The Welfare State and the Elderly (Hansard, 9 May 2000)

§ Earl Attlee
asked Her Majesty's Government:
Whether the operation of the welfare state in respect of the elderly is satisfactory.

§ The Parliamentary Under-Secretary of State, Department of Social Security (Baroness Hollis of Heigham)
My Lords, the measures:flowing from the Green Paper Partnership in Pensions, together with those announced in the past two Budgets, demonstrate the priority that the Government have given to ensuring a decent income in retirement and improved quality of life for pensioners; hence our proposals for an earnings-linked minimum income guarantee for poorer pensioners now as well as for a state second pension and a stakeholder pension to reduce pensioner poverty in future. The winter fuel payment, worth £3 a week, as well as the minimum tax guarantee and the provision of TV licences will benefit most eligible pensioners.

§ Earl Attlee
My Lords, I thank the Minister for that reply. As I had a word with her private office, she will be aware that I am straying slightly from my usual topic. At a time when we are spending over £100,000 million on social security, can the Minister explain why increasingly I meet beggars who are clearly too 1366 old to work and who have obviously spent most of their time in the UK? Is the problem one of social security, of law and order, or of health?

§ Baroness Hollis of Heigham
My Lords, I am grateful that the noble Earl told me that he would ask about beggars. However, I do not believe that that has allowed me to acquire any useful further information to share with the House. We have no statistics about the number of beggars who are elderly—presumably elderly women—for example, over 75. From my experience, beggars are usually younger people who have come to London to try their luck. Certainly any elderly person—someone over 65 or over 75—would be entitled to state benefits, including a state pension. They would be entitled to a minimum income guarantee if they did not have alternative means and they would be entitled to housing benefit.
Given that, the problem ought not to be a social security one. If they are elderly and on the streets, or in some sense sleeping rough, there may be mental health problems or substance abuse problems; certainly there are social exclusion problems.

§ Lord Clement-Jones
My Lords, if the Minister has had an opportunity to read the recent survey into accident and emergency departments, carried out by the Association of Community Health Councils for England and Wales and the Royal College of Nursing, she will have seen that there are horrendous examples of age discrimination against the elderly. Is it not time, as we urged on the Health Act last year, that there should be an outlawing of age discrimination in the public services?

§ Baroness Hollis of Heigham
My Lords, I agree with the noble Lord. The Government are entirely and utterly opposed to any discrimination against older people in the National Health Service. Any treatment of elderly people must be done on clinical grounds only, and on no other grounds at all. That is precisely why the Government and my noble friend Lord Hunt of Kings Heath are developing a National Service Framework for Older People. That is being developed this year to ensure consistent quality and decent care for older people across all health authorities.

§ Baroness Wilkins
My Lords, can the Minister give an assurance that the Government will follow the recommendation of the Royal Commission on Long-Term Care of the Elderly that personal care should be free of charge to those who need it? Do they recognise that personal assistance should be regarded as a fundamental human right? People who can no longer get out of bed, feed or dress themselves without personal assistance or support are not in that position from choice. That service is as essential as the National Health Service, education and others.

§ Baroness Hollis of Heigham
My Lords, I am batting slightly off my wicket, but I shall have a go. The noble Baroness will know that the Government are considering the Sutherland report, but have not yet 1367 come to a decision as to which path they will take in terms of the recommendations. They have not decided whether to follow a majority recommendation or a minority recommendation, associated with my noble friend Lord Lipsey. He made the point that, given that one is dealing with scarce resources, a real decision has to be made as to whether the cost to people of the existing service is reduced or whether that money is used to improve existing services. The Government are reflecting on that and will make a judgment in due course.

§ Lord Goodhart
My Lords, will the Government consider giving particular assistance to older pensioners by providing age additions to the basic state pension of a substantial amount for those aged 75, 80 and over?

§ Baroness Hollis of Heigham
My Lords, I accept the diagnosis of the noble Lord of who are the poorer pensioners. They tend to be the older pensioners—those over 75 or over 80—and often they are single women. The interesting proposals put forward by the Liberal Democrats, and particularly by the noble Lord's right honourable friend Steven Webb, are for a 75 per cent increase between the figures of the basic state pension and the minimum income guarantee. However, I have difficulty with the fact that he proposes that it should be funded by the removal, or the scrapping, of our proposals for the state second pension. That would mean that it would be to the disadvantage of women, carers and disabled people. Another problem is that under the Liberal Democrats' proposals, more people in 2010 would be on income-related benefits rather than fewer.

§ Baroness Masham of Ilton
My Lords, does the Minister believe that there are enough physiotherapists, occupational therapists and speech therapists to rehabilitate elderly people when they become ill so that they can return home, enjoy their pensions and live an independent life?

§ Baroness Hollis of Heigham
My Lords, perhaps I could beg the noble Earl, Lord Attlee, the next time he asks this question to go for a UQ rather than a Starred Question! I am assured by my noble friend Lord Hunt—for whose advice I am grateful—that we have a national working scheme looking at precisely those proposals. We recognise how dependent elderly people are, particularly for mobility, on physiotherapy and occupational therapy.

§ Lord Ashley of Stoke
My Lords, is my noble friend aware that she bats off her wicket very well indeed? I ask her to continue to do so now. Does she agree that there should be an inquiry into the allegations that some hospital trusts use "Not for resuscitation" notices in relation to elderly people without their consent and without consultation with their relatives? If she disagrees with that, I hope that she will consult her colleague. Does she agree that a step forward 1368 would be for the Government to demand from every hospital trust a report on how many "Not for resuscitation" notices are issued, so that those trusts with an abnormally high number can easily be identified?

§ Baroness Hollis of Heigham
My Lords, that is an interesting question which has been heard by my noble friend Lord Hunt and on which he will want to reflect. Perhaps I may emphasise a response I gave earlier: the Government absolutely deplore "Do not resuscitate" notices in the spirit in which the noble Lord has enunciated. That is a matter for clinical judgment within the framework of careful guidelines drawn up by the Department of Health and the BMA. It is precisely to overcome some of the apparent—I was going to say "discrepancies" but that is a cold word—different responses of hospitals to similar situations that the DoH is developing its National Service Framework for Older People to ensure consistency, decency and quality for all elderly people at a most vulnerable time—when they are in hospital.

§ Lord Higgins
My Lords, as the Question specifically refers to the operation of the welfare state, is it not the case that there have been considerable problems as a result of break-downs and deficiencies in computer systems, for example, in the payment of deferred pensions? Can the Minister bring us up to date on that? On the point raised by my noble friend Lord Attlee, is there not a case for carrying out a survey on the particular problem to which he has drawn the attention of the House?

§ Baroness Hollis of Heigham
My Lords, on the second question, I shall certainly ask my colleague in the DETR whether he can give further information on the number of women beggars. I shall write to the noble Earl, Lord Attlee, and put a copy in the Library, when we have further information.
The noble Lord, Lord Higgins, also asked about computers, particularly the NIRS2 computer. The latest information that I have on contributory benefits, as opposed to income-related benefits, is that something like 95 per cent of all benefits have now been paid and that the backlog, if it has not already been cleared, will be cleared by the end of this month. Where appropriate, compensation has been paid.

§ Baroness Greengross
My Lords, perhaps I may put two points.

Noble Lords
Questions!

§ Baroness Greengross
My Lords, I apologise. I should like to put two questions to the Minister. First, as regards homeless people and beggars, research published a while ago showed that a high proportion of elderly people are homeless in and around London. Does the Minister agree that we should set up an investigation into the current situation? Secondly, as regards "Do not resuscitate" orders, that is one example of discrimination in the NHS and I am 1369 grateful for the Minister's comment that this will not be tolerated. However, in this area also we do not know all the facts. Does the Minister further agree that it would be better to hold an inquiry to examine all aspects of discrimination in the NHS so that we can eliminate it on the basis of full information?

§ Baroness Hollis of Heigham
My Lords, noble Lords, including my noble friend Lord Hunt, have heard the points made by the noble Baroness. Obviously my noble friend will reflect on whether it makes good sense to conduct an inquiry. However, what is needed is to ensure that this does not continue to take place in the future. The best way of ensuring that is to establish a National Service Framework for Older People. That is being developed and will apply to all local authorities. I hope that, in a year or two, the noble Baroness—who has worked so wonderfully for Age Concern—will no longer consider this to be a problem.

§ Baroness Gardner of Parkes
My ]Lords, in the light of so many questions on health being raised today, can the Minister say whether they typify the problem of lack of cohesion between the social services and health sectors? When does she think that this gap in communication will be bridged?

§ Baroness Hollis of Heigham
My Lords, as my noble friend said, I do not believe that this is so much a matter of lack of joined-up government as a lack of joined-up Questions. In all seriousness, I recognise that the major concerns affecting the elderly, which range from pensions, health, housing, fuel poverty, social exclusion and so forth, need to be addressed by all government departments. That is precisely why the Prime Minister has set up an inter-ministerial group on ageing and the care of the elderly. That group will range across all the fronts of government. Furthermore, that is why my right honourable friend the Secretary of State for Social Security has become the champion of older people in that respect.