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Mr. Chris Smith (Islington, South and Finsbury): Despite all the hype about radical reform, does not the statement merely amount to the enforced privatisation of those relatively small parts of residential care not already carried out by the private or voluntary sector? Coupled with that was the sabre rattling of the Secretary of State about political correctness on children's services, with precious little action to back it up.
Does the Secretary of State acknowledge that well over three quarters of residential care is provided by the independent sector? Surely the last thing that is needed is ideologically imposed privatisation from Whitehall. Should not those decisions be made locally, taking into account local circumstances? Decisions should be made by the local director of social services, and should not be dictated by the Secretary of State.
Is not the right hon. Gentleman making an automatic assumption that the private sector is always good and the public sector is always bad? Surely such dogma is as outdated as if we on the Opposition Benches tried to argue that the reverse was so. Is not the common-sense approach to secure a mix of accommodation appropriate to the needs of the elderly people concerned?
Will the Secretary of State confirm that his figures about cheaper private sector costs do not compare like with like? Has he not simply taken the total gross expenditure and divided it by the number of residents--taking no account whatever either of the dependency of the resident in each case, where the higher levels of dependency are overwhelmingly concentrated in the local authority-provided sector, or of the standards of accommodation, food and care provided?
Is not that point strongly borne out by the report that has just been produced jointly by the Audit Commission and the social services inspectorate from the Secretary of State's Department, after carrying out an independent evaluation of services provided by Stockport metropolitan borough council? Does not the report say:
With regard to what the White Paper has to say on children, is not all that we have had from the Secretary of State rhetoric--rhetoric, I suspect, aimed at the right wing of his party? If one searches for action in the White Paper, one finds a Labour policy for better training for social workers and the preparation of children's services plans, and otherwise only paragraph 3.4, which grandly states:
We are all concerned to ensure good value for money in social services, and high standards of care for some of the most vulnerable people in our communities. May I therefore welcome the commitment to independent regulation and monitoring of residential care across all sectors--private and public--for which we have long argued? That must be the way forward--but there is no need to privatise in order to achieve it. Why also, however, have the Government not embraced the idea of a self-financing council of social service, to regulate the profession and provide reassurance on safety to the public? We shall legislate for those measures in our social services reform Bill after the election.
In short, does not this whole White Paper represent the triumph of dogma over common sense? Will we not see precisely the same internal market imposed on social services, which has caused so much damage to our health service in the past six years? What we want is a sensible mixture of private, voluntary and public provision, decisions taken locally, not dictated by Whitehall, strong and independent regulation to ensure high standards, and
the needs of service users put first, not those of providers, from whatever sector they come. In short, we need a Labour Government.
Mr. Dorrell:
The hon. Gentleman is clearly in need of a message, electronic or otherwise, from the hon. Member for Hartlepool (Mr. Mandelson). In that tirade, he has just demonstrated how thin the veneer is that covers the true face of the Labour party. Show it any concept that there may be a way forward to improve services through choice, and it runs a mile. It opposed the introduction of choice and the private sector through the 1980s in a wide variety of measures; it now says that it was right. A few weeks ago, it opposed the introduction of the private sector into London Underground. It is now opposing the further development of the private sector in the provision of social care. Old Labour shows through, the moment it is given the remotest opportunity to do so.
The hon. Gentleman prefers to believe that the higher cost of residential care provision in the public sector is related to dependency. The problem for the hon. Gentleman is that the evidence simply does not bear that out. When we consider the average age of people in independent sector homes, we find that it is higher than the average age in the local authority sector, so to argue that dependency is higher in the local authority sector is not borne out by the evidence. He still has to explain why any social service department should prefer to use its own care homes at an average cost of £283 a week, when the average cost of providing the same service in the private sector is £246 a week.
Let us move away from averages to the social service department in the constituency of the hon. Member for Stockport (Ms Coffey) and the report to which the hon. Gentleman referred. There we do not need to consider averages; we can consider specific facts in that local authority. It is true that it delivers good-quality services to some of its users. So it should: it spends 37 per cent. above standard spending to do so.
Furthermore, I should have hoped that the hon. Member for Stockport would want to know why that authority is placing people in residential care at £330 a week when, as the report shows, in that specific authority, there are private sector places available at £230, a price difference of £100 per week per place. Furthermore, this involves not only residential care, but day care and domiciliary services provision. The rate per hour for domiciliary services in Stockport is £10 for the public sector and£8 for the private sector. Let the Labour party explain why, against those facts, it maintains its blind commitment to the view that the public sector must always be protected.
The hon. Gentleman asked me where there are ideas for the development of vouchers in the planning for these services. The answer, among others, is in Bradford, an authority that I should have thought he might be interested in supporting. Bradford social service department wants to use vouchers to improve the services available to service users in Bradford. He just shot his own supporters in Bradford in the back.
I made it very clear that, after the legislation is changed, the onus of proof will be on social service departments that want to sustain provision of care, to show that the need can best be met through public sector provision. If they can discharge that burden, public sector provision
will of course remain an alternative. Against the barrage of facts about the real choice between the public and private sectors, however, the hon. Gentleman's blindness is the outstanding feature.
I welcome the hon. Gentleman's endorsement of the approach that the Government intend to take in reforming regulation of the sector, and I am grateful for his support of our plans for improving training for social workers working with children.
"Care for older people was particularly well organised and of good quality"?
Does not that report also specifically commend Stockport metropolitan borough council for having developed
"a mix of providers for older people's services"?
I should like to ask the Secretary of State three further specific questions. First, in paragraph 2.17 of the White Paper, he envisages the development of a voucher scheme for nursing homes. Can he tell us what the cost of administering that scheme will be? Will we not simply get the same shambles as has occurred with nursery vouchers? Secondly, in paragraph 2.30, he says that a local authority can provide its own care only where there is "insufficient independent sector provision". Does that in effect mean that, no matter what the comparable quality of care, if there is space in the private sector, it must be used? Thirdly, is not an inevitable consequence that, as local authorities are forced more and more into the use of private sector spaces, local authorities' own accommodation will become emptier and unviable, and in a relatively short period, elderly residents will have to be forcibly moved out of their homes?
"The Government will continue to monitor the influence of the Children Act on social services departments."
There is not much action there. If the Secretary of State wanted to take arms against political correctness, why on earth has he not brought forward the adoption Bill, which was ready at the time of the Queen's Speech, was supported by Members on both sides of the House and takes a common-sense approach to adoption and parenting issues?
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