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"if disability benefits...were to be reformed as part of the National Care Service, those receiving the affected benefits at the time of reform would continue to receive an equivalent level of support."
"an equivalent level of support",
Andy Burnham: I am sorry, but "equivalent level of support" is pretty plain-it means no cash losers. It is an equivalent level of support: that could not be clearer. I have said very clearly that people will keep the cash and keep the control. We have said that all along, but the hon. Gentleman has been choosing not to listen because it did not suit the grubby campaign that he has been mounting for the past couple of weeks. We have made this absolutely clear. He may not like it, because it does not suit his purposes, but it could not be clearer.
As I said, the three principles in the benefits system will all be important features of a new care and support system. [ Interruption. ] If the hon. Member for South Cambridgeshire will stop chuntering, let me say that cash payments will be at the heart of a new system. The care services Minister, my hon. Friend the Member for Corby, and I have been saying that every day since we launched the Green Paper. That is what
"an equivalent level of support"
Mr. Speaker: Order. I apologise for interrupting the Secretary of State, but I must say to Ms Milton that there seems to be a competition among Front-Bench Members for the dubious accolade of chunterer-in-chief. [Interruption.] Order. I do not require any help from the hon. Member for West Chelmsford (Mr. Burns)-he is often competing for that accolade himself
Mr. Speaker: And we need no further intervention from him. I simply say to Front-Bench Members that they need to simmer down. It is good that there is a lively debate, but I want Back Benchers to be heard.
The point that the hon. Member for South Cambridgeshire seems to have missed is that we have said all along that cash payments will be part of the new system. I said in response to my right hon. Friend the Member for Stirling (Mrs. McGuire) a moment ago that in recent years, we have begun to see a merging of the local authority support system and benefits, with the introduction of direct payments. That is a trend that we want to continue. It is not about giving people's benefits to councils, as the press releases accuse us of. People in the care system are already getting used to getting cash budgets, and the number of people receiving them has risen by 28.9 per cent. over the past year. Including carers, 115,000 people have received them, and our reforms will take the process further. Let me be clear: we will reform disability benefits only if we are certain that the new system can better support the needs of older and disabled people.
The hon. Member for South Cambridgeshire is often good at taking a big position without any reference to what other people in his party say. His whole thesis today was to raise the spectre of the loss of benefits, and he gave the idea that any reform of benefits means
somebody losing out and that we cannot possibly raise these issues without trying to cut support. However, I have before me a speech that the right hon. Member for Witney (Mr. Cameron) made in Scotland on Monday 16 October 2006. It was a long and, I may say, quite good speech about how to provide better support to disabled people in the long term. I shall come to the crux of it, because it is important that the House hears the right hon. Gentleman's peroration. He said:
"So there are the problems in the benefits system. It is too complex. It does not incentivise work sufficiently. And it relies too much on large government agencies...Our policy review is examining the option of a radical simplification of the benefits package for disabled people. I welcome the principle of Individual Budgets. But I'd like to go much further."
It is unbelievable-he was giving exactly the same argument that we have been mounting, which underpins our Green Paper. [Interruption.] Hear me out, there is more. He went on to back us up even further, saying:
"Instead of the half-dozen different benefits a disabled person can receive-each with its different conditions and its own application form"- [Interruption.]
"we should be moving towards a single assessment process, and perhaps even a single benefit."
There it is in black and white, in a speech, the same thing that we are talking about-the simplification of the support system, perhaps through a single benefit. Yet the Conservatives have brought the motion before the House today because, three years on from that, it suits their purposes to issue press releases and frighten disabled and older people up and down the country.
Mr. Lansley: I am still utterly unable to reconcile what the Secretary of State is now saying about the Government's change of policy with what is in the Green Paper. The use of disability benefits to pay for the national care service is intended to back what was clearly one of the preferred options, the partnership model. Page 109 of the Green Paper even has a helpful diagram showing how, under the current system, there is a big shift from people paying for themselves to people getting part of their care free. The Green Paper states that
"those who were on the lowest incomes would continue to get all their care for free."
Is he really telling us that under the national care service as he proposes to introduce it, existing disability benefit recipients will continue to get the exact cash benefit that they currently get, plus their social care free? In that case, where is the money to come from to provide universal care for others?
Andy Burnham: Can the hon. Gentleman tell me what part of "no cash losers" he does not understand? Interestingly, just as I was coming to a rather sensitive and difficult part of my speech for the Conservatives, he got up and raised a different point. He did not like hearing what I was saying, did he, but he was quick to come back with a red herring. The policy is "no cash losers" and it could not be more simple.
That brings me to the Personal Care at Home Bill. There are still huge challenges in the care and support system. The Green Paper sought people's views on how
we resolve those and create a sustainable system for the long term. In our view, those with the greatest needs cannot wait, and we cannot stand still in meeting the challenge of rising costs. Currently, an estimated 80,000 older people in the highest need receive free personal care, but 40,000 pay part of their costs, and 50,000 pay all their costs.
Andy Burnham: No-I am making progress. Among younger adults, an estimated 90,000 receive free care, while 20 per cent. pay all or part of their own costs, so we want to start now with reform, by helping people to live independently for longer in their own homes for free, which is something they tell us they really want. Our Bill will do just that. It will end the postcode lottery in care for those most vulnerable members of our society. Let us not forget that many have already paid significantly out of their own pockets to fund their own care- [ Interruption. ] The hon. Member for South Cambridgeshire says, "Second Reading on Monday." We are putting forward reforms that support people in their entirety-support for older and disabled people-and I am very sorry that he considers that unimportant.
Mrs. Moon: Does my right hon. Friend remember the scaremongering that took place when our party was introducing the Care Standards Act 2000? We were told that we would drive agencies and care home owners out of business, and that we would not raise standards or improve the quality of care. Some companies went out of business, but they could not provide quality care. The Bill is the next step in the reform of care that will improve life for the elderly and disabled. As such, should not everyone welcome it?
Andy Burnham: My hon. Friend makes her point very well. The Conservatives have a track record on these issues-a track record of opposing any step forward that has given more dignity to older people, particularly those in residential or nursing care. I remember that on the day we launched the Green Paper in the House, a distinguished Member of the Opposition stood up to complain about the burden of the national minimum wage on care homes and asked whether more could be done to give more deregulation to care homes. Quite frankly, that is their true voice-that is what they have done in their past. When they come here with the pretence of speaking up for older people, I am afraid it just does not wash.
Mrs. May: As the Secretary of State has changed the Government's policy this afternoon, I think it would be helpful if the House could understand exactly what he is saying for those existing pensioner recipients of either attendance allowance or disability living allowance. Is he saying that under the Government's proposals, those people will no longer receive attendance allowance or DLA, but instead receive a cash payment? Is he also saying that, as with attendance allowance and DLA, they will be free to spend the payment on whatever they choose, or will they be able to spend it only on the provision of social care?
I do not think the shadow Work and Pensions Secretary has been listening this afternoon, nor do I think she listened yesterday at Work and Pensions questions, when the Under-Secretary of State
for Work and Pensions, my hon. Friend the Member for Chatham and Aylesford (Jonathan Shaw), said quite clearly that an equivalent level of support meant no cash losers. She has not been listening to this debate nor indeed did she listen to the debate yesterday.
The right hon. Lady asks if our proposals mean that people can have the control to buy what they need. How many times have I said that this afternoon? The crux of what we are building is the power and control that people get in cash benefits-that is at the heart of the national care service. It could not be clearer and she clearly has not been listening to anything we have said.
We want to go further. In the Personal Care at Home Bill, we want to build a system that does all it can not just to pick up the pieces when people need help, but that has prevention at its heart. We want to invest resources in re-ablement-services to get people back on their feet and to give them intensive support after illness, an operation or a fall, so that they can live independently at home. The hon. Member for South Cambridgeshire is only proposing to help people who end up in residential care. What kind of a vision of the future is that-giving people an incentive to go into residential care? Surely the best way forward for care is to invest in prevention, to give people support to live independently at home and, at all times, to support them to live in their home. That is what they tell us that they want.
Alistair Burt: Before the Secretary of State finally moves away from the clash of press releases, will he comment on the quote in the Health Service Journal today from a national health service source? Under the headline "NHS to take responsibility for social care", the report outlines the Government's plans to take more responsibility and states:
"Social care is currently provided by local authorities, the majority of which are now Conservative controlled. A move towards greater control of social care by the NHS has been described to HSJ by an NHS source as one way to 'rip the guts out of' Tory-controlled councils."
Some 1.3 million people work in the NHS, and I cannot be responsible for what all of them say at all times. It is my judgment that, whatever happens, more money from the health budget will have to be spent closer to the line with social care. That is just the way things will have to go, and that is why I am talking about finding resources from within my Department to fund re-ablement services-intense support to get people back on their feet after a vulnerable or low moment in their lives. Because we do not provide such support at the moment, people end up at the door of the NHS or asking for support from local authorities. We want to expand the level of support. We should also be less precious about spending health resources on equipment and telecare to help people to live in their own homes. That is all part of my vision. We have to break down the approach of the past that has said, "The health service pays for this and councils pay for that", and we argue about the bit in the middle. We can no longer sustain that-the hon. Member for North-East Bedfordshire (Alistair Burt) is nodding in agreement. The hon. Member for South Cambridgeshire should listen to more
distinguished voices on his Back Benches if he wants some good advice about policy. The hon. Member for North-East Bedfordshire has a long track record in these areas.
This is an ambitious vision and it will not happen overnight. It raises complex and difficult questions that this House needs to consider carefully before proceeding with any reform. It cannot be a debate that is reduced to crude electioneering, because that would block out and shout down the debate. That is what we have heard from the Conservatives this afternoon. We have raised the issue of social care and the response from them is to shout it down and frighten people. The Conservatives cannot open up the debate because they do not have the ideas to put into the debate. Let us have a few more ideas and constructive comments, rather than the low politics that we have heard from them this afternoon.
The Prime Minister has committed to making social care our top domestic priority in the next Parliament. That shows that we have the ideas, the courage and the confidence to tackle the big issues that the country faces. I believe that the national care service could be a major social reform that will stand alongside some of the major reforms of the last century. It would be easy to say that it is too difficult. We have been under pressure this afternoon to say that we will drop it all, as the hon. Member for South Cambridgeshire invited me to do at the end of his comments. But we will not do that; we will see this through. If we fail to act, we will make the choices more difficult, the unfairnesses will grow year on year and this post-war generation-it includes people who own their own properties and who will live longer, which is a good thing-will face ever more unfairness than their parents did. These are big challenges. The Government believe that we have the right ideas to address them, and I urge my hon. Friend to oppose the motion.
Steve Webb (Northavon) (LD): As we have heard, we are effectively debating early-day motion 1, which was tabled by my hon. Friend the Member for Colchester (Bob Russell) after a night spent in a sleeping bag to ensure that he was in the Table Office to table perhaps slightly more than one early-day motion. However, of all the issues that could be brought to the House's attention, he chose this to be the first motion of the new Session, and rightly so. I congratulate him.
The subject of our debate is important, and I am delighted that the Conservatives have put the words in my hon. Friend's motion on the Order Paper. He was quite surprised when I told him last night that they had done so-he was slightly surprised too that they did not tell him directly, but never mind. However, the debate gives us the chance to put to rest, I hope, something that has caused great anxiety among millions of disabled people in Britain.
We have all seen the press release being talked about, and as much as the hon. Member for South Cambridgeshire (Mr. Lansley) might pretend otherwise, it is transparent that the release that he is encouraging his party's candidates to put out is designed to alarm current recipients of the allowances. All the statistics that his office-I assume that it is his office-has inserted into the press release
relate to current recipients. It refers to 2.4 million pensioners who are current recipients. It reads: "In (constituency) ,"-fill in the gap-
"this would affect (x) pensioners- (y) who receive Attendance Allowance"-
"and (z) who receive Disability Living Allowance".
I hope that the Department will reflect on whether its language in the Green Paper should have been more unambiguous and should not have left the door open to such campaigning. It is helpful that the Secretary of State said clearly this afternoon that there would be no cash losers; that was not the phrase used in the Green Paper. For the avoidance of doubt, and for those 2.4 million people, I shall describe, as faithfully and as accurately as I can, on the strength of the conversations that we have had, what I understand the Government's policy to be. If I get anything wrong, I hope that Ministers will correct me.
John Mason: The hon. Gentleman has made the exact point that I was going to put to him. The Government have said that people will be guaranteed an equivalent level of support, but that could mean anything. We assumed, as did many vulnerable people, that it meant that people's disability benefits were under threat. Does he agree that the Government themselves have been the main cause of the problem?
"Conservatives will protect (area's ) pensioners and fight against Gordon Brown's plan to scrap benefits for the disabled."
That rather extends what the Green Paper might have been thought to mean. For the record, however, I shall describe what I think the Government are saying. Under the proposals, existing recipients over pension age of disability benefits-attendance allowance and DLA-will continue to get, first, the same amount of cash; secondly, they will be as free as they are now to spend it on what they like; and, thirdly, if, in addition to those cash benefits, they receive social care from a local authority, that will continue as well. Those are the three strands that I understand are present from what Ministers have said.
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