HC Deb 13 March 2001 vol 364 cc810-4
7. Mr. Tom Clarke (Coatbridge and Chryston)

What measures he has taken to promote a strategy of health care for older people that is based on keeping them in the community. [151955]

The Minister of State, Department of Health (Mr. John Hutton)

The Government are committed to promoting older people's independence and ensuring that they are helped to remain in their own homes for as long as possible. The NHS plan announced a range of measures to promote independence and improved quality of care for older people, including additional intermediate care beds and places, extra rapid response teams, additional home care and other support services, improved community equipment services, and carers respite services. In 1999–2000 an estimated 15,000 to 20,000 more older people were being helped to live at home than in 1998–99.

Mr. Clarke

I thank my hon. Friend for that reply. Does he agree that for many disabled elderly people the provision of aids and equipment can make the difference between enjoying living in their own homes and being forced into residential care? Does he agree that tackling that approach and ensuring that there is proper funding lie at the heart of modern care in the community?

Mr. Hutton

I certainly agree with my right hon. Friend, and I pay tribute to his work in the House and outside to support people with disabilities. He is right about the importance of community equipment services. That is why in the NHS plan we announced a further £100 million of NHS expenditure in the next three years to support new types of equipment and ensure that they reach older people more quickly. That is the key to improving the independence of older people. By the same token, it is a matter of real regret that the Conservative party has not yet been able to match our commitment to making those investments in community equipment services. The Conservatives have refused to match our spending on social services, which lies at the heart of the new investments that we are making. Until they do so, their promises to older people will be treated with utter and total contempt.

Mrs. Lorna Fitzsimons (Rochdale)

Is my hon. Friend aware that the report that, thankfully, he commissioned in Rochdale on the care of older people looks as if it will show that there has not been enough investment in intermediate and intensive home care for the elderly? Will he do everything he can to ensure that the investment is there to help our council to prioritise that much-needed home care, rather than there being an over-average reliance on putting people into residential homes?

Mr. Hutton

I agree with my hon. Friend. Most Members, and most of our constituents, would certainly prefer to be looked after at home whenever possible—it is certainly where I would want to be, and I am sure that every right hon. and hon. Member would want that option too. For far too many older people that option has not been available because the necessary health and social care services have not been available. We are putting that right. Nearly £900 million in new investment is going into health and local authorities in the next three years. I repeat that the Conservative party will not match that expenditure, and that would compromise the health and well-being of millions of older people—I am sure that my hon. Friend will want to take advantage of that fact in the next few weeks.

Mr. Julian Brazier (Canterbury)

Whatever the Minister's plans for home care for elderly people, may I urge him not to allow the Nunnery Fields geriatric and stroke hospital to be closed until alternative provision is genuinely available? It is now only a few weeks since 97-year-old Connie Jones died after a two-day wait in a corridor for a proper medical bed. Yet again, over the weekend all three of our accident and emergency units were completely overloaded, leaving many elderly people waiting; one unit was closed to new entrants. Will the Minister ensure that we have enough bed provision for elderly people before that hospital closes?

Mr. Hutton

I hope that the hon. Gentleman will understand that I am not familiar with the facility that he describes—but I will certainly write to him about the issue that he has raised. I am sure that he will be the first to acknowledge that the Government are making significant additional resources available both for the NHS in Kent, and for Kent county council to improve the range of services for older people. I know that it is the common practice of the hon. Gentleman and his hon. Friends to bemoan rates of expenditure, but until he can persuade his right hon. and hon. Friends on the Front Bench to match the expenditure to which we are committed, his words will sound rather hollow.

Mr. Nick Harvey (North Devon)

I welcome the objective of treating more people in their own homes. However, is the Minister not alarmed that social services budgets throughout the country are expected to finish the financial year more than £200 million overspent? Although he has announced rises in the standard spending assessment for next year, social services directors expect next year to be even tougher. What hope is there that the services the Government talk about can be provided for people in their own homes, if social services departments struggle to meet even their existing commitments out of their existing resources?

Mr. Hutton

I am aware of the concerns to which the hon. Gentleman rightly draws attention—as are most right hon. and hon. Members. However, during the past three years we have provided 12 per cent. real-terms growth in social services spending. More real-terms growth is coming. It is worth comparing like with like: during the previous Parliament, real-terms growth in social services spending was 0.1 per cent. During this Parliament and over the comprehensive spending review period, it will be 3.4 per cent. in real terms.

The hon. Gentleman and his hon. Friends are always saying that we must have more—I am sure that is what he is saying today—but when we look at the small print of the Liberal Democrats' policies on public finances, we realise that that is a complete load of old cobblers. The money does not add up; there is the same one penny on income tax—they recycle it time after time after time. The hon. Gentleman's policies on public finance are kindergarten economics; they stand up to no scrutiny whatever.

Mr. David Taylor (North-West Leicestershire)

Most Labour Members support the sentiments in the main question. However, when I addressed the Caretalk conference for care home proprietors and managers at Leicestershire county cricket club last Friday, I heard that far too many elderly people, when they are eventually admitted to care, are poorly nourished, lonely, depressed, frail and more ill than they might otherwise have been, because of the failure of home care services. Is the Minister confident that we can improve those services so that it really is worth while to encourage elderly people to stay at home?

Mr. Hutton

If more older people are to be looked after properly at home, there is no doubt at all that we shall have to provide not only more but better quality services to support them in that environment. Last year, through much hard work and sensible use of resources, local authorities were able to provide a significant number of additional care packages to support more older people so that they could remain independent at home for longer. We intend to build on and develop that, but it is important—and fundamental to our plans—that if we are to encourage more older people to stay at home, which is the right thing to do, we provide better and more easily accessible services that are better supported and resourced. That is precisely what we are trying to do.

Mr. Michael Fabricant (Lichfield)

The Minister knows, however, that from time to time older people have to go into respite care. Is he aware that in my constituency, South Staffordshire health authority now plans to close Hammerwich hospital and to halve the number of beds in the Victoria hospital in Lichfield? Is he further aware that Staffordshire MPs held a meeting with the health authority, and were told that the Government had uplifted prescribing costs by 9 per cent? That is good, except for the fact that the full cost of prescriptions is likely to be 12 per cent.—bad—and that, as a result of the National Institute for Clinical Excellence, the Government have made an extra commitment of £500,000 for South Staffordshire health authority—good—except that the result of the cost will be an extra £2 million—bad. We currently suffer a £4.7 million rolling deficit. Come on, let us have adequate funding.

Mr. Hutton

I am probably not the only hon. Member in the House who did not follow the hon. Gentleman's question. Perhaps there is a chance that when I read it in Hansard it might make better sense. The hon. Gentleman ended his question—[Interruption.]

Mr. Speaker

Order. The hon. Member for Lichfield (Mr. Fabricant) has asked a question. The Minister must be allowed to reply.

Mr. Hutton

I am grateful to you, Mr. Speaker. The only point that I understood in the question put by the hon. Gentleman was the request that the Government should spend more on the national health service. No one in the House could regard that as a serious question or a serious proposition. The official Opposition have not even committed themselves to matching the expenditure that we have provided for. [HON. MEMBERS: "Yes, we have."] No they have not. Of course Opposition Members want to claim that, but it is complete and utter nonsense.

One of the points that the hon. Gentleman and his hon. Friends refuse to deal with is their plan to spend £500 million more on subsidising private health insurance. Where is that going to come from? The hon. Gentleman should have a conversation about that with the hon. Members on the Opposition Front Bench. His party will not match our expenditure on health and social services, so his question is complete nonsense.