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Lord Laird: My Lords, I thank the Minister for his reply. However, does he not understand that there is a considerable amount of unease throughout the country about the Government's failure to mark in a significant way the 200th anniversary of the creation of the United Kingdom? Does he not believe that the contribution that the United Kingdom has made to world civilisation in the form of the industrial revolution, in the defence of freedom, culture and sport, and in passing on democratic values is worth

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celebrating specially? Will he at least confirm that the Government have no plans to spend the year 2001 apologising for the creation of the United Kingdom?

Lord Falconer of Thoroton: My Lords, I can certainly confirm that. I can also make it absolutely clear that we are as proud of the distinguished history and traditions of this country as is the noble Lord.

Lord Mackay of Ardbrecknish: My Lords, if the Government are so reluctant to celebrate the 200th anniversary of the creation of the United Kingdom of Great Britain and Ireland, will they show the same reluctance about joining with us in 2007 to celebrate the creation of the United Kingdom, England and Scotland? Or, thanks to the devolution policies, do they believe that we shall still have a United Kingdom, given that the SNP is beating the Labour Party in the opinion polls?

Lord Falconer of Thoroton: My Lords, I am glad to notice that the noble Lord believes that we shall still be the Government in 2007. Of course, I believe that there will be a United Kingdom in the year 2007. That has been made all the more certain by the devolution plans that we have introduced. Perhaps I can reiterate that we are as proud of the distinguished history and traditions of the Union as is everyone else in the House.

The Welfare State and the Elderly

3 p.m.

Earl Attlee asked Her Majesty's Government:

    Whether the operation of the welfare state in respect of the elderly is satisfactory.

The Parliamentary Under-Secretary of State, Department of Social Security (Baroness Hollis of Heigham): My Lords, the measures flowing from the Green Paper Partnership in Pensions, together with those announced in the past two Budgets, demonstrate the priority that the Government have given to ensuring a decent income in retirement and improved quality of life for pensioners; hence our proposals for an earnings-linked minimum income guarantee for poorer pensioners now as well as for a state second pension and a stakeholder pension to reduce pensioner poverty in future. The winter fuel payment, worth £3 a week, as well as the minimum tax guarantee and the provision of TV licences will benefit most eligible pensioners.

Earl Attlee: My Lords, I thank the Minister for that reply. As I had a word with her private office, she will be aware that I am straying slightly from my usual topic. At a time when we are spending over £100,000 million on social security, can the Minister explain why increasingly I meet beggars who are clearly too

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old to work and who have obviously spent most of their time in the UK? Is the problem one of social security, of law and order, or of health?

Baroness Hollis of Heigham: My Lords, I am grateful that the noble Earl told me that he would ask about beggars. However, I do not believe that that has allowed me to acquire any useful further information to share with the House. We have no statistics about the number of beggars who are elderly--presumably elderly women--for example, over 75. From my experience, beggars are usually younger people who have come to London to try their luck. Certainly any elderly person--someone over 65 or over 75--would be entitled to state benefits, including a state pension. They would be entitled to a minimum income guarantee if they did not have alternative means and they would be entitled to housing benefit.

Given that, the problem ought not to be a social security one. If they are elderly and on the streets, or in some sense sleeping rough, there may be mental health problems or substance abuse problems; certainly there are social exclusion problems.

Lord Clement-Jones: My Lords, if the Minister has had an opportunity to read the recent survey into accident and emergency departments, carried out by the Association of Community Health Councils for England and Wales and the Royal College of Nursing, she will have seen that there are horrendous examples of age discrimination against the elderly. Is it not time, as we urged on the Health Act last year, that there should be an outlawing of age discrimination in the public services?

Baroness Hollis of Heigham: My Lords, I agree with the noble Lord. The Government are entirely and utterly opposed to any discrimination against older people in the National Health Service. Any treatment of elderly people must be done on clinical grounds only, and on no other grounds at all. That is precisely why the Government and my noble friend Lord Hunt of Kings Heath are developing a National Service Framework for Older People. That is being developed this year to ensure consistent quality and decent care for older people across all health authorities.

Baroness Wilkins: My Lords, can the Minister give an assurance that the Government will follow the recommendation of the Royal Commission on Long-Term Care of the Elderly that personal care should be free of charge to those who need it? Do they recognise that personal assistance should be regarded as a fundamental human right? People who can no longer get out of bed, feed or dress themselves without personal assistance or support are not in that position from choice. That service is as essential as the National Health Service, education and others.

Baroness Hollis of Heigham: My Lords, I am batting slightly off my wicket, but I shall have a go. The noble Baroness will know that the Government are considering the Sutherland report, but have not yet

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come to a decision as to which path they will take in terms of the recommendations. They have not decided whether to follow a majority recommendation or a minority recommendation, associated with my noble friend Lord Lipsey. He made the point that, given that one is dealing with scarce resources, a real decision has to be made as to whether the cost to people of the existing service is reduced or whether that money is used to improve existing services. The Government are reflecting on that and will make a judgment in due course.

Lord Goodhart: My Lords, will the Government consider giving particular assistance to older pensioners by providing age additions to the basic state pension of a substantial amount for those aged 75, 80 and over?

Baroness Hollis of Heigham: My Lords, I accept the diagnosis of the noble Lord of who are the poorer pensioners. They tend to be the older pensioners--those over 75 or over 80--and often they are single women. The interesting proposals put forward by the Liberal Democrats, and particularly by the noble Lord's right honourable friend Steven Webb, are for a 75 per cent increase between the figures of the basic state pension and the minimum income guarantee. However, I have difficulty with the fact that he proposes that it should be funded by the removal, or the scrapping, of our proposals for the state second pension. That would mean that it would be to the disadvantage of women, carers and disabled people. Another problem is that under the Liberal Democrats' proposals, more people in 2010 would be on income-related benefits rather than fewer.

Baroness Masham of Ilton: My Lords, does the Minister believe that there are enough physiotherapists, occupational therapists and speech therapists to rehabilitate elderly people when they become ill so that they can return home, enjoy their pensions and live an independent life?

Baroness Hollis of Heigham: My Lords, perhaps I could beg the noble Earl, Lord Attlee, the next time he asks this question to go for a UQ rather than a Starred Question! I am assured by my noble friend Lord Hunt--for whose advice I am grateful--that we have a national working scheme looking at precisely those proposals. We recognise how dependent elderly people are, particularly for mobility, on physiotherapy and occupational therapy.

Lord Ashley of Stoke: My Lords, is my noble friend aware that she bats off her wicket very well indeed? I ask her to continue to do so now. Does she agree that there should be an inquiry into the allegations that some hospital trusts use "Not for resuscitation" notices in relation to elderly people without their consent and without consultation with their relatives? If she disagrees with that, I hope that she will consult her colleague. Does she agree that a step forward

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would be for the Government to demand from every hospital trust a report on how many "Not for resuscitation" notices are issued, so that those trusts with an abnormally high number can easily be identified?

Baroness Hollis of Heigham: My Lords, that is an interesting question which has been heard by my noble friend Lord Hunt and on which he will want to reflect. Perhaps I may emphasise a response I gave earlier: the Government absolutely deplore "Do not resuscitate" notices in the spirit in which the noble Lord has enunciated. That is a matter for clinical judgment within the framework of careful guidelines drawn up by the Department of Health and the BMA. It is precisely to overcome some of the apparent--I was going to say "discrepancies" but that is a cold word--different responses of hospitals to similar situations that the DoH is developing its National Service Framework for Older People to ensure consistency, decency and quality for all elderly people at a most vulnerable time--when they are in hospital.


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