| Previous Section | Index | Home Page |
Mr. Burstow: So the hon. Gentleman is telling me that a debate about the future of older people and their security should not include care homes and should not pinpoint the key reasons why care homes are going out of business. Is that what he is telling us? Many people outside the Chamber would be appalled to hear that that is what the hon. Gentleman is saying.
Mr. Burstow: No, I will not give way.
The hon. Gentleman makes a point about money. I shall deal with funding shortly.
Richard Younger-Ross (Teignbridge): Is my hon. Friend aware that in my constituency two care homes have closed recently? A constituent told me last week that having moved her grandmother to the Gatehouse care home in Dawlish, only for it to be closed six months
ago, she then moved her to the Kiniver care home in Teignmouth last week, only to discover that it is closing. Is it not the cost of the Government policy that elderly people are moved from care home to care home at a time in their life when they are least able to cope?
Mr. Burstow: Sadly, what my hon. Friend has described is all too often now the reality for people in care homes. People can be given notice of no more than four weeks that their care home is about to be closed. The trauma of being evicted from a care home can shorten lives and result in people losing their lives. My hon. Friend is right to highlight that concern. There is a fundamental lack of security of tenure, which means that people can easily be passed from pillar to post in the way that he rightly describes.
I have said that the Government are presiding over a back-door tax on the frail and elderly and their families. As the gap between care home fees and what councils are willing to pay widens, more and more families are forced to choose between eviction or topping up the care home fees. It is no wonder that so many older people feel betrayed by the Government.
As more care homes close and demand outstrips supply, the problem can only grow. The plain and simple fact is that the market for care homes is still in freefall. Fee levels are at the heart of the matter. Councils cannot or will not pay a fair rate for care. Yet fees must rise if care homes closures are to be halted. That is not only my view, and it is not only the view of a number of organisations from Age Concern and Help the Aged to the King's Fund, as well as many others. It is also the finding of the Government's research last year. The research states:
- "An increase in care home fees paid by local authorities was the change that might have prevented home closures identified most often by providers."
Have fees risen enough to make a difference? Earlier this year I received a letter from the National Care Homes Association, which said:
- "This year . . . Local Authorities have awarded a fee increase of between two and five per cent. These fee increases came into effect in April. At the same time care homes have had to face additional 'on costs' imposed by the Government."
This means increasingly—certainly in my constituency—that those running care homes look at property values and judge that they have been in the
business long enough and that it is time for them to retire. They close their care homes and realise a profit by selling them for something else. The victims are the people who, as a result, get passed from pillar to post, having been told that they must move from one home to another.I want to make it clear that, for us, the issue is not about the livelihoods of care home owners; it is all about the lives of care home residents. A care home can close in just four weeks. A resident has no security of tenure. As I have said, it is a traumatic experience to be told that a home that you have lived in, possibly for many years, is suddenly to be denied to you. That experience can be terrible. It can shorten lives, and in some cases it has cost lives.
Most of those deaths—those tragedies—go unnoticed and unreported. However, earlier this year two cases widely highlighted the plight of the frail elderly. These were the tragic deaths of Winnifred Humphrey and Violet Townsend in different parts of the country, Kent and Gloucestershire. Winnifred Humphrey was forced to move home because her council was not willing to pay the home's latest care home fees. She died 16 days after her move. Violet Townsend was forced to move when the home she had lived in for eight years stopped subsidising council-funded places.
The question of charitably run care homes subsidising state-funded placements is a big issue. Two years ago, the charitable sector was having to find more than £184 million a year to plug the gap between what councils were paying and what was necessary to provide a decent quality of care for older people in care homes. As a consequence of being forced to move, Violet Townsend died five days afterwards. I hope that the Minister responsible for these matters at Westminster has had the opportunity to study the report commissioned by Gloucestershire. It was a local inquiry into the events surrounding Violet's tragic death. I shall quote the report's conclusions. It said:
- "The funding required to support the provision of residential and nursing care beds has not kept pace with the growth in the market resulting from improved healthcare and subsequent changes in demography including longer life expectancy. National research and local experience shows that funding initiatives tied to current government priorities do little to address the underlying weakness in the funding structure. When seeking to supplement a shortfall in resources for residential and nursing care, the Council is obliged to balance the risk to its other social care responsibilities, notably in services to children.
Market forces including recruitment and retention problems, increased care standards and rising expectations are resulting in a shrinking care home industry. The Council, working in partnership with the care home industry, is seeking to secure future provision by developing a mutually acceptable contract strategy. In the longer term the Council may be priced out of the market unless additional funds are available to pay the level of fees required to attract private capital investment in new build provision that is compliant with the improved care standards."
Miss Anne Begg (Aberdeen, South): I have been listening carefully to the hon. Gentleman, and accept what he is saying about the tragedy of those two cases. However, care homes close for various reasons—not just because of lack of funds, but often because they do not come up to the new care standards. I would expect
the hon. Gentleman from his political perspective to accept that that is quite right. However, what is the solution to the difficulties caused by the closure of care homes that simply do not come up to the standards that we expect in a modern care service?
Mr. Burstow: The hon. Lady makes an entirely fair point. At the moment, care home residents have less security of tenure than a council tenant or a private tenant. We are arguing that they need greater security, and we need a procedure for care home closures—there will be closures, because there are bad care homes that should be closed—that is slow-paced and meets the needs of the individuals. It should not be rushed to meet the needs of the social services budget or care home owners' priorities in selling their care homes. That is what we want, as it is not standard practice everywhere. The findings of the inquiry in Gloucestershire show that there are lessons to be learned from the way in which the tragic circumstances of Violet's death were handled, and changes in procedure will be required in future.
The Government's response to the problem is apparent in their amendment—it is simply to pat themselves on the back and to say what a wonderful job they are doing and that everything in the garden is rosy. Good regulations and higher care standards are something that we all want, but the Government, in fact, have managed to pull off a double whammy of botched regulations and, as a consequence of their botched introduction, poor standards. The care standards that were introduced in April 2002, only to be ditched in July 2002, were for many care home owners the final straw. During the passage of the legislation in 2000, the Government said that better standards would be cost-neutral. Larger rooms, wider doors, lifts and many other physical changes are required to bring homes up to standard so that that they are fit not only for today but for future generations. The Minister has stuck to the line that that need not cost more, which was nonsense in 2000 when the legislation went through the House. When the penny finally dropped with Health Ministers, they ran away from higher standards and the higher costs of meeting them, and waved away the physical standard requirements for the care home sector. The standards for care homes for disabled children and adults are in practice and detail higher than the standards that will apply to the care of the elderly. What happens to an adult in a care home who makes the transition to an older persons' home? Suddenly, they are told that they have to start sharing again because standards do not require the provision of single rooms in a care home for the elderly. Such changes are the result of the Government's ill-thought-out approach. Yet again, elderly people face discrimination solely on the basis of age.
Discrimination does not end there. In February this year, the health service ombudsman published a highly critical report on long-term care. She found that the NHS had adopted unfair, even unlawful, rules for deciding who was entitled to fully funded continuing health care. Despite court judgments and the ombudsman's rulings, the Government have done next to nothing to put that injustice right. They remain in denial about the fact that they have done anything wrong at all. However, the guidance issued by the Department of Health under this Government's watch
has served only to obscure the legal position and left the NHS locally to draw up its own rules. Those rules amount to age-based rationing of health care. Once assessed—and thousands never even get that far—people who are turned down are directed to social services and are means-tested. It is a scandal that for so long the sick elderly in need of health care have been forced to sell their homes to pay for services that they thought throughout their working and taxpaying lives they would receive free when they needed them.We are not talking about personal care or the recommendations of the royal commission on long-term care. We are talking about the law of the land, dating back to the institution of the national health service and the principle that health care is free on the basis of need. For far too many elderly people, that is not the practical everyday reality—they are denied that right and are charged for going into a care home. In too many cases, the rules mean that people only qualify for NHS funding when they are at death's door, yet no law was ever passed to draw the line between what is free and what is paid for. It has been done instead by poorly drafted guidance and neglect. Ever since the ombudsman reported in February, Ministers have stonewalled on the Government's response. I hope that when the Minister stands at the Dispatch Box today, he will offer a sincere apology to the families who have had to battle for so long to get their rights recognised and who had only the ombudsman to rely on to get change and recompense for what they have lost.
The problem is not just unfairness and insecurity in care—the same goes for pensions. The withering away of the basic state pension started under the previous Government, but it has continued under this one. Today's basic pension is a weak foundation on which to build security in old age. Women do particularly badly, and their relative position in the past decade has not improved. The basic pension should be a strong foundation for income in old age. The oldest pensioners, as we know—indeed, even the Chancellor now accepts this—are the poorest pensioners. We believe that they should receive much more as part of their basic state pension.
I shall now come on to the questions asked by the hon. Member for Croydon, Central (Geraint Davies). If the money that the Government are ploughing into mass means tests for the pension credit were spent on a better basic pension, the figure that my hon. Friend the Member for Northavon (Mr. Webb) reported to the House a while ago would be of great interest. The over-75s would receive an extra £19 week in their basic pension—no questions asked, no forms to fill out. Even the Government accept that the basic state pension is not enough, which is why they are introducing the state second pension. I had the doubtful pleasure of serving on the Committee that considered the legislation introducing that pension. The trouble with that measure is that, after 40 years of making contributions, someone retiring on a full basic pension and a full second pension will be so poor that they will immediately have to apply for means-tested support.
The basic pension and the state second pension both leave pensioners in poverty, so the Government are introducing the pension credit to fill the gap. However,
they have introduced more complication and confusion in the system. Complication and means testing lead to lower take-up. The Government think that 3.8 million pensioner households should be entitled to the pensioner credit, but the reality is that by next year Ministers expect just 2.8 million of them to be receiving it—1 million pensioners will, on the Government's own figures, be living below the Government's pensioner poverty line.
| Next Section
| Index | Home Page |