House of Commons Hansard Debates for 10 Dec 1991

Column 745

tradition that regiment has? When may we expect a statement on the medical services aspects which are so important to the Northern Ireland situation? Will there be protection for those who have served in the Territorial Army for some 10 years, so that they may be allowed to complete their service and receive their TA decorations?

Mr. King : I will need to consider the hon. Gentleman's latter point, and I cannot comment on it now. I appreciate the disappointment felt in Northern Ireland, because I know the willingness to serve that exists there. It is striking how many more people proportionally have served in the TA in Northern Ireland than in other parts of the United Kingdom. I make that point with proper sensitivity. Those who wish to continue to serve can volunteer to do so on a part-time basis in the Ulster Defence Regiment. We are maintaining a significant presence in Northern Ireland : there will still be a higher percentage of volunteers per head of population there than in all but two of the other TAVRA areas.

We are moving on with the medical services. All the services are involved-- the regular medical services of the RAF, the Navy and the Army. The question then arises of the most suitable arrangements to be made for the Territorial Army. In the past, the TA has been responsible for massive field hospitals ; the current approach is to make such hospitals much smaller and more flexible, and to increase their number. Work is now in progress, although I cannot give an exact date for its completion. I have noted the hon. Gentleman's interest in the matter.

Several Hon. Members rose --

Mr. Speaker : Order. I must protect our subsequent business, on which there is considerable pressure. I will allow questions to the Secretary of State to continue for 10 minutes ; if hon. Members ask brief questions, they will all be called.

Mr. John Wilkinson (Ruislip-Northwood) : May I congratulate my right hon. Friend particularly on the formation of a second Territorial Army Air Corps squadron? Is it not a little perverse that, while the Army seems to recognise the value of flying reserves, the Royal Air Force is not yet convinced--unlike the air forces of the United States, Switzerland and Israel?

Would it not be more cost-effective to use auxiliary jet pilots who have come out of the service under "Options for Change" than to train women as fast jet pilots, however keen they may be? Most of them will probably go off and get married.

Mr. King : In that interesting contribution, my hon. Friend has probably managed to offend two distinct groups. He has expressed some fairly pungent criticisms, but his point is interesting, and I take note of it.

Mr. David Marshall (Glasgow, Shettleston) : Is it not astonishing that the Secretary of State, having made a decision on 15 Para, cannot or will not answer the pertinent points put to him by my hon. Friend the Member for Glasgow, Hillhead (Mr. Galloway) and the hon. Member for Glasgow, Govan (Mr. Sillars)?

Cannot the right hon. Gentleman accept that the Para battalions should have been the last to be cut, and that, if cuts must be made, they should be made on the basis of

Column 746

operational effectiveness, not political expediency? Is not this the worst possible decision for both 4 and 15 Para? For how long can the right hon. Gentleman guarantee the existence of a 15 Para based in Glasgow? Why did he not decide to reduce the three para battalions to the new standard size?

Mr. King : I am interested to hear what the hon. Gentleman has to say. I am sure that that announcement will be greeted with great interest by the 1st and 2nd battalions the 52nd Lowland Volunteers and the 1st, 2nd and 3rd battalions of the Highland Volunteers. They happen to believe that they, too, make a pretty pertinent and effective contribution to the Territorial Army from Scotland. Of course the paras make a valuable contribution. That is why we have sought to respond to representations, and to continue to give people in Scotland who wish to serve in the parachute regiments the opportunity to do so. There will be a number of such opportunities, whether they be among the commandos or the Marine commandos, or in the SAS, the new Royal Engineers Regiment--whose headquarters will be in Scotland--or the new Scottish Yeomanry Regiment which is to be set up. Certainly, it is no secret that, in proportional terms, Scotland has done rather well out of the arrangements.

Mr. Patrick Cormack (Staffordshire, South) : Is there any message of consolation that I can take to the very bruised people in Staffordshire, who watched with pride as the 3rd battalion received its new colours in September? Will that battalion be allowed to survive?

Mr. King : I am not sure which battalion my hon. Friend means, but I shall look into the matter and reply later.

Mr. John McFall (Dumbarton) : The Secretary of State's catchphrase "smaller is better" has now given way to "so small that it is almost non- existent" in regard to 15 Para. With only one company left in Glasgow, is it not a fact that numbers will fall from over 600 to 150? That will do nothing for morale and recruitment in Glasgow. Does not the Secretary of State agree with one of my constituents, Brigadier Alastair Pearson, who was the regiment's honorary colonel until 1989? In a letter to me, the brigadier said, "It is nothing but political. It is Treasury-led. It is not based on military criteria, and it will do nothing whatever for Scotland."

Mr. King : Sadly, that comment is completely uninformed. I do not know when it was made, but it is incorrect. The hon. Gentleman serves on the Select Committee on Defence, and he knows that a settlement has been made. The Select Committee has taken an interest and has recognised that we have fully funded the programme that we set out. Far from being Treasury- led, it is defence-strategy-led, and the Treasury has now agreed to fund the programme, so the comment was uninformed. I am sorry that the hon. Gentleman cannot see the broader picture of what is happening to the other units and that it is not an unfair arrangement.

I apologise to my hon. Friend the Member for Staffordshire, South (Mr. Cormack) for not responding to him. I confirm that the 3rd battalion will continue.

Column 747

Mr. Ian Grist (Cardiff, Central) : Is my right hon. Friend aware of the dismay that his proposals have caused in Wales? Why have the cuts been so disproportionately heavy there?

Mr. King : When my hon. Friend has a chance to read the full details, he will see that, although there is an amalgamation of regiments, other units will be moving into Wales and there will be new opportunities for serving in Wales. Proportionately, the reduction in Wales is less than the average for the United Kingdom as a whole.

Mr. William McKelvey (Kilmarnock and Loudoun) : Has the Secretary of State made any advance in redressing the ridiculous situation of the Scottish soldiers in the territorial units who served in the Gulf for 51 days and who were constantly under attack by Scud missiles? They have been informed that they do not qualify for their bounty because they have spent insufficient days at summer camp, despite serving 51 days in the Gulf. Are not 51 days in the Gulf more of a training exercise than running around the sand dunes at Barry with thunderflashes?

Mr. King : I know that my right hon. Friend the Minister of State for the Armed Forces is considering the issue, having given an undertaking to the House to do so. I shall ensure that the hon. Gentleman's interest is drawn to his attention.

Mr. Peter Viggers (Gosport) : As to the background, does my right hon. Friend agree that, such is the high level of unit loyalty, any change will be greeted with apprehension by the Territorial Army community and the reserve community? However, does he agree that the news that he has announced today is good news for the reserve forces, because the units will be well equipped and will have an important role, and there will be full support for good recruiting areas such as Hampshire?

Mr. King : I am grateful to my hon. Friend. He has summed up the issue much better than I could. That is precisely the point--the new reserve forces that we have announced will have important roles, will be relevant to our new defence strategy and will be well supported and equipped. That is our absolute intention. It is also our intention--this differs from what has been the case for a long time--that they will be fully manned units.

Dr. Norman A. Godman (Greenock and Port Glasgow) : Is it likely that the changes and related developments will lead the Ministry of Defence to release land in Scotland which it presently owns and leases for training purposes?

On a more parochial basis--

Mr. Speaker : Order. Only one question, please.

Dr. Godman : The Secretary of State mentioned "Grennock"--was he referring to a detachment in Greenock?

Mr. King : That pronunciation is a mistake that I made all the time that I worked in Scotland and I know the sensitivities which it aroused. I apologise.

There will be some rationalisation of the estate, but not in terms of training areas, of which there is, if anything, a

Column 748

shortage. Following the changes under "Options for Change" and the withdrawal of our units from Germany, there will be considerable pressure on our training areas. However, there may well be some rationalisation in terms of drill halls and buildings, and some buildings may become available.

Mr. Patrick Thompson (Norwich, North) : Although I welcome the way in which my right hon. Friend has responded to pressure from those of us who are concerned about the future of the volunteers in the Territorial army and elsewhere, and I especially welcome his statement about the future of the Army Cadet Force and the support it receives from the reserves, what are his particular plans for the three reserve battalions of the Royal Anglians? I understand that the changes are fairly limited, and I should be grateful if he could give me any further information.

Mr. King : I think that there was concern that, under the previous proposal, one further Royal Anglian Regiment battalion would be disbanded. I can confirm that the 5th, 6th and 7th volunteer battalions of the Royal Anglian Regiment will continue. That should deal with some of the problems about which my hon. Friend is concerned.

Mr. Robert Banks (Harrogate) : May I congratulate my right hon. Friend on the structure and military role that he has announced today? Will he consider the historical importance of many units, especially in Yorkshire, which have provided reservists for emergencies? Will the 8th (Yorkshire) battalion the Light Infantry Regiment be maintained?

Mr. King : I am grateful for what my hon. Friend says. I give him that assurance.

Mr. Conal Gregory (York) : Will my right hon. Friend take the opportunity of the review of the Territorial Army to commend to the Confederation of British Industry, to the Institute of Directors and to others the training that is given by the TA so that greater public recognition can be given to it? For the TA's members in Yorkshire, can my right hon. friend give any reassurance to the House in connection with the Yorkshire Volunteers, which will next year celebrate its silver jubilee? Are there any plans to re-badge the Yorkshire Volunteers?

Mr. King : The 1st and 2nd battalions of the Yorkshire Volunteers continue, and the 3rd and 4th will be amalgamated. My hon. Friend also has an interest in the Light Infantry, which is relevant to Yorkshire.

In respect of the role of the CBI and of employers, I pay tribute to the work done by employers and by the National Employers Liaison Committee. What my hon. Friend said is profoundly appreciated by those who have employees who serve in the TA. The quality, calibre, extra capability and extra commitment that they give are well worth any time that may be given up to volunteer reserve service.

Mr. David Marshall : On a point of order, Mr. Speaker. When I put my question to the Secretary of State for Defence, I referred to the hon. Member for Glasgow, Govan (Mr. Sillars). I should have referred to the hon. Member for Dunfermline, West (Mr. Douglas), who comes from Govan. I apologise for the error.

Column 749

Points of Order

4.31 pm

Mr. Robert G. Hughes (Harrow, West) : On a point of order, Mr. Speaker. You will recall that, over a week ago, I raised with you the fact that an hon. Member had clearly used the free post improperly on behalf of Islington, North Labour party. I have been sent another example, which is rather more serious.

The hon. Member for Leicester, East (Mr. Vaz) is specifically identifiable on this occasion. It seems that he has been using the free post to send out quantities--I do not know how many--of his so-called "Annual Report". It has been sent back with a frosty message from one of his constituents, who is unidentified. There is plainly an abuse.

I seek your guidance on two further matters, Mr. Speaker. The royal crest is used on the front of the annual report, which I should have thought was improper. I know that the hon. Member for Leicester, East thinks that he is important, but he is not that important. The crest of Parliament is used on the inside of the report. I thought that that could not be used, so I seek your guidance, Mr. Speaker.

Mr. Speaker : I asked the hon. Member before to bring the matter to my office. I will look into it. From what he says, there appears to have been an abuse.

BILLS PRESENTED

Amusement Machines (Protection of Children)

Mr. Patrick Thompson presented a Bill to empower local authorities to prohibit in their areas the use by children of amusement machines :

And the same was read the First time ; and ordered to be read a Second time on Friday 7 February 1992 and to be printed. [Bill 39.]

Established Church

Mr. Michael Latham presented a Bill to abolish the General Synod of the Church of England, on a date to be appointed ; to provide for the creation of a Church of England Assembly, consisting of a house of all diocesan, suffragan and assistant bishops, and a joint house of clergy and laity, to be directly elected by all Church of England clergy and lay persons on parochial electoral rolls ; to make provision for the Diocese of Sodor and Man ; to empower the Assembly to decide on all appropriate matters, except those within the legal responsibilities of the Church Commissioners, without further reference to Parliament ;

Column 750

to provide for the election of new bishops by members of the house of bishops, saving the right of final approval of the chosen candidate by the Crown ; to abolish the Ecclesiastical Committee ; to abolish the automatic places of bishops in the House of Lords ; to permit ordained clergy of the Church of England, with the consent of a diocesan bishop, to seek election to the House of Commons ; and for connected purposes :

And the same was read the First time ; and ordered to be read a Second time on Friday 7 February 1992 and to be printed. [Bill 40.]

STATUTORY INSTRUMENTS, &c.

Motion made, and Question put forthwith pursuant to Standing Order No. 101(3) (Standing Committees on Statutory Instruments, &c.).

Representation of the People

Ordered,

That the draft European Parliamentary Constituencies (England) (Miscellaneous Changes) Order 1991 be referred to a Standing Committee on Statutory Instruments, &c.-- [Mr. Wood.]

Question agreed to.

Mr. Harry Ewing (Falkirk, East) : Further to that point of order, Mr. Speaker. I am not sure what you referred to just now as "an abuse". You have not yet seen the document out of which the tell-tale hon. Member for Harrow, West (Mr. Hughes) is making a career day in and day out. Before you consider the document, may I remind you of a letter that you received from the convenor of Stirling district council? The hon. Member for Stirling (Mr. Forsyth)--I am not complaining about him, so I do not apologise for not having given him notice that I should raise the point--uses the crest of the House of Commons on his parliamentary report. He also uses the crest of the House of Commons on his advertisements for his constituency advice bureau.

I honestly do not see anything wrong with that, and I am not complaining about it. However, with respect, Mr. Speaker, I have seen your reply in which you said that using the crest of the House of Commons on such material was not an offence, so I hope that you are not referring to that aspect of the issue that the tell-tale Member has just raised with you.

Mr. Speaker : I think the hon. Gentleman is quite right. I am constantly enjoined not to give my reasons, but I did. When I said that I must look into the matter, I was referring to the franked envelope, not its contents.

Column 751

ESTIMATES DAY

[1st Allotted Day]

SUPPLEMENTARY ESTIMATES 1991-92

CLASS XIV, VOTE 1

[Relevant documents : The fourth report from the Social Security Committee of Session 1990-91 on the Financing of Private Residential and Nursing Home Fees (House of Commons Paper No. 421) and the first report from the Health Committee of Session 1991-92 on the above report (House of Commons Paper No. 28).]

Residential Homes

Motion made, and Question proposed,

That a further sum not exceeding £1,680,076,000 be granted to Her Majesty out of the Consolidated Fund to defray the charges that will come in course of payment during the year ending on 31st March 1992 for expenditure by the Department of Social Security on non-contributory retirement pensions, Christmas bonus payments to pensioners, pensions etc., for disablement or death arising out of war or service in the armed forces after 2nd September 1939 and on sundry other services, on attendance allowances, invalid care allowance, severe disablement allowance, mobility allowance ; on pensions gratuities and sundry allowances for disablement and specified deaths arising from industrial causes ; on income support, transitional payment, child benefit, one parent benefit, family credit, and on the vaccine damage payment scheme.-- [Miss Widdecombe.]

4.35 pm

Mr. Frank Field (Birkenhead) : It is my privilege to open the debate on the report of the Select Committee on Social Services into the financing of private residential and nursing home fees. It gives me the opportunity not only of placing on the official record the Committee's thanks to its staff for their work, not only of drawing to the attention of the House what I think is the first debate on community care to be initiated in the Chamber which is not part of a debate on another measure, but also of drawing attention to the number of firsts that we score with this report and debate. This is the first joint report to be submitted to the House by the Select Committees on Social Security and on Health. This is the first time, speaking in this capacity, that I have welcomed my hon. Friend the Member for Manchester, Withington (Mr. Bradley) to the Opposition Front Bench. Anyone who knows my hon. Friend's track record before he became a Member of the House will know how well deserved that promotion is.

This is also the first time that the Under-Secretary of State, the hon. Member for Maidstone (Miss Widdecombe), has been allowed out to speak from the Treasury Bench in the Chamber. We heard from the hon. Lady several times in Committee, but the Secretary of State for Social Services has kept her firmly muzzled on other occasions. Hon. Members can draw an important lesson from the hon. Lady's rise to office as a junior Minister in the Department. She got the post because she proved such a thorn in the Government's side on this very issue. Those hon. Members who are told by the Whips that their loyalty, obedience and voting record will all be taken into account may rest assured that those things are, indeed, taken into account, but in a totally different way from what one is led to believe if one wants to speak in the House from either Front Bench.

Column 752

With those introductory remarks, I hope that I have drawn attention to the firsts that we celebrate in this debate, but although those matters are important, matters of far greater importance form the substance of our debate. I refer to what has been, is and will be happening to the financing of some of the most frail and vulnerable members of our community who live in residential or nursing homes. I know that my hon. Friend the Member for Wakefield (Mr. Hinchliffe) wishes to contribute to the debate if he is able to catch your eye, Mr. Speaker. From the many written questions that my hon. Friend has tabled on this matter, I note not only that the numbers of people in residential and nursing care have increased substantially, as we all know, but also the surprising fact that there has been only a modest fall in the numbers of people in local authority care. I had thought that there had been a really massive shift from what one might call the public sector into the private sector. Although there has been a slight fall in the numbers of people in local authority care in the past 10 years, there has been a remarkable increase in the numbers of people cared for in what is described as the private sector--in the homes run as nursing or residential care homes. I know that criticisms will be made as a proper part of our deliberations today about whether that is the best use of the money. My hon. Friend the Member for Wakefield raised such criticisms in Committee and may well do so again later. However, on behalf of many of my constituents--I am sure that this is true for many other people around the country--I should like to stress that, although none of us thought in 1979 that we would be discussing this situation today, as a result of it many of our constituents have received a quality of life far superior to that which they might otherwise have had. I certainly recall visiting residential and nursing homes in my constituency of which one could genuinely say that one would be pleased to be a member of that community. We are called upon to make such statements in all sorts of circumstances in our constituencies and sometimes we do it slightly with tongue in cheek, but I can genuinely make such a statement about many homes. I do not want any criticisms that we may have of some home owners or some trends to detract from that important fact.

We all agree, however, that there are some real problems with the current provision. Many of us share some deeply felt worries about what will happen under the current procedures until the changeover takes place in 1993. While our minds may boggle at the difficulties which exist now, goodness knows what the scene will be after 1993. We welcome to our debate the Minister for Health, who is in her place on the Treasury Bench.

First and foremost, there has been a remarkable and outstanding growth in the social security budget for residential care. This is one of the few occasions in the House when I can say that many hon. Members on both sides of the House told the Government that that would happen if the Government allowed the policy to develop in the way it has. Hon. Members made a plea in the early stages of the 1979 Parliament that the Government should allow local authorities to appoint gatekeepers who would judge whether people qualified on not only income grounds but more general medical needs grounds for the care that they sought.

Every time hon. Members put that point to the Treasury Bench, the Government knocked it aside. One of

Column 753

the consequences of that is a high level of provision, from which many of our constituents benefit. But if some of our constituents had been offered other options, they would not have chosen residential or nursing care.

It is because the Government would not allow local authorities to appoint a couple of gatekeepers that we face a bill probably in the region of £1.9 billion. Undoubtedly, the Under-Secretary of State will bring us up to date on that. I think that it is fair to say that, if hon. Members on either side of the House had realised 10 years ago that we would be debating a sum of almost £2 billion, none of us would have recommended the one-track community care solution that has been adopted. To some extent, that is water under the bridge. I do not say that to score a cheap point. It is not a party point but a House of Commons point against the Treasury Bench. I make the point because, in the report that we are debating, we make several recommendations and we wish the Government to take them more seriously than those that we made in the past. The fact that the Government disregarded our recommendations largely accounts for the debate that we are having today.

The next problem that the Government face is the fear of evictions. If I were the Secretary of State for Social Security, which I am not, my nightmare would be the early morning phone call from the Department's press office saying that an eviction is taking place that day, that the media and particularly the television cameras will be there and asking whether I would be there and what were the Government's comments. It is because that fear exists that some home owners know perfectly well that they have the Government over a barrel. When they want to see fees generally jacked up, we get talk of impending evictions.

The Under-Secretary of State said in her discussions with the Select Committee that she did not have any examples of evictions, yet the Association of Metropolitan Authorities told us that 24 per cent. of its members had reported evictions to it. It added a phrase so extraordinary that I quote it directly :

"although these were felt to be isolated incidents."

All that I can say is, thank God that they were isolated incidents. Even so, a quarter of the authorities reported to their central body that such incidents had taken place. It is a real worry that evictions might take place.

It is because we wish to strengthen the Government's hand against a fairly well organised industry which seeks universal general increases that we make a series of recommendations in the report, to which I shall come in a moment. The Government are vulnerable at any time, but especially in the run-up to a general election, to the prospect of evictions of people who are no longer able to pay the full fees for which the home owner calls.

The Committee has highlighted two other problems. When the policy was first implemented, there was no question but that those who were then on supplementary benefit and are now on income support gained a first-class service from the homes. Indeed, many of the homes said that the fees from supplementary benefit were so adequate that the people who came in on that ticket were given some of the best accommodation in the establishment. That is not so now. There is not only a form of filtering within homes of the rooms offered to those on income support, but homes sometimes put up a bar against those whose

Column 754

only contribution is up to the ceiling laid down by the Government. Within homes, a two-tier system is developing.

More importantly, a different tier system is developing in different parts of the country. I see the hon. Member for Chislehurst (Mr. Sims) in his place and I know that he hopes to catch your eye, Mr. Deputy Speaker. He is a member of the Select Committee on Health and played an enormously valuable part in our proceedings. We were given evidence by Age Concern England. It quoted a Health Advisory Service report on Bromley, which said :

"Frail, elderly people face exile in private residential homes far from Bromley".

In other words, the rates that the Government lay down are such that one must be extraordinarily lucky in Bromley and many other places to obtain a place near one's home. It gives a new and cruel twist to community care that people may have to be shipped perhaps as far as Birkenhead to find a community home. That provision will cut a person off from all that he or she most values--family and friends. That is the background to some of the problems that the report has highlighted.

I come quickly to our recommendations. I stress that we have made them in the most constructive vein possible. I sought to score points earlier on the cavalier way in which previous Ministers dismissed the suggestions from the then Select Committee, by which we sought to limit the rate of increase in the residential care part of the Government's budget. We did so not because we did not want money spent on community care, but because we did not necessarily believe that a one-track policy was the best way to ensure the ideal form of care. We want the Government to think carefully and respond positively to our recommendations, because we are anxious that the rate of increase in the Budget from now on should not be jacked up by the powerful lobby of the industry and the influence that it can exert on the Government.

Therefore, our recommendations were tailored to some selective targeted measures which the Government could implement to avoid conceding increases across the board. We emphasise in our report that we do not see those measures as a way of dealing with the shortfall. We are interested in how to make good that shortfall. That is what our recommendations are about, but we also aim to help the Government to limit the rate of increase in the budget.

I wish to touch on three proposals. First, the Secretary of State told the Committee and the House that the new form of community care, which will be run by local authorities, would have the extraordinary advantage that people in the locality who knew the scene would make the decisions. Why cannot that proposal be brought forward, so that the local offices of the Department of Social Security could make the decision about topping-up arrangements?

Secondly, as new residents in homes will be able to claim housing benefit under the new proposals, why cannot housing benefit be claimed as a way of helping to make good the shortfall? Thirdly, as the Government are turning a blind eye to many of the disregards being allowed for people on income support and in residential and nursing care, could that be codified and made safe for all forms of disregard?

We hope that the Government will respond to other priorities and suggestions in the report, which I shall list as headings because I know that other hon. Members wish to speak and will doubtless develop many of those

Column 755

arguments. We are worried about the date on which local authorities will know the size of their budget. Will the Government issue clear guidance on which responsibilities will fall to health authorities and which to social services? How far down towards the locality will the decision on housing benefit be made?

One more issue, which I often return to from these Benches, although I hope that before long I shall be able to support those on the Treasury Bench from the other side of the House--

Mr. John Marshall (Hendon, South) : Is the hon. Gentleman crossing the Floor?

Mr. Field : When I am ready for residential care, I may totter over to that side of the House, but until then I am happy to stay on this side.

Finally, on the proposals in our report about extending freedom, many of us fear that, after the changeover, people's freedom will be limited under the Government's proposal, although so much of their rhetoric suggests the opposite. We have three proposals. First, as we wish to encourage carers and strengthen families--even the extended family--if a person who is caring for someone loses them to a home, the person's home should not have to go on the market to meet the cost of fees.

We are not saying that taxpayers should not be able to claw back some of the costs at a later stage, but the carer's position should be protected. Under the new system, we want people to have rights to choose the sort of care that they receive, rather than be directed to it. We all have too much experience of what it is like for council tenants trying to exercise their supposed freedom for us to lie easily with the Government's assurances on that matter.

The most important issue regarding freedom is that we fear that, far from more people being given control over their lives, when the new system comes into play, fewer people will have control. Our plea to the Government is that they take a leaf out of their own book on the independent living fund, which was set up in haste and has played a role that it was never meant to play. It has been a noble role, as it has allowed people grants and cash to fix the level of care that they want. They have been in control. Under the new system, we want an increasing proportion of the budget to go into a pot of cash, which local authorities will be able to give out. That cannot happen in year one, but as the years went by, it would enable people to build their own packages of care rather than having to take care designed by others for them off the shelf, as in a supermarket. As I have emphasised three times, the previous Select Committee on Health and Social Services made a number of pleas to the Government not to get us into the position that we are in now. I am being polite about the way in which the Government have behaved when I say that they have dealt with our recommendations in a cavalier fashion. When the Under-Secretary of State responds, I hope that we will know that the joint recommendations from the Select Committee on Health and the Select Committee on Social Services will be taken more seriously than previous recommendations.

4.54 pm

Mr. Nicholas Winterton (Macclesfield) : My contribution will be brief. I support everything said by the Chairman of the Select Committee on Social Services, the

Column 756

hon. Member for Birkenhead (Mr. Field). I am sure that all those who participated in the report--in his Committee or in my Select Committee on Health--endorse the responsibile recommendations and conclusions in the report.

The hon. Gentleman presented the case for the Committee and introduced the debate in a measured and responsible way. Like him, I welcome my hon. Friend the Under-Secretary of State for Social Security to the Front Bench to respond to this important debate. As the hon. Gentleman said, she made a substantial reputation for herself by the stand that she took in seeking to represent the best interests of the elderly and others who would be looked after in private residential or nursing homes.

Having endorsed--on behalf of the Health Committee--all the recommendations made by the Social Services Committee, I wondered precisely what my contribution to the debate could be. I need not have worried. Following the appearance that I made with the hon. Member for Birkenhead on a Channel 4 programme, which generated quite a volume of correspondence, I received a letter from the proprietor of a private nursing home in Chesterfield. The letter precisely sums up the remarks that I would have wished to make in this debate. The gentleman concerned--the proprietor--decided to establish the home after he had cared for his father-in-law in his own home until he died. He described that as a traumatic and difficult experience, following which he and his wife pledged to find a better way to look after the elderly and people who need residential or nursing care. In his compassionate letter, he advised me that, after 12 years research and work, they opened their present nursing home. He told me that they have about 50 residents, cared for in a purpose-built home by about 100 staff. That is a measure of the cost of looking after the elderly and those who need residential and nursing care properly. The 100 staff include 25 state registered nurses.

Like the hon. Member for Birkenhead, I have taken considerable time during the years that I have represented Macclesfield in the House to visit private residential and nursing homes and part III county homes in my constituency. I have not given notification but have dropped in.

The proprietor says in the letter that the facilities that he is able to provide are a better way to look after people who are among the most vulnerable in our society. The kernel of the argument is that, because of the costs he incurs by running a highly staffed, well-motivated and caring establishment, he has to limit the number of income-supported residents that he can accommodate. The fees that he can get back from the Department of Social Security are inadequate to cover the costs that he incurs.

In his letter, he gives one or two examples :

"May I give Margaret as an example of costs. This lovely lady has suffered extreme arthritis for many years, and her skeleton is crumbling away. Three of my staff take 1 hour to wash and dress her, morning and night--cost £210.00 per week.

Treatment, laundry, food, room and other overheads raise the true cost of her care to £400.00 per week. Income support for this lady is £255.00 per week, or £1.55 per hour."

The cost of £210 is the fee that he currently charges the lady. He asks me to consider another case whose Christian name is Jennie :

Next Section

Home Page