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Mr. Archy Kirkwood (Roxburgh and Berwickshire): It is very interesting that the Department has received 800 responses as a result of Sir Stewart Sutherland's excellent piece of work. Does the Minister know off-hand how many that he received were in favour of the minority recommendation of the royal commission?

Mr. Milburn: I do not know the answer. I know from my discussions with Sir Stewart that he, too, has been receiving a fairly weighty postbag. I guess that many right hon. and hon. Members have as well. We need to consider extremely carefully the range of views that have been put forward by a full range of organisations and individuals. We need also to consider the royal commission's recommendations.

Miss Julie Kirkbride (Bromsgrove): Can the Secretary of State tell us how many of the responses that he has received support the recommendations set out in the majority report? Perhaps he could give us a guide rather than an absolute number. Is it 50, 60 or 70 per cent. Can the right hon. Gentleman give us an idea or a clue?

Mr. Milburn: It is so tempting to guess from the Dispatch Box. On balance, however, that is a temptation

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that I shall probably avoid. [Interruption.] I know that Liberal Democrats often guess about policy issues but it is probably wiser that the Government continue to take a considered view of these issues.

Since March, the Government have been taking action to improve long-term care. We are improving services by allocating £140 million over three years to help fund respite care as part of our new national carers strategy. We are providing local authorities with special grants totalling almost £300 million this year to encourage them to help older people return to independent living and prevent their unnecessary admission to institutional care. We are extending direct payments to people aged 65 and over as well as to the parent carers of disabled children.

Our approach recognises that any system for funding long-term care must be part of a wider policy of support for older people. Over the next year we shall extend this programme of support for older people still further. For too long older people have found the care system a bewildering maze full of differing rules and confusing criteria for access to services. There has been a lottery in long-term care just as there has been one for health care. The Government are determined to tackle both.

Rev. Martin Smyth (Belfast, South): Has an assessment been made of the pressure upon both the independent and voluntary systems at this stage when we are emphasising community care? So many statutory homes throughout the country have been closed and people are puzzled about what the future holds for them.

Mr. Milburn: I understand the concerns of the residential care sector. I shall be coming to that. However, I do not accept that there is a wholesale crisis in that industry. The hon. Gentleman should remember that over the course of this year, next year and the following year, social services budgets are being increased by more than 3 per cent. in real terms, with an extra £3 billion going to them.

Miss Kirkbride: Not in Worcestershire.

Mr. Milburn: The hon. Lady says that she wants more for Worcestershire. She should have a word with the Conservative Treasury spokesmen. They are always telling us that our spending plans are reckless, madness and irresponsible. The Conservatives, Back Benchers and Front Benchers, cannot have their cake and eat it on these spending issues.

We will be taking four important steps to ensure greater fairness and transparency in the care system. First, today we are honouring another manifesto commitment by publishing a new charter for long-term care. [Interruption.] The hon. Member for Sutton and Cheam (Mr. Burstow) scoffs. I think that it is an important idea to honour manifesto commitments. Does the hon. Gentleman not agree? "Better Care, Higher Standards" will for the first time give people who need long-term care the information that they need to know what they can expect from their local health and housing authorities as well as social services.

The charter will require local health, housing and social care agencies to implement local charters by June 2000. In that way everybody will know what to expect,

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how they will be treated and where to go to get effective help and advice. Annual public satisfaction surveys of services covered by the charter will be published.

As we know from our postbags and surgeries, many people going into long-term care, and their relatives, are naturally anxious and worried about their future. I hope that the new approach to setting standards will ease some of these worries and ensure that people receive a higher quality service at this crucial time in their lives.

Mr. Edward Leigh (Gainsborough): It is all very well talking about charters, but the Prime Minister spoke about these issues in the most inflammatory terms during the general election. He said that we, the Conservatives, were


and that pensioners deserved better than that. There is a royal commission report, and the Secretary of State passed over it in about four minutes. It was allowed to gather dust for six months. Is it true that the report will never get out of the long grass because its recommendations will be too expensive?

Mr. Milburn: I would be extremely cautious if I were the hon. Gentleman. As I remember it, he served as a Minister in the previous Government. They established a royal commission on criminal justice. It was set up in June 1991 and the final Government response was made in June 1996--five years later. If the hon. Gentleman will wait a moment or two, I shall set out very clearly the timetable for our response. It will be far shorter than the previous Government managed with their royal commission.

Mr. Paul Burstow (Sutton and Cheam): Will the Secretary of State confirm that the announcement he has just made about a long-term care charter is about providing guidance to local authorities to draw up their own local charters? Will he confirm that that was a policy of the previous Government, when they required local authorities to produce community care charters? Is his announcement not just a relabelling and recycling of old policies?

Mr. Milburn: No, that is not true. We want to ensure that there are clear national standards in all areas--in the national health service and in social services, too. The hon. Gentleman will be aware that, last week, the Minister of State, Department of Health, my hon. Friend the Member for Barrow and Furness (Mr. Hutton), published new information about the performance of individual social services authorities. I take a fairly fundamentalist view on this issue. I believe that the people who pay for and receive such services have the right to know how well they operate or, in some cases, how poorly they operate. We shall continue the drive to make such information available, not just locally but nationally.

Mr. Frank Field (Birkenhead): Will my right hon. Friend give way?

Mr. Milburn: Yes, but I will get on to my second point.

Mr. Field: If we publish information about how well local authorities do, is it not important that it is accurate

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and up to date? Is it not true that the information recently published on Wirral social services was grossly inaccurate on the improvements that Wirral has made not only during the period of the inspection, but, much more importantly, since the inspection?

Mr. Milburn: I am reliably informed by my hon. Friend the Minister of State, Department of Health that the Wirral local authority not only provided the information that was published, but that it was invited to comment on the draft publication. My right hon. Friend's point is not quite accurate.

Mr. Field: Wirral made comments, but damn all effect they had.

Mr. Milburn: We shall look into that issue, but I am now determined to move on to my important second point; it is only the second out of four.

Secondly, early in the new year, we shall consult on new guidance to give everyone fairer access to social services. We want to iron out the unacceptable variations that exist at present and to create a fair set of rules and procedures that everyone can follow and understand. The aim will be to achieve greater consistency between local authorities in the way that they apply eligibility criteria for accessing all adult social services, including long-term residential care. Importantly, the guidance will stress the need to align social services criteria with NHS continuing health care criteria. It will also stress the need to agree eligibility criteria with housing agencies to ensure a properly co-ordinated response to people's needs.

Thirdly, we also want the care provided to older people by the health service to be of a higher standard in future. Older people are entitled to be treated with dignity and respect wherever they use the NHS. They are entitled to have fair access to health care; age discrimination has no place in the modern national health service that we seek to establish. That is why next year we shall publish a new national service framework for older people. For the first time, we shall lay down clear national standards, defining the treatment and care that older people can expect in all settings--whether in hospital, general practitioners' surgeries or from social services--as they move from hospital into care or back home.

The national service framework will be ready next year for implementation by April 2001. In the meantime, we are making good progress in eliminating mixed-sex accommodation in the NHS, which many old people feel--I agree with them--threatens their dignity and self-respect.

Fourthly--[Interruption.] The hon. Member for Roxburgh and Berwickshire (Mr. Kirkwood) is having difficulty counting, but this is my fourth point. Fourthly, we want to ensure higher quality in all aspects of care. We are currently consulting on draft national minimum standards for residential and nursing homes. Final standards will be published next year. The quality of care provided in people's own homes, however, is not currently regulated at all, so in the new year we shall launch a consultation exercise on possible new standards in that area.

The setting and enforcement of standards of home care providers will be central to our drive for higher quality social care services. Other elements will include the first

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ever quality strategy for social care, together with improvements in the training, qualifications and regulation of the social care work force, far too many of whom remain unqualified.


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