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Mrs. Spelman: I am sure that, as a professional politician, the Minister understands that tactically it was worth waiting to see whether the Government would have a knee-jerk reaction, as they did in Scotland.
Ms Stuart: Unlike the Liberals, who are now jumping on every bandwagon that comes their way, the Conservatives will sit on the fence to see which way the wind blows, and will then decide in which direction to jump. We all look forward to that.
I congratulate my hon. Friend the Member for Stockport (Ms Coffey) on her thoughtful speech. She gave strong support to what the Government are doing. I particularly appreciate her support, which she gave not because of political allegiances but because of her experience of working on the ground. She acknowledged the difficulties with definition and that it was not straightforward, but she made it clear that no alternative was offered--someone who has worked on the ground recognised that that was the right way forward.
I was fascinated by the contribution of the hon. Member for Teignbridge (Mr. Nicholls), who told us that his was a principled statement. If I understood the principled statement correctly, he was arguing along the lines not of justice but of the right of inheritance for the wealthier, and, if that did not work, insurance would be a way forward. In many ways, it did not add up.
I welcome what my hon. Friend the Member for Wakefield (Mr. Hinchliffe) said. He has tremendous experience and is a highly respected Chairman of the Select Committee on Health. He made a powerful point about the failure to invest in alternative provisions for care. He acknowledges the difficulties. We know that we have some differences, but he is broadly in support. Just because it is difficult to make that distinction does not mean that it is impossible.
My hon. Friend specifically requested that we move away from institutional settings and look radically at the matter, recognising people's human rights and supporting their right to live independently. I hope that, when he looks at what we have done, he will realise that we have taken that on board. I am grateful for his contribution.
The hon. Member for Roxburgh and Berwickshire (Mr. Kirkwood)--as a former member of the Select Committee on Social Security, which he chairs, I almost called him my hon. Friend--suggests that what is happening in Scotland indicates a two-tier system. That is a fundamental misunderstanding of the driving force behind what we are doing. We decided to take that route in England because it delivers better care and addresses some of the inequalities of the previous arrangement.
Mr. Kirkwood: I was not making myself clear. I was talking about the two tiers between personal and nursing care, not between north and south. I apologise.
Ms Stuart: I am grateful for that intervention.
The hon. Gentleman welcomed the royal commission, but we rejected the proposal on personal care not because of cost, but to deliver better care. May I briefly come back to Scotland? Different solutions for funding will not
provide one extra nurse, one extra doctor or one extra provision north of the border, so it is not logical to conclude that there will be better care.
Mr. Donald Gorrie (Edinburgh, West): Does the Minister accept that all the six parties represented in the Scottish Parliament support the proposition and that all the people who gave evidence, who really know about the subject, to the Scottish Parliament's Committee all favoured the policy? Therefore, the policy is not as insane as she makes out.
Ms Stuart: I was not for one moment suggesting that. I am simply saying that that is a logical conclusion of devolution: different choices are made. The debate is about making choices, but I am still somewhat puzzled about why the Liberal Democrats support the proposal in Scotland, but have different views in Wales and are not sure about England. There may be some inconsistency there. [Interruption.] Hon. Members may not like it, but may I make a little progress?
My hon. Friend the Member for Wythenshawe and Sale, East (Mr. Goggins) described powerfully the changes that he has seen on the ground and the benefits to his constituents as a result of bringing in the new models of service, which deal with such things as delayed discharges. He has seen what home care packages are doing for people on the ground.
The hon. Member for North Devon (Mr. Harvey) made an interesting observation about what the debate was really all about: it was about political positioning. He made that clear. I am grateful for that honesty. I am delighted that he has put on the record his support for the royal commission because, in 1999, when we had the previous debate, the Liberal Democrat spokesperson would not be drawn on whether the Liberal Democrats supported it. Again, it was a case of sitting on the fence, seeing how it played and suddenly saying, "We fully support it."
The hon. Gentleman questioned the arguments about the demographic time bomb. There is a whole line of arguments to be made, but what he does not deal with is the fact that what we are putting forward is based not on cost, but on better services that provide a better response.
Extraordinarily, the hon. Gentleman questioned the £1 billion cost figure. Underlying his assertion that the change would not cost that sum was the good old Liberal Democrat approach of accepting everything that the Government are doing and our extra investment and asking for more. He said that the change would not cost £1 billion, but would be much cheaper, because of all the Government's action in intermediate care. That is the bottom line.
Ms Stuart: I am glad that we have put that on record.
Nothing that we have heard today has shed any light on the Opposition's policies or on how they would fund them. It is very easy to make proposals without saying where the money will come from. Liberal Democrat Members say that extra tax on those making more than £100,000 would fund both their care proposals and their education proposals, but I would like to see the calculations. Liberal Democrat Members want more money, but they do not say where they will find it.
Conservative Members broadly agree with the Government and will probably do so until they have developed their own comprehensive policies. However, they have still not said whether they will match our vital social services funding. The Opposition might therefore find it helpful--I always try to be helpful--if I outline the real action that the Government have taken using real money, not sweet aspirations and empty words.
The NHS plan outlines a vision of health and well-being for older people and for those who care for them. I do not think that we have said enough today about carers. That vision is backed by real investment of an extra £1.4 billion by 2003-04. With that investment, we will promote better health, encourage faster recovery from illness, support independence, avoid the increasing institutionalisation of the elderly and deal with hospital admissions. We offer not only new choices and new opportunities, but the money necessary to realise those opportunities.
By 2004, the new investment will help an extra 130,000 people annually. By 2004, the number of people benefiting from community equipment services will increase by 50 per cent., helping people to stay at home safely for longer. Although all hon. Members want that outcome, we are actually achieving it. Not only will 50,000 people be able to live more independently at home, but we will support the carers.
Opposition Members asked the interesting question what will happen when we are 90 and our children have to look after us. I remind them that, by then, our children themselves may well be 70 and require support. We are therefore supporting carers by doubling the carers' special grant from £50 million to £100 million. My right hon. Friend the Secretary of State for Social Security has also announced a package worth £500 million to back up our words. That money will benefit 300,000 carers in the next three years. The national service framework will back up those investments and support older people with mental health problems and dementia sufferers.
Those measures were created to deal with the individual concerns of people whom we need to support. It is also essential that those services are reconfigured. As my hon. Friend the Member for Wakefield said, simply doing more of the same is not a long-term strategy. We are therefore providing money to reconfigure services and to provide essential independence. We are extending free nursing care to all settings to promote independence.
It would have been gracious of the hon. Member for North Devon to acknowledge that some progress is being made, and that the Government will be preventing people from having to sell their homes against their wishes. As the Prime Minister said, such a situation is disgraceful. I wish that Opposition Members would even partly recognise that we are moving in the right direction. We are tackling unacceptable variations in charges for home care. We are also providing guidance on the NHS continued care responsibilities.
The Government are taking action to provide a fair and sustainable way forward. Opposition Members have a long way to go to convince anyone that they have any credible policy and funding options that anyone could accept. What we have heard today will convince no one, either in the Chamber or outside it. It has been an entirely missed opportunity.
Question put, That the original words stand part of the Question:--
The House divided: Ayes 41, Noes 271.
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