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Andrew George (St. Ives): The fundamental point is that, although we welcome the introduction both of care standards and of the increase in the minimum wage, there is an increasing mismatch with the money provided to social services. The Minister knows that, next week, I shall be meeting her with a delegation of representatives from health authorities, social services and the independent sector to raise the issue of that increasing gap between the cost of meeting the welcome standards and improvements in the residential sector and the money provided for social services. That problem affects not only Cornwall but many parts of the country. The Minister must address that gap.
The way that we implement the standards is crucial. In particular, the focus of the National Care Standards Commission, when it takes over regulation and inspection in April, will be to work with providers to help them to meet national minimum standards. In practice, that means that if standards were not being met in a few respects the commission would note that in its inspection report and would write to the home owner giving reasonable time in which to make the changes.
Of course, the point of national standards is to ensure consistent high standards throughout the country, not to close good homes. That is why, when we heard the results of the consultation, we made changes to the standards, putting off the environmental space standards until 2007 and ensuring that space could be used flexibly. However, I am determined that the standards will be introduced in a way that will safeguard users and maintain good homes. I will be discussing with industry representatives and with the National Care Standards Commission the details of the environmental standards, and how we can ensure that they are introduced in a way that promotes higher standards for users but does not drive high-quality care homes out of business.
Local authorities are rightly responsible for decisions about the fee levels that they pay. It was interesting to hear Liberal Democrat Members speak about the failure of some Liberal Democrat councils to live up to the enthusiasm of their Members of Parliament. However, fee levels should reflect the quality of care that we expect from care homes for our older people. That is why I welcome the fact that local authorities are using funding from the £300 million building capacity grant to buy additional places in care homes.
A number of councils have drawn up new agreementswhich include increased fundingwith the independent sector, to stabilise the sector and ensure that standards of care are maintained. That will help to ensure that capacity is maintained locally, so that the right range of care services can continue to be provided to older people in the future.
The debate about care goes wider than care homes alone. The Government have also introduced a range of reforms to the long-term care system. Free nursing care in nursing homes was introduced on 1 October, as we had promised. The benefit is felt by more than 42,000 people, who could save as much as £6,000 per year. Councils have had extra money to introduce deferred payments, so that people do not have to sell their homes to go into residential care. Since last March, the value of a property has been disregarded for 12 weeks in the residential care means test, and capital limits have been increased.
It is important to maintain capacity and make the system fairer, but more of the same just will not do if we want to provide real choices and independence for our older people. I am encouraged by the figures that show that 5 per cent. more households were receiving intensive home care packages in 2000 than in 1999. About 1.5 million people now receive care packages of all types in their own homes.
Dr. Evan Harris (Oxford, West and Abingdon): Is not the Minister concerned that the 5 per cent. more people receiving intensive care packages at home might have come at the expense of the 93,000 fewer people who receive all types of care packages at home? Stealing from one group of vulnerable people to provide for another such group is a cynical tactic, not something of which she should be proud.
Jacqui Smith: I am sure that Liberal Democrat councils around the country will be interested to hear that Liberal Democrat MPs think that they are stealing when they make local decisions about resources. The important point is that local authorities and their health partners are using the extra resources that have been made available to find new and different ways to support old people's independence. That is to be welcomed.
Central to raising standards in the national service framework is the increased development of intermediate care services to provide rehabilitation, to support independence, to prevent people from going into hospital into the first place, and to help them back into their own homes after a spell in hospital. The extra investment in these services has already led to more beds, more places and more people receiving these services.
A new advice and information line, Care Direct, went live in the south-west from 1 October, providing advice and information on health, housing, social care and social security issues. These types of servicesnew services that promote information and independence for older peoplewill be developed across the country. These and other initiatives already being delivered, totalling £1.4 billion from 2001 to 2004, will support older people more effectively and independently.
Richard Younger-Ross: The Minister is generous in giving way again. She is good at blaming Liberal Democrat councils for what they do or do not do, as if we controlled the world. No party is in overall control of Devon county council, but the leaders of all the four political groups in that countyLiberal Democrat, Conservative, independent and Labourcame to lobby Devon MPs last week. They had but one message: that funding for Devon is inadequate, and that there is insufficient money for the SSA for services for the elderly or for children. Devon's problem is that it cannot deliver enough money to the independent care homes. It recognises that, as do the independent care homes. How can the council improve the care standards
Jacqui Smith: I had started to speak about the extra resources going into local authorities. Some of those extra resources are, rightly, finding their way into new services and into increases in fees.
Jacqui Smith: The hon. Gentleman called the policies sticking plasters, but not one of them is a quick fix. The accusation is ironic, coming as it does from Liberal Democrat Members, who think that the only fix is more money, more quickly.
Of course we need to reform the system further: we need new services, new choices and new ways for health, social care and their independent partners to work together. That is why my predecessor established a high-level strategic commissioning group to give greater direction to the commissioning of care services for adults.
The agreement published by the group, which brings together representatives from a variety of organisations, sets out responsibilities and expectations for central Government, local government, the NHS and independent providers. It stresses the need for councils and the independent sector to enter into long-term agreements on placing people into care homes or giving them other forms of support. It will lead to improvements in the commissioning of services and therefore more choice and security for older people.
The Government have broken down the legislative barriers that prevented health and social services from working together, so that services are now beginning to be designed around what older people actually need and want rather than what fits administrative boundaries.
Incidentally, before we hear from the Conservative Opposition spokesman, I should say that that increase stands in contrast to an average annual real-terms increase of 0.1 per cent. in the last five years of the previous Government and no promise to match our social services spending at the last election.
Mr. Burstow: Perhaps we can have a quick reality check. Will the Minister confirm that the gap between what the Government say social services need to spend and what they actually spend amounts to £1 billiona 12 per cent. difference? That is the reality, is it not?
Jacqui Smith: We are working with the Local Government Association to ensure that, as I have said, we continue to put extra resources into social services. In fact, the gap has narrowed in the past year. We are working to attract more staff through a recruitment campaign that we launched last year, and it has already attracted at least 14,000 responses. We are investing in training support to ensure that our care workers have the skills that they need.
Today, Liberal Democrat Members have been big on calls for more money and short on vision or ideas for reform. The Tories will be big on complaint and low on investment. What people will get from a Labour Government is more investment, higher standards, more services, more choice, more independence and more hope for the most vulnerable people in our society. I commend the amendment to the House.