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1.44 pm
The Secretary of State for Health (Mr. Alan Milburn): I beg to move, That the Bill be now read a Second time.
Nearly 2 million people in our country rely on social services--more than a million older people, 400,000 children and 300,000 disabled people. They--above all other citizens in our society--have a right to expect that care is available for them when they need it and that, wherever that care is provided, it is of the highest possible standard. That is as true for social care services as for health care services. For too long, social care has been the poor relation. It is time to change that; this Bill does just that.
Changes in society, growing public expectations, an ageing population and shifts in family structures make social care ever more central to the Government's ambition of a fair and decent society. Social services enhance the quality of life for some of the most vulnerable people in our society. Our task is to modernise those services so that they can provide our country with the best possible care.
Dedicated and caring staff try to do just that. Thanks to their efforts, standards of care are often good, but sometimes--too often--they are not. Countless reports and inquiries have highlighted the weaknesses and failings of the safeguards that are supposed to protect vulnerable people, especially children. The most recent and devastating example is the Waterhouse report, presented to the House by my right hon. Friend the Secretary of State for Wales a few weeks ago.
At the heart of the Bill lies the concern to drive up standards of care, not only for the almost 2 million people who rely on social services, but for the 900,000 children reliant on early years services and for the 800,000 patients using private hospital services. In this day and age, the public should know that those who provide crucial services are competent and well trained, that clear quality standards will be set and enforced and that those most in need of protection are properly safeguarded. The Bill will enable us to make real progress on each of those matters. It is based on the philosophy that what counts in service provision is the quality of care that the public receive.
The Government have already set up a major programme of reform to raise standards in both health and education. The Bill applies that same approach to those other vital services for the public. The fundamental reforms that it sets in place are long overdue. The regulatory system that we inherited was a mess. It failed to provide adequate protection from abuse; it was characterised by a lack of consistency, independence and coverage.
First, there were no national standards and no consistency of approach. The regulatory system was fragmented, with 250 separate local inspection or registration bodies, all operating according to their own rules. That helped to produce a lottery in care. The new system will mean less rather than more bureaucracy.
Secondly, the essential ingredient for successful regulation--independence--was severely compromised under the old arrangements. Local authorities inspected independent care homes at the same time as purchasing most of their services. Worse still, council-run care homes were exempt from statutory regulation and subject to inspection only by their own staff. Such a system could never guarantee residents either the peace of mind or the quality of care that they deserve.
Thirdly, some services--most notably, home care services for elderly and disabled people--were subject to no regulation whatever, with all the potential for abuse that that allowed. Where there was regulation, it was often ineffective, because, more often than not, it was inappropriate, especially in the way that high-tech private hospitals were regulated as though they were low-tech nursing homes.
Fourthly, there was no professional regulatory body dedicated to overseeing standards and practice in the social care sector. There was no organisation, such as those in other fields, to take a lead on driving up training and standards of care throughout the work force. Despite the overwhelming consensus on the need for such a body, the previous Government set their face against it; they refused to listen and refused to act.
In my view and that of many other people, those were shameful failings in the previous system of regulation. The record of the previous Government was one of neglect and complacency. They were so mesmerised by the market that they became careless over standards.
I should have expected the Opposition to have learned their lesson--not least because of the all-too-glaring failings in the regulatory system. Their amendment shows that, sadly, they have not. They remain as blinkered as ever. When asked to choose between safeguarding the public or protecting the providers, they made the wrong choice. They are reinventing their history and not learning from it. Theirs is a record that this Government are determined to put right.
Alongside the other measures that we have already introduced--the new flexibilities for health and social care to work together, the best value programme to drive up standards and the quality protects programme to protect the most vulnerable children in the care system--this Bill will put in place new arrangements for ensuring excellence in vital care services. For no one are these guarantees more needed than for elderly people. Older people are entitled to be treated with dignity and respect wherever they use health or social care services.
I take very seriously the criticisms that have been made of the current system of care. Age discrimination has no part in a modern care system. That is why--alongside the measures that we have already introduced to raise standards in the national health service through the Health Act 1999 and the measures contained in this Bill to raise standards in other care services--later this year, we will publish our national service framework, which will set new tough enforceable standards for the treatment and
care of older people wherever it takes place. I expect all parts of the care system to rise to the challenge of meeting these standards of care not just sometimes but always.These twin pieces of legislation--the Health Act 1999 and this Bill--will revolutionise the standards of care provided for older people and for others who use the care system. Our ambition is this: whatever health or social care service people receive wherever they receive it--and whether it is public or private--they should be assured that the care will be safe, will meet proper quality standards and will be delivered by skilled and competent staff.
Mr. Desmond Swayne (New Forest, West): Will the Secretary of State acknowledge that the draft standards that have been issued for care homes have not been reassuring? They have filled care home providers with horror at the thought of the burden of regulation that may fall on them, and they are the only examples that the providers have seen. Will he acknowledge that it will do little for elderly people if their providers are driven out of business?
Mr. Milburn: Good providers have absolutely nothing to fear from the standards that we set out in "Fit for the Future?". As he knows, there has been detailed consultation. We received well over 1,000 responses, and we shall respond to them in due course. As the Minister of State, Department of Health, my hon. Friend the Member for Barrow and Furness (Mr. Hutton) has said to the independent care home sector, we shall be sensitive about the way in which we phase in the changes to ensure that the standards can be met. However, the hon. Gentleman would expect, as I would, the highest possible standards of care for our elderly relatives. There should be no compromise on standards of care. However, he and those on the Opposition Front Bench are making the same mistake that they made for 18 years--they are more worried about the providers than the users. It is the users of services who count.
Mr. Paul Burstow (Sutton and Cheam): On the point about demanding higher care standards, will the Secretary of State tell us when the care assistants who work in care homes and in domiciliary services will come under the registration scheme for the General Social Care Council? Until they do, the policing of the standards will not be absolute and will therefore not give confidence to many people.
Mr. Milburn: The hon. Gentleman asks a good question. I shall discuss the General Social Care Council shortly, but he knows that there has been no such system of registration in the past. We shall have to phase in the scheme for a very simple reason. Some 80 per cent. of the staff who provide social care services have precisely no qualifications whatever. That is appalling. There is an enormous training deficit and a skills deficit that will have to be tackled if we are to ratchet up the standards of care in the way that we want. We will begin the registration process with those--the social workers--who have recognised qualifications, but we want to move as quickly as we can to register others who are professionals in their own right, but who have not had the training input that they require.
We shall do that as soon as we can, but that depends on our being able to implement our training strategy for social services. We have the right approach, we are
making the right investment and we have the means to register staff in a way that they should have long since been registered.
Mr. Geraint Davies (Croydon, Central): Does my right hon. Friend agree that the new initiative offers the private sector new opportunities to provide a range of services for elderly people, particularly for short-term rehabilitative care, as well as to carry out the traditional role that it has now established? There is a growth in demand for such services and in places such as Croydon where there is a lot of provision, the private sector will welcome the opportunity to provide a range of service and the fresh demands and higher standards that that opportunity will bring.
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