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Mr. Philip Hammond (Runnymede and Weybridge): I thank the Secretary of State for his statement and for his courtesy in letting me see it in advance. However, I cannot help asking myself why the Government chose today. The White Paper has been trailed since the spring and we are told that it has been ready since the summer. It was extensively leaked in September and the right hon. Gentleman has already had one bite at the cherry in his statement last month on children in care. Now, what a coincidence it is that he has chosen to release his rather predictably entitled White Paper on the day of an important debate on the Government's constitutional proposals--a debate that the control freaks and spin doctors in Downing street would rather not have had and are desperately trying to curtail.
I shall be as brief as the importance of the subject will allow. The Utting and Burgner reports were commissioned by the previous Government. We welcome any effective measures to protect the vulnerable--young or old--from abuse. However, inspection is about more than preventing abuse; it is about ensuring quality and we welcome the level playing field that will be achieved by the establishment of an independent inspectorate for local authority and private and voluntary sector provision alike. Can the Secretary of State confirm that the same standards will be applied identically to both sectors? Can he further confirm whether the inspectors will have power to investigate value for money? Will they be able to close down facilities that offer poor quality at a high cost?
Some local authorities persist in offering direct provision of residential care, which can be 40, 50 or 60 per cent. more expensive than comparable private sector provision. What will he do about the obscenity of high-cost, low-quality care, which some local authorities provide on a captive basis while many of the people who are assessed as needing residential care have to wait on a list to fill dead men's shoes?
Will the Secretary of State assure the House that inspectors will have no power of entry to individuals' private homes? Even the Government who brought us the beef-on-the-bone ban must recognise that a compulsory power of entry to an individual's private home on the sole grounds that he needs domiciliary care is a step too far. An Englishman's home must remain his castle, even when he needs support from social services.
As performance standards will be set and monitored by the commissions for care standards, will the right hon. Gentleman explain how local authorities and councillors will in practice be held accountable, as he said in his response to the Utting report that they would? Will he confirm for the record that the £750 million that he announced today is part of the £3 billion that he announced at the time of the comprehensive spending review?
Does the right hon. Gentleman accept that, in many areas, private and voluntary sector providers are struggling to maintain quality, as local authority social service departments refuse to allow fee increases even at the rate of inflation? Will he require that private providers receive recognition for good practice, such as investing in increased staff qualification levels through premium payments?
In most cases, local authorities are not squeezing private providers because they want to. Does the right hon. Gentleman recognise that whatever he says today about raising standards will be meaningless if the revenue support grant settlement to be announced shortly further savages the budgets of many local authorities in the south-east, where residential care costs are high and rising sharply? Is he happy to see an increasing proportion of social services spending channelled under central control via health authorities, which further diminishes the responsibility of elected local government?
If the need for regulatory reform is so urgent, why has the White Paper been so delayed and why will there be no Bill in this Session? It is no good for the Government to tell us how important reform is; the Queen's Speech has just been delivered and we can judge the Government by their deeds, not by their words. Has not the Secretary of State been one of the losers in the great legislation lottery? The much-delayed White Paper is little more than his consolation prize.
Mr. Dobson:
I thank the hon. Gentleman for welcoming our proposals to raise standards and to establish an independent inspectorate to secure those standards. The inspectorate's job will be to ensure that top-quality services are provided everywhere.
Cost-effectiveness will be dealt with as part of the general best-value approach that we will introduce to local government and for which we will be legislating in this Session, as was made clear in the Queen's Speech.
The inspectors will seek to ensure that services are of the same standard, whether they are provided--I thought that I had made this clear in my statement--by councils, the voluntary sector or the commercial sector.
The hon. Gentleman mentioned inspectors of people's homes. We have no such preposterous proposal--it is a manifestation of the fantasies that fill the minds of leading members of the Conservative party. Social services, including voluntary organisations, deliver services--for which the public pay--into people's homes. Some of those services are not up to scratch, so we shall ask people voluntarily to comment on the standard of the services that they are receiving. That is a very proper function for an inspectorate. Nobody will be given powers of entry, or anything daft like that. We want to make sure that where social services are provided to people in their own homes, those services are subject to inspection and checking. That has never happened in the past--something that has been seriously wrong with the system.
On the duties of local authorities and councils, the basic duty--to deliver top-quality services--will lie with the local authorities. That will be their job. We have issued advice to elected councillors on how they can better go about their job of making sure that proper quality services are delivered for children in care and children in need. There will be an inspectorate, but it will not be responsible for the delivery of top-quality services; it will be responsible for checking that others are delivering those services. Private providers should get on with their job of making the necessary provision to the highest possible standards, subject to the regulation that everybody will face.
On channelling money to social services through the NHS, I am glad that we did it. That was one of the reasons why social services and the NHS worked so well together
last winter, and I hope that they will do the same again. Frankly, I cannot go to the Prime Minister and the Chancellor of the Exchequer and say that we need co-operation from social services and the NHS to look after people properly during the winter, and then not deliver that. If that has interfered with a few rights, but has meant that a lot of old people have been properly looked after, so be it.
A lot of the powers will be provided for in the best-value proposals, which will be in the Local Government Bill. Some matching powers and duties will be established in the national health service Bill. We are determined to get on with all the improvements as quickly as we can. As I say, I hope that people of good will will welcome them, instead of fantasising about people jackbooting into other people's homes.
Mrs. Llin Golding (Newcastle-under-Lyme):
The Secretary of State's statement will go a long way towards helping the most vulnerable in society. I welcome the introduction of a children's officer. Needless to say, I think that that is a step towards a children's commissioner, for which many in this House have been waiting for a long time. May I ask that the officer be given facilities for publicity on television and radio? In the past, far too many people with knowledge of abuse have turned their backs and walked away from that knowledge. If there is publicity and an officer is appearing regularly on television and radio, people will have less excuse for saying, "We do not know who to talk to or go to."
Mr. Dobson:
I very much welcome my hon. Friend's support, because she has played a prominent role for a long time in working to improve the standard of service provided for children, and in campaigning for a national children's commissioner. There are arguments for a national children's commissioner, and there are arguments for our proposal that it would be better done regionally. On balance, we have come down in favour of the regional option. Certainly, I want no one in future--either in social services or in the NHS--to have the excuse of saying, "Well, I knew things were going wrong, but there was no machinery to draw attention to the things that were going wrong." That is unacceptable--we will get rid of it.
Mr. Paul Burstow (Sutton and Cheam):
I thank the Secretary of State for his statement. Liberal Democrats also want action to raise standards of care--wherever and whoever they are being provided by. We welcome the right hon. Gentleman's warm words today about the importance and value of social care workers, in whatever sector. People outside this House will welcome his comments.
The Secretary of State has talked a lot about Berlin walls between health and social care. Why, therefore, does the White Paper fail to put in place a single seamless inspection and regulation agency to cover all aspects of health and social care? Social services are increasingly in the business of rationing care through care charges. How can health and social care services provide a seamless service when the NHS is provided free and universally, but social services are charged for and rationed?
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