors are employed by the new care commissions will be taken by them, not by me.