Community Care: Responsibilities (Hansard, 24 April 1991)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, nothing in the new proposals changes the responsibility of local authorities for managing social services, including the phased introduction of community care between 1991 and 1993. Local authorities implemented phase one on 1st April this year and are currently preparing plans as required for the implementation of phase two on 1st April next year.

§ Lord Carter
My Lords, I thank the Minister for that Answer. Does she agree that the proposed reform of local government structure means that councils are being asked to plan community care services without knowing whether they will exist a year after the plans have been implemented? Can she confirm that no consideration is being given at ministerial or official level to the possible deferment of the transfer of community care responsibilities beyond 1993 or the removal from local authorities of their existing responsibilities for community care?

§ Baroness Hooper
My Lords, on 12th February my right honourable friend the Prime Minister said that the Government's policy on community care remained as set out in the White PaperCaring for People, and in the National Health Service and Community Care Act 1990. On 28th March my right honourable friend the Secretary of State for Health said that responsibility for managing social services, including the phased introduction of community care, will continue to rest with local government. Paragraph 18 of the Green Paper on local government structure published yesterday records local government's increased responsibility for community and child care. It contains no proposals to alter local government involvement in those responsibilities.

§ Baroness Faithfull
My Lords, will my noble friend say when the community care Act is likely to be implemented?

§ Baroness Hooper
My Lords, I assume that my noble friend is referring to the community care 264 elements of the 1990 Act. The first phase of the implementation took place on 1st April this year when local authorities introduced a complaints procedure and inspection units. That phase has already been completed. From April 1991 we have also had available the mental illness specific grant and the specific grant for drug and alcohol services. Development work is continuing on all fronts. By 1st April 1992 the community care plans will be in place. The final phasing-in of the transfer of resources will take place on 1st April 1993.

§ Lord Mellish
My Lords, the Minister will be aware that previously it has been the practice of some local authorities to say that they will do many things providing that the Government find the money or do not stop them from doing so because of cutbacks. Will the Minister assure the House that no such excuse can be put forward in respect of community care?

§ Baroness Hooper
My Lords, from 1978–79 to-date there has been an increase in personal social services expenditure of up to 53 per cent. in real terms. Therefore local authorities are moving in the right direction. The Government remain committed to providing adequate resources for community care plans taking into account demographic pressure and new responsibilities within the framework of the phased-in timetable. Allowance has been made for the implementation of phase one within the context of the local authority settlement for this year. The cost of implementing phases two and three will be considered in the appropriate financial years.

§ Lord Molloy
My Lords, is the Minister aware that during the past decade a new problem has arisen in community care? It relates to old people who are left alone because their children have moved away to other parts of the country or the world. Magnificent work is being done for them by home-helps. However, I understand that the pressure now put on home-helps is becoming heavy. Old people rely on them. Therefore can the department consider what help it can give?

§ Baroness Hooper
My Lords, we are examining in considerable detail the whole range of services required as a result of the demographic pressures to which I have referred. We remain committed to providing adequate resources.

§ Lord Ennals
My Lords, does the Minister accept that the decision to pay£140 to reduce the headline poll tax charge but to postpone the bulk of the community care provisions for two years for the sake of£15 per head per year shows the low priority that the Government are now giving to community care? Does the Minister appreciate that the uncertainty about the future of local government created as a result of yesterday's statement and by the two years' postponement, leads to uncertainty in local authorities, in voluntary organisations which are expected to implement the community care provisions, and in the needy people?

§ Baroness Hooper
My Lords, the Government's proposals for the phasing-in of community care show great consideration for the needs in that area and for 265 the importance of them to be effectively implemented. The change in funding referred to by the noble Lord should have no effect. The fact that standard spending assessments will continue means that discussions with local authorities about the way in which resources will be transferred from the Department of Social Security will be easier as a result. I do not accept the statement that there is any uncertainty.

§ Baroness Oppenheim-Barnes
My Lords, will my noble friend confirm that if local authorities allocate their spending priorities sensibly, operate efficiently and do not waste their money on irrelevant items, they should have plenty to spare for the important items that we all wish to see?

§ Baroness Hooper
My Lords, I happily agree with my noble friend. In addition to the increased spending on personal social services, the department is issuing guidance to health authorities in the implementation of community care. It will also produce practice material on contracting and purchasing and other materials to aid and encourage them.

§ Lord Dean of Beswick
My Lords, is the Minister aware that the answer she gave to my noble friend Lord Mellish was misleading? The figures that she quoted have nothing to do with community care, but they show the gradual inflation increases in social security department spending. The question was about the new responsibility now being placed on local authorities. Are the Government prepared to find new money for local authorities so that they can adequately carry out that function?

§ Baroness Hooper
My Lords, I have already answered the noble Lord's question by saying that the new local authority settlements allow for the phasing-in and implementation of the community care plans.

§ Lord Glenamara
My Lords, will the Minister take more seriously the point made by my noble friend Lord Molloy? I know of a number of old people who have had visits from home-helps reduced from weekly to fortnightly. As home-helps often shop for old people, that reduction causes great hardship. Will the Minister consider that specific matter, because the situation exists everywhere in the country?

§ Baroness Hooper
My Lords, nothing in my reply suggested that we are not considering that specific matter.