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Mr. John Butterfill (Bournemouth, West): Is my hon. Friend aware that the Minister's own figures show that in Bournemouth alone, between 1997 and 2001—that is, last year—the number of care homes has gone down from 261 to 166? That is a 40 per cent. reduction in Bournemouth.
Mr. Burns: Sadly, my hon. Friend is right. His example typifies the problem, which I shall elaborate on shortly. That is happening all over the country, as a result of the closure of homes.
Small homes have been particularly badly hit and the effect of this trend has been greatly to reduce the choice of homes for elderly people, who as a result have to be moved further and further away from where their homes were, and where their families and their friends are. These closures have inevitably resulted in a radical and unprecedented decline in the supply of long-term care places. All over the country, homes are closing and are being lost.
Mr. Hilton Dawson (Lancaster and Wyre): Will the hon. Gentleman give way?
Mr. Burns: If the hon. Gentleman will allow me to make some progress, I shall give way in a moment.
To give the House some idea of the magnitude of the problem, in the Secretary of State's constituency, Darlington, over the past 18 months, 17 homes have closed, with 499 beds lost. In the region represented by both the Minister of State, Department of Health, the right hon. Member for Barrow and Furness (Mr. Hutton), and the Under-Secretary of State for Health, the hon. Member for Salford (Ms Blears), the number of beds fell by 18 per cent., with a loss of almost 5,400 beds over the past four years. In the region represented by the Minister of State, the hon. Member for Redditch, the number of beds fell by
10 per cent., with a loss of almost 2000 beds. In the region represented by the Under-Secretary of State for Health, the hon. Member for Tottenham (Mr. Lammy), the number of homes fell by 21 per cent., with a loss of 1,350 beds. Since 1998 in the constituency of my hon. Friend the Member for Altrincham and Sale, West (Mr. Brady), 29 residential and care homes have closed, with a loss of 1,683 beds.
Mr. Dawson: The hon. Gentleman makes a strong case for the quality of care in the private sector. I agree with him, but there is also excellent public sector care. However, is he seriously suggesting that the only form of care that we should support for older people is residential care? Surely there is a duty on the part of people who work in residential care to work in clear partnerships with local authorities and health departments to produce new models of flexible care.
Mr. Burns: I am certainly not saying what the hon. Gentleman suggests. He can rest assured that I shall shortly deal with his county, Lancashire.
Sadly, the future looks bleak. A survey that I have carried out over the past two weeks suggests that there is no abatement in the pressures forcing homes to close. Cheltenham, which has already lost 700 beds, is facing a further six home closures. BUPA is carefully considering two of its homes; Devon is losing its last two nursing homes; and three homes are in the process of closing in Kirklees. Reading is facing the closure of a 48-bed home by its own local authority, and South Shropshire has 12 homes under threat of closure. To answer the hon. Member for Lancaster and Wyre (Mr. Dawson), Lancashire is considering closing all its 32 care homes. The hon. Member for Pendle (Mr. Prentice), whom I am glad to see in his place, said in this House on 26 February that there was
- "tremendous anxiety for the many elderly people in my constituency. They . . . are fearful about what is to happen."
- "We read . . . of people's despair about the proposed closures, yet the area has a Labour MP, a Labour Government, a Labour district council and a Labour county council, so no one else's fingerprints are on it."—[Official Report, Westminster Hall, 26 February 2002; Vol. 380, c. 177WH.]
If we are going to talk about statistics, the truth is that the overall number of beds lost in this country since 1997 is 46,700—a loss of more than 8 per cent. of capacity in only five years. Independent research commissioned by the Labour-dominated Select Committee on Health has confirmed those figures, which coincide with those produced by an equally independent source—Laing and Buisson.
Mr. Edward Garnier (Harborough): Does my hon. Friend also realise that the Labour Government's fingerprints are to be found in Conservative Market Harborough? Lenthall House, a Leicestershire county council home, is threatened with closure as a direct result of this Government's policy of introducing what they
ludicrously call "best practice". Several people will be thrown out of the home during the next few months if the policy is allowed to stick.
Mr. Burns: My hon. and learned Friend describes a problem that is sadly all too well known throughout this country, as more and more homes are being closed and beds lost because of the actions of this Government.
Mrs. Joan Humble (Blackpool, North and Fleetwood) rose—
Mr. Burns: I will just make the point about the figures, and then I will move on to the hon. Lady.
Some of those beds have been lost in the independent sector, and the figure also includes 26,000 lost in the public sector: 13,500 from local authorities and 12,500 from long-stay NHS provision.
Mrs. Humble: I thank the hon. Gentleman for giving way. I remind him that he supported the implementation of the National Health Service and Community Care Act 1990 under the previous Conservative Government, who said that too many people were in residential care and would be better supported in their own homes. Is he now saying that they got it wrong?
Mr. Burns: No, I am not. What I am saying is that this Government are hitting those people with a double whammy: they are closing the homes, the beds are being lost and the amount of domiciliary care provided has declined by 12 per cent. The hon. Ladies on the Labour Back Benches nod their heads in chorus, but they do not listen. The number of people getting domiciliary care has fallen since 1997. The number of hours that they are receiving has risen, but the total number of people who are getting the care has been cut.
To return to the figures, the Government keep claiming that the overall number of beds lost is 19,000, but in the true spin mode to which we are all accustomed, they seek to massage bad news and have used a different and highly disingenuous basis for calculating those figures. To try to massage that bad news, they have used a different period and a different basis for their calculations. Their figures are based solely on the independent care homes sector and exclude the beds lost from local authority and NHS provision. Remarkably, they totally exclude any figures for 2001. As if that were not enough, they use a late year base of November-December for their figures, rather than the year ending in March-April.
For the NHS, the closures are having serious consequences on delayed discharges from hospitals. The total number of delayed discharges is still above the 5,000 level, and a growing minority of delayed discharge patients are staying longer in hospital, with more than 36 per cent. staying for more than 28 days. The knock-on effect is that the number of cancelled operations is rising, as it has done each year since this Government came to power. More worryingly, the rate for readmission within 28 days of discharge is rising and is especially high for over-75s. It is also worrying that a number of trust chief executives are again beginning to see rising pressures in terms of delayed discharge. They are all fearful that
further anticipated home closures will significantly and adversely affect their ability to reduce the numbers in the next 18 months.
Mr. Ronnie Campbell (Blyth Valley): Will the hon. Gentleman give way?
Another reason for the problems facing care homes is fee levels. The Joseph Rowntree Foundation highlighted the fact that the average cost per week for nursing care of older people in a home is £459, and that the cost for residential care is £353. Those costs are about £75 to £85 higher than the average fees paid by local authorities. In addition, there is the looming problem of the estimated £300 million increase in national insurance contributions from next April, which will be a crippling blow to the sector.
Mr. Campbell: The hon. Gentleman has been speaking for a very long time, but if I were a Conservative supporter, I would still be wondering which way to vote; I would want to know what he was going to do about the problem.
Mr. Burns: The hon. Gentleman must think the House is stupid if he expects us to believe that he is still thinking about how to vote. We all know that, like every other clone in the Labour party, he will be voting with the party tonight, in defiance of what is going on in this country.
Ironically, it is estimated that local authorities are paying fees to place residents in their own homes that are up to 40 per cent. higher than they pay in the independent sector. That is unfair, it is a short-term catastrophe and it is one of the major contributing factors to the closure of care homes, and especially the small and medium-sized ones.
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