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Care Homes
Mr. Deputy Speaker (Sir Alan Haselhurst): I must advise the House that Mr. Speaker has selected the amendment in the name of the Prime Minister. There will be a 10-minute limit on Back-Bench contributions to this debate.
4.17 pm
Mr. Simon Burns (West Chelmsford) (Con): I beg to move,
- That this House expresses its profound concern at the continuing crisis in care for elderly people; deplores the Government's over-prescriptive, expensive and bureaucratic regulation of the care home sector, which has greatly exacerbated the crisis in care and has led to many care home closures; condemns the loss of over 70,000 long term care places since 1997 and is gravely concerned that the number of people receiving domiciliary care has fallen by 100,000 since 1997; is further concerned that the implementation of the Community Care (Delayed Discharges etc.) Act 2003 will merely place an unfair financial burden on Social Services departments, and could lead to patients being discharged prematurely from hospital into inappropriate care, resulting in an increase in emergency readmissions; and calls on the Government to recognise the crisis in the provision of long term care for elderly people, to take action to reduce the current rate of care home closures and to combat the decline in the availability of domiciliary care, rather than simply disregard the crisis.
- "As a nation we are facing a crisis".
- "there is clearly a crisis in care and older people are suffering".
- "There is no national crisis in the sector".
Mr. Andrew Mitchell (Sutton Coldfield) (Con): Far from the Minister being complacent, should he not be losing sleep and worrying greatly about the state of social services in Birmingham? Is my hon. Friend aware of the recent Audit Commission report, which singled out social services there as absolutely appalling and deeply letting down local people? What does he think that the Minister should be doing about that?
Mr. Burns: I am extremely grateful to my hon. Friend for that intervention, and I shall indeed refer to Birmingham at a later stage. He will be as aware as I am
that in the year to the middle of 2003, 96 homes closed in Birmingham. Social services have been forcing down prices to a level at which it is not feasible to run homes. They are prepared to pay only £265 per client, whereas in respect of their own homes they are prepared to pay £525. I agree with my hon. Friend that it would be more reassuring for the elderly and their families in Birmingham if Ministers—including the Minister and his predecessor—were prepared to spend more time and be more concerned about examining what is causing so much distress in relation to care problems in the city of Birmingham.
Mr. Patrick McLoughlin (West Derbyshire) (Con): My hon. Friend has just dealt with problems in Birmingham. Does he acknowledge that one problem that greatly annoys people who run private care homes is that the local authorities pay much more to their own care homes than they are prepared to pay to the private sector? That is one of the big problems often put to me by private care home owners.
Mr. Burns: My hon. Friend raises an important and valid point. The fact that that is happening all over the country is not only unfair, but anti-competitive. If my hon. Friend will allow me, I shall deal with that point again later in my speech.
I believe that the Government can pursue two options: either the dangerous one of remaining in denial and doing nothing, or the positive one of seizing the opportunity to end the current confusion and crisis surrounding the care of some of the most frail and dependent members of our society. Because the Under-Secretary seems so oblivious to them, it might help if I explain the problems facing the care of elderly people in this country.
The first problem is the collapse in the provision of homes and beds throughout the country. The most recent data published by Laing and Buisson in July shows that long-term care capacity across all sectors is now some 74,000 places lower than its peak in 1996. Indeed, some 13,400 elderly care places were lost in the 15 months to April 2003 alone, yet demand for elderly care is growing. We estimate that between 2005 and 2020, 130,000 more people each year will require care than currently receive it—an increase of 25 per cent.
Ms Meg Munn (Sheffield, Heeley) (Lab/Co-op): What would the hon. Gentleman say to my constituent, Mr. Watson, who is currently waiting to be discharged from hospital? He wants to go home and be cared for by his family, not to go into a nursing care home. Is it not the case that most people want to stay at home and do not want to go into nursing care homes? Is that not the real issue?
Mr. Burns: The hon. Lady makes a good point and is, in many ways, quite right. I would say to her constituent that he should not remain in hospital any longer than is
clinically necessary, and that he should receive the most appropriate care for his needs. If the hon. Lady will bear with me, I shall discuss the issue in greater detail in a few moments.
Mr. David Hinchliffe (Wakefield) (Lab): I am glad that the hon. Gentleman has clarified that point in response to my hon. Friend the Member for Sheffield, Heeley (Ms Munn). As a Minister responsible for community care in the previous Conservative Government, does he feel that his Government bear any responsibility for the current difficulties in the care sector? In particular, in the 10-year period before community care changed in 1993, there was a 4.7 per cent. increase in the number of elderly people, but the Conservative Government increased care and nursing home places by 500 per cent.? Is that not a factor in our current difficulties?
Mr. Burns: No, it is not a factor. As the hon. Gentleman will recall, when community care was introduced with the support of his party in the early 90s, we had to deal with circumstances that needed to be controlled because of excessive—and I choose that word carefully—growth. The growth was due to demand and was not stimulated by Government. I shall return to that point later, as the portion of my speech that concerns domiciliary care was written with the hon. Gentleman in mind. I know his views, which he has made clear in the Health Committee.
In the 15 months to April 2003, about 13,400 elderly care places were lost, yet demand for elderly care is growing. We estimate that, between 2005 and 2020, more than 130,000 more people each year will require care than currently receive it—an increase of over 25 per cent. New analysis shows that, as a result of that projected growth in demand, and of the rate of decline of availability of care, overall demand for care home places will outstrip supply by 2005—that is, in just 12 or 24 months.
The human consequences are potentially dire. I know that the Government—and the Minister, who has done it often before—will claim that the problem is not as great as it seems, because there are about 10,000 spare beds in the country. However, what the Minister sadly fails to understand is that that spare capacity is not located where the demand is. Too often, areas where there is a shortage of beds are also those areas where demand for beds is greatest. The unfortunate result is that, too often, elderly people have to be placed further and further away from where they have lived all their lives, and from where their families and friends live. That is deeply distressing to elderly people, and to their families and friends. They feel that they are becoming increasingly isolated, in unfamiliar surroundings.
However appalling the problem is, we must not forget that residential care is only one element of care for the elderly. It is important to remember that the guiding principle for the provision of long-term care must be that the elderly receive the most appropriate care suitable to their needs. That care may be provided in a residential home but, equally importantly, it could also be domiciliary care provided in the familiarity of an
elderly person's own home. Unfortunately, however, the number of people receiving domiciliary care has fallen by almost 100,000 since 1997.
Ms Munn: Will the hon. Gentleman give way?
Mr. Burns: No, I want to make some progress. That is a fall of more than 20 per cent., and it came about even though the 1997 royal commission on long-term care emphasised the need for increased levels of domiciliary care to allow people to retain their independence for as long as possible—something about which all hon. Members are, I am sure, united. It is all very well for Ministers to state that the provision of domiciliary care rose between 1997 and 2002, but that is disingenuous spin.
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