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Mr. Burstow: My hon. Friend is absolutely right. Earlier today, Methodist Homes came to Portcullis House and staged a short play to demonstrate that if we are serious about people-centred care and about removing the divide between health and social care, we need to focus on individual needs. Unfortunately, maintaining a charging system for personal care makes it impossible to provide seamless care to the individual, and the result is discrimination against people with dementia, Parkinson's disease and many other chronic, long-term conditions. That undermines the Government's claim that they want a seamless service, because until they deal with the issue that the royal commission was asked to address, they will not achieve that seamless service.
Following the intervention by the hon. Member for Buckingham (Mr. Bercow), I want to tackle the Conservatives' policy, which he said is clear.
Mrs. Caroline Spelman (Meriden) rose--
Mr. Burstow: I will happily take the hon. Lady's intervention because I am interested to hear precisely what
the Conservatives' policy is and whether they will be sticking to the Government's spending plans for social services.
Mrs. Spelman: I can probably save the House a great deal of time by pointing out that during the Second Reading of the Health and Social Care Bill, my hon. Friend the Member for Woodspring (Dr. Fox) made it perfectly clear that we would match the Government on personal care and NHS funding. We share the hon. Gentleman's concern about the definition of nursing care.
Mr. Burstow: That is why I felt that the policy was not clear. What the hon. Lady said is as clear as mud. Taking their classic position, the Conservatives want it both ways; they want to be concerned about the definitions, and we share that concern, but they want to stick up for the Government's position on financing care rather than committing themselves to the necessary finance. Are they prepared to find the extra resources to deliver free personal care?
Mrs. Spelman: We may be taking things out of sequence. I shall make our position perfectly clear. I repeat that we will match NHS spending, as we said on Second Reading of the Health and Social Care Bill. My hon. Friend made it clear that we will match the Government's spending on the provision of nursing care, as more accurately defined, which I shall come on to later. When I make my speech, I will explain the reasons for that position.
Mr. Burstow: I am grateful for the hon. Lady's further clarification. She has told the House that she and her Front-Bench colleagues wish to sustain the capricious separation of definitions to which the hon. Member for Buckingham referred. By taking the position outlined by the hon. Lady, the Conservatives will stick with the definition, which the Government are introducing, of registered nurse time only and the costings for that. The hon. Lady has well and truly buried the Conservatives' policy on free personal care. The Government's proposals mean that there is no money in the system to provide free personal care, so the Conservatives will not deliver that if they stick to the Government's spending plans, unless they make lots of cuts to other services. I shall come on to that point later.
Until the hon. Lady intervened, it was unclear whether the Conservatives supported the status quo, an insurance- based system, which seems to be their preference for other parts of the NHS, or the Government's position. We now understand that, for the moment at least, their position is the same as that of the Government.
Where do the Conservatives stand on what I regard, using their language, as a stealth tax on the elderly and the sick? We have a tax that penalises people for being sick and disabled. It is clear from reading speeches in this House, the Lords and elsewhere that the Conservatives are all over the place, as we have seen this evening. Despite the hon. Lady's comments, it is hard to find a definitive statement by a Conservative Front Bencher that clearly sets out the party's position on the royal commission's proposals. Even during the Second Reading of the Health and Social Care Bill, the exchanges about the
Conservatives' commitment to social services spending made it clear that they were not prepared even to match the Government.
Dr. Jenny Tonge (Richmond Park): My hon. Friend is being very generous in giving way. Does he agree that it is interesting that the Conservatives' policy, announced today, to make tax free any income from savings for older people, contrasts rather badly with the continuing idea that older people must sell their home, which may be the bulk of their savings, to get personal care?
Mr. Burstow: My hon. Friend highlights another inconsistency in the Conservatives' health policy.
Speaking of inconsistencies, the shadow Health Secretary, the hon. Member for Woodspring (Dr. Fox), complained that Labour now has two policies on long-term care and talks of a two-tier health system, but he forgot to mention that a two-tier system is exactly the policy that his party now espouses. In Scotland, the Conservatives have supported the Liberal Democrats and backed the royal commission in full. They will play a part, with the Liberal Democrats and others, in securing free personal care in Scotland.
Until tonight, to find out the position of the Conservatives in England, one had to look to their lordships House for a definitive statement. We should thank Earl Howe, the Conservative health spokesman in the Lords, for setting out that policy. He confirmed that the Conservative party would stick with the Government and implement the same policy.
Mr. Patrick Nicholls (Teignbridge): The hon. Gentleman is characteristically generous. He seems to think that there is something slightly strange about the fact that there might be a difference of emphasis between Conservatives in Scotland and Conservatives here. In the other two Parliaments in this country, the Liberals keep the Labour party in power, but they are pretending today to be opposed to Labour.
Mr. Burstow: The hon. Gentleman should take up that point with the hon. Member for Meriden, who has effectively attacked his colleagues in Scotland for allowing the creation of a two-tier system. He should check his lines before delivering them in the House.
It is hardly surprising that Conservative Members are all over the place on the subject of our debate--they caused the mess. They closed long-stay wards in the 1980s and 1990s without a thought for the thousands of older people who would have received free NHS care, but were confronted with means-tested care. It was a cost-cutting measure that was dressed up, with warm words, as community care. During their 18 years in government, the Conservatives drew the boundaries of state-funded care ever tighter. Thank God they were not re-elected at the last general election; otherwise, the fate of the public sector would have been to act as the 21st century administrators of a new poor law.
Before the election, the Conservatives set out plans for a private, insurance-based solution to the problem of long-term care. They were complex and, as the royal
commission pointed out, it was difficult to perceive the benefits and to whom they would apply. The American experience of similar schemes shows that their take-up is low and that, in practice, many pensioners would be too old, too poor or too great a risk to qualify for immediate private cover.Those who oppose the royal commission's recommendation to scrap charges for personal care say that it would do nothing to improve services. They are wrong; they have accepted the Treasury mantra hook, line and sinker. Let us consider the report of the Scottish Parliament's Health and Community Care Committee, which undertook a comprehensive inquiry into the royal commission's proposals. It found evidence that convinced all its members that for health and social care to form a genuinely seamless service, the two systems of charging and assessment--indeed, the multiplicity of assessment systems around the country--should be brought together.
The Royal College of General Practitioners presented evidence to the Health and Community Care Committee's inquiry to show that people had refused the most appropriate care in the most appropriate setting because they would be charged. Removing the obstacle of charging would therefore ensure that people received the most appropriate care. That means a better outcome for them and their families.
The Government found money to pay for free television licences for the over-75s. No means test was used. Collective responsibility led to the provision of a welcome universal benefit. They also found the money for a winter fuel allowance. Again, no means test was employed. A universal benefit was provided and collective responsibility acknowledged. If the Government can find approximately £2 billion to fund those initiatives, it must find the political will to take responsibility for the chronically sick and disabled in this country.
When the Select Committee on Health considered long-term care in 1999, it quoted the royal commission chairman, Sir Stewart Sutherland, who said:
- "We need to change. The status quo is not acceptable."
- "Failure by the Government to act urgently would be a serious dereliction of duty."
Liberal Democrats believe that the royal commission offers a fair, sustainable and workable basis for organising and funding long-term care in the United Kingdom. Instead, the Government, with Conservative support, are imposing an unfair, unsustainable and unworkable system. The message is simple: those who get sick had better get well quickly. Those who do not get better, those who suffer from a chronic disease, dementia or Parkinson's will have their life savings bled away before the state offers a helping hand.
For a Labour Government to do nothing to end such injustice and to take a Parliament in which to do it is a serious dereliction of duty. Liberal Democrats will campaign throughout the country to make people aware of that and to ensure change.
7.34 pm
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