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Mr. Michael Stephen (Shoreham) : Is my hon. Friend aware that many independent care home proprietors are worried because local authorities are unfairly preferring local authority homes when making referrals, and also unfairly applying much higher inspection standards to private care homes than they apply to their own premises?

Mr. Bowis : I am aware that that is alleged, and also that, if it were happening, it would be wrong, because public sector homes are required to be inspected and assessed according to the same standards as are set for voluntary and private sector homes.

I am equally aware, as my hon. Friend says, that, in some parts of the country, perhaps in parts of his own area, there are examples of people being persuaded to go into residential care homes in the public sector which are more expensive than appropriate and suitable accommodations available in the independent sectors.


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Mr. Hinchliffe rose --

Mr. Bowis : I am responding to an intervention from my hon. Friend.

The Audit Commission is one of the monitoring organisations which consider the cost and value for money of community care, and I expect it to draw it to the attention of local authority social services departments should it find that that is the case. Of course, that will become apparent as the year progresses.

Mr. Hinchliffe : On the issue of the choice of people and the question of the use of local authority accommodation, is it not a simple fact that vast numbers of older people prefer to go into local authority accommodation because that accommodation is of a good standard, and especially because it is often located in areas where those people have lived all their lives? The Government are destroying that choice, because they are deliberately attempting to close down local authority accommodation. Where does the choice of local authority homes lie in the Government's policy?

Mr. Bowis : It is for local people, local authorities and local social services to decide the sort of provision they may or may not wish to provide in their own sector. It is also up to them to purchase, on behalf of people whose needs they have assessed, suitable accommodation in residential care where that is the preference--as opposed to domiciliary care--of the individual who has been assessed. That individual should then have a choice under our statutory direction of choice on the home to which he or she is directed. That choice can be there in the public sector as in the independent sectors.

What I am saying, what my hon. Friend the Member for Shoreham (Mr. Stephen) is saying and what far too many care home managers and owners are saying, is that, all too often, that choice is not real in Labour authorities, which seek to promote their own homes at the expense of choice for the individuals who wish to choose homes in the independent sectors. I hope that the hon. Member for Wakefield (Mr. Hinchliffe) will begin to support us on that line, instead of showing his innate hostility to the private sector.

On bed blocking, the dire predictions of some people have also happily proved unfounded. Some parts of the country are reporting lower levels than before April. There have been some small isolated problems, for which local managers have been prepared and which they have been able to deal with, as we expected.

Joint working between local authorities and the national health service is also generally good. The agreements we required them to make on discharge arrangements and placements in nursing homes have had a positive effect, and there are welcome signs of commitment to joint development. That condition is one that I am repeating this year.

That is the big picture, but I have also been impressed by earlier reports of what it has been possible to achieve for individual users of services. For example, the lady with a husband suffering from dementia who wanted him to be cared for at home has been able to receive 28 hours of home help each week, district nursing, and two weeks' respite care in every six.

Another lady with significant health problems, who would previously have had to enter a residential care home, has been able to stay in her own home, thanks to a


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comprehensive package of care--meals on wheels, home help seven days a week, respite care to ease her isolation, district nursing, various aids and adaptations and a laundry service. All the ladies so worried about coping alone

Mr. Rhodri Morgan (Cardiff, West) : Where?

Mr. Bowis : Of course, the Opposition do not want to hear these things, because they are examples of the success of the policy. As I began by saying, they are only happy when they think that the policy is not working. If they will listen, I am giving examples of people who are benefiting from the policy, such as the lady who was so worried about coping alone that she was thinking of moving into residential care, but was reassured when her local authority arranged for someone to visit each night before she went to bed to ensure that the gas was turned off and the house was locked up.

Ms Tessa Jowell (Dulwich) : Will the Minister give way?

Mr. Bowis : In a minute.

Equally, I have seen good examples of the provision of residential care, such as the lady who woke up one night to find a burglar in her room and decided that she needed to move to a home for reassurance and company, and who was able to choose a home where friends of her Church of denomination were living.

Ms Jowell : I am sure that hon. Members on both sides of the House celebrate examples where community care is working well. Can the Minister tell the House which authorities these examples have been taken from?

Mr. Bowis : I wish that the hon. Lady would replace some Labour Front-Bench Members, because this is the first time that I have heard from Labour Members a recognition that the reforms are going well? When we produce examples selected--

Mr. Morgan : Where?

Mr. Bowis : --from around the country as a result of the monitoring process, the hon. Lady will celebrate those successes, even if Labour Front -Bench Members will not.

It has been said that the implementation of the community care reforms marked the beginning of a decade of change, rather than an overnight revolution. That is perfectly true. It is now clear that the early days of the reforms represent a satisfactory foundation for that decade--a view shared by many other observers, including the Audit Commission and the Association of Directors of Social Services. [Interruption.] The Opposition spokesman on health is in the wrong debate. This is about local authorities in England. If he listens, perhaps he will learn some lessons for Wales as well.

Mr. David Blunkett (Sheffield, Brightside) : Given the Minister's flattery of my hon. Friend the Member for Dulwich (Ms Jowell), perhaps he will now answer her question and tell us which English authorities he drew his examples from.

Mr. Bowis : I have already told the hon. Gentleman that the examples come from a variety of areas of the country, and we could give him many more if he so wishes.

The point is that the policy's success is a tribute to the considerable efforts made up and down the country by local authorities, health authorities and users and carers.


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We need to be vigilant to ensure that that progress continues. I look forward to the next year of community care with some confidence, and I commend the report to the House.

10.46 pm

Mr. David Hinchliffe (Wakefield) : The Opposition welcome this opportunity to have an albeit brief debate on Special Grant Report (No. 10). I think that people would be alarmed if they knew how rarely we get the opportunity in the House to discuss such an important subject as community care. As the Minister said, the report contains the amount of grant to be made available to individual local authorities during the second year of operation of the changed community care arrangements.

In view of the Minister's comments, it is worth reminding the House that Labour supported the broad thrust of the community care provisions in the National Health Service and Community Care Act 1990 as a means of unravelling the mess created by the Government's ill-thought-out, publicly funded expansion of private institutional care.

In many respects, the arrangements set out in the report are still constrained by the same Government preoccupation with the market that we heard throughout the Minister's speech. That preoccupation led to the need for the 1990 changes in the first place. Labour believe that as long as Government policy remains more concerned about the interests of private providers of care than about service users and their carers, genuine community care reform will remain a long way away.

As the Minister is well aware, the central motivation for the changes introduced last April was Exchequer anxiety over the soaring cost of DSS expenditure on income support claims made by residents of care and nursing homes. Following a change of policy in 1981, those rose from £11 million per annum to £2.5 billion per annum in the past financial year, and constituted a £10 billion investment in the resurrection of institutional care as the central plank of the Government's community care policy. A vast number of people entered private residential care and nursing homes without any formal assessment whatever, and many could and would have been able to remain in their own homes if some of those resources had been invested in genuine community care.

Last April's changes aimed to address what has been now recognised as the gross misuse of public funding. The Opposition fully supported the introduction of care planning at local authority level and, in particular, the arrangements for assessing care needs. Our worry, however, is that in the funding arrangements for both the first and the second year of care, the changes are placing deliberate barriers in the way of the achievement of progress in community care provision.

When the House debated the current year's funding arrangements on 11 February and 3 March 1993, as set out in the special grant reports 6 and 7, I made clear the Opposition's concern over the adequacy of grant mechanisms used for its distribution, and the requirement on local authorities to spend 85 per cent. of that in what the Government call the independent sector. I wish to reiterate some of these concerns tonight, but, before I do, perhaps I can issue one word of welcome to the Minister. He should make the best of it, as it might be the only one he gets.


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The Minister is aware that the Opposition felt that the formula used to distribute the current year's special transitional grant was profoundly unfair, and that it verged on the bizarre. The grant was based 50 per cent. on the individual local authority's standard spending assessment and 50 per cent. on the previous income support claims by people in private care and nursing homes in the area. The nonsense of that formula was that it was weighted heavily in favour of councils with the most private care and nursing homes, despite the fact that many of the residents concerned originated from other local authority areas and had preserved their entitlement to continuing income support payments being unaffected by the changes.

I know that the Minister was concerned about the unfairness of the formula. He intervened during the speech of the hon. Member for Suffolk, South (Mr. Yeo) during the debate on 3 March, and said : "the allocation is perhaps weighted towards rural areas--as opposed to the inner cities"--[ Official Report, 3 March 1993 ; Vol. 220, c. 401.]

The Minister shares my concern about that point.

The unfairness of the formula to which I have referred was brought home to me most strongly when I went to an establishment in the constituency of my hon. Freind the Member for Tooting (Mr. Cox). Nightingale House, which may be known to the Minister, is a Jewish home which is jointly registered as a care and nursing home, and offers nearly 400 places. Many of the residents receive income support and their claims counted in the grant calculation for the local authority in which the home is situated, even though most of the claimants originated from other local authority areas. It is clearly coincidental that the local authority gaining grant in this way is Wandsworth, because, in certain other respects, that authority, like nearly all London boroughs and many metropolitan authorities, lost out badly under the formula used during the current year. If the funding had been distributed on the basis of SSA--as it will be in 1994-95--Wandsworth would have nearly £900,000 more in its existing budget.

The fact that London boroughs alone lost nearly £25 million as a result of the first year of community care changes puts the Secretary of State's announcement last Thursday of an extra £10 million for London's mental health provision into some perspective.

Regardless of arguments about the overall care funding, the majority of local authorities--68 out of 108--lost substantially on the grant that they received during the first year. Sheffield lost over £2 million, Southwark lost £1.7 million, and Leeds lost £1.3 million. Smaller authorities such as Wakefield--my own local authority--lost nearly £1 million. Those are huge chunks of resources which should have been made available on the basis of the Government's calculation of population needs.

Many councils have struggled desperately to make decent care available against a background of the totally inadequate special transitional grant and, according to the Association of Directors of Social Services, alongside spending freezes and cuts in the base budgets of social services departments in the current year. The association obviously welcomes the fact that the Government have abandoned their previously discredited distribution formula and, in this report, are moving to SSA as a basis for the formula.


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While the Opposition applaud the Government's long-overdue conversion to common sense, we would strongly press the Minister to address the problems that have arisen during this first year because the formula was completely wrong.

First, the Minister should address the serious difficulties facing those authorities that have lost out on millions of pounds in the current year. Secondly--this point was made by my hon. Friend the Member for York (Mr. Bayley) ; my hon. Friend has left the Chamber, but he made an important point--the Minister should recognise that authorities that gained in the first year will, in many instances, come down to earth with a severe bump as a result of the contents of the report. The Government have bungled the funding arrangements badly and made the proper planning of community care year on year a total impossibility.

The original funding formula was badly skewed because the Government acceded to pressure from the private care home industry, which feared the impact of the care changes. The difficulties facing so many local authorities stem from the fact that the Government take more notice of the business interests of private providers than the needs of users and carers. They relate to a manifestly inappropriate market ideology at Government level, which is holding back in so many ways properly planned and thought- out responses to the needs of users and carers. The Minister's speech was full of phrases such as "use of the independent sector". The Government's policy is not to provide what people positively choose or need. It is use of the independent sector, right or wrong. That is not good enough.

The Government have conceded that their previous distribution formula was wrong. But in this report, they continue to shackle the development of genuine community care, again by insisting that 85 per cent. of the special transitional grant should be spent in the so-called independent sector. That requirement stems purely and simply from an ideological desire by the Government to protect the interests of private care providers and extend their involvement into domiciliary care.

The Government are again putting their obsession with market forces before the real interests of those who receive services. That obsession is clearly preventing the provision of a range of services geared to offering alternatives to institutional care.

I am sure that the Minister will be aware that social services directors and local authority associations have urged the Government to review their 85 per cent. requirement because it obstructs proper community care provision. I have no doubt that the Department of Health's intelligence networks have advised the Minister that in the past few weeks the Labour party has undertaken a survey of directors of social services on the impact of the 85 per cent. requirement. We shall publish the detailed results within the next few weeks and, as usual, I shall sent the Minister a copy.

The initial findings of the survey are worrying. It is clear from the range of responses received that the 85 per cent. requirement means for many people unnecessary admissions to residential care because in various parts of the country private or voluntary sector domiciliary care remains either non-existent or minimal. It says a great deal about the Government's priorities on community care that they are prepared to see unnecessary and expensive institutional care used inappropriately because of a


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dogmatic refusal to allow special transitional grants to be used to extend and improve local authority care home provision.

The Minister will recall that, shortly before Christmas, the chief social services inspector and the chief executive of the national health service management executive wrote local authorities a letter saying that their decisions on community care expenditure should be based on value-for-money grounds. But we have been told by local authorities in the survey that we have undertaken in the past couple of weeks that the requirement to spend 85 per cent. in the independent sector is bringing them into direct conflict with that directive. It is causing them to misuse and waste their scarce resources in unnecessary admissions to institutional care. Will the Minister state which directive has precedence--the 85 per cent. requirement or the Laming-Langlands letter? I shall give way if the Minister wishes to respond to this point because I could do with a drink of water.

Mr. Bowis : If the hon. Gentleman had listened to what I said in response to his intervention in my speech, he would recall that I reminded him that, in the past, what is represented by the 85 per cent. for the independent sector was 100 per cent. for the independent sector. We are talking about the money that previously went direct to the independent sector to look after the residents in those homes. Substantial resources are available from the social services general budget which traditionally have been used to support people in part III homes and in domiciliary and day care. I should like to know what the hon. Gentleman is doing to ensure that authorities controlled by his party look to use that money sensibly, wisely and in the best interests of individuals. It is in their interests that the widest possible choice is made available. That includes, of course, the services provided by the independent sectors, private and voluntary.

Mr. Hinchliffe : The House will have noticed that the Minister failed to answer the question that I put to him. I repeat that question. Does the 85 per cent. requirement take precedence over the Laming-Langlands letter? It is as simple as that. The House requires an answer-- [Interruption.] If the Minister has now received a message from his officials, I shall willingly give way to him again. We have clear evidence that the 85 per cent. requirement is forcing people into unnecessary and expensive institutional care that they do not need. Local authority directors are telling us that, and they must be telling the Department of Health. What will the Minister do to unravel that mess? Does he wish to intervene?

Mr. Bowis indicated dissent .

Mr. Hinchliffe : He does not wish to do so--the House will draw its own conclusions from that.

I want to make it clear that the Opposition's argument is not simply that there has been an underinvestment in community care. The Government, through their obsession with private provision--which the Minister mentioned throughout his speech--have grossly misused the resources provided.

What could have been achieved if much of the £10 billion investment, through supplementary benefit and income support payments in private residential and nursing homes, had been used instead to develop real community


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care where people need it? People need home care, day care, day and night sitting services, meals provision, communication technology, aids and adaptation, respite provision and the range of mental welfare services that can provide safe and caring alternatives to psychiatric hospitals. What could have been achieved if the Government had not abandoned community care to the market? The Government are now trapped. Private home owners are screaming at them because referrals for permanent care are falling--we have heard their views represented tonight by Conservative Back Benchers. How sad it is that the Government seem to see their task as ensuring a continued and wholly inappropriate use of outdated institutional provision simply because it is in the private sector. The Opposition recognise that the non-statutory sector has a role to play in care provision, but that role has to advance the development of community care, not hold it back.

Mr. David Congdon (Croydon, North-East) : If the hon. Gentleman means what he says, why does he not encourage social service departments to promote the development of the private sector in domiciliary and home help services rather than obstruct their development?

Mr. Hinchliffe : Unlike, I suspect, the hon. Gentleman, I worked for many years in a social services department. When dealing with someone in need, one does not bother about which sector provides the services, but merely tries to provide for that person's needs. The hon. Gentleman suggests that social services departments, with all their massive daily pressures, should have to spend time on trying to find entrepreneurs, who simply do not exist in many areas. The second issue that the hon. Gentleman should consider is that such providers are not regulated or inspected. They are not registered, and could come straight out of prison or from the courts, with all sorts of convictions. They could enter people's homes and offer domiciliary and physical care. They could be dealing with an old person's finances--the Labour party do not believe that such people should offer community care.

Mr. Andrew Rowe (Mid-Kent) : The hon. Gentleman paints a picture of a divided Britain that I find distressing. In my local district, the purchasing authority has made it perfectly clear that it will not buy services from people who do not meet the standards that it has laid down. It has had no difficulties, and I do not understand why other local authorities cannot make the same decisions.

Mr. Hinchliffe : I know that the hon. Gentleman takes an interest in social services, for which I commend him. But he has missed a fundamental aspect of the checks and guidelines on domiciliary care, as has the Minister. We are assuming--as the Minister does constantly--that all domiciliary care is provided through the contracting process. Vast numbers of elderly and disabled people purchase domiciliary care directly, without the involvement of the local authority. They have no safeguards. The fact that the Government are not acting on that is disgraceful, and the Minister knows it.

Mr. Bowis : The hon. Gentleman is missing the point. Greatly increased resources are available to social services departments. He said that he used to work in a social services department ; I bet that he never had a year such as Wakefield did this year, with resources increasing from


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£29 million to £40 million. More money is available, and if we are asking for a proportion of that to be spent in the independent sector, that means more money for domiciliary care in the independent sector, over which there is control through the contractor. We are able to ensure that standards are required of the voluntary or private sector placing tenders for domiciliary services.

The problem is that too many authorities run by the hon. Member's party refuse to put out a specification so that the independent sector can tender at all.

Mr. Hinchliffe : I am happy to debate until the cows come home the position of Wakefield social services and its financial situation. Nobody was more surprised than the acting director of social services in Wakefield when the Minister quoted those figures last Tuesday. I have a letter here which, if the Minister cares to read it, I will pass over to him and which shows that the way in which the Minister has come to calculate the questions is beyond everybody in Wakefield.

If the transitional grant is put to one side, there is to be a real reduction in the revenue budget for 1994-95 of £400,000, in order that the council can avoid being capped. When the Minister talks about SSA, special transitional grant and all the other things that he mentions, he seems to forget that, although we are being given all these generous resources, local authorities, including a responsible local authority such as Wakefield, are also being capped. I am proud of my local authority and I will debate with the Minister, if he wishes, the issues of deep concern to me in my own locality. I was saying that the Opposition genuinely recognise that the non-statutory sector has a role to play when it is developing community care, innovating, offering new services ; but the sad fact is that in so many respects the private sector, in particular, is hanging on to outdated models of institutional provision that are totally inappropriate to this day and age.

I have certainly seen in the private sector excellent examples that can offer something of genuine relevance to people's comunity care needs. I have looked in some detail, as I think the Minister is aware, at communication technology, where what is on offer from the private sector enhances real choices and opportunities for those in need of care and does not hold back the development of community care, as is unfortunately happening in some respects at present.

I urge the Minister seriously to consider the problem being caused by the 85 per cent. requirement. I am not suggesting that he drop the specific quota in its entirety, as I understand the need to safeguard the voluntary sector, in particular, for example, in those areas concerning drug and alcohol provision where the voluntary sector has a specific role to play--a role of which the Minister is well aware and which, like me, he values very much. But the 50 : 50 split suggested by the local authority associations would, I am sure, enable a radical improvement in care provision and overcome many of the problems that I have mentioned.

The Minister has again implied that the Government have been somehow generous in their special transitional grant provision. It is important to make it clear that the STG is money for new local authority responsibilities which would have been spent anyway by the Department of Social Security. May I press him again on the point that


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he did not answer in last week's health Question Time and which he has not referred to tonight? If the funding is, as he suggests, so generous, why are the Government urging local authorities to introduce charges for basic care services that have been freely provided in many areas from the time that they were first introduced? He must be aware that that is a matter of huge concern in various parts of the country, especially, for example, to the parents of young people with learning disabilities who find themselves being charged quite high prices for the attendance of their sons and daughters at day care establishments. Many people feel that to be totally inappropriate and highly insensitive. I should welcome the Minister's comments on that point.

Our debate takes place against the background of growing public concern about the Government's community care policy. As the Minister knows, my party has consistently supported the development of community care, but we recognise that the Government's commitment to market forces in health and care obstructs and undermines strategic planning at national and local level and the achievement of a seamless service.

It is an unfortunate coincidence that tonight's debate takes place only a few days after the publication of two separate reports concerning the care of the mentally ill, both of which expose the fundamental contradictions of Government policy. The first, with which the Minister will be familiar, was commissioned by the North West Thames health authority and found that managers of a proposed health trust were so obsessed with achieving trust status that they neglected disturbing shortcomings in care that may have contributed to the deaths of some 14 patients.

The second report concerns the case of Mr. Christopher Clunis. I am surprised that the Minister did not refer to that important and tragic case. Mr. Clunis, who suffered from schizophrenia, caused the death of Mr. Jonathan Zito in December 1992. The report clearly demonstrates that the Government have yet to start proper co-ordination and collaboration of care provision at a local level. It exposes how the lack of resources contributed to that appalling tragedy and shows how limited the alternatives to hospital care still are.

I am genuinely sorry that the Secretary of State, who is not present in the Chamber tonight, chose to try to make political capital out of this issue at the weekend, singling out a Labour council for specific mention, when page 105 of the report clearly states :

"We do not single out just one person, service or agency for particular blame".

I pay sincere tribute to Jonathan Zito's widow, Jayne, who, since her husband's death, has campaigned ceaselessly and courageously for proper care and help to be given to the likes of Christopher Clunis. I urge the Minister to listen to her message--a message not of vengeance and malice but of genuine concern for the likes of her husband's killer who, as she says, have been condemned to a life of degradation and poverty. On Thursday, she said :

"It is not enough to make a market out of mental health. These people need care and supervision. You cannot compete when you are dealing with people's lives".

For those very reasons and the other concerns that I have expressed, I urge all hon. Members who share our anxieties about community care to join us in the No Lobby at the end of the debate.


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11.11 pm

Mr. Barry Field (Isle of Wight) : May I congratulate you, Mr. Deputy Speaker, on the 20th anniversary yesterday of your arrival in this House? My hon. Friends and I hope that it will be many years before you require community care.

I am pleased to follow the hon. Member for Wakefield (Mr. Hinchliffe) because he attended the conference on the Isle of Wight when my right hon. Friend the Secretary of State announced the ring fencing of funds for community care. I know from recent conversations with the hon. Gentleman how seriously he takes community care. He observed me in the Members' car park with my car engine running and was so concerned about my welfare that he returned three hours later to make sure that I was all right.

On the Isle of Wight, 26.4 per cent. of the population are of pensionable age. That is the 17th highest percentage in England and Wales, where the national average is 18.7 per cent. Moreover, 18.8 per cent. of households consist of one pensioner living alone, which is 3.7 per cent. above the national average of 15.1 per cent. Care in the community is, therefore, of considerable importance to the island.

I wish to raise two points. The first concerns Haylands farm at Ryde, which was formed under the auspices of Mencap in 1977 and provides sheltered work for mentally handicapped students. It has a number of sheep and goats, sells 300 eggs locally, and rears pigs that are sold as meat. The farm extends to more than 16 acres, most of which are owned by the Isle of Wight county council, which charges a fair and unsubsidised rent. One acre is owned by Mencap. The farm is entirely supported by donations of money and its own manpower and materials. It is now recognised as a day centre unit by the Isle of Wight county council and receives very limited funding. The local authority should purchase the services and facilities offered by the farm under the care in the community legislation. The farm meets all the requirements of a provider of services but does not get much of the cash. For the past three years, the county council has promised to put the farm on a permanent financial basis but, unfortunately, it still staggers from month to month. A number of us on the island are concerned that that excellent facility continues to have that problem.

My second point is about the concerns of members of the Isle of Wight Registered Care Homes Association. We seem to have made a little progress on funding. When the funding was first announced, we were told that it would run out in July. We are now told that it might stretch until September. Clearly, things have moved on a little.

I should like to explore the possibility of using any notified underspending by councils against their 1993-94 special transitional grant allocation. First, let me make it quite clear that the Isle of Wight county council has not suffered a cut in community care funding in 1993-94. The council received £2.354 million in special transitional grant funding. The figure for 1994-95 is £3.376 million, an increase of just under £1 million on the pervious year. I should like my hon. Friend to tell me in due course whether he has yet reached a decision on the possibility of the unused STG money being reallocated to the Isle of Wight and I hope to hear from him shortly as to whether that is possible.

There is and always has been considerable mistrust on the island between the councillors and the private sector. To try to reduce that, I asked the private sector to set up its


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own association, which it did, and by and large that has done a great deal to break down the barriers of suspicion and mistrust so often voiced by Liberal councillors about the private sector when I was a county councillor. The private sector still has misgivings about the county councillors' operation of Islecare and the way it was financed, the subsidies that the county council day care facilities receive and the almost total lack of opportunity for the private sector to participate in the provision of those care facilities. Having said that, while I would like to see the councillors take a step back from the management of the companies providing these facilities, as well as the residential homes in competition with the private sector, the district auditor might yet feel compelled to insist that the whole arrangement must become more transparent and arm's length--at least, I hope so.

Despite that caveat, community care is working well on the island, and to some extent I suspect that part of the difficulty is the fact that so many elderly people are now being maintained in their own homes--the very intention of community care. However, I believe--and the Minister's letter shows--that the formula has worked against the interests of the Isle of Wight this year and that there is a problem.

I consider it my job to separate the hype and attention-seeking tendencies of the leader of the council whose ability to deploy extravagant language has created more tension in the Isle of Wight than Lindy St. Clair's stays and whose contribution to a reasoned debate is about as welcome as woodworm in a rowing boat, but I would be remiss not to bring the concerns of Haylands farm and the Isle of Wight Registered Care Homes Association to the attention of my hon. Friend and my right hon. Friend the Secretary of State.

As so often happens in the House, the truth lies somewhere in the middle. I therefore leave the last word to Mike Leyshon, the editor of the association's newsletter entitled, "Homing In". On page 17 he writes :

"What are we really faced with here? A few less social service funded placements each. A faster rate of contraction of our market than originally predicted. A dozen or so businesses pushed over the edge on which they may have been teetering for some time. It may be most care homes will survive this year's struggle, some may even prosper".

11.18 pm

Ms Liz Lynne (Rochdale) : The report that we are discussing tonight gives us a rare chance to debate community care, an issue of great importance to many constituents of many right hon. and hon. Members. Unfortunately, we are limited tonight to debating the money that the Government consider sufficient to fund community care and how they have decided that that money should be allocated.

On the first point, it is quite clear to me that the resources that the Government have allocated to fund care in the community are totally inadequate. One need not take my word for it ; one has just to read the report of the inquiry into the Christopher Clunis case. In what has been universally acclaimed an excellent report--including by Jonathan Zito's widow, Jayne--the inquiry team declared that the care and treatment of Christopher Clunis was a

"catalogue of failure and missed opportunity in which lack of resources played a part."

Mr. Bowis : The hon. Lady and the hon. Member for Wakefield (Mr. Hinchliffe) raised the Clunis case. It is a


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tragic case. We take it seriously, as indeed we would any other instance of a breakdown in the care of people with mental health problems. But the hon. Lady should recall and remind the House that the Clunis-Zito case pre-dates community care. We are talking about a case in 1992, as the hon. Gentleman acknowledged. We are now talking about resources for community care that started on 1 April 1993. The hon. Lady should recall that the background to that case and the report, as the hon. Gentleman said, mentioned a number of areas in terms of discharge, information, communication and so on. Reference was made to the resources for medium-secure units, particularly in London, but that does not relate to the report, important as it is.

Ms Lynne : I am grateful to the Minister. He must realise, however, that the report stated that lack of resources played a part. We must address that in this debate on resources for community care. I do not think that we can ignore it. I know that other parts of the report stress that lack of monitoring was a problem. I sincerely wish that when the Government brought in care in the community--I am grateful that they did--they had set up the proper monitoring. If they had, we might not be in the state that we are now in. Resources played a part and there is no way that the Government can get away from that fact.

Mr. Bowis : That was before community care.


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