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3.56 pm
Mr. Simon Burns (West Chelmsford): I, too, broadly welcome much of what is in the Bill. However, a number of areas cause me concern. I believe that the Government could have improved the drafting, but that can be considered in Committee.
I also welcomed a great deal of what the Secretary of State said. One could not disagree with much of it. That also applies to the remarks of the right hon. Member for Holborn and St. Pancras (Mr. Dobson) and others. Clearly, any sane individual wants the very best care for their parents or the elderly.
I thought that the Secretary of State slightly spoiled an otherwise balanced and reasonable speech by claiming that nothing had been done in this area between 1979 and 1997. I believe that the Bill is yet another stage in a rolling programme of community care, and it is to the community care aspects of the Bill that I wish to devote my comments.
In the late 1970s and early 1980s, there was a fundamental shift in the way in which we sought to look after our elderly population, and rightly so. The old philosophy for the frail and the elderly, as opposed to the
elderly who needed medical nursing care, was to shut them away in hospitals--much as happened to those suffering from mental illness--where their quality of life was negligible. All they had was a dormitory-style bedroom with a bedside table and a lamp. That is not dignified for anyone. We were absolutely right to adopt a more enlightened policy on caring for these people.The main emphasis was to provide all the support possible where it was feasible for the elderly to remain within the security of their own homes, with support through social services and other agencies. Where elderly people were not ill but were too frail realistically to be supported or support themselves at home, they lived in residential homes.
As my right hon. Friend the Member for South Norfolk (Mr. MacGregor) said, we saw the development of many independent, privately owned residential homes as well as a local authority sector providing this form of care and help for the elderly. Many of these homes are of the highest quality. In many instances, the children of elderly people are looking in their localities to find a home that fits the requirements and needs of their parents or their elderly relatives. Like us all, they want the best quality care and home for their parents. They are not prepared to take second best.
However, it would be naive to say that every home in the private and local authority sectors is of the highest quality. Clearly that is not so. That is why it is probably right that we have a legislative framework to raise quality of care standards. However, that must be done sensitively and realistically.
To suggest that nothing has been done since 2 May 1997 is patent nonsense. With the change in philosophy of the community care programme, we saw a great deal done. The moneys given to local authorities to assist the policy have frequently been mentioned. Since then, as part of the developing programme, we have seen changes introduced where they have been needed. The Registered Homes Act 1984 was an important piece of legislation. Contrary to what the Secretary of State said, there was the important Burgner report of 1995. There was also the landmark speech of my right hon. Friend the Member for Charnwood (Mr. Dorrell) in October 1996, in response to the Burgner report, which set out what the previous Government proposed to do. That was followed by the publication of White Papers early in 1997.
If we had won the 1997 general election, we intended to introduce what was known to us as the great social security reform Bill. Fundamental changes were to be made. Many of them foreshadowed the contents of the Bill. In some instances they have been slightly changed and arguably improved upon with time and more consultation.
For example, we were going to remove local authority responsibility for inspecting private homes, when their homes were not subjected to the same regime. The Bill will rightly stop that practice because it is patently nonsense. All homes for the elderly should be inspected on a consistent basis. Similarly, we intended to introduce a national benchmark system. The Government have moved slightly further with their commission. Perhaps that is an improvement with hindsight, but it represents the same principle of seeking to raise standards.
We intended to enshrine in legislation the regulating of domiciliary care. That important issue must be addressed, and the Bill does that. That is why I broadly welcome many of the provisions set out in it. However, I am slightly concerned with some of the details. The issue uppermost in my mind concerns minimum standards and requirements for homes. The approach must be sensitive, responsive and flexible. Having read "Fit for the Future?", I have grave concerns about some of the suggested benchmarks, especially those relating to room requirements.
The Government could jeopardise a good intention and lose a good policy overall by becoming too bogged down in stipulating minutiae, which will place a significant burden on many homes without necessarily improving standards. I would argue that some of the requirements are patently ridiculous and that it would be absurd to introduce them.
As my right hon. Friend the Member for South Norfolk said, it would be ludicrous if, by being over-prescriptive, we were to put out of business many excellent residential homes because they could not afford to fulfil the requirements, or because they did not have necessary space to enable them to do so. That would cause an even greater problem than that raised by requiring them to raise standards. If they were put out of business, there would be no homes available for many people.
A suggested basic room requirement is that there should be
- at least 4.1 sq m for each resident (communal space must include a social room and a dining room).
- Single rooms, in current use, must have at least 10 sq m of usable floor space (12 for wheelchair users).
I assume that "single rooms" means bedrooms, and 10 or 12 sq m would be quite a lot of space in those rooms. Is it absolutely necessary?
I am concerned that, as has been mentioned by several hon. Members, these minimum standards will emerge as a result of the Government's consultations. Then, as the Secretary of State said, ministerial decisions will be made. However, as I understand it, they will not be enshrined in regulations that come before the House. Unless the Minister can correct or reassure me--
Mr. Hutton: The hon. Gentleman is wrong. Standards will be reflected in regulations, so the House will have the opportunity to debate them in the normal way.
Mr. Burns: I am extremely grateful to the hon. Gentleman. Is he saying that if minimum standard room requirements are to be prescriptive, including specific room measurements, they will be set out in regulations that come before the House to be debated?
Mr. Hutton: I do not want to take the hon. Gentleman's time. However, we shall have to await the detail of the regulations. To reassure him and the House, let me say that minimum standards cannot take effect unless they are reflected in the regulations. Standards will not have any independent, free-standing effect. They will
take effect only through regulations. If there is to be a 10 sq m requirement, that will have to be reflected in the regulations.
Mr. Burns: I am grateful to the Minister but I am still unhappy. Even if the regulations were to include minimum room space standards, they would almost certainly be subject to the negative resolution of the House. That means that they would not be amendable. If the House debates regulations and raises problems with them, a Minister will not say from the Dispatch Box or in Committee, "We accept what you say. We shall withdraw the regulations and bring in new ones." From my experience in the House, I know that Governments do not do that. I am surprised that the Minister is relatively laid back on this issue. Governments do not withdraw regulations and reintroduce them. They believe that when they publish regulations, they are the best on offer and should be implemented. I am worried because I think that grave hardship will be caused to many extremely good residential homes, which we do not want to put out of business.
There are problems with local authority homes. Local authorities have said over the years that they have not had the financial resources to improve and enhance their residential stock. If they have to upgrade their properties to meet minimum standards--in reality, probably for the first time--either they will have to close them because they do not have the necessary resources, or their budgets will be strained even more unless the Government are content to provide additional funding.
Much of the Bill is broadly welcome in principle. I have raised some issues on which the Government must listen carefully. They must listen to the responses to their consultations; they must listen at the Committee stage and take account of further comments--notwithstanding the fact that the measure will have already gone through that process in another place. We all want to make sure that the measure is right; we do not want to score political points. We are united in our belief that standards for the care of the elderly are of paramount importance.
Parallel to that, and of more immediate concern to many elderly people, is the Government's response, later this summer, to the problem of long-term care. Many elderly people and their families confront that problem not in relation to the home in which they live--where many will be content--but in relation to paying for it. They want to know what the Government will do to improve the present situation, because, over a period of time, it has become a mishmash.
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