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3.45 pm

The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): The debate has been, as usual, good-humoured and enjoyable. It has also been informative, although I doubt whether it informed us in quite the way that the Liberal Democrats hoped. It tells us that they have not changed their ways—they would rather make a lot of noise and issue a lot of press releases than do any serious thinking about an issue. Although this is their Opposition day, and they started by saying that the issue is one of the most important of the day and absolutely key to their policies, at times they did not even have any Back Benchers in the Chamber and very few tried to contribute to the debate.

We have heard so many contradictions that it is difficult for me to figure out where to start, but I shall do so with a word that was mentioned by the hon. Member for Northavon (Mr. Webb)—choice. That represents the key dividing line between what the Liberal Democrats intend for older people and what this Government intend. When the hon. Member for Sutton and Cheam (Mr. Burstow) opened the debate, he used the phrases, "People stuck in hospital when they are ready to go to a care home," and, "We want elderly people to go to a care home at the right time and the right place." The assumption that the Liberal Democrats make in all their planning is that the right place for older people is a care home. That is the inevitable consequence of everything that they try to do in local government and other places where they have positions of power, such as Scotland, and of what they are trying to do here in Westminster.

Mr. Martlew: To emphasise what my hon. Friend says, in Cumbria, where the Liberal Democrats are in control of the county council, the first thing that they did when they got power was to increase home care charges, despite having said during the election that they would not. We now have 250 pensioners who cannot afford home care any more because of the Liberal Democrats.

Dr. Ladyman: I am grateful to my hon. Friend for bringing that to the House's attention, because I bet that it is a story that is repeated all over the country wherever the Liberal Democrats are in a position of power.

Let me give an alternative view of what we should be offering to older people. Primarily, we should assume that older people know best what they want. We should bear it in mind that this is the generation that got us through a world war—in many cases, two world wars. We intend to respect their right to control and make choices about their own lives. We want them to have a spectrum of choices for their old age, ranging from being looked after in their own home to a variety of provision, including extra-care housing, residential care and nursing care. We want to enable them to make practical decisions.

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Yesterday, I had the privilege of opening Alexandra house in Coventry—an extra-care facility that was created as a result of some foresighted thinking by the Anchor trust and Coventry social services. The council is Labour run, I might add. Every resident has their own flat—not a room, but a flat, with a living room, a bedroom, a bathroom, a kitchen and its own front door. Although the front door opens not on to a street, but on to a corridor, the corridors are named after streets, so people live in, say, 31 Primrose way instead of a numbered room in a house. It is therefore a private home where the individual can close the door on the rest of the world whenever they want. There, I met an elderly lady in a wheelchair who is no longer able to see or feed herself—she is fed through perentaneous endoscopic gastrostomy, or PEG, feeding—and needs total and constant nursing care. Yet she lives in her home with her own space and privacy. She is able to do that because she can plug into the services that she needs when they are required.

We should like to extend the model of extra-care housing to give additional choice to older people. Some people could choose to rent extra-care housing and others could choose to transfer the equity from their homes to buy it. There would be a range of provision, and people could make the choice when they approached retirement age. They would know that, as their care needs progressed, they could plug into different, more intensive care packages. We want to add such provision to the spectrum of choice. We are realising that by devising an £85 million competition to encourage people to propose ideas for creating such extra-care facilities. We shall not assume that people want to be in a care home. Our planning will be predicated on giving people genuine choice.

Before considering care home closures, I want to deal with some aspects of pension credit. I shall not do that in depth, because my hon. Friend the Minister for Pensions did so earlier, and I do not pretend to be an expert on it. However, the hon. Member for Caernarfon (Hywel Williams) raised some local issues involving the centralisation of the Pension Service in Wales. He made some constructive points that deserve a constructive answer, and I shall ensure that my hon. Friend the Minister for Pensions reads his comments and takes them on board. I shall deal with two points.

First, the hon. Gentleman said that 60 per cent. of pensioners in Wales rely on the minimum income guarantee. That means that 60 per cent. of pensioners in Wales benefit from our targeting resources on the poorer pensioners—those who need them most—rather than spreading them too thinly.

Secondly, the hon. Gentleman said that there are two language lines for people in Wales to ring when they claim minimum income guarantee and pension credit. Of course, there should be two language lines and their existence shows the detail into which the Department for Work and Pensions and the Pension Service go to ensure that everybody can easily claim the minimum income guarantee and the pension credit. The fact that people can do that by telephone and that Pension Service officials will go to people's homes to help them to apply for the benefits shows the lengths to which we go to boost the number of claimants and ensure that everyone can claim. The Department and the Pension

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Service should be congratulated on their work, and not encounter the sort of blocking that Liberal Democrats are attempting.

Events in Brent, East have constituted another sub-theme of the debate. Liberal Democrats in one place claim that they would scrap the pension credit, but in Brent, East they claim that it is wonderful. For the first time, I witnessed a political party changing its policy three times in one debate. The hon. Member for Sutton and Cheam began with an explicit statement that the pension credit should be scrapped and that we should give £19 extra a week to people over 75. [Interruption.] That is what he said—I am not going barmy and I did not imagine it. Anybody under 75 would not benefit from that Liberal Democrat policy. When he claimed that he would get rid of means-testing, he did not mean it because £19 is not as much as the total minimum income guarantee, which is closer to £26. Anybody who did not benefit from the £19 and remained worse off would have to be means-tested to reach the minimum income guarantee, and anyone under 75 would still have to be means-tested to get the minimum income guarantee.

The hon. Member for Sutton and Cheam sits here trying to give the impression to the pensioners of this country and the voters in Brent, East that if his party were in power, it would scrap means-testing and give everyone an extra £19 a week, but he is going to do neither of those things. By the end of the debate, the hon. Member for Northavon had said, "Well, we did believe in scrapping the pension credit when it first came out, but we've changed our mind now. We're going to keep it." Yet, by the time he had reached the end of his speech, in answer to a question from my hon. Friend the Minister for Pensions as to whether he would scrap it he said, "No, but if we were in power, we would shift to some other means of providing pensioner benefits." He had changed his policy within 15 seconds of making it, which has to be a record, even for the Liberal Democrats.

Let us move away from pensions, although that will not involve moving any closer to an issue that the Liberal Democrats have done any serious thinking about. Let us consider the so-called crisis in care homes that they keep talking about. I would be the first to admit that, in some parts of the country, there are some difficulties in respect of capacity in care homes. How are we dealing with that? We have given local authorities substantial extra funding, along with the responsibility to manage care home capacity in their own areas. We have given resources above the level of inflation since 1997. We have given local authorities nearly a quarter more funding for personal social services, and they can use that money in any way they want—to balance provision between domiciliary care and care homes, or to stabilise the care home market, for example. They can do whatever they want with it, because we believe in local government autonomy. That is something that the Liberal Democrats are always telling us that they believe in, yet as soon as local authorities make a decision that they do not like, they want us to intervene from Whitehall.

Mr. David Heath (Somerton and Frome): Where is it working?

Dr. Ladyman: It is working all round the country. My hon. Friend the Member for Wigan (Mr. Turner) told us

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how it is working in his constituency. He has a Labour council—that is why it is working there. Why is it that Conservative and Liberal Democrat Members raise the issue of problems in the care home market? It is because most of them have constituencies with Conservative and Liberal Democrat local councils. Labour councils balance these provisions in the way that they were intended to be balanced. Let me give the House one final figure on care home closures. There are 500,000 care home places available in this country, yet only 460,000 people want to use them. There is still excess care home capacity.

With regard to domiciliary care, we want to give a real choice to older people. No less than 80 per cent. of older people tell us that they want to stay in their own home for as long as possible. The suggestion by the hon. Members for Sutton and Cheam, for Northavon and for Sutton Coldfield (Mr. Mitchell) that there are now fewer domiciliary care packages in place is—dare I say it—a sophisticated use of spin. The reality is that the number of hours of domiciliary care provision is now 14 per cent. higher. The difference is that home care packages are now being properly targeted on the people who need them so that they can stay in their own home, rather than being spread among all elderly people. We are taking practical steps to keep people in their own home.

We believe in choice, respecting older people and giving them security in retirement. The Liberal Democrats believe in taking away that choice and security. They believe in introducing policies that might help a few pensioners, but at the expense of destroying the economy, slashing the value of pensions overall and taking choice away from everybody. That is not what the Government are about. We are about respecting and valuing old age, and ensuring that people have cash in their pockets when they become older. This Government ensure that people have choice of provision when they get older and we respect their right to choose. That is what the Government are about, and I advise the House to treat the Liberal Democrat motion with the contempt that it deserves.

Question put, That the original words stand part of the Question:—

The House divided: Ayes 58, Noes 315.


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