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Ms Julie Morgan (Cardiff, North): I can assure the hon. Gentleman that the National Assembly for Wales is well aware of the scope of the Bill and intends to extend its scope as soon as it is passed.
Mr. Burstow: I am delighted that the scope will be expanded, but why wait until the Bill is passed? Why not establish the commissioner in the Bill?
Dr. Brand: It is possible for the National Assembly for Wales to expand the role of the newly named commissioner which, according to the Bill, will be exactly the same as the English equivalent. However, I can think of no legal ways in which this House will be able to expand the role of the English commissioner without further legislation.
Mr. Burstow: That is right. The Welsh Assembly does not have its own legislative powers so it will rely on this House to give it the additional powers needed to widen the scope. The Bill provides an opportunity now to put in place the necessary powers to enable the Assembly in due course to widen the scope, and that matter needs to be considered further. The hon. Member for Lancaster and Wyre (Mr. Dawson) recently introduced a ten-minute Bill which would have provided for a children's rights commissioner for England, and I understood that the same provisions would be made for Wales in this Bill. It now appears that that is not what is intended, and I hope that the Minister will explain what the differences will be in practice. It now appears that one will be called a commissioner and the other will be called a director, but they will exercise the same jurisdiction, functions and responsibilities.
Ms Julie Morgan: The National Assembly for Wales will add on advisory powers to the role of the commissioner, in addition to the powers given by the Bill, but will await additional legislation from this House to create the full commissioner role. The National Assembly sees the Bill as the first step in creating a full-blown children's commissioner in Wales.
Mr. Burstow: I am encouraging the Government to take several more steps to achieve the full intentions of the ten-minute Bill, which hon. Members on both sides supported. I hope that we can achieve that end, because many right hon. and hon. Members have campaigned for it for many years and felt that we were much closer to achieving it than we in fact appear to be.
When it comes to "Fit for the Future?" and the other national standards that will follow, I know that many care home owners and providers feel that the Government have failed to recognise that higher standards, better regulation and more training come with a price tag. Unless fee income can be increased, the numbers of providers leaving domiciliary care and residential care will continue to rise. Reducing choice and competition will result in lower standards. Providers will seek to pass on the costs of the extra obligations that are rightly being placed upon them in the form of higher fees and, in turn, social services departments will pass them on in higher charges or tighter eligibility criteria. Our aim has to be to protect vulnerable people from neglect and abuse and it cannot be right that we then present those very people with the bill for that service.
Only last week the Audit Commission published a damning report on unacceptable variations in the level of charges for non-residential services. The range is staggering. Nine out of 10 councils now charge, but it cannot be fair that two people with the same assessed
need for care and the same financial means can pay widely differing amounts for their care package--anything from no charge to £120 per week. What the Audit Commission found is yet another postcode lottery. I am not opposed to charging, but it must be based on ability to pay. It must also be fair and consistent, and personal care should be free on the basis of assessed need. The Audit Commission found that one in three councils are operating charging policies that leave pensioners with less to live on than income support. Far too many councils fail to take account of the costs of disability in their charging policies and, as a result, the most disabled service users face the highest charges.I have already asked my own council to benchmark its charging policies against the Audit Commission's report, pending the guidance from the Government that the Secretary of State said was imminent, but many local authorities feel that they have been left to stew when it comes to developing charging policies. Since publishing a White Paper in 1998, the Government have maintained a Trappist silence on the subject of charging policy. Local authorities have had to develop their charging arrangements in a policy vacuum. We were expecting an announcement in July, so I was heartened to hear the Secretary of State say that the Government will take the necessary powers in the Bill to give the necessary instructions to local authorities to stamp out the practices that the Audit Commission criticised. I am delighted that the dialogue that a delegation and I had with the Minister seems to have encouraged that change. We will work hard to support any such amendment as best we can, because it is wrong that pensioners can be driven into poverty by local authority charging policies.
Mr. Hammond: As the hon. Gentleman seems to have such a close understanding of the Government's intentions, does he understand that the Secretary of State intends to cap fees chargeable at a maximum or to introduce some standardisation? The latter would mean an increase in fees in those areas in which they are at present low or non-existent.
Mr. Burstow: At a delegation organised by the all-party disablement group last week, I raised with the Minister the need for the power to be included in the Bill. As the hon. Member for Woodspring (Dr. Fox) recognised in his speech, we now have a framework for progress, but it is mostly an empty box and we have to wait to see the regulations. Will we have to wait until July, or beyond that? Will we see change before the general election or will change have to await the outcome of that election?
As there has been a vacuum in non-residential charging policies, so has there been a vacuum in long-term care charges. The British Medical Association, in its briefing on the Bill, said:
It is a disgrace that, in this country, debt collectors should still be chasing after dementia sufferers for money to pay for their care. Liberal Democrats support the royal
commission's main recommendation. Personal care should be free on the basis of assessed need. Location should not matter when people need intimate care such as bathing, dressing or feeding: that care should be free.The Bill deserves a Second Reading. It has been improved in the Lords, but serious questions remain. I hope that the spirit of co-operation that characterised deliberations in the other place will inform our examination of the Bill in Committee.
Mr. Hutton: I am grateful to the hon. Gentleman for giving way, and for sharing with the House that information about his party's policy on care issues.
The hon. Gentleman said that he supports the principle of free personal care for people receiving residential care, but he has confirmed his party's view that it is acceptable to charge for domiciliary care. He also said that he understood that there was a justification for charging in that respect.
Mr. Burstow: When the Minister reads Hansard, he will see that I also made it clear that the personal care element of non-residential care should be free. As the Minister is interested in our policy, I will ensure that a copy of the policy statement from our last conference is sent to him so that he can inform himself more about the matter. It is appropriate for Liberal Democrats to set out where we stand on this issue. Too often, we are criticised--unfairly--for not stating what our policies are.
As I said, the Bill deserves a Second Reading. The public require a system that promotes dignity and independence by providing the support and help that people need, when they need it and in the way that suits them best.
Mr. Tom Clarke (Coatbridge and Chryston): I have listened to the debate with mixed feelings. I am truly delighted that the Government have introduced this Bill. It demands our support, and it enjoys the overwhelming support of the organisations working in the sector. However, I must admit that until my right hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson) and my hon. Friend the Member for Wakefield (Mr. Hinchliffe) made their contributions, I had a feeling of deja vu. We know that there are problems, but the House seemed determined to stick at the detail of the proposals.
I have been a Member of Parliament since 1982. I must tell the right hon. Member for South Norfolk (Mr. MacGregor), with great respect, that he did not ask a single question that has not been answered in report after report. The reports compiled by Sir Roy Griffiths and Lady Wagner are especially relevant in that respect. Given the problems that remain, and the fact that demography is making them worse, it is intolerable that we are not prepared to make progress until every detail of cost has been spelled out. It is as if the House were filled with accountants who are unaware of the vision needed to make progress and meet the day-to-day challenge of improving the lives of the vulnerable people whom this Bill seeks to help.
My right hon. Friend the Member for Holborn and St. Pancras was right to say that many people give the impression that we should do nothing, despite the evidence to the contrary. More than a decade ago, Sir Roy Griffiths said that the status quo was simply not an option with issues such as this. If that was true then, it is even more so today.
I realise that cost is important and, if I have time, I hope to deal with the question of resources, but there is a danger that those who know the price of everything and the value of nothing will prevail. I welcome the Bill because it will allow progress to be made in such sectors as community care and child care, and in the provision of protection for vulnerable adults. That progress will not come a minute too soon.
It is said that the public despair of Parliament, but they do not do so because of our power, influence and democratic role in society. People despair at the way in which we go on and on, nitpicking and debating questions to which they know the answers. For example, Mencap gave a wonderful briefing today, at which it described the problems faced by young people with learning difficulties, and set out the need for proper regulation and inspection of their institutional care. However, many of the points that it made are ones that it has made for years.
We must move on and implement the proposals contained in the Bill. I welcome the proposals for long-term nursing and social care for older people and for disabled people. I welcome the Bill's approach to services for children in special care. I welcome the proposals regarding care provided for people in their homes, as a result of which an extremely important component of modern community care will be subject to statutory regulations.
The proposed National Care Standards Commission is profoundly welcome, and long overdue. It will ensure that local circumstances are seen as part of a bigger picture. It is absolutely right and perfectly reasonable for the Bill to encourage the commission in the establishment of minimum standards. I am more and more convinced that what matters is our response to the needs of individuals, especially the most vulnerable. In all candour, I can tell the House that, if asked to choose between the views of service providers and those who need the services, I am on the side of the latter.
It is entirely unacceptable that four in 10 councils do not carry out their inspection duties with regard to adult care. That is an argument for minimum standards in itself, and there are other examples of where improvements must be made. Do needs vary that much? I respect the rights of every individual, and acknowledge that every individual is unique, but what does the Bill seek to achieve?
The aim behind the Bill is to provide a clean and healthy environment for people, to offer comfort, acceptable standards of hygiene, a sensitive response to the problems caused by double incontinence, and a social environment in which people can feel wanted, and loved. That is not too much to ask. If the House can support those aims through legislation and regulation, that is what it should do.
It is absolutely right for hon. Members to criticise the work that is going on, but the House must remember that examples of best practice in all the matters that I have set out can be found in many parts of Britain. I am sure that all hon. Members want that best practice to become the norm.
I unreservedly welcome the Bill's proposals on training for care workers and social workers, and the proposal for general social care councils. The point has been made more than once in this debate--as it was in another place--that 80 per cent. of care workers have no recognised qualifications. That is an important point, but I invite the House to consider the other side of the coin: this country has depended for many years on people such as auxiliaries, cleaners and home care workers to deliver those vital services. In many cases, they make a sterling contribution to the life style and quality of life of the people with whom they work.
I hope that we can put right problems to do with training, but also that we can do so with a sense of appreciation of those people who are so committed to helping others in so many ways, often without much in the way of financial reward. Moreover, what I have just said about that 80 per cent. of people and their dedication applies to many social workers as well. I hope that that does not make me sound too much of a populist.
Let me turn to the provisions on the very important issue of child care. I had the privilege of leading for the Opposition during the passage of the Children Act 1989. My hon. Friend the Member for Wakefield (Mr. Hinchliffe) made an outstanding contribution. The Minister at the time was David Mellor who, in my opinion, was excellent, not least because he was prepared to listen. I know that Ministers will listen to the points made by the hon. Member for Sutton and Cheam (Mr. Burstow) and others who support the principles of what we are seeking to achieve but who, quite rightly, will question the detail and put forward better ideas if the opportunity is there. I hope that we will continue in a spirit of optimism and progress.
My overwhelming recollection of the passage of the 1989 Act was the dreadful evidence of the inquiries into Cleveland, the Orkneys and elsewhere. I listened to the social workers and took the view that for many it was a case of "damned if you don't and damned if you do". That does not excuse the House from its responsibilities, which are addressed in the Bill.
I welcome the proposals for introducing a children's rights director, for protecting vulnerable children, for introducing the National Care Standards Commission and for the regulation and inspection of children's homes. Such proposals are extremely welcome and long overdue. The same is true of plans for fostering agencies, voluntary adoption agencies and, above all, for removing the exemptions on children's homes. My hon. Friend the Member for Wakefield sought to do that, and was in some measure successful, when the 1989 Act was before the House.
I could not welcome more warmly the new duties to be placed on those involved in looking after children aged between eight and 14, or 16 in the case of disabled children and, as Mencap points out, children with learning difficulties. Providers should be obliged to demonstrate that they and their employees are suitable to deal with such serious responsibilities in child care. Few occupations could be more important. I am glad that the issue is being addressed in the Bill. I have no doubt that, as it goes through its various stages, the provisions, acceptable as they are in principle, can be improved still further. That can do Parliament nothing but good.
I recall my days in local government and my work on a social work committee for children. I end this part of my speech by reflecting on a conference on children that I attended many years ago. It was addressed by a lady who, happily, lived a long life and was active in another place, Lady Elliot, who gave so much to the National Society for the Prevention of Cruelty to Children. What she said then is just as profound and relevant today. She said:
Finally, I turn to the provisions on home care. Because care in the community is so dependent, and rightly so, given that so many people continue to exercise their right to stay at home, we must ensure that services are available, that they are properly scrutinised, and that the people who benefit from home care have a say in service delivery.
In the past few days, I visited Mr. Muldoon in my constituency. Until Christmas, he was a perfectly able man. He became disabled within a matter of weeks. He is now trapped in his bedroom; he is not able to use a chair lift--there are none--and there is no ramp at the door. He wants to get out and meet the bowlers and the people with whom he shares his life. I accept that when it comes to resources, even in my constituency, my local council has difficulty in delivering.
We are talking about carers and about some people who will not understand what we are seeking to do in the Bill unless it really impacts on their quality of life. Mrs. Walker, who runs a carers' organisation in my constituency, drew to my attention the case of a person who suffers from schizophrenia who, because the nurse was on holiday, did not receive medication for five days. I hope that if these policies are pursued by the Scottish Parliament--because I realise the Bill's limitations--such problems will no longer occur.
I end my speech by welcoming the Bill.
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