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Andrew Selous (South-West Bedfordshire): Will the Secretary of State give an undertaking to look very seriously at the role of airport consultative committees, which to local people at the moment give an illusion of consultation? Will he particularly consider the issue of vectoring, whereby aircraft move from approved routes purely for time reasons?
Mr. Darling: Those are two separate matters. If the hon. Gentleman has a particular point about a consultative committee, perhaps he would let me know. I am not aware of a general concern. I am not saying that there is not one, but I am not aware of it because representations have not been made to me.
Aircraft go off route—presumably with the permission of air traffic controllers—from time to time for perfectly good operational reasons. Again, if the hon. Gentleman has specific concerns or thinks that it is happening too often above his constituency, perhaps he would let me know.
Mr. John Smith (Vale of Glamorgan): I warmly welcome the statement as it relates to Wales: the recognition that air travel will be at the cutting edge of business communication in Wales; the concentration on development at Cardiff international airport rather than building a new airport at Severnside; and the emphasis on surface access to the airport in order to develop it. Will my right hon. Friend work closely with the Welsh Assembly to progress that excellent agenda?
Finally, may I remind right hon. and hon. Members to wear flight socks when they fly on holiday this summer? Apart from saving lives, they can be very fetching.
Mr. Darling: I will bear that in mind.
As I said in my statement, I know that the announcement by BMI to establish a second base for its new low-cost airline in Cardiff is very welcome. I have also said that surface links, not just to airports but for passengers living in Wales who want to travel from airports in England, need to be improved. I am grateful for what my hon. Friend has said, and we are of course working closely with the Welsh Assembly.
Dr. Jenny Tonge (Richmond Park): The Secretary of State should know that my constituents are not saying, "Not here"; they are saying, "Not any more here." We already have four terminals at Heathrow and do not want any more, although one is to be imposed on us. If he
cannot guarantee that air traffic movements will be capped at 480,000 a year and that there will be no third runway at Heathrow, which were both conditions imposed by the inspector on the granting of permission for terminal 5, what is the use of public inquiries in the first place?
Mr. Darling: As I said in reply to the hon. Member for Westmorland and Lonsdale (Mr. Collins), who speaks for the Opposition, the decision on terminal 5 was recognised as one in relation to the airport as it is now. It needs a fifth terminal to deal with the airport as it is now. The inspector noted and acknowledged in his conclusions the fact that the Government would consult on what was necessary for the next 30 years. The decision made by the Government at the time made that clear.
I appreciate the point that the hon. Lady makes on behalf of her constituents, and the subtle distinction between "Not here" and "Not any more here", but no matter what part of the country we live in, we must acknowledge that people fly. Many of her constituents fly—from Heathrow. Indeed, I would guess that the propensity to fly in the south-east of England and in Richmond is rather greater than that in some other parts of the country. It is necessary to strike a balance. As I said before, the one thing we cannot do is ignore the fact that over the next 30 years conditions will change. We need to plan for those changing conditions and we need to do it now. Pretending that there is no problem gets us nowhere.
Mr. Clive Soley (Ealing, Acton and Shepherd's Bush): May I remind my right hon. Friend of Heathrow's importance as a premier airport to jobs and the economy in west London? If it were to decline seriously, the impact on the region would be at least as devastating as was the closure of the docks on east London. People need to understand that when making this judgment on air transport. As one who has lived under a flight path for much of my life, I admit that it is not easy to live with the noise, but I think that if Heathrow went into decline, the devastation wrought on west London would be extremely serious.
Mr. Darling: I am grateful to my hon. Friend because he has put his finger on the problem. He rightly draws attention to the concerns of people living at or near Heathrow and its flight paths, but that airport employs, directly or indirectly, more than 100,000 people. It is therefore critical that we get the decision on the future of the London airports, in particular Heathrow, right, and we need to get it right fairly soon. To leave the decision to someone else—to say that I want nothing to do with it—is not the right approach, so I welcome my hon. Friend's comments.
Mr. Deputy Speaker (Sir Alan Haselhurst): Order. I have important business of the House to protect. No one understands better than I the importance of the issue, but experience suggests that it is one to which the House will return.
Older People's Services
4.46 pm
The Secretary of State for Health (Mr. Alan Milburn): With permission, Mr. Deputy Speaker, I wish to make a statement on services for older people.
As the House will recall, the Budget made available substantial increases in funding, not only for the national health service, but for social services. In due course, I will outline how some of the major increases in resources for the health service will specifically assist older people. Today, I can outline to the House how older people will benefit from the extra resources for our country's social services.
Older people are the generation who created our great health and social services. They, above all others, deserve to get the best from them. The mark of any civilised society must surely be how it treats its most senior citizens. Labour Members take pride in the Government's commitment to help to secure dignity and security in old age. Increases in pensions make the average pensioner household £840 a year better off today than in 1997, and there is also special help to lift pensioners out of poverty.
It is for others in the House to explain their opposition to reductions in VAT on heating, extra winter fuel payments and free television licences, given that more than 11 million pensioners have been helped by those measures, which were introduced by the Labour Government. Eye tests are now free, whereas older people used to have to pay for them. Nursing care is now free for older people; they used to have to pay for that, as well. Breast screening is being extended to women aged over 65. Last year, the number of knee operations on older people rose by 7 per cent., cataract operations by 11 per cent., and heart operations by 13 per cent.
None the less, there is much more to do to provide services that genuinely offer security, promote independence and widen choice for older people. Ours is an ageing society. We should not fear that—in my view, it is something that we should celebrate—but it means that our public services must now rise to the challenge of delivering better, faster care with higher standards for older people. Indeed, securing improvements in older people's care is one of the key priorities of our 10-year NHS plan. Today, I can announce how we intend to take that commitment forward.
Social services have for too long been the poor relation to health services. Between 1992 and 1997, real-terms funding for social services rose by only 0.1 per cent. a year. Today, it is rising by 3 per cent. a year, and from next April that rate of growth will double to an average of 6 per cent. a year above inflation. I can confirm today that older people will be the principal beneficiaries not only of those extra resources, but of the reforms that we are introducing to secure improvements in social care, working with our colleagues in local government, the private sector and the voluntary sector.
By 2006, compared with the resources available today we will provide an extra £1 billion a year in real terms for social services for older people. Reform will be required to get the best from these extra resources. The extra £1 billion—combined with the reforms that we will make—must guarantee for older people not more of the same but faster access to a wider range of services, offering older people greater choice.
First, we will guarantee older people faster assessment of their needs. Reforms are already in train to bring local health and social services together and to ensure that they provide a single seamless assessment process. Older people, above all others, need a one-care system, not competing care systems. Older people also need faster assessment. Some councils currently delay assessments for older people for up to nine months. That is completely unacceptable. I can tell the House today that by the end of 2004, all assessments will begin within 48 hours and will be complete within one month. Following assessment, the services to older people in need will be in place within one month. All equipment needed to help people live independently in their own homes will be provided within just one week.
These shorter waiting times will be accompanied by major reforms to ensure that older people are able to leave hospital when they are ready to do so. To accompany these extra financial resources, which will increase capacity in all aspects of older people's care, local authorities will gain the financial responsibility for older people once they are ready to leave hospital. I can tell the House that we intend, subject to legislation, to introduce this reform by April next year.
Secondly, there will be more support to help more people who need care in residential and nursing homes. For many frail or disabled older people, care homes—thanks to the efforts of care home staff—offer the best security and support. The size of the care home market peaked in the mid-1990s. Since then, it is true that the boom in the property market—especially in the south of England—combined with low increases in fee levels paid by local authorities, has led to a fall in the number of care homes beds. Laing and Buisson, perhaps the foremost analyst of the care home market, says that ideally occupancy levels in care homes should be at about 90 per cent. It estimates that occupancy levels are now running at about 91 per cent., suggesting that a modest increase in bed numbers from current levels is what is needed. We will now plan to increase the number of care home places supported by local councils.
Since last November, when we made available an extra £300 million to social services, fee levels have risen—by up to 10 per cent. in some parts of the country. The resources that we are providing from April next year will allow local councils to pay higher fees still if that is what is needed to stabilise their local care home market.
Greater stability must be accompanied by higher standards. That is what care home providers called for and, indeed, it is what the Care Standards Act 2000 enshrines. For the first time, clear national standards are in place, but we always said that we would keep the new standards under review.
The size of rooms and doors, the availability of single rooms and the number of lifts and baths are important, but they should not mean good local care homes having to close. We will therefore shortly issue for consultation an amended set of environmental standards to remove them as a requirement on existing homes, instead making it clear that they are good practice to which all care homes should aspire. We will require care homes to spell out whether they do or do not meet those standards and let those who are choosing homes make an informed choice for themselves.
Other standards—for example, those covering qualified staff—make a greater contribution to the quality of care provided for older people. I can therefore tell the House that we will make £70 million available by 2006—ring-fenced—to support training for social care staff, most of whom currently do not have a qualification, and many of whom are employed in the care home sector.
Thirdly, we will guarantee greater choice for older people in the services that they receive. Care homes are a good option for some older people, but not for all. They are not, and must not become, the be all and end all of elderly care services in our country. Our objective is to broaden the spectrum of services available for older people to widen choice and promote independence.
To enable local councils to provide more rehabilitation services, we will earmark resources to ensure an extra 70,000 older people a year get those services to avoid them going into hospital unnecessarily or to help them leave hospital speedily when it is safe for them to do so. I can tell the House today that I intend to legislate to ensure that those and intermediate care services will be free whether they are provided by the health service or, indeed, by social services.
We will also invest in new models of supported care for older people. We will therefore resource a 50 per cent. increase over the 1997 total in the number of extra-care housing places—very sheltered accommodation—available for older people, and we will work with local authorities, housing associations and others to bring that about.
Fourthly, more older people will get the support that they need to continue to live in their own homes if they choose to do so. The choice that too many older people have faced in the past is between going into care homes or struggling on in their own homes. Just like everyone else, older people want to remain as independent as possible for as long as possible. As a result of the investment that I am announcing today, by 2005 there will be twice as many older people receiving the intensive help that they need to live at home than there were in 1995.
Charges are currently made for community equipment, such as hand rails or hoists, which can make the difference between older people becoming dependent or remaining independent in their own homes. So I can tell the House today that—again, subject to legislation—from April next year, I plan to remove those charges altogether. Through ring-fenced funding, up to 500,000 extra pieces of community equipment will be provided free of charge to an estimated 250,000 more older people.
Fifthly, older people will be given a direct choice over their own care. Direct payments have already given younger disabled people the chance to spend for themselves the resources that they are assessed as needing. Now, in line with our manifesto commitment, I can tell the House that we will make it an obligation on every local authority, for the first time, to offer older people access to direct payments. Every older person assessed as being in need of care—whether for rehabilitation after a hip operation, or for a bit of help with household chores—will be given the choice of receiving a service or, instead, receiving a cash payment to purchase care for themselves that better suits their individual needs.
We will work with older people's organisations to make that choice a reality for tens of thousands of older people. I believe that that reform will empower older people, their families and their carers in a way that has never been possible before. Direct payments will give older people direct choices over the services that they receive.
Finally, many older people rely on more informal care from their family, their friends or their neighbours. Without the millions of carers in our country the services provided by the NHS or local councils simply could not do their job. In my view, the whole country owes our community of carers an enormous debt of gratitude. They are living proof that there is such a thing as society.
In recent years, we have provided more help to carers. Now we plan to build on that. So I can tell the House that I intend to more than double the carers grant to £185 million by 2006. As a result 130,000 additional carers will get help not just with short breaks through respite care, but with the extended care that they need so that they can continue caring. Carers put so much into the community, so it is right that they should get something back.
That is a major package of investment and reform to the services older people receive. The proposed new independent commission for social care inspection will be responsible for ensuring that councils in every part of the country deliver for older people. I can inform the House that the new commission will start operating in shadow form by the end of this year, so that it can inspect and audit how those extra resources are being used. The councils that do best will get more freedoms and greater rewards. There will be intervention for those that fail.
Those reforms and those resources will increase capacity to make choice a reality for hundreds of thousands of older people. There will be more places in care homes and sheltered housing. There will be more intermediate care services. Crucially, there will be more support for older people to live at home and for their carers. More older people will be able to gain access to more services and exercise more choice.
Increasing choice for older people is possible only because of the choice that this Government have made to put sustained levels of investment into our health and social services. As Labour Members, we know that resources plus reforms deliver results.
Our commitment is to deliver for this generation of older people and future ones. It is for those who oppose both the investment and the reforms to explain now how they would go about delivering dignity and security in old age. For our part, the emphasis must now be on helping more older people to live more independently for more of the time. When these reforms are fully implemented, there will be a greater proportion of older people being cared for at home than there is now.
After all, that is the choice most older people say they would prefer. That is what older people have every right to expect. It is what we intend to deliver. I commend the proposals to the House.
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