HL Deb 06 March 1991 vol 526 cc1391-2

2.55 p.m.

Lord Carter asked Her Majesty's Government:

What is their response to the finding of the National Association of Citizens Advice Bureaux that elderly people in residential care homes are suffering unacceptable levels of anxiety and stress due to the shortfall between income support levels and the fees charged by such homes.

The Parliamentary Under-Secretary of State, Department of Social Security (Lord Henley)

My Lords, the findings of the National Association of Citizens Advice Bureaux report Beyond the limit are at variance with the findings of the survey commissioned from Price Waterhouse by the Department of Social Security into the costs of providing residential care. In October 1990 my right honourable friend the Secretary of State announced increases to the limits payable in residential care and nursing homes of some £225 million to take effect from April this year. The basic income support limit for the elderly in residential care homes has increased faster than inflation over the last five years.

Lord Carter

My Lords, I thank the Minister for that Answer. He will know that the report revealed a substantial number of cases of severe hardship. Is he aware that government policy in this matter was clearly stated in a circular from the Department of Health, HC 89/5, which says that no one should be placed in residential or nursing care against their wishes if that meant that they or their relatives became personally responsible for the charges? If that is government policy, why are the Government unable to accept the proposal in the NACAB report that, as an interim measure until the community care plans are implemented, the benefit levels should be topped up by the Department of Social Security in these cases of severe hardship?

Lord Henley

My Lords, as the noble Lord knows well, it has never been our intention to meet all the fees, however high they might be. It must be a matter for the homes and the clients in them to negotiate their fees. In response to the findings of the Price Waterhouse survey and other evidence before us we have announced real increases of some £225 million from this April. The suggestion that the noble Lord repeats from the NACAB report would quite simply have the effect of pushing up the fees to whatever limit the homes agreed to put them.

Lord Stallard

My Lords, is the Minister aware that there is a serious problem in residential care homes which is exacerbated by the Government's failure so far to implement the community care programme and to uprate benefits annually in line with the rate of inflation?

Lord Henley

My Lords, community care is another question. The matter of income support limits in residential homes will remain with us after the implementation of community care. As I said in my original Answer, we have increased support for the elderly by more than the rate of inflation over the past five years. I also remind the noble Lord that increases this year for the very dependent elderly have risen by even more than the standard £155 to £160. The amount has gone up by £15 to £185.

Lord Ennals

My Lords, is the Minister aware that the report by the Council for Caring for the Elderly which came out just a few weeks ago confirms the evidence in the NACAB report? Does he accept that there are some disturbing cases both in care homes and in nursing homes where people are being asked to top up fees on behalf of their relatives, thereby reducing their savings to nothing, and elderly people—sometimes very elderly people—are being asked to leave the homes because they cannot pay the full fee? Is that not absolutely wrong? Should not some action be taken to ensure that private care homes do not act in that way?

Lord Henley

My Lords, in setting the limits my right honourable friend looked at a great deal of evidence. In particular he looked at the Price Waterhouse report which considered the costs—I stress the word "costs"—and not the charges in some 700 homes and was the widest detailed analysis of this matter ever undertaken. As a result, my right honourable friend was able to increase income support limits. The evidence we have at the moment suggests that at least half the homes are at the level of income support or below. If we followed the line suggested by the noble Lord of raising income support limits willy-nilly to whatever figure he cared to put forward, we should find that the charges would go up and up and the noble Lord would find that that had a serious effect on those not in receipt of income support.

Lord Ennals

My Lords, the noble Lord has replied to a question that I did not put to him. I was not arguing the case for raising the levels. I drew his attention to the problem and I asked whether the department could take action about private nursing homes which are asking elderly dependent people to leave because they are not able to pay the full fee required.

Lord Henley

My Lords, as I said earlier, it has never been our intention to meet all the fees, however high they may be, in any individual home. There will always be homes, and indeed there are homes in all parts of the country as the Price Waterhouse survey showed—that is, both nursing and residential homes—which fall within the limits we have set.

Lord Strabolgi

My Lords, is the Minister aware that many of these homes were started as a result of the business opportunity schemes and that the owners are therefore obliged to charge very exorbitant fees in order to satisfy their shareholders?

Lord Henley

My Lords, I do not accept that point. Those responsible for any home will want to try to set a fee level which will attract clients to the home.