HC Deb 16 December 1986 vol 107 cc459-60W
Mr. Hayward

asked the Secretary of State for Social Services what steps he has taken to ensure that the money going towards community care is used to best effect; and if he will make a statement.

Mr. Fowler

I am concerned that our community care policy should be as effectively delivered and efficiently managed as possible. It is a key element in our strategy for the Health Service, for the personal social services and for social security. We devote substantial public funds to it so we need to be sure that we are doing all we can to get it right.

I have therefore asked Sir Roy Griffiths, the Government's adviser on the Health Service, to undertake an overview of community care policy. The review will be geared towards advice on action, as was Sir Roy's review of management in the Health Service. The review will be completed within 12 months.

The terms of reference of his remit are: To review the way in which public funds are used to support community care policy and to advise me on the options that would improve the use of these funds as a contribution to more effective community care.

We have in hand detailed studies of certain aspects of community care, particularly residential care. But we need to complement these studies by Sir Roy's overview for three main reasons.

First, the present structure of social security benefits may encourage people to go into residential or nursing care, when they might actually be better off in their own home and prefer to remain there. It is important that the social security system is sensitive to individual requirements. But it is equally important that the system should

Single payment decisions (rounded to nearest '000)
Four week MIS period ending
24 September 1985 3 June 19861 23 September 19861
Number of refusals 80,000 121,000 190,000
Number of awards (full and partial) 308,000 428,000 351,000
Average award (£) 80 73 85
11986 data are provisional.

Source: Management Information Statistics.

operate neutrally and not distort individual choice. Given the sharp rise in expenditure on residential and nursing care in recent years, we need to see whether the system is operating sensibly and fairly. One of the main focuses of Sir Roy's work will therefore be to examine the financing of nursing homes, residential care homes and other group accommodation in which social care facilities are provided on a communal basis and compare it to the financing of domiciliary care.

Second, substantial public funds go, quite rightly, into supporting our community care policies. They are provided through social security, through the personal social services run by local authorities and through the health service. Given the scale of funds involved, we need to look at whether they are being used to give best value for money, whether they are properly targeted and whether people who have help are given the help most appropriate to their needs.

Third, there is considerable variation in the way that community care funds are managed in different parts of the country. Indeed, it is sensible that the arrangements should be capable of adaptation to suit local circumstances. But this does not mean that there is no scope for better budgetary and other financial management arrangements, which would help to improve the use of resources. This, too, is an area which would benefit from an expert outside scrutiny.