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Tim Loughton: That is a good point. What makes the difference is whether people are in an all-round caring environment geared to provide a home life for elderly residents, or merely on a conveyor belt for those who are no longer able to look after themselves.

I received an e-mail from a nursing home owner in my constituency who has been running her business for 20 years. She says

How right she is. The problem is that the regulations are too inflexible. They do not differentiate between quality care homes and those that simply provide a service—homes that happen to have the right environmental specifications, but without the right care environment. To add insult to injury, Anne Parker, chairman of the National Care Standards Commission, warned owners who are unable to comply with the new standard to

Some solution! On the shortfall in funding, a nursing home owner in my constituency pointed out that the suggested amount for a nursing home bed is £460, yet our local West Sussex authority pays the not untypical rate of £375. As she says:

There are big differentials throughout the country. In Islington, for example, the Government's elderly residential standard spending assessment per resident is £917, yet in Kent it is £351. That leads to distortion in prices and to London boroughs placing their residents

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in care homes on the south coast, thereby pricing local people out of the market. Local people will be unable to live in care homes near their families and near where they were brought up, thereby adding to their vulnerability in old age.

Some 80 per cent. of care home costs are staff costs. The minimum wage alone added £90 million to those costs; according to Sir Jeremy Beecham, of the Local Government Association, national insurance increases added £300 million; and BUPA added £50 million. Of course, none of that money was refunded through additional spending on the national health service. That will have a big impact on the 5 per cent. margin on which many independent home owners operate, and on their viability.

Staff shortages and the consequent reliance on agencies is leading to great increases in the costs payable by such homes. For example, in the north of West Sussex, an unqualified 18-year-old can walk into a job at the Gatwick airport branch of Burger King and get paid £6 an hour. However, some care homes down the road can pay only £4.50 to £5. It is a no-brainer. An added problem is the bureaucracy associated with vetting by the Criminal Records Bureau. As a result, those who would work in care homes have to wait at least 13 weeks. In the meantime, they give up and go elsewhere.

It is little wonder that many people in the care home business are giving up the ghost, taking advantage of rising property prices and converting their care homes into luxury apartments or back into family homes. Pressure is being applied to social services departments that are already suffering through the accumulated shortfall of £1 billion. Eligibility criteria are being tightened in most social services departments throughout the country. Two thirds of local authorities predict that they will be unable to look after the same number of residents next year as this year. For many authorities, it has become more a question of shifting responsibility between local authority departments and the health services.

As the hon. Member for Lancaster and Wyre (Mr. Dawson) said, we certainly need greater working together, but the Government's only response is to fine local authorities that happen to have high bed-blocking figures. What impact does the hon. Gentlemen think that that has on working together in partnership? It is the good social services departments, many of which achieved a three-star rating, that have the greatest number of delayed discharges in their areas. That shows that the problem is not their fault, but one of the Government's own creation. The Government should solve it, but they are failing to do so.

This is a crucial and complex problem that demands much more serious attention from Ministers on all fronts, rather than the complacency and contempt that we have seen from the Prime Minister, the Secretary of State and the Minister. All hon. Members have an increasing number of elderly constituents, and however sophisticated we become at looking after people properly in their own homes, more care home beds will be needed over the next 30 years. A measure of how in touch we are with our constituents, and how effective we are on their behalf, is the concern that we show for our older citizens, translated into practical action to make their lives more comfortable and to allow them to live with dignity and choice.

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For all the show of fake concern and indignation by Labour Members, we have heard nothing from them to give a crumb of comfort to any of our elderly constituents that this Government are doing anything to address the problem. Yet again, we see a Government in denial, who claim credit for every success, but who say, "Not me, guv" in respect of every problem. This is a growing problem that will not go away, and they could make a start in grasping the magnitude of it by backing our motion.

9.44 pm

The Parliamentary Under-Secretary of State for Health (Mr. David Lammy): I am grateful for the opportunity afforded to the House to debate this serious subject, but it is unfortunate that the hon. Member for West Chelmsford (Mr. Burns) chose to raise it in such an appalling manner. His tone was completely out of place and, frankly, he showed his disrespect for elderly people.

As my hon. Friend the Minister made clear in her opening remarks, the Government intend to create a system of care that offers choice to those who need it. Opposition Members seem incapable of grasping that point and we have seen tonight that they are preoccupied with scaremongering.

It is worth reminding ourselves how we got into this position. It is important to remember that we experienced a significant but unplanned and unmanaged expansion in the independent care home sector as a result of the use of an uncapped Department of Social Security budget throughout the 1980s. That led to the unnecessary and completely avoidable admission of many older people and others into institutional care. From what Opposition Members have said, it is clear that they believe that elderly people are always best placed in institutional care. They do not understand that there are many modes of care—

Mr. Burns: We do understand.

Mr. Lammy: Why then did no Opposition Member choose to mention care at home, and the role of nurses, sisters and others?

Mr. David Cameron (Witney) rose

Tim Loughton rose

Mr. Lammy: I shall give way to the hon. Member for Witney (Mr. Cameron).

Mr. Cameron: Does the Minister think that there are too many residential care homes or too few?

Mr. Lammy: The hon. Gentleman misses the point. [Interruption.] I intend to assist him with the answer in the course of the debate, if he will let me make some progress. [Interruption.]

Mr. Speaker: Order. May I call for some calmness on both sides of the House?

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Mr. Lammy: There are many modes of care and ways of entering care for our elderly population, and that is the major thrust of the Government's policy. I agree that some people will of course always need residential care, and we need to ensure that they get it. However, the Opposition have been all too quick to scaremonger about the crisis in the home sector. Their approach is at best cynical and at worst schizophrenic. Much of what they talk about requires investment in the NHS and our social care system, but how did they vote on the Budget? They voted against that investment.

Mrs. Browning: On a point of order, Mr. Speaker.

Mr. Speaker: I have a feeling that it is not a point of order, but I had better hear the hon. Lady.

Mrs. Browning: Is it right for people with mental health problems to be abused in that way by a Minister from the Dispatch Box?

Mr. Speaker: The Minister is in order.

Mr. Lammy: Care homes have always closed. The Opposition choose to ignore the fact that new homes are opening and existing homes are expanding. Some 31,000 new beds have opened since 1997. That is a 4 per cent. drop, which roughly matches the figure in 1997.

The Conservatives' focus is in the wrong place. We need to move the debate on from the sterile argument about numbers to the challenge of delivering a full range of social care services to meet people's needs. There is undoubtedly a need for residential and nursing care, but it is one of many options.

We are supporting more people to live at home than in the past. For every 1,000 older people, 82 were supported to live at home in 1998–99 and by 2000–01 the figure had risen to 84. That includes people receiving support in the form of home care, community equipment, home adaptations and repairs. My hon. Friend the Member for Crawley (Laura Moffatt) talked about partnership and the ways in which care is provided in the home in her constituency. The number of contact hours has increased.

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