HC Deb 22 January 2002 vol 378 cc744-6
14. Mr. Nick Gibb (Bognor Regis and Littlehampton)

How many beds for elderly people have been lost in residential homes between May 1997 and the latest available date. [26373]

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

The Department's figures show that there were 261,600 residential care home places for older people in March 1997. That figure had fallen by 1,500, to 260,100, in March 2001.

Mr. Gibb

It is strange that the hon. Lady cites those figures, because experts appointed by her Department—Laing and Buisson—show 49,000 fewer beds in residential care homes since 1997, as a consequence of which almost 6,500 beds are now being blocked in NHS hospitals. Is not that an absurd misallocation of scarce NHS resources?

Jacqui Smith

There are pressures on the care home sector. That, of course, is part of the reason why the Government are investing £300 million this year and next year, partly to help to stabilise the care home sector; but I really do not think that a discussion about this important issue is helped by Opposition Members' consistent misuse of figures. Laing and Buisson has no axe to grind, and the Laing and Buisson figures actually showed a net loss of 19,000 beds since 1996—a period in which there has also been a considerable increase in the number of older people receiving intensive care packages at home. In other words, we are doing what older people want us to do—helping them to be independent.

Kevin Brennan (Cardiff, West)

My hon. Friend is right to concentrate on intensive home care packages. Is she aware of the report in this month's British Medical Journal that suggests that, if the NHS could reduce the acute bed/day average down to levels such as those in the Kaiser organisation in California, we could save up to 17 per cent. of the NHS budget? Does not that send the message that it is important to have such acute home care packages and that we should concentrate on reform, rather than just pouring money into the health service?

Jacqui Smith

My hon. Friend is absolutely right. That is why the investment that has already gone into intermediate care and the £300 million that the Government are providing over this year and next year is buying not only more care home places, but more intermediate care to keep people out of hospital and help them move more quickly from acute beds to independence. It is also buying more intensive home care, so more people are receiving nursing and other support to stay at home. This is a time of transition in the care that we provide to our older people, and a mature debate recognises that and the extra support that the Government are providing to help to promote independence and to maintain capacity in the care home sector; it does not focus on misusing statistics to the benefit of no one.

Mr. Nicholas Winterton (Macclesfield)

Although I appreciate the content of the Minister's replies to the questions that she has been asked on this subject, does she not agree that there is a problem with residential care for the elderly and that a number of elderly people require residential care? Although home care packages can play a very important part, there is a problem because of the increased costs that residential care proprietors have to incur. Will she not accept that there is a problem with the costs incurred in certain areas of the country, not least in my own, where a residential care home provided by an independent body—County Lifestyle Services—has closed in Cheshire? Will she not take account of the fact that some people require care homes for their retirement?

Jacqui Smith

I agree with the hon. Gentleman. Some people need care homes, and the fees and commissioning arrangements at local authority and local health service level are important for the publicly funded residents in those homes. That is why my predecessor set up a strategic commissioning group, to bring together representatives of local authorities and of independent health care and residential home providers to develop an agreement which the Government published at the same time as we invested £300 million in the system. The group also addressed the need for better commissioning and explicitly said that, when local authorities make decisions about fees, they should bear in mind the costs faced by care homes and the quality that we want for residential care provision.

Decisions about fees are rightly made at local authority level. However, with the guidance and extra investment that the Government are putting into social services, it is possible to remodel our services and to maintain the necessary high-quality capacity in residential care to give a real choice to our older people.

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