Care in the Community: Funding (Hansard, 15 June 1992)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, we shall announce the funds for the third and final phase of the implementation of the Community Care Act in this year's local government expenditure survey.

§ Lord Monkswell
My Lords, while I thank the Minister for her reply, are the Government aware of the grave difficulties which will be faced by local councils trying to implement community care by 1st April 1993 if the announcement of the funding available to them is made only in the autumn, which is what I gather to be the situation from the Minister's reply? Therefore, will the Government please bring forward that announcement to give more time for local authorities to make the necessary plans? Further, are the Government aware of the serious concerns expressed by local government that there will he a shortfall in funding for the implementation of community care, which, as the Government will be aware, affects the most vulnerable members of our community?

§ Baroness Cumberlege
My Lords, to answer the noble Lord's first point, it is important that local 2 authorities should not be blinded by the transfer. As a former chairman of a social services committee I know that at the beginning of the year one knows the bulk of the expenditure that one has for the coming year. It is the marginal parts of the budget which are negotiated with the Treasury. I do not believe that local authorities will have a problem.

§ Lord Renton
My Lords, does my noble friend's original Answer mean that funds will be provided in order to implement fully care in the community? Can she say when that process will be completed? Will it be at the end of the coming financial year—and if not, when?

§ Baroness Cumberlege
My Lords, perhaps I may answer my noble friend by saying that I believe that the implementation of care in the community will take many years. So far we have dealt with the first two phases. The third phase will take a considerable time. My right honourable friend the Secretary of State and her predecessors have given undertakings that the policy will be fairly resourced, that the transfer funds from social security will be transparent and the basis of the calculation made clear, and that the Government will use their powers to ensure that money transferred from social security will not be diverted or misused.

§ Lord Ennals
My Lords, is the Minister aware that in my view it is appalling for local authorities to have to wait until November? As she well knows, they have to make great plans. Here we are dealing with the most vulnerable members of society, particularly the elderly and the elderly mentally infirm. The Government have had nearly four years to work out the funding: why have they not reached a decision by now? Can the noble Baroness tell me what consultations have taken place, both with the local authority associations and with the principal voluntary organisations involved, so that they at least may know what resources they will have to fulfil this major responsibility?

§ Baroness Cumberlege
My Lords, considerable negotiations have been taking place with local 3 authorities, housing authorities and the voluntary sector. The money that is being transferred from social security is new money. The bulk of the work being carried out in the community will continue. Local authorities are aware of that. This is new money and local authorities will be very grateful for additional resources.

§ Lord Rix
My Lords, is the Minister aware of the anxiety felt by people with disabilities and their organisations at the Government's refusal to implement the sections of the Griffiths Report relating to special funds being made available for community care for 1993? Will she also say how the Government will ensure that community care funds, such as they are, are not diverted to some other cause?

§ Baroness Cumberlege
My Lords, I have already given that undertaking. The Government are determined that the policy of community care will be fairly funded. The transfer will be transparent so that local authorities, voluntary organisations and other people in the community will be able to assess whether that money is going where it is intended. The Government are determined to make the policy a success.

Baroness Faithful
My Lords, does that mean that the money for community care will be ring fenced?

§ Baroness Cumberlege
My Lords, I repeat that the policy will be fairly resourced. The Government are determined to ensure that none of the social security money that is transferred will be diverted or misused. There are monitoring mechanisms through the social services inspectorate to ensure that that happens.

§ Baroness Seear
My Lords, can the Minister tell us the date when the money for community care will be made available? We waited for over two years after publication of the Griffiths Report. We expected to have the money a year ago. We have been told that it will be available in 1993. Does she agree that there are a great many people up and down the country, particularly those who are doing the caring in the country—6 million of them—who will be waiting for the money and who do not know what will happen? They require a date and they require it soon. Will the Minister tell us when the money will come?

§ Baroness Cumberlege
My Lords, it will come with the PES settlement.

§ Lord Rea
My Lords, will the noble Baroness consider the assessment procedure that will have to be carried out on each client who receives community care? Who will undertake that assessment? Will it be undertaken by the district nurse or general practitioner who looks after the client? Will that procedure be financed with new money?

§ Baroness Cumberlege
My Lords, considerable additional money has already gone into community care especially for training. The assessment will be done by social workers in close collaboration with district nurses, home helps and all the other people involved in looking after the dependent person at 4 home. It is essential that they work together, but the assessment will be done by special care officers who are trained for that role.

§ Baroness Hollis of Heigham
My Lords, does the Minister agree that it is deeply unreasonable that while the Government should take four years to plan community care and their Algebra Group has completed its financial sums, they allow individual local authorities only four months' notice of their budgets? Mr. Redwood, the Minister for Local Government in another place, has said that the delay is because of concern at the cost of community care proposals for the new council tax. Will the Minister confirm that the Department of Health's smooth introduction of community care, which we all want, is being delayed by and may be sacrificed to the Department of the Environment's deeply flawed council tax?

§ Baroness Cumberlege
My Lords, the noble Baroness is correct to say that there will be a smooth introduction of community care. It is absolutely right that the Government have taken three years to introduce it. From 1st April 1991 social services departments were required to introduce inspection units and complaints procedures and they have done so. Additional money has been made available through specific grants. In 1992 local authorities and health authorities were required to produce and publish community care plans. They have done so. This year we shall transfer the social security money into local authority budgets. I have every confidence that that will take place smoothly. The Government are fully committed to this policy and will ensure that it is introduced smoothly and effectively.

§ Lord Molloy
My Lords, I acknowledge the importance of the reply given by the noble Baroness, but does she agree that one of the disturbing and distressing features of this subject is that in various parts of the country assistance for community care is desperately needed and in others it is not so urgent? Does she agree that it would be proper for the department to examine where its help and services are most urgently needed and to provide them there first?

§ Baroness Cumberlege
My Lords, it is essential that this policy is introduced throughout the country. We have waited for it a long time. It will be introduced on 1st April next year.