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1.17 am
The Minister of State, Department of Health (Mr. John Hutton): I congratulate my hon. Friend the Member for Hemel Hempstead (Mr. McWalter) on choosing the subject of residential care for this debate, and also for the way in which he has spoken up for some vulnerable people in his constituency. How we as a society provide for the care needs of older people is a hugely important subject. We live in an ageing society--which is something to be celebrated--and it is therefore right that we look critically at every aspect of our system of providing long-term care for older people, with a view to improving choice in, and the quality and flexibility of, those care services.
My hon. Friend has expressed a number of specific concerns about the provision of residential care services in his constituency and the proposed closure of Gadebury house, in Hemel Hempstead. I shall try to deal with those concerns later in my speech. I think that it would be helpful if I were, first, briefly to spell out the Government's wider policies on residential care, to explain to my hon. Friend the background and context within which residential care services should be planned and delivered.
My hon. Friend may be aware that there are about 30,000 residential and nursing homes in England, providing a range of services for almost 500,000 people. The vast majority of those homes are now being operated by the independent sector. Less than 20 per cent. of residential homes are operated by local authorities. It is the responsibility of local authorities to plan and to commission a suitable range of services to meet the needs of local communities.
The Government's responsibilities are, first, to set the right policy and legal framework to regulate and improve the quality and standards of care being provided in care homes; secondly, in partnership with employers, to develop the appropriate training necessary for the social care work force; and, thirdly, to provide adequate resources to local authorities to allow them properly to fulfil their social services responsibilities.
As my hon. Friend has acknowledged, the Government have started a major programme of reform and modernisation in all of those three key spheres. Many of the reforms were described in the White Paper,
"Modernising Social Services". Our main ambitions are to improve the quality of social services and the protection afforded to vulnerable people and better to promote the independence of those who need to use those vital public services.
The Care Standards Bill contains many of those proposals, including the establishment of the new independent regulation and inspection arrangements and the introduction for the first time of a proper framework of national standards for care homes. The new National Care Standards Commission, which my hon. Friend mentioned, will take over from health and local authorities the responsibility for registering and inspecting residential and nursing homes, closing the loopholes that exclude many homes from any effective monitoring. For the first time, all local authority-run homes will be subject to independent quality control and monitoring.
The commission will inspect and register homes against a new set of national minimum standards for the first time. National minimum standards should help to ensure that poor standards and shoddy treatment are rooted out for good and that all residents in care homes, irrespective of which part of the country they are in, will be afforded the same protection and access to decent services.
In September last year, the Department began a consultation exercise on a proposed set of standards developed by the Centre for Policy on Ageing. The consultation ended in January and we are considering our response. The Department received 1,400 responses to the consultation on "Fit for the Future?".
We have made it clear that we want the final set of standards to reflect best practice in ensuring a quality care environment for older people. The standards will be realistic and affordable and will give care providers a sensible time in which to make any necessary improvements in the care home. The national minimum standards will, at the least, depend on the new National Care Standards Commission being fully operational, which will not happen before April 2002. Some of the standards, particularly the more challenging ones relating to the physical environment of a care home, will not be introduced until some time after the commission has started its work.
It should be clear that there can be no substance to the claim that the "Fit for the Future?" proposals by themselves provide any justification for the closure of the care home in my hon. Friend's constituency. We have not yet fixed the final set of national standards, and in any case some of them are several years away from being implemented. The effective planning and commissioning role of local authorities is central to the exercise, because they have the main responsibility for ensuring that the social care needs of their communities are properly met. Many of my hon. Friend's comments addressed that issue.
The previous Government's devotion to the privatisation of care provision put dogma before the care needs of service users and threatened the fragmentation of vital care services. However, it is equally true that the near monopoly of local authority provision that used to be a prominent feature of social care frequently led to a "one size fits all" approach, with users being expected to accommodate themselves to the services provided, regardless of their needs and preferences.
We want to put those bogus distinctions and arguments behind us and move on. We want to move the focus away from who provides the care and place it firmly on the
quality of the services experienced by, and the outcomes achieved for, individuals and their carers and families. We do not take a rigid position on whether services should be provided directly by local authorities or by the independent sector. It is the quality of the care provided that counts.
Decisions about the provision of residential care services in Hertfordshire were taken several years ago, as my hon. Friend made clear. That included the decision to transfer the existing residential care homes operated by the county council to Quantum Care, which is a not-for-profit organisation with an excellent reputation for providing quality care to older people.
The role of my Department is to ensure that the local authority has in place proper mechanisms for the effective discharge of its statutory responsibilities and that the people of Hertfordshire receive high-quality social care services.
The social services inspectorate provides a powerful monitoring and inspection role to ensure that both those objectives are met in all parts of the country, including my hon. Friend's constituency, but it is not my Department's role to overrule local decisions made by social services departments or to intervene directly in decisions made by care home providers to continue to operate a particular home.
I understand that Gadebury is closing because it does not meet existing registration standards set by the county council. It is always distressing for residents when a care home closes, so it is enormously important that the upheaval be handled with sensitivity and respect. I understand that every effort is being made to ensure that the residents are found suitable alternative homes that fully meet their choices and care needs.
The new regulatory system will certainly provide stronger powers to monitor the financial viability of homes and will ensure that residents have contracts that clearly spell out their rights--a matter to which my hon. Friend rightly drew attention.
The present situation regarding training is completely unacceptable, as I am sure that my hon. Friend will agree. The social care work force is nearly 1 million strong, but currently 80 per cent. have no formal social care qualifications whatever. The Government have set up a
national training organisation for social care, the training organisation for personal social services--TOPSS--which is developing a national training strategy.
We have substantially increased the training support grant, which is now more than £120 million, to support social care training provision. The Care Standards Bill is also setting up a new general social care council. We are taking urgent action to improve training, which will in turn lead to improved care for those in residential care homes.
Hertfordshire's standard spending assessment for social services is increasing by 5.8 per cent. this year, which represents nearly £165 million and is more than twice the rate of inflation, compared with an average increase of 5.1 per cent. nationally. We are providing record resources to the council to allow it to provide effective social services.
In all the three areas to which I referred at the beginning of my remarks, the Government are taking action to improve the quality of social services, and we will continue to do so, because those vital services can be a powerful force for good, performing crucial functions that are fundamental to any decent and compassionate society; but social services are local services, and it is for local councils ultimately to take responsibility for how the resources are used in the front line.
My hon. Friend raised his genuine concern over the decision to close Gadebury house and transfer the residents elsewhere. I fully understand and respect his concerns, and I will be happy to meet him at any time in the future to discuss them in more detail. I will, in particular, draw his remarks about the sale of local authority assets to my right hon. Friend the Minister for Local Government and the Regions.
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