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Mr. Burns: Will the hon. Gentleman help me? Is it not the policy of his Government and the Secretary State to use the private sector in the provision of acute health care as well?
Mr. Hinchliffe: I am still trying to explore what has happened this week; it has been an interesting experience
for one or two of us. I referred to the use of the private sector in care because I fear the consequences of its use in the NHS, as the hon. Gentleman knows full well; he knows my feelings in great detail.
Mr. Drew: Following that point, does my hon. Friend agree that as a result of the Griffiths report the previous Government wrongly decided to demand that 85 per cent. of all moneys be spent in the so-called independent sector? They spoke about a mixed economy of health and social care provision, but it was nothing of the sort.
Mr. Hinchliffe: My hon. Friend is right; that decision pushed people into permanent, expensive institutional care when in many instances they did not need it.
Mr. Waterson: I have not lost the thread of the hon. Gentleman's fascinating argument, which is being followed closely by his own Whips. Will he comment on places such as East Sussex, where well over 90 per cent. of care home beds are provided by the private sector?
Mr. Hinchliffe: I did quite a bit of research while advising the Labour Front-Bench spokesmen on community care for a number of years. In a sense, the problem in East Sussex arises from the use of the market. We found from my research that the market had gone for areas where there were large houses and where, in some but not all cases, there were larger elderly populations. We found that people were being moved out of inner London to places such as Sussex and Surrey, where there were more private care homes. The investment was not in the areas where they were living.
My concern is that the Conservative Government allowed the market to provide what was in the interests of the care home owners, not what was in the interests of the people who ended up having to occupy those homes. The solutions that those people got were not what they wanted. They wanted care in their own homes, or at least near to where they lived. Precisely the opposite happened.
My main concern about the use of the private sector is the way in which it invested in wholly outdated models of institutional care. There was no recognition that most old people do not want to go into a care home. Our country is unique in our reliance on institutional care. In Denmark, which is the obvious example, care homes were made illegal in 1988. Other models of care exist there, because care homes are deemed to be a humiliating form of care.
The models developed by the private sector in this country until recently were based on our old workhouse institution. Some of the care homes are not much better than some of the workhouse institutions of many years ago. I am sad to say that, and I am sorry that there have been attacks on the care standards legislation from the Liberal Democrats. [Interruption.] There certainly seemed to be attacks. I shall check the record. I was actively involved in exposing standards in the private care sector, where people were genuinely suffering.
Dr. Evan Harris: When he checks the record, the hon. Gentleman will see that our concerns have been about care standards that have not been funded and are therefore threatened. When he criticises care homes that are doing
their best with the resources and staff that they have, he should reflect on the implications for the care home staff. Are they workhouse staff?
Mr. Hinchliffe: Of course not. I am speaking of the model of institutional care, which is a direct consequence of the workhouse system. It is its historical successor, whether the hon. Gentleman likes it or not. In 2002, it is about time that we moved away from a system set up in the 1600s. None of us here wants to end up in an institutional setting, but the debate assumes that we all want to end up there and that we all want to see more care home beds. I, for one, do not. I should like to see a gradual reduction in institutional models and a move towards the models that exist in other countries—
Richard Younger-Ross: Will the hon. Gentleman give way?
Mr. Hinchliffe: No. I have given way enough.
I should like to see a move towards models such as care link schemes and housing with care schemes. There are many in the private sector, as well as in the public and voluntary sectors, where intensive care packages are available so that people are not permanently institutionalised in their old age. The key challenge is to move away from costly, outdated institutional care and to develop alternative models of care within the community. That is what people want and it is about time we delivered it.
I have studied the Liberal Democrat motion. As the Government amendment states, it relates more to the producer interest than to the consumer. The motion refers to the
- "loss of homes and beds"
8.33 pm
Mr. Nigel Waterson (Eastbourne): I am delighted to have the opportunity of taking part in the debate, and I am particularly pleased to follow the hon. Member for Wakefield (Mr. Hinchliffe). We all feel for him in his personal voyage of discovery, as he finds out what modern Labour party policy is towards our health care system.
It is breathtaking to witness the sheer opportunism and cynicism of our Liberal Democrat friends in some of the matters that they choose to bring before the House, especially in view of the experience of some of us in East Sussex. For eight long, painful years the Liberal Democrats ran East Sussex county council. As I mentioned in an intervention, in every year they succeeded in hitting the bottom of the national league table as the lowest payers to the private sector of any council in the entire country. Interestingly, Sedgefield council was at the top of the table, but that is another matter. There was a combination of incompetence and political dogma. The Liberal Democrats were getting a bit excited about the remarks of the hon. Member for Wakefield, who speaks with great authority and knowledge on these matters. I do not want to upset him,
but I must say that they are philosophically very close on these issues. I am convinced that the attitude of the Liberal Democrats in East Sussex during the eight years to which I have referred was based on dogma and the notion that people should not be able to make a profit out of running private care homes. I am sure that that is what drove their attitude to private care homes in my county. Other people's experiences may differ and I am sure that we will hear more about that.
Richard Younger-Ross: Value for money.
Mr. Waterson: I hope that the hon. Gentleman will say that to the people running private care homes in East Sussex—especially those that have gone out of business in recent years.
As I said, several different pressures were faced. First, the area was the worst paid of any in the country. Secondly, there was the dogmatic insistence of the Liberal Democrat-controlled county council on keeping open its county council-operated homes. My hon. Friend the Member for West Chelmsford (Mr. Burns), who is gracing the Front Bench, may not remember an Adjournment debate on 19 February 1997 on social services in East Sussex, which I initiated. He was the Minister who responded to the debate, in which I pointed out the disparity between what East Sussex county council was paying the private sector and what it was paying per bed per week for its own homes. At that time, the gap was a staggering £150 a bed a week. He said:
- "When a local authority is complaining that it does not have enough money, I cannot understand how it can justify spending about £152 a person a week extra just by placing them in its own homes."—[Official Report, 19 February 1997; Vol. 290, c. 898.]
More recently, in July 1999, I secured a debate on a similar subject. By that time, East Sussex was paying the private sector £209 a week, but it was paying for its own homes the equivalent of £401 a week. That is a difference of almost £200 for every single person in its homes. I am sure that that figure is now even bigger. In those days, it was difficult as a local Member of Parliament—I anticipate the points that the Liberal Democrats might make—to lobby the Government, whether Conservative or Labour, for more resources when the existing ones were being squandered by the county council.
The third factor that has been hitting care homes in my area very hard is the new standards that will be introduced in April this year. In principle, we are all in favour of better standards. It is right that there should be constant pressure to improve standards and make life better for people in care homes throughout the country. We have no problem with that, but the reality on the ground is that many homes have rooms that are the wrong size and do not have the facilities or the area of land that is necessary to expand their resources in the way the rules demand.
The details of the regulations were made available extremely late in the day. We should bear in mind the fact that this is a question not only of care home owners and operators, but of their bankers. For some time, banks that have previously been heavily committed in the care homes sector have stepped back and decided to wait and see how the new regulations impact on their existing and potential customers. That, too, has had a major impact on care homes in my constituency,
It is worth considering the figures that were provided in answer to a parliamentary question that my hon. Friend the Member for Wealden (Mr. Hendry) tabled on 9 January 2002. The reply stated that in 1999, 48 residential care homes closed in East Sussex alone, and that in 2000 the figure had increased to 69. Five nursing homes closed in 1999 and 10 closed in 2000. Those figures are worrying. A rapidly escalating number of private homes are being forced to close through a combination of the factors that I have outlined.
We could face circumstances similar to those in Australia, where Government neglect over many years meant that the private care sector died, went out of business and had to be reinvented by the Government at vast expense—many billions of dollars—because there was clearly a need for it. East Sussex is not unusual in having such a high proportion—more than 90 per cent.—of care beds provided by the private sector.
More and more of our older people will need such facilities and they will have to rely increasingly on the private sector. As I said, East Sussex county council kept its homes open for several years. Some of them are simply not up to the task in the 21st century. Recently, I revisited such a home, Parker house, in my constituency. It was built in the early to mid-1960s, and its fabric is crumbling. The facilities do not fulfil existing requirements, and will certainly not fulfil the new requirements that come into force in April.
The now Conservative-controlled county council has consulted on whether Parker house should be closed. I do not want to pre-empt the process or suggest that I have any inside knowledge. However, I should be surprised if the consultation did not conclude that the home should be closed. However, in the run-up to the local elections in May, some prominent local Liberal Democrats will be beating their breasts and claiming that closing the home would be outrageous, and that old people would be thrown on the streets. We should tackle such cynicism head on, and I intend to do that. Liberal Democrats would be saying, in effect, that some of our older people should be consigned to third-rate facilities and care. That is a reflection not on the dedicated and caring staff but on facilities that do not meet existing standards, let alone new ones.
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