Private Residential Care: Costs (Hansard, 16 March 1992)

§ Lord Henley
My Lords, the recent report of the social security and health committees did not recommend a general increase in the levels of income support for people in residential and nursing homes beyond the normal annual up-rating exercise. The Government welcome this support for their policy and note that the numbers in such homes being supported by social security benefits continue to increase.

§ Lord Molloy
My Lords, I thank the Minister for his reply. Is he aware that this is both a sad and serious matter and that in many instances people cannot afford these increases which have been imposed as a result of escalating costs? There are many ex-servicemen and ex-servicewomen who are now approaching their mid-70s and 80s who could be the victims of these higher costs because their children or 1565 grandchildren cannot afford to meet them. Will the Minister and the Association of Directors of Social Services take a fresh look at this matter to see whether private nursing homes can be assisted and thus enabled to continue their magnificent work?

§ Lord Henley
My Lords, the noble Lord's Question relates to residential homes as opposed to nursing homes. I have to say that the levels of income support available to people in residential homes vary from £160 to some £230 per week. Those figures are to increase to £175 and £245 per week as from next April. Those are very significant increases and I do not see a case for any further increases in income support levels on top of that.

§ Lord Ennals
My Lords, bearing in mind that we have an ageing population and therefore there is a great need for high quality nursing and accommodation in many parts of the country for people who are highly dependent on such care, does the Minister think the time has now come when a government, regardless of their complexion, should consider whether residential and nursing homes should be required to accept residents who are within the level of income support rather than force families to have to pay up and often to reduce their own level of savings? That requirement should apply to residential and nursing homes irrespective of whether they are privately run, run by local authorities, or by health authorities.

§ Lord Henley
My Lords, quite honestly I see nothing wrong with relatives, charities and other bodies topping up residents' fees. Special provisions in the income support regulations allow for that money to be disregarded in relation to income support. Therefore, the full levels of income support are still available to those residents. As I said to the noble Lord, Lord Molloy, the levels of income support available to people in residential homes vary from £160 to £230 a week.

§ Lord Ennals
My Lords, does the Minister accept that in some cases people have been asked to leave homes because they cannot afford the fees charged and the relatives cannot afford to top up their resources? Is that a satisfactory situation for any government or party?

§ Lord Henley
My Lords, it may be that some homes cannot provide places at the income support levels. We have little evidence of this but it might be that people have therefore had to leave those homes and move to another home in the same area that can provide places within the income support limits. However, I should say to the noble Lord that I see no case for increasing the income support levels willy-nilly, much as the noble Lord would like that, because what happens then —surprise, surprise—is that the fees of the homes go up. That is not really fair on those who are paying the fees out of their own incomes rather than out of income support.

§ Baroness Platt of Writtle
My Lords, can my noble friend assure me that the Government recognise the importance of the home help service which enables so 1566 many elderly people who would prefer to stay at home to avoid going into an institution, whether private or public?

§ Lord Henley
My Lords, the point raised by my noble friend goes slightly beyond the Question on the Order Paper. I hope that that is something which will be very much considered by local authorities once the community care policy comes into effect next April.

§ Lord Desai
My Lords, will the noble Lord comment on the fact that private residential homes face uncertainty as to how much money they will receive from the Government because that will not be known until November 1992? In the meantime, costs are high and some homes are being squeezed and may go out of business. Will he also comment on the fact that, as the noble Baroness, Lady Platt, said, if people have to resort to home helps there may be a nationwide shortage of home helps to meet the needs of people thrown out of private residential homes?

§ Lord Henley
My Lords, the noble Lord has raised a very interesting point. I have to say that there is no uncertainty for the homes themselves. They know exactly what the levels of income support are. I also think it very unlikely that they will find themselves short of people coming in to the homes if one considers the demographic changes which are taking place and which have taken place over the past few years. I suspect that the noble Lord was referring to the uncertainty that those people running homes feel they face as a result of the changes which will take place in April next year and the fact that local authorities do not yet know exactly what resources will come to them. I have to say that I think that those uncertainties are somewhat unfounded, and I suspect that they probably reflect the concerns of the Association of Directors of Social Services about future funding rather than the concerns of individual homes.

§ Lord Ennals
My Lords, does the noble Lord know how many private homes have gone out of business?

§ Lord Henley
My Lords, no.

§ Lord Monkswell
My Lords, following the Minister's earlier reply about the provision of home helps and the advent of community care, what assurance can he give to this House that there will be adequate financial support from central resources to local authorities to ensure that community care and the provision of home helps will be adequate?

§ Lord Henley
My Lords, we have always made it clear, and it has been made clear by my right honourable friend the Secretary of State on many occasions, that there will be adequate funding for the community care policy when it comes into effect next April. No doubt the noble Lord and other noble Lords opposite will say that whatever figure we come up with is inadequate, but they would say that wouldn't they?

§ Lord Molloy
My Lords, is the noble Lord aware that home helps do a remarkably good job? However, they are not qualified doctors or nurses, and when old 1567 people reach the stage when a doctor has to be called several times a week it is wise for them to be sent to one of those private institutions. Is the noble Lord further aware that much of what he has said today would be strongly contested by no less a body than, as I mentioned, the Association of Directors of Social Services? Can there be some contact now with the directors to see whether positive action can be taken to resolve what is now a sad and serious situation?

§ Lord Henley
My Lords, the noble Lord's Question relates to residential homes. I am not aware that it is necessary for either doctors or nurses to be resident in residential homes.