Care Home Beds (Hansard, 13 November 2003)

§ 2. Mr. Ian Liddell-Grainger (Bridgwater)
How many care home beds for older people were provided by (a) the private sector and (b) local authorities (i) in May 1997 and (ii) on the latest date for which figures are available. [137441]

§ 4. Simon Hughes (Southwark, North and Bermondsey)
What assessment the Government have made of care home provision in London for older people. [137442]

§ 12. Alistair Burt (North-East Bedfordshire)
How many care home beds for the elderly provided by (a) the private sector and (b) local authorities have been lost since May 1997. [137453]

§ The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman)
Overall, the total number of care home places for older people in England fell by 6 per cent. between 1998 and 2001, accounting for about 26,100 places. In local authority homes, the number fell by 21 per cent., or 10,900 places, compared with a fall of 4 per cent., or 15,200 places, in independent care homes. Information for 1997 is not available in a comparative format. The number of care home places in London was 47,430 in March 2001. The Government have encouraged local councils to commission an appropriate range of care services to provide older people with more choice of quality service. In London, more people have received care in their own home, as demonstrated by the 2001 figure of 17.1 households per 1,000 of population aged 65 or over receiving intensive home care, which compares with the average of 9.9 for England.

§ Mr. Liddell-Grainger
It was so kind of you to mention London. I was going to talk about Somerset—

§ Mr. Deputy Speaker
Order. May I suggest that the hon. Gentleman uses the correct parliamentary language in this Chamber? I am not involved in that at all.

§ Mr. Liddell-Grainger
Thank you, Mr. Deputy Speaker.
147WH The loss of care beds in Somerset and throughout the west country corresponds to the figures that the Minister gave, but the same is happening in local authority homes. The situation is getting worse. I am not surprised that neither the figures for 1997 nor the latest figures are available; they would be absolutely horrendous. When will the Minister stop the rot and start to provide beds and care for elderly people? More and more people in areas such as Somerset and the west country have to stay in hospital for longer, be looked after by people who are not qualified or, worse still, be pushed round the countryside by general practitioners to find beds. That is not a happy situation.

§ Dr. Ladyman
I mentioned London in my answer because the hon. Gentleman's question was linked to the question of the hon. Member for Southwark, North and Bermondsey (Simon Hughes), which specifically relates to London. The hon. Member for Bridgwater (Mr. Liddell-Grainger) mentions Somerset, so I shall point out one other factor that he seems to have overlooked. There are in this country, according to Laing and Buisson's figures, 10,000 more care home beds than are actually needed. The idea that we have a shortage is completely wrong. With regard to Somerset, perhaps the hon. Gentleman would like to ask his council why only about 8 per cent. of people there have an intensive care home package. Most older people tell us that they do not want to be in care homes in the first place.

§ Simon Hughes
Let me return to London. Does the Minister accept that, according to the National Audit Office report earlier this year, the figures for London and the south-east show that demand there is 12 per cent. above recommended occupancy rates? Speaking from constituency experience, I can say that the reality is that many people do not find homes in the communities where they live. As the report says, a severe shortage of care homes in the capital means that London boroughs seek to place their clients outside the capital". What are the Government doing to ensure that people in the capital city who need care in a care home can find it somewhere near their family, friends and community?

§ Dr. Ladyman
The hon. Gentleman should give London councils credit for the huge efforts that they are making to maintain people in their own homes. I give them great praise for being far ahead of the rest of the country on that. About 50 per cent. of people who need care in London receive it as an intensive care home package, and that is what most older people want.
Clearly there is a problem if people who have to have a care home place cannot have one locally. However, we have given all councils, including those in London, sufficient resources to start to make interventions in the local marketplace and to pay the local rates needed to obtain care home places local to the people who need them.

§ Simon Hughes
If I find, as I believe that I easily can, several London local authorities, irrespective of political management, who tell me that they cannot afford to provide in their boroughs the amount of residential care that people need who cannot have care at home—care at home is a good thing—will the Minister agree to see them? Will he explain to them why 148WH he says that they have the money to provide the service when they say that they do not? Will he guarantee that the service that they can provide is of the quality that he would want for his parents and I for mine?

§ Dr. Ladyman
I should be delighted to receive the names of such councils. If I do, I will look out the substantial increase in real terms resources that we have given those councils precisely so that they can deal with those issues. I will provide the hon. Gentleman with those figures so that he is aware that the councils have the money to deal with the issue if they wish to do so.

§ Sandra Gidley (Romsey)
The Minister has obviously seen the Laing and Buisson report, but perhaps he will concede that he is being rather complacent about the fact that there are 10,000 vacancies. Last year there was a drop of 11,800, but all the predictions show that demand will double over the next 50 years and that we have reached a low plateau. What is the Minister doing to increase the number of care home places? It is not enough to consider the current situation; we must provide for the old people of the future.

§ Dr. Ladyman
I reject the charge that demand for care home places will double over that time. Laing and Buisson is a respected consultant in the field, but it tends to take the view of the care home lobby. Let me put this to the hon. Lady: we have made available to local councils 25 per cent. more funding over and above inflation so that they can take local decisions about care home capacity. We cannot take decisions at the centre about the price that needs to be paid locally or the capacity required locally—that is a job for local government. Were we to take the view proposed by bodies such as Laing and Buisson that there should be a general and compulsory increase in care home rates across the country, it would cost us nearly £400 million. How would the hon. Lady guarantee that that money would get to the care homes when most councils tell us that they do not need to pay it, and where would she get the money from?

§ Mr. Simon Burns (West Chelmsford)
I agree with the Minister that Laing and Buisson is a highly respected independent body, but, whenever we have discussions of this nature, Ministers seem to be in denial. The Minister should be aware that his figures suggest that there has been a loss of just under 40,000 beds. Laing and Buisson's figures for the latest available period show that, between 1997 and 31 July 2003, the number of places in care homes fell from 572,600 to 501,900, which is a drop of 70,700. In his original answer, did the Minister include figures for the voluntary sector, as well as the private and local authority sectors? Can he explain why there is such a glaring discrepancy between his figures and what Laing and Buisson and people in the care home sector, who are at the sharp end of delivering care, believe is happening? Even if the Minister's statistics show that there are 10,000 surplus beds, he must understand that they are in the wrong place. Too many parts of the country have a severe shortage of beds, and people have to move further and further from their communities to find a place in a home.

§ Dr. Ladyman
Let me start with the last point. Let the hon. Gentleman come to me with authoritative 149WH statements from people who have the figures to demonstrate his case. Over the past month or so, I have had my officials ring around local authorities to ask, "Do you have an absolute shortage of care home beds or is it that the rate that you wish to pay for those beds is lower than the market in your area is demanding?" So far we have not found anywhere where there is an absolute shortage of care home places.
I have had occasion before to remind the hon. Gentleman that he constantly quotes the reduction in care home beds since 1997. Why does he pick that particular date? Why does he not pick the date at which the contraction of the care home market began? The hon. Gentleman knows full well that it began as a result of the implementation of the National Health Service and Community Care Act 1990, which was implemented in the mid-1990s. The peak in care home capacity occurred while the hon. Gentleman was Minister. That is when the contraction of the care home market began.

§ Mr. Burns
I find that quite staggering. The Minister must know that, after the introduction of the policy in 1990, there was a significant increase in care homes and care home beds in this country. For him to try to suggest that there was a contraction in the number of beds as a result of that policy initiative is just gobbledegook.

§ Dr. Ladyman
The hon. Gentleman is being economical with the actualité—I think that is the expression. He knows perfectly well that although the legislation was passed in 1990, it was not implemented until several years later.

§ Mr. Burns
When?

§ Dr. Ladyman
It was implemented from about 1993. If we use the figures from Laing and Buisson to determine when the peak in care home capacity was reached—and the Act started to kick in—we find that it began in 1995–96, just as the hon. Gentleman took over as Minister.

§ Mr. Deputy Speaker
Order. May I say to Ministers in the hope that they pass this on to their officials, that it is extremely important when questions are being grouped that hon. Members are given notice of that fact? If someone's question is very low down in the order and is grouped with one higher up, it can be very misleading unless that information is passed on.