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Madam Speaker: I am not taking questions on my statement--I am simply reaffirming what I said in May. I met the two Members at their request, and it is right that I should tell the House factually about the exchanges that took place. If there are to be any changes to the Oath, that is not a matter for me. I am sure that the House has listened carefully to the right hon. Member for Chesterfield (Mr. Benn)--I certainly have.
Long-term Care
3.35 pm
The Secretary of State for Health (Mr. Frank Dobson): With permission, Madam Speaker, I should like to make a statement.
As people approach old age, many become anxious about how they will be looked after, how much it will cost and who will pay. At the general election, we promised that we would establish a royal commission to work out a fair system of funding long-term care for the elderly. Today, I can announce that the Queen has agreed to the setting up of the royal commission, whose terms of reference will encompass the United Kingdom as a whole. The new Government are keeping yet another of their election promises.
The royal commission is to be chaired by Professor Sir Stewart Sutherland, principal and vice-chancellor of Edinburgh university. I am confident that he will bring to the commission the skills and experience necessary to ensure rapid and vigorous scrutiny of the issues involved and practical cost-effective proposals to deal with them.
Sir Stewart will be joined by 11 other commissioners: Professor Dame June Clark, professor of community nursing at the university of Swansea; Sir Nicholas Goodison, deputy chairman of the Lloyds TSB Group and former chairman of the stock exchange; Dr. Iona Heath, a GP in Kentish town who represents the Royal College of General Practitioners on the British Geriatrics Society; Joel Joffe, a human rights lawyer, founder director and former deputy chairman of Allied Dunbar Assurance and chairman of Oxfam; David Lipsey, political editor of The Economist and a public interest director on the Personal Investment Authority; Professor Mary Marshall, director of the dementia services centre at the university of Stirling; Claire Rayner, writer, broadcaster and president of the Patients Association and a former nurse; Paula Ridley, the chair of the Liverpool housing action trust; Professor Robert Stout, professor of geriatric medicine at Queen's university Belfast; Robin Wendt, the former secretary of the Association of County Councils and a former civil servant at the then Department of Health and Social Security; and Len Woodley QC, a recorder who chaired the Laudat Mental Health Act inquiry.
Briefly, the commission's terms of reference will be to examine the short and long-term options for a sustainable system of funding of long-term care for elderly people, both in their own homes and in other settings, and to recommend how, and in what circumstances, the cost of such care should be apportioned between public funds and individuals. I have placed the full terms of reference in the Library of the House.
The commission will consider the implications of its recommendations for younger people who have long-term care needs because of illness or disability, and will have regard to the Government's continuing review of pensions.
The Government want both sound and swift advice, so the commission has been asked to report within 12 months--thus it will be different from previous royal commissions. This royal commission will be different from its predecessors in other ways, too. In the past, some royal commissions have included representatives of
pressure groups that were involved in the topics to be covered. This one does not. The commissioners are not supposed to be representatives. They are there to take a fresh look. However, pressure groups and representatives of users and carers should have their say, so the commission will establish a reference group of organisations to help to gather views and receive advice.
The chairman of the commission is today inviting a range of organisations to serve on that reference group. It will include charities and other groups that are involved in long-term care, the financial services sector, the health service, local government and other service providers, together with representatives of the major religious faiths in the United Kingdom. By that means, the commission will be able to draw on the most up-to-date experience of users and carers.
The commissioners will make visits throughout the country to listen to other users and carers. They plan to be "out and about," so that they can really get the full flavour of the current concerns in different parts of the country.
The task of this royal commission is neither simple nor easy, but it is important. The present situation cannot go on much longer. People are entitled to security and dignity in their old age, so we must find a way in which to fund long-term care which is fair and affordable both for the individual and for the taxpayer. With the independent advice of the royal commission, I hope that we shall be able to establish a consensus from which we can fashion a sustainable system of long-term care that will meet the needs of elderly people well into the new century.
Mr. John Maples (Stratford-on-Avon):
This is a very serious problem; a long lead time is required to do anything through policy changes. Before the election, the Labour party was critical of the means test and of people being forced to sell their homes, but its only policy was to set up a royal commission. I am concerned about the use of a royal commission. It is usually a way of kicking things into the long grass for a long time.
Will the Secretary of State assure us that he will ensure that it sticks to the 12-month timetable, unlike the previous royal commission that was set up by a Labour Government, which was asked in the 1970s to examine the health service, and which succeeded in reporting two months after Labour had lost the 1979 general election--although, if that sequence of events is followed this time, we shall be happy to wait five years for it?
We also need a cast-iron guarantee on the timetable because of the Department of Health's failure to meet its timetable on the White Paper, which we expected in September, were told we would get in October and were promised in November. Will the Secretary of State assure us that we shall have it before Christmas? Is it true that the Prime Minister is so dissatisfied with the White Paper that he has taken over the drafting? Does that mean that the Secretary of State will be overruled on this, as he was on the formula one exemption? Will he assure us that his Department will not make as big a shambles of this as it has of the tobacco advertising directive? Today, his party's proposals have been contemptuously rejected at a meeting in Brussels, where he has succeeded in putting a new blocking minority in place.
Anyone who fought the election knows how important long-term residential care is for the elderly. People feel that it is desperately unfair that the present system often
requires them to sell their homes before they qualify for public funding, but we all know that, without a means test, public spending would soar, and, with an aging population, the problem is getting worse.
During the previous Parliament, the previous Government raised the means test threshold substantially and, in May 1996, they published a White Paper entitled "A New Partnership for Care in Old Age". We proposed a partnership scheme to encourage people to take out insurance, enabling them to protect an additional £1.50 of assets for each £1 of insurance. Our Community Care (Residential Charges) Bill would have achieved that.
As the royal commission will take some time to report, will the Secretary of State consider bringing that Bill back before the House as a Government Bill, because it would give relief to many elderly people who will not be able to afford to wait for the royal commission to report? Will he ensure that the Bill's proposals are put before the royal commission?
We know that about 5 per cent. of 75 to 85-year-olds and 20 per cent. of people aged over 85 go into care for an average of about three years, at an average cost of £15,000 to £20,000. Does the Secretary of State agree that that is a clearly insurable risk, and that the solution in the long term must lie, at least in part, in greater private provision, via increased saving through pensions or life insurance, or some similar arrangement? Will he ensure that the royal commission examines how private savings might help to finance long-term care for the elderly, whether such provision should become a required part of people's pension packages, and, if so, how that might be encouraged?
Saving against the possibility of requiring long-term care through a working lifetime is feasible for a great many people, but it will take a generation to have a noticeable effect. Does the Secretary of State agree that we need schemes now that will enable more people to bear the costs of their care, while protecting their assets from the means test? Will he ensure that the royal commission looks carefully into possible ways to achieve that?
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