Elderly People in Residential Care: Funding (Hansard, 27 February 1990)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, the National Health Service and Community Care Bill makes provision for a new system of community care from 1991, including residential care, and the Government recognise that local authorities will need adequate resources to enable them to discharge their new responsibilities, including assessment, care management and securing the provision of appropriate care. We are taking the necessary steps to ensure this.

§ Baroness Turner of Camden
My Lords, I thank the noble Baroness for that reply. Will the provision that is to be made cover the situation where elderly people have resources which have run out and where they simply do not have the money available to meet the costs of residential care where that is required?

§ Baroness Hooper
My Lords, in determining the resources that will be made available, account will certainly be taken not only of income support that would have been payable under the present scheme to people in private residential care and nursing homes but also of demographic trends and the rate at which local authorities will assume responsibility for the care of new clients. Certainly the system will allow for assessment of needs as and when they arise, whether that is at the initial stage or in the course of a period of residential care.

§ Lord Mellish
My Lords, the Minister will be aware that recent surveys have shown that by the turn of the century the number of elderly people will be enormous. Thanks to advanced medical knowledge, people are today living at ages over 80. That is quite common.

§ Lord Hailsham of Saint Marylebone
Hear, hear!

§ Lord Mellish
My Lords, I thought that would give the noble and learned Lord, Lord Hailsham, a bit of a fillip. People are living much longer and are much healthier today. The need for residential care will be quite extraordinary in years to come. The Minister said that local authorities had been given special funds. Will she make sure that they use them?

§ Baroness Hooper
Yes, my Lords. In order to reassure the noble Lord, I can tell him that it is intended there shall be a special weighting factor for those aged over 85.

§ Lord Taylor of Gryfe
My Lords, I welcome the assurance that old people will be taken care of and funds made available. Will that be in any way influenced by the desire of the Government to put a limit on local authority spending?

§ Baroness Hooper
My Lords, I believe that is a separate question. As I said in my original Answer the Government recognise that adequate resources will be necessary.

§ Lord Dean of Beswick
My Lords, over the past 20 to 30 years some local authorities have had to take care of an increasing number of elderly people in their areas. They have had to build residential homes at substantial cost to their taxpayers. Is the Minister saying that because of the increase in the number of ageing people, as mentioned by the noble Lord, Lord Mellish, ratepayers will no longer have to bear the funding? Will the Government pick up the bill as they ought to have done in the past?

§ Baroness Hooper
My Lords, we believe that an uneven playing field exists under the present system and that encourages a healthy mixture of statutory residential accommodation provided by local authorities, and residential care and nursing accommodation provided by the private and voluntary sectors. The provision in the White Paper seeks to promote this mixed economy of care. It is intended that the demographic trends be taken into account.

§ Lord Monkswell
My Lords, are the Government aware that central government lay continual burdens on local government to provide services, particularly to the elderly? Are they also aware that central government have continually over the past 15 years constrained the abilities of local authorities to raise their own revenue? Are they aware that the introduction of the poll tax has further constrained the ability of local authorities to raise revenue to fulfil their duties? Are the Government looking at changes to the way in which local authorities can raise revenue in order to meet the responsibilities laid on them by central government?

§ Baroness Hooper
My Lords, as I said before, I believe that the reference to the community tax is a separate question. My understanding is that the community tax will only produce one-quarter of the local authorities' spending revenue. The revenue support grant will be assessed in the usual way and will make a substantial contribution particularly in the area of community care.

§ Lord Stallard
My Lords, is the Minister aware that since the registered homes tribunal began operating in 1984 over 100 cases have been heard? That includes many cases of serious incidents of abuse against vulnerable residents. In addition, the poor condition of the homes and the inadequacy of the local authority resources for alleviating the problem have been mentioned. Will the new powers to which the Minister referred assist in, for instance, introducing a national standard of contributions for residential homes?

§ Baroness Hooper
My Lords, the Government's policy continues to rest on the principle that it is the duty of local authorities to provide residential care. Under the new proposals there will be stricter arrangements for assessing needs for residential care as opposed to the possibility of elderly people remaining in the community with appropriate back-up services.

§ Lord Ennals
My Lords, I wish to put two questions to the Minister. First, she referred to legislation. Can she tell the House, in relation to the community care part of the legislation, at what stage the Government will make a statement about the additional resources to be made available for the fulfilment of the obligations?
Secondly, the Minister will recall that last week I asked her a question about community tax capping. I was then worried about the homeless. I am now worried about whether expenditure of local authorities on elderly people could be cut. Will the Minister repeat the assurance she gave me last week that there is no proposal to put a cap on local authority expenditure in this connection?

§ Baroness Hooper
My Lords, I am not sure that I gave the noble Lord that assurance last week. What I seem to recollect saying is that we believe that local authorities have a duty to deal responsibly with their local needs. That does not mean that they should be expected to raise revenues through the community charge. That charge and the resources 595 are being assessed for the purposes of community care through the revenue support grant mechanism.

§ Lord Ennals
My Lords, perhaps the Minister will look again at the assurance she gave me last week. I thought that it was fairly firm.

§ Baroness Turner of Camden
My Lords, perhaps I may thank the noble Baroness for her response to my question. Will she give some attention to the interim situation before these provisions come into operation? According to information that I have received from Age Concern, there are a number of cases outstanding where people require this care and simply cannot find the resources to pay for it.

§ Baroness Hooper
My Lords, my understanding is that the arrangements at present in place will continue for this interim period and that the new assessment arrangements and care arrangements to be made will operate from April 1991.