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Mr. Burns: I am not going to change my mind. I shall state my position clearly so that there can be no misunderstanding by Liberal Democrats, because we all know what Liberal Democrats do in our constituencies. I said that, like the Government, the Conservative party fought the last general election on a policy of free nursing care, but we did not have a policy of free residential care.
Dr. Harris: I am glad that the hon. Gentleman repeated his position; I just wish that he had done so a bit more quickly. The hon. Gentleman does not understand, or perhaps he does, that such a policy discriminates against elderly people. It subjects them to the degrading assessment of whether bowel care, catheter care and stoma care is nursing care—that is, a requirement of their health needs—or personal care. What a way to treat elderly people. The Government are saying to them, "If that care need is delivered by a nurse, we'll pay for it, but if it is not, you'll pay for it. Having saved and paid taxes all your life, you will pay for care that you were told would be free from the cradle to the grave."
Dr. Tonge: Does my hon. Friend agree that the policy also discriminates against elderly people who are not only physically but mentally ill?
Dr. Harris: Absolutely. We know that people who suffer from dementia will have a mixture of personal care needs and nursing care needs, and it is degrading, discriminatory and invidious to try to make a distinction between them. We are prepared to say that we would fund personal care, and we have said where the money would come from. I know that there are Labour Members who know, in their heart of hearts, that that is the right policy.
The hon. Member for West Chelmsford did us the favour of quoting Liberal Democrat research, the aim of which, as I think he accepts, was to show that people still have to sell their home to fund their personal care even though the Labour party, in opposition, used to claim that that was a scandal. Very little has changed.
The charges that the Minister must answer are clear. Discharges are delayed, beds are blocked and elderly people have to wait to receive suitable care in an unsuitable setting, which means that other elderly people who require that care have to wait to get into a hospital bed. Indeed, in many places, they have to wait in corridors, with the resulting lack of privacy. Who would have thought that five years into a Labour regime we would see wards made up in corridors, with no screens, no privacy and no dignity, and health care staff struggling to provide the care that patients need?
The Government stand charged with presiding over a system in which 19 per cent. fewer people are receiving social care because of the shortage of cash. They stand accused of under-resourcing that threatens the quality standards that Liberal Democrat and Labour Members want to see. The Government are committed to more tax cuts for the better-off at the expense of services for the less well-off. They are denying elderly people the free
provision of personal care on the NHS and subjecting them to degrading and invidious assessments. They are overseeing the tightening of eligibility criteria by local councils, which they are making the scapegoats.We want to hear the Minister accept that there is a problem, that funding as well as reform is needed and that the Government have the courage to say where that funding will come from. We believe that the better-off who have done well under this Government should help to provide care for the vulnerable elderly who are getting a raw deal from the Government.
9.44 pm
The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): The Government believe strongly in giving people the right treatment at the right time in the right setting. We have had a wide-ranging debate, but I was particularly disappointed by the contributions of the hon. Member for Sutton and Cheam (Mr. Burstow), who opened the debate, and the hon. Member for Oxford, West and Abingdon (Dr. Harris), who closed it for the Liberal Democrats.
There were good contributions in between, but it was extremely disappointing that the hon. Member for Sutton and Cheam used incredible and unbelievable figures, from which he extrapolated beyond the bounds of comprehension to talk about 5,000 years and 88,000 operations. Where would he get the surgeons to do those 88,000 operations? He was utterly unreasonable and went on to insult care home staff in the most appalling manner that I have witnessed in the Chamber for a long time. To talk about them as rejects from Tesco and McDonald's, when they are putting in time and energy and showing commitment to looking after people in care homes, is dreadful.
I am disappointed that Liberal Democrat Members spoke almost exclusively on behalf of care home providers. That is nothing new. When the hon. Member for Oxford, West and Abingdon moved a motion at his party conference last year, he spoke 26 times about doctors, nurses and staff, but only once about patients; they are important, but he spoke about them only once.
Dr. Evan Harris: I know that the hon. Lady follows the Liberal Democrat conference carefully; I just wish that she would take note of the fact that the motion was about staff in the NHS. When we talk about staff in the NHS, we talk about staff, not stabilisers or modernisers.
Ms Blears: When we talk about partnership, we talk about a partnership of staff and patients working together to shape services; that is the difference between the Liberal Democrats and the Labour party.
We appreciate that the independent care home sector is facing a number of challenges; we are certainly not in denial about the issue. However, the position is nothing like the one represented by Opposition Members. Let us have a bit of honesty in the debate—it would make a refreshing change for the Liberal Democrats. Figures have been bandied about; the loss of care home places was said to amount to 50,000 beds. It went down to 35,000 beds, but the true figure is 19,000 beds. Those figures are ludicrous. I am glad that Liberal Democrat Members reduced their first figure by about half; perhaps by the end of the debate we shall have the proper figures. They did
not take into account the fact that 33,500 beds were created between 1997 and 2000 by new registrations. They should be clear about the figures that they submitted.Our policy is to allow people to remain as independent as possible and be supported at home, which is why 1.5 million people are receiving care packages of various types in their own homes. Last September, the number of people receiving intensive home care packages was 3,500 higher than it was the previous year. My hon. Friends the Members for Wakefield (Mr. Hinchliffe), for Stroud (Mr. Drew) and for Stockton, South (Ms Taylor) spoke imaginatively and creatively—[Laughter.] I am sorry, it appears that Liberal Democrat Members do not recognise imagination and creativity when it stares them in the face. My hon. Friend the Member for Stockton, South spoke passionately about the local partnership in her community that is beginning to design facilities around the needs of patients. My hon. Friend the Member for Wakefield said correctly that we must not judge our success in community care by a simple number-crunching exercise involving the number of beds. We must look at the kind of services that we provide to support people in the community.
My hon. Friend the Member for Stroud mentioned, extremely importantly, the role of the mutual sector in drawing up new solutions to those problems. The Secretary of State in his speech yesterday talked about new models of care. The mutual sector has a role to play. I have recently been made aware of a project in St. Helens in which the co-operative movement is looking at providing a range of services—not just residential care, but supported housing with care services in place. When someone begins to become frail, they can get day care; when they are a little more frail, they can get sheltered housing; when they need residential care, they move into that; when they need nursing care, they move into that. They do all of that within the same village community in which their carers and families are involved. That is the kind of new model of care that local people want, and which the Government, with their creativity and imagination, will begin to put in place. The Liberal Democrats have simply spoken about more money for business as usual and the same old system. That simply will not wash.
Solving delayed discharges is important to us and we have made tremendous progress. Since last September there has been a 10 per cent. drop in the national number of delays. We are keen that the figure should fall even further, which is why we announced the investment of £300 million. I am pleased to tell the House that by 6 January 501 beds had been freed across the country.
Richard Younger-Ross: I thank the Minister for graciously giving way. She makes the situation sound rosy, but can she explain the following statement from all 15 local authorities in the south-west, including Labour-run local authorities? They state:
- "Local Authorities are placed in an impossible situation with no recourse other than to hold back spending on older people in order to provide marginally safe and adequate services for children and other adults."
Ms Blears: I was not painting a rosy picture. I acknowledge that there are problems. The Government are not in denial. We are dealing realistically with problems in the community. If local authorities are taking that position, after they have received extra resources from the cash for change programme, it is outrageous that they are not putting in place services for older people. We will look into the matter.
About 2,500 more people will be able to leave hospital at the appropriate time as a result of the extra funds that we have allocated. The hon. Member for Eastbourne (Mr. Waterson) stressed the need to ensure that that happens in his area. I shall examine the distribution of the allocation of those funds in his area, but I understand that the Conservative-controlled county council there has cut grants to carers, leaving them without respite care. That is a serious matter, which will not help the situation.
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