Home Help Service (Hansard, 8 February 1990)

§ Baroness Blatch
My Lords, changes from the traditional home help, providing mainly shopping and cleaning services, to a home care service able to provide personal care have been introduced by many local authorities to enable the service to offer a higher degree of support. That helps dependent people to continue to live in the community in a home of their own. At the same time, authorities are moving towards remodelling their services so that resources are concentrated on those most in need of support.

§ Baroness Masham of Ilton
My Lords, I thank the Minister for her reply. Is she aware that many severely disabled and elderly people are now having acute problems in getting their houses cleaned and that to remove the priority of cleanliness makes them feel demoralised and depressed in dirty houses?

§ Baroness Blatch
My Lords, it is true that cleaning services are a vital support to keeping elderly and disabled people in their own homes. Inevitably, the change to the new type of home care service will mean that some people who have received help with cleaning will no longer have it provided by the local authority. However, I hope that local authorities will recognise the importance that many recipients attach to that home help cleaning service and that, where they deem it to be essential, cleaning services should not be removed or, where they are removed, alternative arrangements and other ways of providing them should be sought.

§ Baroness Elles
My Lords, does my noble friend agree that cleanliness is paramount in the comfort of a home? Is it surprising that the country is, frankly, becoming so dirty if that is the kind of view taken by local authorities in looking after the people in their care?

§ Baroness Blatch
My Lords, there are two responses to that point. First, it is important to remember that domestic services for those people have not disappeared from the job description of the new kind of home care service. Secondly, my noble friend's point is well taken. For many elderly people who have traditionally looked after their homes, the most distressing part of growing old is to see that their bathrooms are not clean and that their floors are not cleaned and swept.

§ Lord Stallard
My Lords, will the noble Baroness ask her right honourable friend to have another look at the remodelling because it has resulted in people throughout the country having their number of hours' help reduced? It is true that they may well receive some minimal housekeeping help, but the time has been reduced to less than an hour on the basis that housekeeping is not seen to be important. Other people have had their applications for the services that they have identified turned down. That point is particularly important with regard to arthritic people who rely on the housekeeping and cleaning services to enable them to get around and do the things that they can do. Will the noble Baroness take another look at the effect of the remodelling on those people?

§ Baroness Blatch
My Lords, the key issue here is proper management of change. It is the Government's policy to keep disabled and elderly people in their own homes. This is an essential part of that service. It is therefore right that we continue to ensure that an essential part of the service is not lost in the course of managing the change. However, the needs of the elderly are now more complex and it is therefore right that a more professional approach to keeping people in their homes is retained while not ignoring the essential part of the domestic side of their lives.

§ Lord Ennals
My Lords, it seems to be a change for the worse. I cannot see how a change for the worse could be recommended. Is the noble Baroness aware that there is growing concern among many organisations about, among other things, the cleaning point raised by the noble Baroness, Lady Elles? One organisation told me that those who have had a home help for some time have had the number of hours reduced or the home help discontinued and those who now apply for a home help are either refused or are not given the help that they identify.
In view of the increasing number of elderly and disabled people dependent upon home helps not just for help but as a lifeline to the community —the one item in their empty diaries upon which they can rely —is it not a matter of deep concern to the noble Baroness that the service seems to be becoming worse?

§ Baroness Blatch
My Lords, I hope that the noble Lord appreciates that I sympathise considerably with the point made in the Question. Local authorities should be reminded of their obligation to the Government's policy of keeping in their own homes people who are dependent on that service. It is also worth remembering that the home help service has expanded from about 47,000 whole-time equivalents in 1978 to about 60,000 in 1987. However, having said that, the business of determining priorities and assessing needs is very much a matter for local authorities. They approach that work in good, bad and indifferent ways.

§ Lord Molloy
My Lords, is the noble Baroness aware that, if there is a severe reduction, as there appears to be, in home help, it will create grave 943 difficulties for the Health Visitors Association whose members are already complaining about the fact that they have no option but to do some of the work that home helps did rather than their own job as health visitors?

§ Baroness Blatch
My Lords, the answer to the previous question proves that there has not been a cut in the service. There has been a considerable expansion in the service. The noble Lord may be referring to the situation where needs change, and to the fact that a person whose need for home help has increased, rather than a person whose need has diminished, will obtain the service. There may be a gap in the services in the way in which local authorities approach explaining the situation to their clients. There is probably considerable scope for improvement in the way that the complexities are communicated.

§ Lord Glenamara
My Lords, the noble Baroness has confused me by agreeing with everyone. Will she tell us clearly whether the cleanliness criterion has been removed? Has it or has it not?

§ Baroness Blatch
My Lords, I hope that, by accusing me of agreeing with everyone, the noble Lord does not think that I am compromising myself on each point. It is important to make clear that, as I said in reply to one question, domestic duties of the home care service have not been removed from the job description. I understand that there is some genuine criticism about in the country that elderly people are confused about why they are losing domestic services and why they are being replaced with services which some might say are not perhaps as high a priority in their lives. There is scope for local authorities to look carefully at the way in which they determine priorities, how they deploy their resources and how they appropriately address the needs of their clients.

§ Lord Ennals
My Lords, does the noble Baroness agree that this is a matter for her department? Does she recognise the strength of concern throughout the House? Will she discuss the issue with her right honourable friend? Surely this is an issue for her department and its Secretary of State.

§ Baroness Blatch
My Lords, I shall of course draw the comments made today to my department's attention. It is also worth saying that there is an inspectorate which is concerned about the burden on local authorities to absorb all the changes in the field of community care. It is already moving in alongside local authorities to help with the management of change and to give guidance on the issue.

§ Baroness Masham of Ilton
My Lords, I know that the noble Baroness is as keen on cleanliness as I am and is concerned about those people who cannot do these things for themselves. Will she ensure that her department monitors the situation throughout the country? Will she take it upon herself to undertake that task in view of her interest in this matter?

§ Baroness Blatch
My Lords, I can give that assurance that the department will play a real part in monitoring; as also will the local authorities themselves.