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Mr. Hutton: I am aware of that. However, the hon. Gentleman and his party introduced a means-tested

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charging regime. Before that, the policy introduced by the Conservatives provided for a flat rate. The hon. Gentleman and his party changed the system. They did not decide not to charge; they introduced a different charging policy.

It is also worth bearing in mind that in Wales, the hon. Gentleman's party supports the view that we have taken in England on these issues, which is that the right priority at present is to invest in better NHS and social care services for older people and to end the unfairness of means-testing people for their nursing care in care homes. There are, therefore, disagreements between and within political parties on the issues. It might have been better if the hon. Gentleman had referred to that in his remarks.

Of course, the funding of long-term care must be fair and reasonable. No one disputes that. However, the acid test that we should use in deciding to increase public spending, given what we know about the existing range of services for older people that are on offer, is whether any option leads to improved and better health care for older people. We should also ask whether more older people would receive the help that they need at home to remain independent for longer, surrounded by their friends and family in the community, where they want to be. We need to ask who would benefit from any extra spending and why, because--as my right hon. Friend the Prime Minister made clear last week--we cannot spend the same resources twice. That is how we should judge the proposal that personal care should be universally free.

Mr. Mike Hancock (Portsmouth, South): Does the Minister agree that three significant things have happened since the previous election? First, there has been a recognition that more resources are available, and that we can, therefore, do more; secondly, there has been a royal commission that supports that view; and thirdly, when people come into care now, they do so with greater needs than they did five or six years ago--a point to which the Minister has already agreed. We have not changed; we have simply moved on.

Mr. Hutton: I am tempted to offer some comment on the hon. Gentleman's last point. Of course his party has changed its position; he should not worry about that.

Mr. Hancock: We have moved on.

Mr. Hutton: The Liberal Democrats have moved on, and they have changed their position. They have moved from a position in which they believed in charging for personal care at all levels--at home and in residential care--to one in which they no longer believe in so doing. We are entitled to ask, when a party changes its position like that, precisely why it has done so.

Mr. Phil Willis (Harrogate and Knaresborough): Will the Minister give way?

Mr. Hutton: No, I will not.

I understand that the point made by the hon. Member for Roxburgh and Berwickshire (Mr. Kirkwood) was that the royal commission has subsequently reported. That is a perfectly fair argument. However, we have to consider not only the rhetoric of the hon. Member for Sutton and

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Cheam, but his record in local government, where Liberal Democrat councils did not refuse to operate charging regimes. We must consider all the issues in the round.

Mr. Burstow: Will the Minister give way?

Mr. Hutton: No, I will not.

The NHS plan sets out how the Government intend to rise to the challenges. It starts with a vision for improving the health and well-being of older people and of those who care for them. It goes on to spell out a comprehensive programme of service modernisation backed by an investment of £1.4 billion of additional spending by 2003-04. That new investment will fundamentally change the way in which our care system supports older people. In future, we want NHS and social care services to provide a wider range of more flexible care options for older people that will actively promote better health, encourage faster recovery from illness, support independence and avoid unnecessary institutional care or hospital admission.

New services will provide new choices and opportunities that will better meet the needs of older people and their carers. They will also help us to address the many criticisms that older people have made of the NHS and social services and to lay the foundations for a healthier older age. By 2004, that new investment will help an extra 130,000 people a year. By that year, there will be a 50 per cent. increase in the number of people benefiting from community equipment services that will help more people to stay at home safely for longer. Through additional home care support, 50,000 more older people will be enabled to live more independently at home. For many, the new services will prevent or delay admission into costly long-term care. The new intermediate care services will be free at the point of use, whether they involve residential or home-based care. We envisage that the services will typically last for six weeks.

If we are to succeed in refashioning those vital services, we need to ensure that standards of care are universally high and consistently observed. We want older people to have greater confidence in the ability of health and social services to meet their needs more effectively. We want them to have confidence that, in the future, the focus will be on maintaining their independence and preventing unnecessary ill health, and confidence that the care system will be there to support them properly when and where help is needed. We want them to have confidence that care agencies will treat them fairly and view their carers as equal partners. That is why we are doubling the carers special grant from £50 million this year to £100 million by 2003-04, allowing more carers to take a break from their caring responsibilities, and why my right hon. Friend the Secretary of State for Social Security recently announced a £500 million package of extra financial support for carers, which will benefit up to 300,000 carers over the next three years.

The national service framework will back up that investment and modernisation for older people, which will set new national standards for the care and treatment of older people, including those with mental health problems such as dementia.

The Care Standards Act 2000 provided for a new National Care Standards Commission, which will start work next year and operate to standards consistent with

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the national service framework. In creating a single National Care Standards Commission and broadening its role beyond regulation, the Government responded to the royal commission's unanimous call for a national care commission to take a strategic overview of long-term care to represent the interests of older people.

Those new standards will be sensible and realistic and care home providers will be given sufficient time to prepare for their introduction. Our main priority is to ensure that there is enough capacity across all care sectors, including residential care, to enable older people and their carers to receive the care and support that they need. We are working closely with the independent sector to ensure that that happens.

The NHS plan also commits substantial investment to develop services that will promote older people's independence and respond to an ageing population with more chronic disease. The system of care across the NHS and social services must work together much more effectively as getting older and frailer becomes more common. Partnership is one of the keys to success. I am sure that the hon. Member for Sutton and Cheam will agree that, all too often, older people find themselves in an accident and emergency department or a busy ward at their local hospital not always because they need to be there and not because there is no real alternative, but because there is simply nowhere else for them to go.

The investment that we are making in intermediate care will help to provide a new range of services, which can offer a new alternative. Intermediate care is about providing the right services in the right places and at the right time to meet patient needs--services as close to patients' homes as possible; services in patients' homes where that is appropriate; services that avoid, in some cases, the need for people to enter residential care; services that genuinely promote independence. None of those services will be able to develop if those resources are diverted--for example, to make more personal care free for some people who are charged for it as the hon. Gentleman suggests.

The hon. Gentleman spoke at length about free personal care. Let us be absolutely crystal clear about that. At present, most personal care is provided on a means-tested basis and three quarters of care home residents already receive some or all their personal care free. Those in greatest need of help with care costs receive that help. Of course, we could have chosen to spend the £1.4 billion that we are making available under the NHS plan on implementing the royal commission's recommendation that all personal care, as well as nursing care, should be free irrespective of a person's wealth. That would not have improved front-line services in any way, shape or form. I disagree with the hon. Gentleman strongly on that. Under his proposals, not one extra older person would receive any extra care or any additional support to remain independent for as long as possible.


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