Free Personal Care for the Elderly (Hansard, 10 December 2002)

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)
My Lords, it is for the Scottish Executive to monitor the implementation of free personal care in Scotland.

§ Lord Lipsey
My Lords, indeed, but would my noble friend agree that the disquieting but completely predictable reports that demand far exceeds the predictions of the Executive bear lessons also for England?
Is he aware of increasing anecdotal reports that councils in Scotland are slashing services to the poor in order to pay for this uncovenanted hand-out to the better-off? Will he accept my congratulations on resisting the blandishments—with the stout support, I may say, of Her Majesty's Opposition—of those who want free care for all to bankrupt the Exchequer in Britain, just as it is fast bankrupting the Executive in Scotland?

§ Lord Hunt of Kings Heath
My Lords, it is much better that politicians in Scotland deal with the issues arising in Scotland. I am of course aware of the various media reports. I am also aware of the comments made by the Scottish Executive. However, I believe that ultimately it is better for Scotland to decide on such matters.
As regards England, the Government took the view, and were supported by the noble Earl, Lord Howe, that spending extra resources on personal care would not be wise. It is better to spend the resources on a range of services designed to keep people out of hospital and in their own homes.

Lord Campbell of Croy
My Lords, has there been any noticeable migration of elderly people northwards across the Border?

§ Lord Hunt of Kings Heath
My Lords, an urban myth suggests that there have been instances of English people fetching up in Scotland in order to take advantage. However, I do not believe that I have seen any figures which will prove that one way or the other.

§ Baroness Greengross
My Lords, does the Minister agree that many people mistakenly believe that the 100 terms "free personal care" and "free nursing care" mean free long-term care? For those in long-term care who are self-funding, average care-home fees of around £400 to £500 a week mean that people in Scotland may still have to find £10,000 or more and people in England and Wales possibly more than £15,000. What proposals does the Minister have to help fill that funding gap across the UK?

§ Lord Hunt of Kings Heath
My Lords, the noble Baroness is right to suggest that on top of the costs of personal care and nursing care many other costs accrue to residents paying their own fees in care homes. It has always been the position that self-funders should pay towards the cost of their care in such homes. The policy of the Government is to put resources into services such as intermediate care and into supporting social services departments in order to try to minimise the number of people who need to go into care homes. I believe that that must be a key priority.

§ Baroness Barker
My Lords, is the Minister aware that the press reports referred to by the noble Lord, Lord Lipsey, relate to the situation in only one local authority, which has now been satisfactorily resolved? Given that he cannot monitor but only compare the different systems running in Scotland and England, will his department undertake to provide such a comparison? Will it include the number of older people in Scotland who have been unable to stay in their own homes and the number of older people in England with Alzheimer's disease who are being forced to pay for their "free nursing care" through the increased cost of care homes?

§ Lord Hunt of Kings Heath
My Lords, I do not believe that that would be a fruitful exercise. The Government have made a policy decision and this House has voted on it. It is that we prefer to put extra resources into wider services such as intermediate care.
The noble Baroness asked about care-home residents who are not benefiting from free nursing care. Early in the year, my honourable friend Jacqui Smith announced a series of measures to deal with that problem, including the development of a core contract that NHS bodies should use as a basis for spelling out how any NHS nursing contribution received by care homes is accounted for. That was done in order to ensure that there is indeed transparency in the system.

§ Lord Campbell-Savours
My Lords, have we learnt any lessons from the experience in Scotland?

§ Lord Hunt of Kings Heath
My Lords, the new system in Scotland was introduced only on 1st July this year. It would be better for all concerned to allow the systems in both England and Scotland to settle down before any hard conclusions are drawn. The development of intermediate care is proving very 101 successful. In England, our priority must be to ensure that as many people as possible have alternatives to going into such homes in the first place.

Lord Renton
My Lords, will the noble Lord bear in mind that people grow old at different ages? A few are finished at 50 and others go on looking after themselves for as long as they possibly can and may not be finished until they are, say, 95. Public money would be saved if there was not a fixed age for the arrangements which are being discussed.

§ Lord Hunt of Kings Heath
My Lords, the noble Lord is a shining advertisements for everything he says. Speaking for myself, the more questions I answer in your Lordships' House the older I feel.