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28 Nov 2002 : Column 562—continued
6.30 pm
Mr. Simon Burns (West Chelmsford): I am not sure whether the Minister needs reminding of the saying that success has many fathers, but failure is an orphan. If one considers the majority of responses to the Bill, it is clear that it is an orphan. The overwhelming view of the Bill has been unfavourable, to say the least. That Labour stalwart, Sir Jeremy Beecham, the chairman of the Local Government Association, has urged Ministers to abandon the Bill. The NHS Confederation and the Association of Directors of Social Services have both condemned the proposals in the Bill. Age Concern has described the Bill as Xill-conceived and impractical".
The British Medical Association has voiced its opposition. Help the Aged is opposed to the imposition of fines, and says that the Government should concentrate their efforts on securing the long-term future of social services. Kent county council, acting as a spokesperson for a group of county councils that will be adversely affected, called the proposals Xgravely flawed".
During the debate, speaker after speaker has condemned the proposals, particularly in part 1. I congratulate my right hon. Friend the Member for North-West Hampshire (Sir George Young) on an elegant and lucid speech in which he highlighted the fundamental flaws in the Government's approach, as outlined in part 1. I also congratulate my hon. Friend the Member for South Cambridgeshire (Mr. Lansley), who presented a compelling argument about the impact that the Bill will have on partnerships. My hon. Friend the Member for Eastbourne (Mr. Waterson) highlighted the problems in his constituency, the way in which the NHS and local authorities have been working closely together, and the damage that the Bill will do to that relationship. Those sentiments were echoed by my hon. Friend the Member for Westbury (Dr. Murrison). My hon. Friend the Member for Southend, West (Mr. Amess), in a typically robust speech, left us in no doubt of his opposition to the Bill.
It is not solely Conservative Members who are opposed to the Bill. I know that the House always listens carefully and with respect to the views of the hon. Member for Wakefield (Mr. Hinchliffe), the Chairman of the Health Committee, who in the course of his comments made it plain that he was against part 1 and thought that it was wrong. The hon. Member for Hampstead and Highgate (Glenda Jackson), who, to be fair, said that she would not vote against the Bill, was critical of certain aspects of it, as was the hon. Member for Blackpool, North and Fleetwood (Mrs. Humble), who urged the postponement of the fines. She was chairman of social services in Lancashire before coming to the House.
The hon. Member for Stoke-on-Trent, North (Ms Walley) was lukewarm in her support. Some of the comments of the hon. Member for Pudsey (Mr. Truswell) may have been unpalatable to me, but the thrust of his powerful message was that the Government had got it wrong in part 1. Looking round the Chamber during the speech of the Secretary of State, it was interesting to see a number of other hon. Members expressing their support through their body language and their sedentary comments. I caution them about being over-enthusiastic in support of the Bill.
I caution in particular the hon. Member for Colne Valley (Kali Mountford). If I were her, I would check what her social services department thinks of the Bill. During the afternoon, my office had an opportunity to speak to the director of social services of Kirklees council who, among other things, made three comments on the Bill: first, that it is not the right way to tackle the problem; secondly, that it is totally wrong and not good for partnership work; and thirdly, that it will rebuild a Berlin wall between health and social services. I understand that hon. Members in the Kirklees local authority area are meeting the social services department tomorrow to discuss the implications of the Bill. The hon. Lady might be interested to hear the department's views in that meeting.
Kali Mountford: I am grateful to the hon. Gentleman for giving way. I am surprised but not alarmed about his telephone call, despite his office having said merely that it was from the House of Commons; the fact that it was his office had to be wheedled out of it. I called the department at 4.30 today, after his call had been made, and it said that it was perfectly happy with the Bill and that working relationships and partnerships were the way forward, and commended such arrangements to other authorities as the best way of making the Bill work.
Mr. Burns: I am grateful for that contribution, but I would be fascinated to know to whom the hon. Lady spoke in the social services department. If she spoke to the director of social services, Mr. Philip Cotterill, it would seem most extraordinary that his views on the Bill should have so radically changed in the course of a maximum of 90 minutes.
The role of the Health Committee is very interesting. Many hon. Members have mentioned the report that was published in July, and it has been interesting to hear in the debate the hon. Members from the governing party who were members of the Committee. The hon. Member for Leigh (Andy Burnham) gave us the benefit of an interesting speech in which he reassured my hon. Friends that he was going to redress the balance by speaking in support of the Government's proposals after an overwhelming number of Labour MPs had spoken in opposition to them. He is perfectly entitled to take that position and I do not criticise him for doing so, but I wonder—I shall leave this in the air merely as a matter of wondering—how he squares the support that he expressed for the fining system set out in part 1 with recommendation 33 in the Committee's report. I remember the discussions that we had in formulating the report, so I wonder how he squares his undying support for what the Secretary of State is doing with two parts of that recommendation, which states:
- XThere are real risks that perverse incentives"—
- Xwill be created that will undermine partnerships that have taken time to develop, and foster an unproductive culture of buck passing and mutual blame between health and social care."
- Xwe would also urge the development of positive incentives"—
- Xthat reward good practice, rather than any precipitate and over-zealous emphasis on penalties."
Mr. Dawson: Will the hon. Gentleman give way?
Mr. Burns: No, because there is not much time.
The greatest flaw in the legislation is that, ironically, it will not achieve the aims that it seeks to promote. Simplistically to believe that the panacea for solving problems of delayed discharge is fining social services departments demonstrates a total lack of understanding of the problem.
Most reasonable people would endorse the policy intention and goal of delivering improvements to the system to ensure better, more timely and safe discharge from hospital, but to hijack the Swedish system, completely misunderstand it and simply produce a negative policy of imposing fines on social services departments is a missed opportunity. I tell the Secretary of State that that approach is ultimately bound to fail. It is beyond argument that for vulnerable people, and older people in particular, to remain in hospital longer than necessary is potentially a danger to health and is grossly unfair and an utter waste of NHS resources, but to pray in aid the Swedish system without understanding the differences and the fact that it is now having to be amended to pick up on the unintended problems that it has created is not the best way to proceed.
The Government have failed to accept the inherent crisis in care for the elderly. Without redressing the problem of the loss of 60,000 beds, the closure of 2,000 homes and the decrease in the number of households that receive domiciliary care by almost 100,000, delayed discharge cannot be tackled satisfactorily.
The burden of prospective fines is hanging over social services departments like the sword of Damocles. It is an ominous and current threat. Regardless of the success of individual departments in reaching their specific targets for reducing delayed discharge, fines are to be distributed with zest. There has been much speculation recently about the financial burden that the fines will place on local authorities. Many authorities have expressed their grave anxiety about the detrimental effect of fines on them from next year.
The Liberal Democrats, the arbiters of financial prudence since the Chancellor finally divorced Prudence, claim that the estimated national cost is £50 million. The hon. Member for Sutton and Cheam (Mr. Burstow) kindly explained in an intervention that he had concocted those figures on the back of an envelope. Although it grieves me to tell him, their sums are wrong. Unlike the Liberal Democrats, who use a piece of paper and the back of a cigarette packet with a clipboard thrown in to calculate a combination or two of figures before announcing a figure that they believe to be newsworthy, I have spent my time more scientifically and productively. In the past week, I have canvassed as many local authorities with social services departments as possible.
The figures that I was given are significantly higher than those that the hon. Gentleman produced at the beginning of the week. London alone estimates a penalty figure of approximately £25 million. That is in line with the figures that the hon. Member for Ealing,
North (Mr. Pound) provided during the debate on the Queen's Speech when he opposed the proposals and claimed that they would cost Ealing, North about £2.2 million.Let us consider the shire counties. Their estimates were £2 million for Buckinghamshire; £6 million to £7 million for Surrey; £1.5 million for Cambridgeshire; £3.9 million for my county of Essex; £2.5 million for East Sussex; and £8 million to £10 million for Hampshire.
In order not to leave anyone out, I also spoke to social services departments in the Health Ministers' constituencies. In case they do not already know, I shall enlighten them about the way in which the proposals will affect them. Worcestershire, which covers the constituency of the hon. Member for Redditch (Jacqui Smith), believes that the financial burden will be approximately £1.8 million. The local authority of the right hon. Member for Barrow and Furness (Mr. Hutton) estimates it at £2.74 million. The local authority of the hon. Member for Salford (Ms Blears) believes that the cost will be around £1 million, and the local authority of the hon. Member for Tottenham (Mr. Lammy) estimates the financial burden as between £500,000 and £750,000.
While I enlighten Ministers about the way in which their perverse proposals will affect their areas, it would be unfair if I did not draw attention to the financial burden that the proposals will place on the local authority that covers the Prime Minister's constituency. It has been estimated as approximately £1.4 million.
Just over half the local authorities that I managed to speak to reckoned that the financial burden would be £76 million. Let us project that upwards to the total: the Local Government Association figures estimate a cost of about £180 million, which also highlights the impact statement figures. That is probably about right. What does that mean? The Secretary of State suggests that he will rob Peter to pay Paul and shift £100 million from the Department of Health to the Department for Work and Pensions. That is ludicrous.
The policy should be abandoned before it does more damage. More help should be given to try to remove positively the problem of delayed discharge rather than introducing some crackpot and punitive scheme that almost nobody likes except the most diehard new Labour stalwarts. It is absolutely crazy and it will cause grave problems for the working and further development of partnerships. It will also do nothing to deal with the problems of admissions and readmissions to hospitals. It will distort operational priorities, create pressure for premature discharges, and discourage social service co-operation with care planning procedures in hospital settings.
For those reasons, I urge my right hon. and hon. Friends to join me in the Division Lobby tonight to vote an emphatic no to a policy and a Bill that are woolly and wrong-headed and that are bound, in the end, to fail, but not before they have done tremendous damage to what has been achieved in the working partnerships between health and social services.
6.45 pm
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