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Rev. Martin Smyth (Belfast, South): The Minister will be aware that South and East Belfast HSS trust has developed a very fine partnership, which allows both domiciliary care and respite care for the elderly. I welcome the further advance in his statement today, because I remember the days when a young woman whom I can think of, who worked in the city hospital laboratory, had to pay superannuation while she went out to look after her mother. Caring for carers is important.
The right hon. Gentleman mentioned assessment. Can he assure the House that there are enough occupational therapists in the country to do the assessments in adequate time, thus encouraging the providers of the equipment and those who make adjustments to houses to get on with the work much earlier than they have been doing?
Mr. Milburn: I agree with the hon. Gentleman on both counts. On the model of care, Northern Ireland has had the distinct advantage for many years of combined health and social services. As he is aware, we are moving towards that in England and we need much more of it. He rightly made a point about the number of people needed to staff social care services for older people. There too, there is good news. For example, the number of physiotherapists entering training has increased by 62 per cent. since 1997 and the number of occupational therapists has increased by 63 per cent. and there are increases in the number of staff employed. As he is aware, that is partly about ensuring attractive careers for those people, but also about ensuring that there are adequate resources for the services that they provide.
Ms Meg Munn (Sheffield, Heeley): I welcome my right hon. Friend's statement, which set out a range of services that will ensure that most elderly people can stay at home, where they want to be, rather than go into residential or nursing care. I welcome in particular the statement on the speed of assessments for equipment and the provision of equipment. Can my right hon. Friend tell me whether that includes minor adaptations to people's homes, which can often be crucial to ensuring that they get home quickly?
Mr. Milburn: My hon. Friend speaks with real knowledge of these issues from her previous occupation
outside the House. As she is aware, there are basically two strands of resources: community equipment grants, which we are going to enhance as I described and, for larger adaptations such as ramps or walk-in showers, the disabled facilities grant, which is operated by the Office of the Deputy Prime Minister. There too, there is good news, because the resources committed to the disabled facilities grant are, or will be, 50 per cent. higher, I think, in the next financial year than they were in 1998–99. She is right to issue a note of caution that we need a greater alignment between the resources available for small pieces of equipment and more major adaptations to housing. I can assure her that my hon. Friend the Minister and I will discuss those issues with colleagues.
Mr. Elfyn Llwyd (Meirionnydd Nant Conwy): The Secretary of State said that one care system was required, not competing systems, and I welcome what he said about intermediate care services being free, whether they are provided by the health service or social services. That principle being established, will some thought be given to those people who require long-term care?
Mr. Milburn: I know the hon. Gentleman's position and that of the Welsh National party on this matter. We studied the issues around personal care at the time of the Sutherland commission and my right hon. Friend the Chancellor and I did so again in the lead-up to the Budget. In the end, we decided that that was not the right way forward for a simple reason: if we went down the personal care route, it would involve spending substantial extra public resources on the minority of better-off pensioners. Perhaps that is what the hon. Gentleman and his hon. Friend the Member for Banff and Buchan (Mr. Salmond) want to achieve; I want to commit those resources to more services for more older people, in particular for poorer older people.
Mr. Hilton Dawson (Lancaster and Wyre): I commend my right hon. Friend for the good sense and compassion of his statement—allied to investment and modernisation, that is four ways in which the Labour party differs from the Opposition. In welcoming his response to the question about Lancashire, will he agree that this statement offers the opportunity for the private sector to develop services creatively in partnership with local authorities? It certainly gives organisations such as the Lancashire Care Association the opportunity to refrain from the very destructive industrial action that they have in effect been taking over their care home fees and to come together to create a much better service for elderly people.
Mr. Milburn: I think that I had better keep out of that particular local dispute. In general, my hon. Friend is
right. As he is aware, it is a condition of the building capacity grant that we issued in November 2001 not only that this money should be spent wisely—the £300 million—but that in addition it should foster much closer co-operation between local authorities and between those authorities and the independent sector, including the private and the voluntary sectors. That is precisely what we would expect to see, not only in his part of the country, but in every part of it.
Mr. James Paice (South-East Cambridgeshire): The Secretary of State has bandied about a number of figures: thousands of people will gain; 70,000 would receive some free services and tens of thousands more would receive direct payments. Can he be more specific? Precisely who will receive that assistance, particularly direct payments? If he is not going to alter means-testing levels, can he be more precise? Who will not be entitled to direct payments?
Mr. Milburn: I thought that the hon. Gentleman was here when I made my statement but that might have been in body rather than in spirit. I said that henceforth every single elderly person who is assessed as part of the reformed, faster assessment process that I described will be offered the choice of a direct payment. In terms of the number of people offered that choice, that is liable to run into many hundreds of thousands.
I personally think that that is a good thing, not a bad thing. I want to empower older people. People should not be just passive recipients of services. They should have the choice and ability to shape services for themselves. I cannot think of a better way in social care services than direct payments. There will be direct payments on offer for all. Of course it is for the elderly person, their carers and families to decide whether to take advantage of that.
The hon. Gentleman asked how many other people would benefit from the package of measures that I have outlined. In terms of the number of households receiving intensive home care support, an extra 30,000 will benefit. In terms of extra rehabilitation services, an extra 70,000 will benefit. In terms of the number of people who are supported in residential and nursing care homes, it will run into several thousands.
Overall, this package of measures will benefit approximately 440,000 people. On top of that, it will benefit the 230,000 old people who are currently supported in the care homes sector. That is because we have committed the investment. The issue for the hon. Gentleman is whether he or his Front-Bench team are prepared to match it.
Mr. Deputy Speaker: Order. We must now move on.
Points of Order
5.42 pm
Mr. Chris Bryant (Rhondda): On a point of order, Mr. Deputy Speaker. I know that you will be aware of the correspondence between the Speaker and me on Rhondda Cynon Taff county borough council's practice of circulating letters to councillors that I had written confidentially on behalf of my constituents and addressed directly to council officers. I am grateful to the Speaker for his robust written correspondence with me on the matter but for further clarification can I check whether you feel that that practice is right and proper? It is a clear breach of the confidentiality that a Member of Parliament should be able to expect in relation to correspondence on behalf of his constituents. Do you hope that the chief executive of Rhondda Cynon Taff will ensure that that practice will end as soon as possible?
Mr. Deputy Speaker (Sir Alan Haselhurst): I am grateful to the hon. Gentleman for giving notice of his intention to raise the point of order this afternoon. Mr. Speaker has asked me to say that constituents who approach their Member of Parliament are entitled to expect that the issues raised will be dealt with in a confidential manner. Where the Member considers it appropriate to refer the issue to a local government officer, it is Mr. Speaker's view that the correspondence should remain confidential between the constituent, the Member and the local government officer to whom the case has been referred, unless specific permission to make it available to other parties has been granted by the constituent. I hope that that makes the position clear to the hon. Gentleman and to the House.
Mr. Graham Brady (Altrincham and Sale, West): On a point of order, Mr. Deputy Speaker. I have just come from another place, where I was observing proceedings on the Education Bill from behind the Bar. I was surprised to hear in a response given by the Minister, Baroness Ashton, reference to a written answer supposedly given to me following a question that I tabled on Thursday—I have not yet received the answer to that question.
I make no complaint about Baroness Ashton, who gave a courteous apology in another place for the breach of courtesy, but I want to raise with you, Mr. Deputy Speaker, what I think is a gross breach of courtesy. Members in another place were given information contained in a written answer for my attention before that information had been provided to me.
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