Westminster Hall
Thursday 13 November 2003
[Sir Alan Haselhurst in the Chair]
Older People
2.30 pm
Mr. Deputy Speaker (Sir Alan Haselhurst): Order. For the convenience of hon. Members, I shall announce the groupings of questions for today. They are as follows: Questions 1 and 2 have been put together, as have Questions 3, 4 and 12, and Questions 5 and 8. We changed the practice on the number of questions to be listed to allow 15, but then there were withdrawals, including one even today, so there are 11. I still appeal for short questions and answers so that we can try to improve the flow. Where possible, I shall allow secondary interventions, but long statements rather than questions will inhibit that considerably.
Oral Answers to Questions
The Government were asked—
Age Discrimination
1. Mr. James Gray (North Wiltshire): If the Government will make a statement on the steps they are taking to reduce age discrimination against older people. [137439]
2. Gregory Barker (Bexhill and Battle): What proposals the Government have to reduce age discrimination against older people in England. [137440]
The Minister for Pensions (Malcolm Wicks) : Age discrimination can be as debilitating to individuals as other forms of discrimination. That is why we are tackling age discrimination in employment through our age positive campaign and through our code of practice on age diversity in employment. Legislation against age discrimination in employment and training will come into force in October 2006. We are tackling age discrimination in other arenas as well. The national service framework for the national health service is designed to outlaw and prevent age discrimination in our hospitals and other health care systems.
Mr. Gray : The Minister's reply echoes the memorable words of the right hon. Member for Makerfield (Mr. McCartney), now the Minister without Portfolio, who said that age discrimination practices
- "are unacceptable, and an incoming Labour Government will give priority to ending them by introducing anti-discrimination legislation."—[Official Report, 9 February 1996; Vol. 271, c. 619.]
He said that in 1996, but the legislation will not become effective until 2006. Was that another early pledge from the Labour party?
I thought that I would find out what the Government have done as employers, and I learned that one has to retire at 55 in the Ministry of Defence and at 60 in the
Foreign Office. What does the Minister intend to do about raising the retirement age for Government employees?
Mr. Gray : About time, too—only 10 years too late.
Malcolm Wicks : The hon. Gentleman asked a long question. He may like a concise answer. We are doing a great deal. We have said that, for civil servants, the normal retirement age in the future will be 65, not 60.
I am also pleased that the employment rates—economic activity rates—are improving for those between 50 and the state pension age. We will outlaw discrimination. That is action from a Labour Government. I do not remember that happening during the Conservatives' 18 years.
Gregory Barker : May I commend to the Minister the excellent campaign being run by the Sunday Mirror on respect for older people and draw his attention to the many facets of ageism that that campaign has highlighted in a survey of British seniors? May I press him specifically on age discrimination in the national health service? Just a couple of weeks ago, a leading conference organised by Cancer Research UK and Help the Aged highlighted the fact that elderly women over 70 are, because of their age, still being denied potentially life-saving surgery for breast cancer. That is happening two years after Ministers published a national service framework for older people and pledged to stamp it out. Why is it still occurring, and what will Ministers do about it?
Malcolm Wicks : The question is asked at a time when our programme to help those with cancer is moving in the right direction and we are getting some very good results. I reiterate that my colleagues in the Department and all of us in the Government are determined to prevent any form of age discrimination from operating in the health service. If there are individual instances, such as those that the hon. Gentleman mentioned, I am sure that my colleagues in the Department of Health will consider them most carefully.
Mr. John Hayes (South Holland and The Deepings): As housing professionals are increasingly sceptical that the Government's target of bringing all social housing up to a decent level by 2010 will be met, does the Minister agree that the most vulnerable members of society—typically elderly people—will own or occupy a disproportionate number of indecent homes, and that there is no worse form of discrimination against the elderly than condemning them to inappropriate housing, which the Government have no plans to do anything about? Will the Minister state the specific measures that will be put in place for elderly people to ensure the end of that discrimination?
The Parliamentary Under-Secretary of State, Office of the Deputy Prime Minister (Phil Hope) : The decent homes target, is to have homes up to a decent standard by 2010. It is a very ambitious target, because, in 1997,
we inherited a housing stock that had been decimated by the Conservative party. There had been massive under-investment, and there was an £18 billion backlog of disrepair in the social housing stock.The Government have released £5 billion of local authority council house sales receipts to spend on improvement of that stock. That will disproportionately benefit elderly people who, as the hon. Gentleman rightly points out, occupy that social housing. The Conservative pledge to sell off social housing in local housing associations will do far more damage to affordable and decent housing for older people than any other single policy of his party.
Mr. Hayes : The Minister stretches our credulity a little far given that the number of social houses built by the Government has fallen by one third, homelessness is at record levels and the number of people in bed-and-breakfast accommodation has risen.
David Cairns (Greenock and Inverclyde): Rubbish.
Mr. Hayes : It is not rubbish; all that can be found in information provided not by the Opposition but by experts in the field who work with people seeking homes and the developers who build them. Will the Minister answer my original question and tell us what specific measures the Government have put in place to help to ensure that the most vulnerable—the elderly—do not live in inadequate housing, and so meet the Government's targets?
Phil Hope : The hon. Gentleman has decided completely to ignore the facts that I stated. The Government have allowed the release of £5 billion of local authority council house sales receipts, which has been specifically identified for improving the quality of social housing. We are well on track to achieve our target of raising to a decent standard every social housing home by 2010. I would like to see the Conservative party make a pledge to match that spending and guarantee that we achieve improvement in social housing over the next five years.
Gregory Barker : I asked a question a moment ago and, given that we are dealing with cross-cutting questions, I was taken aback not to receive a response from the Health Minister who is present. I made a very serious point that women over 70 are being denied health care. That allegation was made by Professor Ian Fentiman of Guy's, King's and St. Thomas' medical school. Will the Health Minister, in his cross-cutting role, provide me with an answer to what the Government are doing and why, when they made a commitment two years ago, nothing has improved?
The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman) : I reject that allegation. If the hon. Gentleman can provide evidence of discrimination, we will deal with it. We are committed to removing that sort of discrimination from the service. In support of my contention, surgery for people over 85 with breast cancer has risen by 13 per cent. Our target
for seeing people once cancer is first suspected is the same for all groups. All targets are the same for all age groups.
Lady Hermon (North Down): Will the three Ministers reflect on their human rights obligations? They will know that article 3 of the European convention on human rights guarantees to everyone within the jurisdiction of the United Kingdom freedom from degrading treatment. Article 14 prohibits discrimination on the grounds of any status whatever. Can the Ministers put their hands on their hearts and say that the measures, legislation and procedures in practice guarantee freedom for elderly people from discrimination and degrading treatment?
Dr. Ladyman : Yes, we can give that commitment. The Government will not tolerate age discrimination anywhere that we find it. If any Members have evidence of it, bring it to us, and we will deal with it.
Care Home Beds
2. Mr. Ian Liddell-Grainger (Bridgwater): How many care home beds for older people were provided by (a) the private sector and (b) local authorities (i) in May 1997 and (ii) on the latest date for which figures are available. [137441]
4. Simon Hughes (Southwark, North and Bermondsey): What assessment the Government have made of care home provision in London for older people. [137442]
12. Alistair Burt (North-East Bedfordshire): How many care home beds for the elderly provided by (a) the private sector and (b) local authorities have been lost since May 1997. [137453]
The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman) : Overall, the total number of care home places for older people in England fell by 6 per cent. between 1998 and 2001, accounting for about 26,100 places. In local authority homes, the number fell by 21 per cent., or 10,900 places, compared with a fall of 4 per cent., or 15,200 places, in independent care homes. Information for 1997 is not available in a comparative format. The number of care home places in London was 47,430 in March 2001. The Government have encouraged local councils to commission an appropriate range of care services to provide older people with more choice of quality service. In London, more people have received care in their own home, as demonstrated by the 2001 figure of 17.1 households per 1,000 of population aged 65 or over receiving intensive home care, which compares with the average of 9.9 for England.
Mr. Liddell-Grainger : It was so kind of you to mention London. I was going to talk about Somerset—
Mr. Deputy Speaker : Order. May I suggest that the hon. Gentleman uses the correct parliamentary language in this Chamber? I am not involved in that at all.
Mr. Liddell-Grainger : Thank you, Mr. Deputy Speaker.
The loss of care beds in Somerset and throughout the west country corresponds to the figures that the Minister gave, but the same is happening in local authority homes. The situation is getting worse. I am not surprised that neither the figures for 1997 nor the latest figures are available; they would be absolutely horrendous. When will the Minister stop the rot and start to provide beds and care for elderly people? More and more people in areas such as Somerset and the west country have to stay in hospital for longer, be looked after by people who are not qualified or, worse still, be pushed round the countryside by general practitioners to find beds. That is not a happy situation.
Dr. Ladyman : I mentioned London in my answer because the hon. Gentleman's question was linked to the question of the hon. Member for Southwark, North and Bermondsey (Simon Hughes), which specifically relates to London. The hon. Member for Bridgwater (Mr. Liddell-Grainger) mentions Somerset, so I shall point out one other factor that he seems to have overlooked. There are in this country, according to Laing and Buisson's figures, 10,000 more care home beds than are actually needed. The idea that we have a shortage is completely wrong. With regard to Somerset, perhaps the hon. Gentleman would like to ask his council why only about 8 per cent. of people there have an intensive care home package. Most older people tell us that they do not want to be in care homes in the first place.
Simon Hughes : Let me return to London. Does the Minister accept that, according to the National Audit Office report earlier this year, the figures for London and the south-east show that demand there is 12 per cent. above recommended occupancy rates? Speaking from constituency experience, I can say that the reality is that many people do not find homes in the communities where they live. As the report says,
- "a severe shortage of care homes in the capital means that London boroughs seek to place their clients outside the capital".
What are the Government doing to ensure that people in the capital city who need care in a care home can find it somewhere near their family, friends and community?
Dr. Ladyman : The hon. Gentleman should give London councils credit for the huge efforts that they are making to maintain people in their own homes. I give them great praise for being far ahead of the rest of the country on that. About 50 per cent. of people who need care in London receive it as an intensive care home package, and that is what most older people want.
Clearly there is a problem if people who have to have a care home place cannot have one locally. However, we have given all councils, including those in London, sufficient resources to start to make interventions in the local marketplace and to pay the local rates needed to obtain care home places local to the people who need them.
Simon Hughes : If I find, as I believe that I easily can, several London local authorities, irrespective of political management, who tell me that they cannot afford to provide in their boroughs the amount of residential care that people need who cannot have care at home—care at home is a good thing—will the Minister agree to see them? Will he explain to them why
he says that they have the money to provide the service when they say that they do not? Will he guarantee that the service that they can provide is of the quality that he would want for his parents and I for mine?
Dr. Ladyman : I should be delighted to receive the names of such councils. If I do, I will look out the substantial increase in real terms resources that we have given those councils precisely so that they can deal with those issues. I will provide the hon. Gentleman with those figures so that he is aware that the councils have the money to deal with the issue if they wish to do so.
Sandra Gidley (Romsey): The Minister has obviously seen the Laing and Buisson report, but perhaps he will concede that he is being rather complacent about the fact that there are 10,000 vacancies. Last year there was a drop of 11,800, but all the predictions show that demand will double over the next 50 years and that we have reached a low plateau. What is the Minister doing to increase the number of care home places? It is not enough to consider the current situation; we must provide for the old people of the future.
Dr. Ladyman : I reject the charge that demand for care home places will double over that time. Laing and Buisson is a respected consultant in the field, but it tends to take the view of the care home lobby. Let me put this to the hon. Lady: we have made available to local councils 25 per cent. more funding over and above inflation so that they can take local decisions about care home capacity. We cannot take decisions at the centre about the price that needs to be paid locally or the capacity required locally—that is a job for local government. Were we to take the view proposed by bodies such as Laing and Buisson that there should be a general and compulsory increase in care home rates across the country, it would cost us nearly £400 million. How would the hon. Lady guarantee that that money would get to the care homes when most councils tell us that they do not need to pay it, and where would she get the money from?
Mr. Simon Burns (West Chelmsford): I agree with the Minister that Laing and Buisson is a highly respected independent body, but, whenever we have discussions of this nature, Ministers seem to be in denial. The Minister should be aware that his figures suggest that there has been a loss of just under 40,000 beds. Laing and Buisson's figures for the latest available period show that, between 1997 and 31 July 2003, the number of places in care homes fell from 572,600 to 501,900, which is a drop of 70,700. In his original answer, did the Minister include figures for the voluntary sector, as well as the private and local authority sectors? Can he explain why there is such a glaring discrepancy between his figures and what Laing and Buisson and people in the care home sector, who are at the sharp end of delivering care, believe is happening? Even if the Minister's statistics show that there are 10,000 surplus beds, he must understand that they are in the wrong place. Too many parts of the country have a severe shortage of beds, and people have to move further and further from their communities to find a place in a home.
Dr. Ladyman : Let me start with the last point. Let the hon. Gentleman come to me with authoritative
statements from people who have the figures to demonstrate his case. Over the past month or so, I have had my officials ring around local authorities to ask, "Do you have an absolute shortage of care home beds or is it that the rate that you wish to pay for those beds is lower than the market in your area is demanding?" So far we have not found anywhere where there is an absolute shortage of care home places.I have had occasion before to remind the hon. Gentleman that he constantly quotes the reduction in care home beds since 1997. Why does he pick that particular date? Why does he not pick the date at which the contraction of the care home market began? The hon. Gentleman knows full well that it began as a result of the implementation of the National Health Service and Community Care Act 1990, which was implemented in the mid-1990s. The peak in care home capacity occurred while the hon. Gentleman was Minister. That is when the contraction of the care home market began.
Mr. Burns : I find that quite staggering. The Minister must know that, after the introduction of the policy in 1990, there was a significant increase in care homes and care home beds in this country. For him to try to suggest that there was a contraction in the number of beds as a result of that policy initiative is just gobbledegook.
Dr. Ladyman : The hon. Gentleman is being economical with the actualité—I think that is the expression. He knows perfectly well that although the legislation was passed in 1990, it was not implemented until several years later.
Dr. Ladyman : It was implemented from about 1993. If we use the figures from Laing and Buisson to determine when the peak in care home capacity was reached—and the Act started to kick in—we find that it began in 1995–96, just as the hon. Gentleman took over as Minister.
Mr. Deputy Speaker : Order. May I say to Ministers in the hope that they pass this on to their officials, that it is extremely important when questions are being grouped that hon. Members are given notice of that fact? If someone's question is very low down in the order and is grouped with one higher up, it can be very misleading unless that information is passed on.
Pension Credit
5. Mr. Bill Tynan (Hamilton, South): What action is being taken by the local Pension Service to encourage take-up of the pension credit. [137443]
8. Kevin Brennan (Cardiff, West): What steps the Government are taking to maximise take-up of the pension credit. [137447]
The Minister for Pensions (Malcolm Wicks) : We want every pensioner to take up entitlement to the new pension credit. At the heart of our campaign is a direct mail pack to all pensioner households who have not been converted to pension credit automatically through
the old minimum income guarantee scheme. We have already written to 1.7 million households and we will be writing to the remainder by June next year. To support this process, we have a television, radio and press advertising campaign. The Pension Service locally is doing remarkably good work in spreading the word about the new pension credit.
Mr. Tynan : "Give credit where it is due, and would you thank the Government from the bottom of my heart?" So speaks an ex-Conservative voter in Hamilton, South who received £46.20 in pension tax credit. However, there is concern regarding take-up. The Pension Service in Motherwell is in the constituency next door to mine. Would the Minister confirm that we have the resources to ensure that as many people as possible will receive personal information regarding the pension credit? Will he commit himself to ensuring that there are plenty of roadshows in my constituency and throughout the country, and will he ensure that adequate finance is available for that process?
Malcolm Wicks : That is a very important question. We are absolutely determined that those entitled to pension credit should receive it. It is terrible to think that someone who could be better off by £30 or £40 a week will not hear about the pension credit. We all have a role to play.
Despite much irresponsible scaremongering, pension credit has got off to a very good start. We reported to the House earlier this week that already 1.4 million individuals are better off because of pension credit. However, locally through advice surgeries, home visiting and in all sort of other ways—we need the advice of Members of Parliament about where best to locate advice surgeries—we are enabling the message about pension credit to get through. We all have a duty to make it a success. We are talking about some of the poorest and most vulnerable elderly people. They deserve pension credit; I am determined that they should receive it.
Kevin Brennan : May I also commend to the House the campaign by the Sunday Mirror for respect for older people? In the implementation of the state pension credit, it is to the Government's credit that the check on the resources of people applying for the state pension credit will take place only every five years. That is an innovative way to show respect for older people while targeting the benefit at those who actually need it. In asking the Minister to make sure that the Government maximise the take-up of pension credit, I want him to minimise its take-up in one small respect by making sure that my constituents who used to work at Allied Steel and Wire and who have lost their pensions are compensated and therefore have no need to apply for it.
Malcolm Wicks : My hon. Friend has led an important campaign for those workers. He knows that we are examining all reasonable ideas, but I must repeat that we cannot make promises because it would be wrong to raise false hopes. I commend his campaign and the skilful way in which he has brought that issue into a question about pensions.
We are determined to maximise the take-up of pension credit. We have got off to a very good start and are on course to meet our target of 3 million people receiving the credit by 2006.
Mr. Nigel Waterson (Eastbourne): Can the Minister confirm that far from getting off to a very good start the figures, that were produced two days ago show that only an extra 93,000 households out of a target of 1.2 million are getting the benefit? At that rate, it will take six and a half years for the Government to hit their modest targets. Can he confirm those figures? I am visiting the Pension Service in Eastbourne tomorrow and shall be keen to see whether the figures are borne out locally.
Malcolm Wicks : I am sure that the hon. Gentleman will have a good visit and I should like to hear his impressions of it. Like many of us, he will be impressed by the Pension Service. When the shadow Secretary of State, who is the new director of policy development for the Conservative party, said how long it would take to reach our target on pension credit take-up, he was, with all due respect, talking nonsense and engaging in irresponsible scaremongering. I am confident that we will hit the target by 2006. It does not do much good if some people pretend that the pension credit is going badly when it is going very well. We all have a duty to try to ensure that people claim it.
Mr. Waterson : The Minister speaks about targets, so can he confirm that it is still a Government target for 1.4 million of the poorest pensioners in this country—more than 2,000 of them live in my constituency—not to get round to claiming or receiving the pension credit?
Malcolm Wicks : No, that is not the case. Some 4 million households are eligible, and our target is for 3 million households to receive the credit by 2006. The target is based on logistics and planning, but we want to go beyond it. My personal target is 100 per cent. take-up, because it is important that everyone who is entitled to the pension credit claims it. My hon. Friend the Member for Cardiff, West (Mr. Brennan) mentioned that the pension credit is 1 million miles away from the old-fashioned means test. The only thing that people must report is changes in their circumstances, and that will occur rarely. Allowing claims to be made over the telephone rather than by filling in a form is a new approach to targeting the poorest.
John Robertson (Glasgow, Anniesland): I, too, congratulate my hon. Friend the Minister, but unlike my hon. Friend the Member for Hamilton, South (Mr. Tynan), I do not have any ex-Conservative voters in my constituency—come to think of it, there are not too many Conservative voters.
I have asked the Minister several times about the simplification of the documentation—the forms and paperwork—that is used after the telephone conversation. I am still waiting for an answer on the documentation relating to the pension credit, which is compiled by a computer. I have read many of the letters, and I am starting to get my head round them. However, does not the documentation make it difficult for the elderly?
Malcolm Wicks : As I have said before, my hon. Friend is a mighty champion for older people in his constituency. I thank him for that. It would probably be helpful if he and I could sit down together to consider the issue in detail. We obviously review the position and want to improve it, but the fact that elderly people do not have to fill in the form themselves—it can be done over the telephone or during a home visit—is a major breakthrough. If there are issues to resolve, however, I hope that my hon. Friend will accept my invitation to discuss them.
Rob Marris (Wolverhampton, South-West): The telephone claim system is a great step forward, backed up by home visits for those who request and need them. Can the Minister give us some idea as to how the telephone system has worked? Sometimes, with private call centres, for example, one has to hang on a long time before the call is answered, and one call is not sufficient. What is happening with the call centres of the Department for Work and Pensions?
Malcolm Wicks : Performance has been good, even during the first week of pension credit when, from memory, we had 160,000 phone calls. We are currently receiving fewer than that, but 95 per cent. of them are answered within 30 seconds. The system is standing up very well. Clearly, if telephony is at the heart of the service, the telephones have to be answered. We monitor the centres carefully, and so far the performance has been excellent. I congratulate the people in our pension centres and in the pension credit application centre on doing a good job in offering that public service.
Mr. James Gray (North Wiltshire): If the use of call centres to apply for pension credit is so good, why did the Sunday Mirror—of all newspapers—say:
- "The very fact a senior has to pick up a phone, tell someone in a call centre they are poor, tell them how much money they have and ask 'can I have some more?' is very demeaning and straight out of a Dickens novel."?
That is the Sunday Mirror's verdict on this Government policy.
Malcolm Wicks : The previous Government relied heavily on means-testing, but the old-fashioned sort. It was a weekly means test, and any savings were knocked off the means-tested benefit, pound for pound. Our system is a long way from that. We have a savings credit, and we are not worried about people with £6,000 of savings, and that includes some 85 per cent. of those who are entitled to the pension credit. With all due respect to the hon. Gentleman, how dare he lecture us about means-testing when his Government exercised that old-fashioned regime?
I do not think, from the evidence, that there is anything demeaning about having a 20-minute conversation to apply for pension credit. One of the wonderful things is that people who are eligible for pension credit are hearing for the first time about
housing benefit, attendance allowance and other benefits. It is a success story, whether the hon. Gentleman likes it or not.
Mr. Deputy Speaker : Lady Hermon.
Lady Hermon (North Down): May I ask a question on pension credit, Mr Deputy Speaker, before moving on to my own question?
Mr. Deputy Speaker : Order. I call the hon. Lady to ask Question 7.
Domestic Security
7. Lady Hermon (North Down): What resources were made available to provide security at the homes of elderly people in Northern Ireland in the last year for which figures are available. [137446]
The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman) : During 2002–04, the Government supported almost 50 projects under the community safety challenge funding initiative. Of those, 15 included measures related to community safety and older people. The value of those projects was estimated at £55,000. The awards were made to community safety partnerships, including four to Ballymena, three to Banbridge, two to Armagh and one each to Belfast, Fermanagh, Larne, Limavady, Lisburn and Antrim.
In October 2003, the Government launched the lock out crime scheme, which will provide £2.25 million for the installation of security measures in the homes of older people during the next three financial years. Those measures will be available free of charge to those aged over 75 who are in receipt of housing benefit and rate rebate. The security features will include door and window locks, door bars, chains and external security lighting.
Lady Hermon : I am grateful to the Minister for that reply. I welcome his visit to Northern Ireland, and will take him to Limavady, where he will learn how to pronounce that name. It is not in my constituency, so he will have to come to North Down first.
I welcome the Government's initiatives, but want to reflect on the answer, which I was given earlier, that there is no discrimination against elderly people. The Minister just said that the security measures are available only to those over 75 who are receiving housing benefit and who live in designated ward areas. Sadly, a gentleman called Mr. Ted O'Hare died in his home at the weekend as the result of a vicious attack during a burglary. He was 73, and would not have qualified. On Sunday afternoon, I visited two elderly constituents in North Down, both of whom have been burgled, but neither of whom would qualify under the criteria. One of them was intimidated by a young man in a balaclava wielding a gun, who threatened to shoot her dog. What criteria would accommodate such threats to elderly people in Northern Ireland? Will the Minister reflect on the importance of tight criteria and take into account the changes that are needed?
Dr. Ladyman : First, I apologise to the good citizens of Limavady if I did not pronounce the name of their town
properly. Northern Ireland is not normally part of my portfolio. I am afraid that that is the only excuse that I can offer.The hon. Lady is absolutely right. Crime against anyone of any age is awful, but it is even more deplorable against older people. If we were to introduce the same measures for people aged between 60 and 75, it would cost about £25 million. We must draw a line somewhere. The Government believe that we should aim our resources at those aged over 75 because, according to the Northern Ireland crime survey, people over that age are more than two and a half times more likely to suffer from crime. However, I shall certainly pass the hon. Lady's comments on to my colleagues in the Northern Ireland Office and ask them to reflect on her constituents' experiences.
Pensioner Incomes
9. Tony Cunningham (Workington): What assessment has been made of the effect of Government policy on the incomes of (a) all pensioners and (b) the poorest pensioners. [137449]
The Minister for Pensions (Malcolm Wicks) : At the heart of the Government's policy is our concern to get the appropriate balance between helping all elderly people and focusing extra support on the hard-pressed and the poorest. As a result, pensioner households will be some £1,250 a year better off in real terms compared with 1997, whereas the poorest one third of pensioner households will have gained some £1,600 a year in real terms. I hope that that demonstrates that we are getting the balance right.
Tony Cunningham : I thank the Minister for that reply. I recognise and applaud both the fall in pensioner poverty and the huge sums of money that have been targeted at the poorest pensioners.
A few people have mentioned the Sunday Mirror "Respect our Seniors" campaign. Incomes are not the only aspect of respect for our older people. I have lived in Africa, and I have been to many developing countries in which income is not great but there is huge respect for older people, their knowledge and experience. Many of our older people want to remain active but have problems with using buses, cashpoints and supermarkets. What are the Government doing to co-ordinate across Departments to ensure that our senior citizens get the respect that they richly deserve?
Malcolm Wicks : We work closely with other Departments—most obviously with the Department of Health, but with others such as the Department for Education and Skills—to develop a co-ordinated strategy. That is important, and I hope to say more about it in due course.
I, too, welcome the Sunday Mirror campaign. The fact that we tend to refer to older people as pensioners is extraordinary in a way. When my wife and I received child benefit, I did not think of myself primarily as a child-benefit recipient. Perhaps language is important. We need to develop the concept of seniors and senior citizens.
Our analysis of need should be about not just dependency and disability but the commitments and contributions of many old people. Many of the younger
elderly are carers—often of the older elderly. Many are active citizens and may be school governors or justices of the peace. At 60 or 65, many want to remain in work, or to take up new training and IT opportunities. We need to develop that vision and match it with concrete policies. We are moving in the right direction, but our society has a long way to go to recognise the challenge of an ageing community in a positive rather than pessimistic way, and to recognise that many 21st century Britons will have retirements lasting 20, 25, 30 or more years. We need a revolution in our attitudes, as my hon. Friend suggested.
Ms Oona King (Bethnal Green and Bow): One of the issues that impacts on the income of pensioners is the uprating of pensions. British pensioners moving abroad may or may not receive an uprating. For example, my mother, moving to France, did receive one, but a former constituent who moved to Australia did not. Pensioners who move to Canada do not receive an uprating either, but those who move to America, Israel or Jamaica do. When the Minister receives my letter on the subject, could he look favourably at extending reciprocal social security agreements to countries such as Australia, so that British pensioners do not have their pensions eroded?
Malcolm Wicks : I always look favourably at my hon. Friend's letters, even though the replies sometimes do not find favour with her. We have agreements on that serious and complex issue with certain countries, and the situation in the European Union is different from elsewhere. Some difficult choices must be made, and this Government and previous Governments have judged that the costs of giving those pension rights in countries such as Australia and Canada are considerable—we are talking about several hundreds of millions of pounds. Notwithstanding those reciprocal agreements, our priority must primarily be to elderly people living in our own country.
Delayed Discharge
10. Mr. Julian Brazier (Canterbury): How many elderly were in an NHS hospital as a result of a delayed discharge in the last quarter for which figures are available. [137451]
The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman) : Some 4,710 adult patients remained in an acute hospital bed on any one day as a result of delayed discharge in June 2003, and 3,150 of those patients were aged 75 or over.
Mr. Brazier : Is the Minister really comfortable with the introduction in Kent in January of fines for bed blocking under the Community Care (Delayed Discharges etc.) Act 2003? He knows as a Kent MP that the devastation in the care homes sector wrought by the botched Care Standards Act 2000 has badly affected the county, and he also knows about the rotten local government settlement. Is it fair that Kent county council should be penalised for the bed blocking in NHS hospitals, when central Government have done so much to make finding places for many elderly people impossible?
Dr. Ladyman : I think that the situation in Kent is fair. I have talked about the situation with the director of
social services in Kent county council, who vehemently denies the charge that there is a shortage of care homes. He can buy his care home places at a particular price because there is overcapacity in Kent. That is the price that the council deals at, and the director is perfectly happy with the situation. Care home owners may not be happy with it, however, because the market is forcing their prices down.As for the Community Care (Delayed Discharges etc.) Act, every council in the country has been given a grant to cover their reimbursements. If they do the job efficiently and with a certain measure of good planning, the grant will be sufficient for them to deal with delayed discharges, pay any fines that may result and make a profit.
Mr. Brazier : The Minister must know, as a Kent MP, that what he said is a severe distortion of the facts. Kent elderly people are in nursing homes side by side with people from London who receive funding from central Government that is, in some cases, up to twice as much per capita as that received by Kent. The Minister also knows that Kent runs one of the slimmest operations anywhere in the country in terms of overheads. Is he seriously asking the Chamber to believe that Kent's problems with funding are due to inefficiency, rather than to one of the three worst settlements in the country, which delivered an increase in real terms for every constituency represented by a Cabinet Minister?
Dr. Ladyman : I did not say that Kent would have problems caused by inefficiency. I said that Kent was not going to have problems—it does not need to, because Kent county council is efficiently run. I work closely with Kent and I take great exception to the hon. Gentleman's implication that I am distorting the situation there. I can tell him from my own experience that, at the height of the problems that were caused by bed blocking two or three years ago, eight fully equipped nursing home beds in a nursing home in my constituency stood empty in the middle of winter, because it was not in Kent county council's interest to help to get people out of hospital and into those beds. The situation has changed throughout the country as a result of the Community Care (Delayed Discharges etc.) Act. For the first time, councils have a real financial imperative to work with the NHS to get people out of hospital beds and into the places where they can be properly cared for. That will happen, and it will be a great success.
Alistair Burt (North-East Bedfordshire): Does not the Minister recognise the concern behind the remarks made by my hon. Friend the Member for West Chelmsford (Mr. Burns) that the pressure in respect of delayed discharges is exacerbated by the loss of care home beds, and that it is not relieved by some notion of a national surplus if there is an especially acute problem in a particular local area? Mike Glynn of the Bedfordshire Care Homes Association told me that at a meeting last week. The members said that Bedfordshire care homes were running at a capacity of 95 per cent. or more, which gives them precious little leeway if a problem arises in the coming winter. How does the
Minister intend to avoid a crisis in delayed discharges during the coming winter if the margin for getting people into care homes is as tight as that?
Dr. Ladyman : First, I apologise to the hon. Gentleman if, inadvertently, we did not tell him that his Question 12 had been grouped with an earlier question. I take full responsibility for that, and I will ensure that the question is dealt with.
We gave substantial sums to local councils. We gave them a capacity-building grant to allow them to start preparing for the delayed discharge grant, so that they ensured that there was sufficient local capacity. This year, we also gave local councils throughout the country a delayed discharge grant of £50 million for six months while the Community Care (Delayed Discharges etc.) Act operates in shadow form. We gave them that money because there will be no reimbursements during that six-month period, and they can use it to build capacity locally. The reimbursements start only from next year.
I believe, and I have no evidence to suggest otherwise, that all councils that undertake proper capacity planning and that are willing to alter the amounts that they sometimes pay, if that is what the local market requires, can prepare for the reimbursement system in such a way that they can avoid paying more money in fines than they have received in grants. I ask the hon. Gentleman to let me know if he has evidence to the contrary, or if there is an absolute shortage anywhere in the country. I will then talk to the local council in that area and find out what they have done with the capacity-building grants that we have given them.
Mr. David Drew (Stroud): Does my hon. Friend accept that considering the care home sector in isolation is the wrong way in which to approach the problem? My local authority, and I am sure that local authorities throughout the country are doing the same, is considering other ways in which to provide care, mainly at home but in another setting if necessary, which includes rehabilitation and respite. The NHS forgot about rehabilitation and respite for a long time, but it is vital that we consider those matters, because locking people into the care home sector, much as it does valuable work, and I have no reason to cast aspersions on it, is not the right solution for everyone. There is a need for greater flexibility, and I hope that my hon. Friend will tell us how that can be achieved.
Dr. Ladyman : My hon. Friend is right: we need to consider the matter with better eyes and focus on more than the care home sector. We have done that. We have, for example, prevented local councils from charging for adaptations to homes, so that people can adapt their homes in order to stay at home if they need to. One reason why I took such exception to the hon. Member for Canterbury (Mr. Brazier) saying that I was accusing Kent county council of inefficiency was that I am working with that council on an innovative scheme that it is leading and that will involve 11 councils throughout the country. They have set themselves the target of preventing 30 per cent. of the admissions of older people into hospital by doing exactly the sort of things that my hon. Friend mentioned.
Only yesterday, I was in Torquay looking at something called the crisis, assessment and rapid reablement intervention for the elderly team, which is a rapid response team. When an older person has an event that would, under normal circumstances, require acute treatment, the CARRIE team moves in quickly, ensuring that the care the person receives enables them to stay at home to deal with it and that they do not need a hospital bed. We must consider admissions, discharges, home care and intermediate care provision in order to build a picture of how to deal with the wider problem.
Council Tax
11. Mr. George Osborne (Tatton): What steps the Government are taking to reduce the council tax burden on pensioners. [137452]
The Parliamentary Under-Secretary of State, Office of the Deputy Prime Minister (Phil Hope) : We understand the pressures that some pensioners face with their council tax bills, but we believe that we should target help through the benefits system to those in most need. Council tax benefit is paid to nearly 2.5 million pensioners. With the recent introduction of pension credit, almost 1.9 million pensioner households will qualify for more help, or qualify for help for the first time.
Mr. Osborne : I did not really like the Minister's emphasis on the word "some". Many pensioners struggle with council tax bills. Pensioner are often, as the Minister knows, on tight budgets, and a sudden increase affecting one aspect of that budget has a disproportionate impact. Is he aware that some pensioners pay up to 10 per cent. of their income in council tax bills—[Hon. Members: "Some?"]—and many more pay equally substantive amounts of their income? What does the Minister think would be a fair proportion of a pensioner's income to be spent on council tax?
Phil Hope : The hon. Gentleman raises a key point, which is causing debate across the country. We are aware of it. The amount of council tax that pensioners have to pay is a matter for local councils. They are responsible for it and for its impact. The grant that local authorities have received has increased in real terms by 25 per cent. since 1997—in contrast with a cut of 7 per cent. in real terms during the last four years of the Conservative Government. When it comes to local councils deciding on tax levels, the Conservative party might like to reflect on its record in office and what it achieved—that 7 per cent. cut—compared with the 25 per cent. increase for authorities around the country under this Government.
Mr. Osborne : As I am sure that the Minister knows, the Government's Red Book is already planning for an increase in council taxes of double the rate of inflation; it is not entirely up to local councils to determine the level of council tax. Perhaps I may ask again the question that I put in my first supplementary: what does he think would be a fair proportion of a pensioner's income to be spent on council tax?
Phil Hope : I understand the point that the hon. Gentleman is making. My point is that the answer
depends on local authorities' decisions about council tax. Vale Royal authority, in his constituency, had a grant increase of no less than 12.5 per cent. in this financial year, and the county council of Cheshire had a 7.9 per cent. increase in grant from the Government. When local authorities make decisions about the amount of council tax that pensioners will have to pay, they will take into account the increase that they have received from this Government. We support local authorities. We have given them freedoms and flexibilities, starting from 18 November, to make choices about pension discounts and other ways of giving support to pensioners, if they so wish. The hon. Gentleman must take the matter up with his local authorities.
Rob Marris (Wolverhampton, South-West): One aspect of the issue is the take-up of council tax benefit. Some innovative councils, such as Thameside, have fantastic take-up rates for council tax benefit. What sort of encouragement is his Department bringing to bear on local authorities to run innovative council tax benefit take-up campaigns, which would assist further in sorting out some of the issues?
Phil Hope : My hon. Friend is absolutely right to point to the importance of take-up. Local authorities have a good record. However, in some areas, particularly those where pensioners own their homes, take-up is not as good as it should be—it can be as low as 40 per cent.—and we could do considerably more.
I am pleased to say that the introduction of the pension credit gives us a good opportunity in that regard. It will go up, and the additional money will not be clawed back. We are going to increase pensioners' savings by as much as £14.79 per week for a single pensioner and £19.20 per week for a couple. The combination of pension credit and council tax benefit will make a real difference—it will reinforce the incomes of pensioners, particularly those in most need.
Mr. Deputy Speaker : Order. I am grateful for the co-operation of hon. Members, which has enabled us to be inclusive this afternoon. I shall arrange for more questions to be printed on the Order Paper for the next cross-cutting questions sitting.
3.24 pm
Sitting suspended until half-past Three o'clock.
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