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Mr. Deputy Speaker: Order. Interventions are getting longer, which is taking away valuable time from Back Benchers who wish to contribute to the debate later.
Dr. Ladyman: My hon. Friend is absolutely right—extra care is a model of older people's care for the future that we must promote. We must do so in all sectors, including the private and social sectors. We must do a lot more in that regard, and I shall say a few words about that later.
The motion's reference to regulation is another example of the Opposition speaking for providers and not older people. When I speak to pensioner groups around the country, they tell me that they want more regulation, not less. They tell me that regulation and inspection should be thorough and rigorously enforced. Did any Member of this House not receive a letter from someone in his or her constituency following the recent "Panorama" programme on care workers, which made that very point? When the Tories were in power, regulation and inspection were at best inconsistent and were non-existent in many places. Every council carried out its own inspections and used its own criteria and decided how hard to push them. The results were poor standards in many areas, bad practice in many homes and abuse and misery for many older people. So we introduced national minimum standards and a consistent national inspection regime. That was the right decision, and it is driving up standards to the discomfort of those who cannot meet them.
Mrs. Humble: I thank my hon. Friend for giving way. I congratulate him on highlighting the fact that the bulk of the care standards introduced in the Care Standards Act 2000 apply to good social care practice, which providers welcome. Is he aware that providers also welcome the additional investment that he and his colleagues have given through Topss England for training their staff? They want to deliver the best quality of care and they will do that by having well-trained staff. Government investment is helping them with that.
Dr. Ladyman: My hon. Friend is absolutely right. We introduced the national minimum standards and have consulted about them continuously since. As the hon. Member for West Chelmsford acknowledged in an underhand way, we have shown that we are prepared to listen to what is said in those consultations and change the standards where necessary. My hon. Friend is right that we have put huge investment into training people involved in social care and into attracting people into the social care work force.
Caring for older people is not only about long-term care, however, but about wider choices. That is why we have invested so much in intermediate care—a type of care provision that many developed nations do not even provide, but which we see as a valuable new tool to ensure that older people get the right care at the right time in the right environment and that there is a real alternative to an acute hospital bed. Compared with 1999–2000, by June last year there were approximately 3,600 additional intermediate care beds and about
12,800 additional non-residential intermediate care places. In 2002–03, that meant that 143,200 additional people received intermediate care services compared with 1999–2002. That is a fantastic achievement, which meant that a significant number of people avoided entering an acute hospital, that even more were able to get out of an acute hospital more quickly and that many avoided entering a care home unnecessarily. Would it not be nice if the Conservatives occasionally congratulated us on the success of that initiative?Over the past two years, we have made good progress in tackling the problem of delayed discharges. Older people do not want to be stuck in a hospital bed when they are ready to leave, becoming more dependent and less motivated. We have positively managed a reduction of almost 50 per cent. in the number of people over 75 experiencing a delay since 2001, and that progress is continuing as a result of people preparing for the Community Care (Delayed Discharges etc.) Act 2003. By September last year, there were only 2,988 people aged over 75 whose discharge was held up—a reduction of considerably more than half—and informal feedback from October to January suggests, contrary to the claims of the hon. Member for West Chelmsford, that delayed discharges are continuing to fall without any adverse impact on quality whatsoever.
Councils have been given £50m for the period since last October, and £100m for the financial year to come, to pay reimbursement charges. I invite the hon. Member for West Chelmsford to do some simple arithmetic, although I know that he was not in school when the numeracy hour was introduced. If he multiplies the number of delayed discharges in September last year by the number of days in the year by £100 for each day, it is clear that even if councils did nothing to make the system better, they have been given a sufficiently large reimbursement to ensure that they are no worse off. In fact, if they put a bit of effort into helping with delayed discharges, they would make a profit under the 2003 Act—that is the positive incentive for which the hon. Member for West Chelmsford was calling. I was disappointed by the sloppy thinking in the article in the British Medical Journal that appeared over the new year. Its authors seemed not to realise that we have already consulted on changes to the direction of choice regulations or that we have put in place a single assessment process that means that prior to people's discharge we will have better information about them than ever before. I believe that the 2003 Act will prove to be one of the great successes of this Government, and I look forward to debating it with the hon. Member for West Chelmsford in a year's time when it has finally and incontrovertibly proved itself.
Our vision is about meeting the genuine hopes and aspirations of older people—for most, that means care in their own homes. To deliver on our vision requires a range of high quality support services and good partnership between all partners. For example, a simple housing adaptation installed in good time can sometimes help someone to stay at home. That is why we have made housing adaptations that cost less than £1,000 free. Home care, especially intensive home care, has an increasingly central role in our plans. The hon. Member for Sutton and Cheam (Mr. Burstow)
mentioned that, but he did not say that 81,500 people now receive intensive home care as a result of what the Government have done. Since 1998, we have increased the proportion of people receiving intensive home care by almost 30 per cent. The total amount of hours of home care that we are delivering is 16 per cent. up on the amount that was delivered under the previous Government. We are targeting home care on where it can do most good in keeping people in their own homes, because that is what they want.We are targeting our resources at everyone, not at free personal care for the elderly—which the Liberal Democrats mention in their amendment, which was not selected. Those resources became available only because of the tough choice that the Government made in putting £1 billion towards making those choices available for everybody, not giving it to the better off. One of the things that we have been able to do with that money is to make £87 million available from the Department of Health to improve the amount of extra care facilities, which act as seed corn in starting people thinking about how they can increase extra care provision.
It is a tragedy that too many Conservative and Liberal Democrat spokesmen do not appreciate the importance of the extra care model of housing. I wish that they would go around the country to see some of the people with severe conditions—dementia, Parkinson's or physical conditions—who will be able to stay in their own home because of the extra care model that we are going to roll out. Those are choices that we are making available. It is sad that the Conservatives do not understand that older people want to make those choices and do not see a care home as an inevitable consequence of old age. It is sad that the Liberal Democrats stick with the nonsense of free personal care for the better off when the resources that such a policy would consume would be better spent on making choices available to everybody. If older people cannot hope that the Conservatives and the Liberal Democrats will hear their voices, they can at least be confident that the Government are listening to them and know that they want independence. They want to be respected, given the choice of planning their care, and being at the centre of it. They want dignity in old age, and high quality and well-regulated services. The Government are proud to be delivering that to older people everywhere.
5.20 pm
Sandra Gidley (Romsey) (LD): The debate is important and Liberal Democrat Members welcome it. Such is its importance that I was disappointed that the shadow Secretary of State for Health apparently did not feel able to put his name to the motion. However, the previous speech more than covered that issue. I wish to consider a more interesting subject: long-term care for the elderly. It is fair to say that neither of the two larger parties has much about which to be proud, but this is no time to comment on the Tory record, because the Government have also provided a lot of material.
Mr. Nigel Jones (Cheltenham) (LD): I believe that it is in fact time to comment on the Conservative party's record in power. I come from Gloucestershire, where the county council was capped year after year in the early 1990s so that it could not provide the sort of services that
we are considering for elderly people. Who was in charge of that damage and distress? The answer is the right hon. and learned Member for Folkestone and Hythe (Mr. Howard).
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