HC Deb 13 November 2001 vol 374 cc700-3
5. Dr. Andrew Murrison (Westbury)

If he will make a statement on how the national care standards for residential care homes will reflect the treatment needs of those with drug and alcohol problems. [12109]

The Minister of State, Department of Health (Jacqui Smith)

The standards will promote better quality care and help to prevent abuse by grounding practice in the principles of dignity, choice, privacy and respect. They will reflect the treatment needs of those with drug and alcohol problems by ensuring that their assessed and changing needs and personal goals are reflected in their individual plans.

Dr. Murrison

I thank the Minister for that response. I welcome evidence from yesterday's Adjournment debate that the Government are softening their thoughts on the regulations. However, they have confused the needs of short-stay patients in treatment with those of residents whose care homes constitute their homes. There is a big difference. Does she agree that free access to mail and visitors would give freer access to illicit substances and that lockable bedrooms would increase the likelihood of deliberate self-harm by residents? Does she also agree that—

Mr. Speaker

Order. The question is far too long, and the hon. Gentleman is reading.

Jacqui Smith

The hon. Gentleman's first comment was right. Although this may be difficult for Opposition Members to recognise, the consultation was a real one. We have listened and we will respond to the concerns that were expressed. The particular concern that he raised related to the treatment regimes that will be allowed under the standards. It is important to emphasise that we realise that, sometimes, the overriding need is to ensure that people get the care and treatment that they need in a safe and secure environment. That is why the standards, at the request of representatives from the drug treatment world, include standard 2.7, which recognises specifically that there will be times when freedom and choice might need to be restricted. It asks only that that be discussed and agreed with prospective service users as part of their initial assessment.

Dr. Brian Iddon (Bolton, South-East)

I am grateful for my hon. Friend's response. Will she please note that the European Association for the Treatment of Addiction, Drugscope and Release, among others, have estimated that, if the care standards are adopted and unit costs are driven up, more than 50 per cent. of the care beds are likely to be lost in this sector?

Jacqui Smith

I think that my hon. Friend is referring particularly to concerns about multi-occupancy rooms. The care standards will put in place the good standards that users of services have every right to expect, and ensure that they are provided and regulated uniformly across the country. When we consulted on multi-occupancy rooms, strong views were expressed by service users about the lack of privacy and dignity involved in sharing. I do not think that many hon. Members would be happy to share their bedroom with someone whom they had not invited into it, and we need to bear in mind the principle behind that when determining the standards.

It is also important, however, that we ensure that the standards are based on evidence of the outcomes for service users. For that reason, we are seriously considering the standards relating to multi-occupancy rooms and, more importantly, we shall also consider whether and how it would be helpful to carry out new research into links between the occupancy of rooms and the sort of outcomes that service users achieve.

Dr. Liam Fox (Woodspring)

How can the House have confidence in the Department of Health's awareness of the suicide risks and the potential for continuing drug and alcohol abuse among those patients when the draft standards stipulate that Staff enter service users"— that means patients— bedroom…only with the individual's permission…Service users have a key to their own bedroom…which can be locked from the inside…Service users choose when to be alone or in company, and when not to join an activity"— and that Service users' own rooms include…lockable storage space"? Who writes this stuff? Have the draft regulations been approved by any of the Ministers, or have they simply been written by advisers who seem to have no understanding or experience of this sort of patient?

Jacqui Smith

The hon. Gentleman obviously wrote and decided to deliver that question before he had listened to my previous responses. On his point about consultation, the standards were drafted and considered by experts within and outside the Department. They were subject to consultation meetings involving users, at which it is fair to say that users and providers expressed different views about them. This is a real consultation, and we are listening. I have already outlined, in relation to standard 2.7, how some of the concerns that he has mentioned might be overcome, but we will continue to listen and respond to people's concerns. When he sees the final standards, he will recognise that this is a Government who talk, but who also listen and respond to concerns.

Dr. Fox

The last time that the Government promised us consultation on similar regulations was in relation to care homes in general. The Minister might remember that, during those debates, we predicted that the result of their botched approach would be the loss of a large number of care home beds, and bed blocking throughout the national health service. Does she understand the anger of those who now see 15 per cent. of beds blocked in Birmingham, 17 per cent. blocked in Buckinghamshire and 18 per cent. blocked in Brent? How can anyone have confidence in a Government whose incompetence means that, nowadays, people have to queue up not only to get into hospital but to get out?

Jacqui Smith

People will have confidence in a Government who put the needs of the users of care homes at the centre of their policy. The hon. Gentleman is restating his claim that 50,000 care home places have been lost. That is wrong, as we have already pointed out to him. We accept, however, that there is a problem with capacity in care homes. That is why my right hon. Friend the Secretary of State set up the strategic commissioning group to consider how we can improve commissioning at local level in partnership with the independent sector. That is also why, on 9 October, my right hon. Friend announced a radical cash for change programme worth £300 million over this year and next, to tackle the problem of bed blocking. Such money was never promised by the Conservatives, and such measures would never have been delivered, had they won the last election.

Mr. Bob Blizzard (Waveney)

Is not the move to national standards and national inspection of care homes meant to take that responsibility from local authorities to achieve greater consistency? Does my hon. Friend share my concern that some local authorities appear to be aiming to continue inspection under the guise of contract monitoring? Is not such duplication a waste of resources and a nightmare for care home owners? Most of those I know welcome national standards.

Jacqui Smith

My hon. Friend makes an important point, and I know that he has taken a close interest in the issue. He is right that the national approach to care standards is beneficial because there will be consistency across the country in regulation and inspection. The National Care Standards Commission, which comes into operation from next April, will ensure that that consistency exists while recognising the flexibility necessary to ensure that good provision continues.

Local authorities, given the extra investment that this Government have provided for them, should concentrate on how they work constructively with local independent sector providers and other partners to ensure that we maintain and expand capacity for older people and others in need of long-term care. That is the priority that the Government set in the agreement that we published on 9 October, which is backed up with significant extra investment.

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