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Mr. Burstow rose

Jacqui Smith: I hope that the hon. Gentleman intends to withdraw that slur on our care staff.

Mr. Burstow: It was an attributed quotation from an organisation. That is all.

Jacqui Smith: The hon. Gentleman has not apologised, but he has attempted to pass the buck.

However, it is clear that we can all do more to ensure that the care system provides the right care at the right time and in the right place, that it promotes independence and choice and that it puts the user and the carer at the centre of services.

The hon. Gentleman made much of delayed discharges and we are all agreed that we need to make sure that people do not have to wait in acute hospital beds when they could be better cared for elsewhere. That is, of course, not a new problem and, in fact, the proportion of older people who have to wait while their discharge is arranged has fallen steadily over the past four years. It is true, however, that we need to consider the issue seriously.

A serious consideration of this issue must start with an honest look at the figures. Today we have heard ludicrous claims about the number of people who have their discharge delayed. This evening, the figure went up to 700,000. Throughout the day, the figure has varied by about 200,000, depending on which edition of the press release is being referred to. The hon. Gentleman's calculator may have been red-hot today, but I am afraid that taking a figure from a parliamentary answer and then multiplying it by the number he first thought of might make for good stories, but it does not get us any further in the important task of ensuring that everybody gets the care they need when they need it and where they need it.

Mr. Waterson: We have all learned to disbelieve figures quoted by the Liberal Democrats, but will the Minister comment on the figures published on Friday by Eastbourne district general hospital that show that, despite the extra money that has been invested recently by the Government, the number of beds blocked has risen since June—when it stood at 46—by so much that the acting chief executive said that the hospital had 75 beds blocked and a consistent flow of patients who need them?

Jacqui Smith: I do not have the figures for Eastbourne at my fingertips, but I know that like other areas it will have benefited from the extra investment and will be subject to the targets for reducing delayed discharges. Of course we need to tackle delayed transfers in order to make sure that the whole system works effectively, but I have to point out to hon. Members that, contrary to what the hon. Member for Sutton and Cheam suggested, more operations are now being done in the NHS and waiting lists are down.

We know that there is more to be done. That is why, in October, we announced an additional £300 million—not £200 million—during this year and next for councils to work with their health and independent sector partners to tackle the delays and the causes of delay.

Richard Younger-Ross: The Minister mentioned a figure of £300 million, but the directors of social services

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estimate that £1 billion is required. What will fill the gap between the £300 million that the Government are providing and the £1 billion that the experts in the field say that they need?

Jacqui Smith: That is not the first example, and I am sure that it will not be the last, of the Liberal Democrats calling for more money regardless of how we change the system. I will say more about the extra resources that the Government are putting in to personal social services over and above the £300 million, but the point remains that we have been willing to invest that sum in order to ensure that we can tackle delays.

Mr. Terry Davis (Birmingham, Hodge Hill): Is the £300 million intended to deal only with delayed discharges from hospitals or also with delayed admissions from the community?

Jacqui Smith: I thank my right hon. Friend for that intervention and I know of the good work that he has done in Birmingham on the problem of delayed discharges. As I will explain later, the investment in social services, and that £300 million in particular, has to deal with all the problems in the system, including funding projects that will ensure that people do not end up having to go into hospital, perhaps by providing better support in their homes, as well as ensuring that we have the capacity and the necessary services to get them out of hospital in a timely manner.

Mr. Heath: Everything that the Minister says shows that my hon. Friend the Member for Sutton and Cheam (Mr. Burstow) is right to say that the Government are in denial. For example, is it not the fact that in Somerset the extra money that has been provided to deal with bed blocking is almost exactly matched by reductions in grants for other parts of social services? That means that no improvement is possible.

Jacqui Smith: No, it does not mean that, as I shall explain later. I monitor carefully the figures for delayed discharges and can assure hon. Members not only that the trend is down but that since last September there are fewer blocked beds and fewer people wait more than 28 days. The investment and the new services that it has brought are working, and the health service and its social care partners deserve congratulations on the progress that is being made.

The hon. Member for Sutton and Cheam made some points about care home capacity. The Government are well aware of those issues. Once again, however, the truth has been misrepresented. Figures show that the loss of beds during the past few years is nowhere near as high as the figure of 35,000 cited today, or the figure of 50,000 that has often been cited. Indeed, residential care and nursing home capacity is roughly the same today as it was four years ago.

It is nonsense to consider closures in isolation. Laing and Buisson's figures, for example, show that more than 33,500 beds were created between 1996–97 and 2000 as a result of new registrations. The net loss of care home beds during that period, according to Laing and Buisson, which has no axe to grind in the matter, was about 19,000.

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To claim a higher figure is both mischievous and misleading. After this debate, I hope that figure will not be used again.

What must we do to maintain that capacity and to ensure that standards are what we would expect for our constituents who use those services?

Sandra Gidley (Romsey): I am listening to the Minister's comments with interest, but let us put the dispute over the historical figures to one side for a moment. When I visit care homes in my constituency, I am told that the wholly erroneous standards specified in the Care Standards Act 2000 are forcing them to make real decisions about the future. They have to decide whether they can afford to make those so-called improvements even though their homes already function perfectly. The owners are all drawing up plans to sell their large old houses for flats. What impact will the Act have on the number of future places in homes? Has the Minister made an assessment?

Jacqui Smith: I thank the hon. Lady for her intervention. We are witnessing a certain amount of confusion among Liberal Democrats this evening—certainly as regards their historical position. The hon. Lady seems to be suggesting that we should oppose the whole idea of setting up national standards, while the hon. Member for Sutton and Cheam supported it. I take the impact of standards extremely seriously, as I shall explain later.

Mrs. Joan Humble (Blackpool, North and Fleetwood): Does my hon. Friend share my concern that the Liberal Democrats seem to be denying the need for care standards to protect elderly people who desperately need them? Is she aware that, when the Government held their widespread consultations on care standards, most care home owners in Lancashire told me that the standards were, by and large, examples of good practice. Those owners were already implementing such standards. If they had a concern, it was about building regulations. The Government responded to that concern by extending the period needed to convert the buildings to the new standards.

Jacqui Smith: I thank my hon. Friend for that intervention. I know that she has a close and good relationship with the care homes in her constituency. I shall talk about care home standards in a moment.

It is also worth pointing out that the Liberal Democrats have turned their fire on domiciliary care. Those services have never been regulated. I am interested to know whether the Liberal Democrat approach is that there should be no regulation of the whole sector that deals with care services provided to people in their own homes.

Mr. Burstow rose

Jacqui Smith: Hopefully, we shall now receive clarification.

Mr. Burstow: I am more than happy to make it clear, as we did throughout the passage of the care standards legislation, that we support the introduction of national

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minimum standards but, as we pointed out, higher quality comes at a cost. The problem is that the Government are not prepared to write the cheque.

Jacqui Smith: I am glad that I gave the hon. Gentleman the chance to correct the impression that he gave in his original comments.

It is important to remember why national standards are being developed—that relates to the point made by my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble). The old regulatory system for care homes is riddled with gaps and anomalies. Existing standards for care homes are set and administered in different ways by different authorities, and some homes are not regulated at all. I am sure that hon. Members will have heard—as I have—the complaints of care homes and users about the current inconsistencies.

The introduction of national minimum standards will mean that providers will be clear about the standards that they have to meet, and users and their carers will know what they can expect as a minimum. It is right to provide that protection and assurance for the vulnerable people who use our care system.


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