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28 Nov 2002 : Column 500—continued

Glenda Jackson (Hampstead and Highgate): Despite my right hon. Friend's previous replies, if British Energy is taken into administration that surely must have an impact on the Government's consideration of what part nuclear energy will play in providing sustainable energy in the future. Even if that does not mean excluding nuclear energy completely, a reduction in its use is something that many of my constituents would welcome.

Ms Hewitt: The problems that we are dealing with today relate to one company. They do not arise specifically from the nature of nuclear power, whose future role will be considered in the White Paper. I am sure that my hon. Friend's constituents will be as interested as everybody else to see it in the new year.


Motion made, and Question put forthwith, pursuant to Standing Orders Nos. 107 and 108 (Welsh Grand Committee),

Question agreed to.

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Orders of the Day

Community Care (Delayed Discharges etc.) Bill

Order for Second Reading read.

Mr. Deputy Speaker (Sir Alan Haselhurst): I should inform the House that Mr. Speaker has selected the amendment in the name of the Leader of the Opposition. There is also a 10-minute limit on Back-Benchers' speeches.

2.39 pm

The Secretary of State for Health (Mr. Alan Milburn): I beg to move, That the Bill be now read a Second time.

Today's older people are the generation who created our great public services. Labour Members believe that they, above all others, deserve to get the best from them. Indeed, the mark of a civilised society is the way in which it treats its most senior citizens. The Bill is, therefore, first and foremost about promoting the well-being and independence of older people. It is about ensuring dignity and security in old age.

Labour Members are proud of the progress that we have already made. The average pensioner household is £840 a year better off today than in 1997. As my right hon. Friend the Chancellor of the Exchequer said yesterday, there is more help to come for Britain's pensioners.

Eye tests are again free for pensioners; that also applies to nursing care. For the first time, almost 150,000 women over 65 have been invited for breast screening. In the next four years, more than 1 million more will be screened.

It is for others in the House to explain their opposition to reductions in VAT on heating, extra winter fuel payments and free TV licences. More than 11 million pensioners have been helped by those measures, which the Labour Government introduced.

Ours is an ageing society. We should not fear but celebrate that. However, it poses formidable challenges for our key public services in providing better, faster care to higher standards for older people. It means providing services that promote what older people say they want: independence not dependence, and breaking down the Berlin wall between health and social care. Older people need one care system, not two competing systems.

When I visit health and social care services around the country, I am always impressed by the power of partnership. When the services work well together, older people receive first-class care; when they do not, older people suffer.

Delayed discharge from hospital occurs when partnerships do not work. The Bill is designed to tackle that problem. On any single day in England, approximately 5,000 people—mainly older people—are trapped in a hospital bed when they are fit to be cared for at home. Consequently, everyone loses.

For patients who are ready and able to leave, hospital is not the right place. The longer that they are forced to stay, the greater the risk of losing their independence and confidence. For the patient's family and carers,

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normal living is suspended, doubt replaces certainty and lives are put on hold. Hospitals incur unnecessary costs from looking after patients who are not their responsibility, and the beds that they need are lost. Other patients who are waiting for the beds pay in longer waiting times for treatment and, in the worst cases, in cancelled operations.

That vicious cycle has existed for too long and we must find a way to break it. Of course, there is no magic wand that can be waved to make the problem disappear. In the past few years, we have tried to introduce policies to deal with it. The Bill builds on what we have done so far.

We have introduced national standards for the first time and a national system of inspection to improve the way in which services work together for the benefit of older people. There was a time when there were no national standards and a local lottery in care. No one who is serious about ensuring equity in social care wants to go back to those days.

We have provided extra investment for the health service and social services. Many of my hon. Friends have long argued that social services have too often been the health service's poor relation. The evidence is on their side. I am pleased that the hon. Member for West Chelmsford (Mr. Burns) nods his head. In the last five years of Conservative government—I believe that the hon. Gentleman was a Health Minister then—spending on social services increased by only 0.1 per cent. a year in real terms. Today, it is growing by more than 3 per cent. From next April, the rate of growth will double to an average of 6 per cent. a year for the next three years.

Some people, even some of my hon. Friends, will say that that investment is not enough. Perhaps I can do more to help social services. I want to say a little more about that shortly.

Mr. Nigel Waterson (Eastbourne): Will the Secretary of State give way?

Mr. Milburn: In a moment. I shall not take lectures from the Conservative party about how social services cannot afford the Bill's provisions. In government, the Conservative party failed to make the necessary investment, and failed to commit the resources that we are providing. In opposition, it fails to agree to match the extra resources that we are committing for the future. Its record on social services is compound failure: the failures of the present are piled on those of the past. The Conservative party offers only failure for the future. Speaking of that, I shall give way to the hon. Member for Eastbourne (Mr. Waterson).

Mr. Waterson : Before the Secretary of State leaves the subject of funding, is he aware that his proposals would mean a fine of £2.5 million, on current figures, for East Sussex, equating to 240 residential or nursing placements or 800 home care packages?

Mr. Milburn: I am sure that that is what the hon. Gentleman has in front of him, but whether it is true is an entirely different matter. As I shall say in a moment, there are growing resources for social services. Indeed, I made a statement to the House in July this year, in which I set out an earmarked package of measures specifically

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to build capacity in elderly care services. I do not believe for a moment that local government or social services simply will not spend that money. They want to spend it; they are the people who have been arguing for it. We have listened to their argument, and conceded it. We have provided extra resources for social services, and we now expect that they will use them to build up the necessary capacity.

That brings me to my third point, the question of building up extra capacity across the care system. In the NHS, for the first time in 30 years, the number of beds in hospitals is rising, not falling. In the community, while it is true that the number of care home beds has fallen, the quantity of care provided in other settings has risen. Our latest estimates are that the number of people helped by intermediate care services has risen by 126,000 in the last couple of years, and that 43,000 more older people receive intensive support at home today than in 1997. As I told the House in July, we will build up capacity further still in the next few years, with a £1 billion package of measures for elderly care services. These resources will allow local councils to pay higher fees to care homes, if that is what is needed to stabilise their local care home market. Although care homes are a good option for some older people, they are not—and must not become—the be all and end all of elderly care services in our country. A broader spectrum of services is needed for older people, to widen choice and to promote independence.

Mrs. Angela Browning (Tiverton and Honiton): Is the Secretary of State aware of the independent research by Exeter university, which shows that, in Devon, the 100-plus intermediate care beds allow discharge to take place approximately seven days earlier than would normally be the case, thus saving the NHS about £3 million? Devon county council is concerned, however, that, having achieved that—no doubt, with support from the Secretary of State—it will now be penalised by £1.5 million as a result of having provided that care.

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