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8.33 pm
Ms Ann Coffey (Stockport): I should like to take this opportunity to complain about the small amount of grant that Stockport has received as compensation for the loss of income due to the changes in capital disregard.
The elderly residential standard spending assessment being used for the distribution of the specific grant comprises a number of indicators. These include, first, the number of elderly people living alone; secondly, the number of elderly on income support; thirdly, the number of residents in residential homes. The formula benefits those authorities with greater numbers of people on income support who are less likely to own their own homes. The SSA is reduced for local authorities with greater income as a result of residents having capital assets following the sale of property or receiving occupational pensions.
The situation is further complicated by the fact that the all-ages social index is used when calculating the overall SSA. It reflects, among other factors, the proportion of persons living in accommodation that is not self-contained; the proportion of persons without exclusive use of a bath or an inside toilet; and the proportion of elderly persons living in privately rented or housing association accommodation. Thus, if a council has a successful housing policy and also has more elderly people who are owner-occupiers, it will receive less central Government assistance. That is not a point of dispute in itself, but the value that each factor is given when calculating the revenue support grant is indeed a point of dispute.
The Department of Health has commissioned research regarding SSAs in two areas--children and the elderly--and both projects are due to report in June. I believe that that research is important. Before the introduction of the poll tax, the central Government contribution to Stockport, as elsewhere, was about one third of the council's total revenue expenditure on services. Since then, the situation has been reversed. Councils are also capped, which makes the new research very important in identifying indicators that will more sensitively match grant to need.
I return to my complaint about the distribution of the £64.487 million specific grant. As I have said, the SSA is reduced for those authorities which have more elderly people with capital assets--that is, home owners. Yet those authorities will lose income as a result of the capital disregard changes. Stockport calculated that it would need £822,000 to compensate for loss of income--£600,000 to compensate for loss of income from existing residents,
and £222,000 to compensate for existing residents and patients whose capital decline brings them into new eligibility criteria and for new residents and patients admitted to care in 1996-97.
Stockport was given a grant of £331,000, which is half what it needs to meet the known loss of income from existing residents. The Government cannot have it both ways: if the SSA is reduced to reflect expected income from charges in residential and nursing homes, it is not unreasonable to expect those authorities with higher incomes to be compensated at a higher level as a result of the increase in the disregard, as they are likely to lose the most income.
From Stockport's point of view, it is ridiculous that the distribution mechanism for the specific grant is not based on actual loss of income as it was supposed to compensate authorities for loss of income. In a letter to the director of social services, Bob Lewis, on 20 March, the Department of Health said:
It was so helpful that it persuaded the Minister to provide more specific grant overall, but it was not helpful in providing a grant which reflected Stockport's estimated, or even actual, costs.
I understand that the Minister argues that, as it is a one-off payment, applying a different distribution mechanism would risk significant changes to authorities' shares of the funding between the two years. Stockport is grateful for any offer of stability from the Government, but we would have preferred that stability to take account of fairness as well. It is not a fair distribution, particularly as Stockport is a capped authority. The social services division already faces cuts of up to £3 million, which must inevitably affect its ability to deliver support services to elderly and disabled people living at home--that is to say, community care.
The £500,000 shortfall must come from somewhere. The authority already has comprehensive charging policies for support services provided to people living at home. The £500,000 can be made up only at the cost of community care, which is delivered to people at home.
I am absolutely fed up with asking the local authority to consider requests from my constituents for something as simple as a shower, for example. People who cannot get into the bath unaided need a shower, which can make a dramatic difference to their quality of life. They cannot get a shower, because the authority does not have the money for that level of community care provision. That is an absolute disgrace, and the situation will be made much worse by the fact that Stockport has been robbed of £500,000 by the Minister. In future, I shall send all requests from my constituents for showers to the Minister: let him explain why they cannot have them. The authority does not have the money because of the unfairness of the way in which the specific grant has been distributed.
Mr. Gareth Wardell (Gower):
I shall confine my comments to the Special Grant Report (Wales) 1996. I shall not make any comments on England, which will give one Minister at least a well deserved respite.
I shall examine the implications of annex B of the report. On 13 April 1993, the National Assistance (Assessment of Resources) Order 1992 came into force, and it impinges on the report. On 23 February 1995 Welsh Office circular 95/7, headed "NHS Responsibilities for Meeting Continuing Health Care Needs", was put out. The connection between that and the report before us today is that the report builds on a basic principle that the Government are still intent on pursuing--that of means testing.
The Chancellor fiddled with the means testing requirement in the Budget. He thought that he was improving the position so that--rightly, in my view, if one accepts the principle of means testing--people who had a certain amount of capital were able to retain that capital at a higher level than hitherto. None the less, the principle that people who have paid national insurance contributions through their lifetime to ensure that they would not have to dip into their savings in old age is still Government policy and is still contained in the report.
The 1992 order brought nursing homes into the remit of the National Assistance Act 1948. The residential home sector was already covered by that Act, but the private nursing home sector was brought into the same category. The 1995 Welsh Office circular amended the 1991 Welsh Office circular. I remind Ministers, not that they need reminding, of the charade and masquerade--I do not like using those words too often--and the difficulty that the Government put professionals into by that circular.
I am the Chairman of the Select Committee on Welsh Affairs and we considered this topic in 1992. On 5 February 1995 I asked a senior officer of the Gwynedd social services department, Mr. Williams, whether the Welsh Office was making the job of professionals impossible through the means testing system, and he agreed. In column 159 of the minutes of evidence, he said:
A tidy outcome is residential nursing home care.
The clear point was that there were two types of people being discharged from hospital to private nursing homes, and that is relevant to the report that we are discussing today. There were the people who knew their rights and who refused to be means tested under the 1991 Welsh Office circular: they said that they would stay unless they were forced to leave. Then there were the others--the majority--who did not have that circular to hand in their hospital beds and who were discharged to a private nursing home under the guise that they had to be means-tested.
Some people knew their rights--they knew that the health authority would have to pay for them to be in a private nursing home if they were discharged--but most people were told a different story by the professionals, who were under enormous pressure in the acute sector to discharge people under an almost false pretence that the law was on the side of the professionals. That is what is behind Mr. Williams' point.
Mr. Rhodri Morgan (Cardiff, West):
Has my hon. Friend seen the latest statistics--I believe that they date from December 1994, certainly no later than that--which
"the Association's survey of authorities' estimated costs was indeed very helpful to us, particularly in relation to the information about residents already known to the authorities".
"I quite agree with the sentiments you are expressing. What we have to look at is the pressures on those people in those circumstances, and they are quite appalling. Sometimes it is a kind of social conspiracy, almost, involving a number of people, quite unconsciously, to achieve certain tidy outcomes, which is residential nursing home care."
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