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Sandra Gidley: I dare say there are countless other examples, but today's debate is not about that. [Interruption.] The Tories say, "Let's not bother." That is because they know that the record does not stand up to scrutiny.
Despite the words of the Government's amendment, they are in no position to rest on their laurels. Before the 1997 election, they promised to set up a royal commission to consider long-term care for the elderly. To give them their due, in December 1997, soon after the election, the then Secretary of State for Health, the right hon. Member for Holborn and St. Pancras (Mr. Dobson) said:
Sandra Gidley: The Minister is merely reinforcing the inverse snobbery that is so prevalent in the Government. Seven out of 10 people may receive some help, but the other three out of 10 are not necessarily wealthy. We shall shortly have the same debate on tuition fees.
What is the point of setting up a royal commission if its advice is to be so roundly ignored? The Government will probably claim that they accepted the bulk of its recommendations, and that it would be wrong to place too much emphasis on this particular one. It might therefore be useful to turn to the statement made by the royal commission on long-term care, which was published in September 2003 and whose purpose was to review the extent to which the long-standing problems in long-term care and its funding had been resolved since the commission reported. The statement points out that the debate about long-term care and its funding is very much alive, that little has been resolved, that Governments in most of the UK still decline to act, and that there is widespread concern. That is the view of the commissioners. The statement also reminds us that this is an important issue not only for older people and their families but for the wider public.
The statement was damning, and highlighted other areas in which the Government's response had been disappointing. The first related to the setting up of a national care commission. The Government will point out that they have set up the National Care Standards Commission, but the remit of that body is much narrower than that envisaged by the royal commission, as its role is merely regulatory and falls far short of the wide-ranging role proposed by the royal commission. The reality is that the establishment of the new Commission for Social Care Inspection will result in a further erosion of the principles originally envisaged by the royal commission.
Ms Munn: My vision is that increasing numbers of elderly people will not need to go into long-term residential care and that they will be able to stay at home, sometimes at a greater cost than would be incurred by their going into a nursing home. How will anything that the hon. Lady is describing help to achieve that goal?
Sandra Gidley: I cannot argue with the hon. Lady's long-term vision, but if she will wait for me to develop my argument, she will see that, while her vision is worthy, it is not being fulfilled by the Government or the party that she supports.
Chris Grayling: The hon. Lady has talked extensively about the recommendations of the royal commission. Has she made an estimate of the proportion of a typical nursing home fee of £500 a week that is taken up by
Sandra Gidley: I am sorry that I do not have detailed figures; I only have the overall costs. I do not know if the hon. Gentleman is referring to our manifesto pledge, but I can assure him that it is fully costed.
The bulk of the report consisted of condemnation of the Government's refusal to adopt free personal care for the elderly. Tempting as it is to concentrate on that aspect of policy, however, it is not the only issue in this very crowded field, and I want to spend a little time examining the Government's record. It is difficult to argue with the assertion that people would prefer to stay at home. Many people would agree with that, but is it actually happening? Is that what the Government are achieving?
It is difficult to get to the bottom of this issue. The latest figures show that, in 200102, some 1.4 million people were helped to live independently at home through the provision of a variety of community-based social services. This was an improvement on the 200001 figure. A response to a parliamentary question revealed that no figures were available for the years prior to 200001. Strangely, however, I came across some figures provided to the Health Committee in the public expenditure memorandum of 2001, which showed that an estimated 1.5 million service users were then receiving community-based care. The reality is, therefore, that 100,000 fewer people are now receiving such care. As the hon. Member for West Chelmsford (Mr. Burns) pointed out, that seems completely contrary to what the Government are trying to suggest.
Although more money is being provided, it is reaching a smaller number of people. I have noted the carefully worded ministerial replies that refer to intensive home care packages. Those have increased, but a definition of "intensive" has been difficult to obtain. The reality is that the number of households generally receiving any sort of care has been reduced. I cannot square that with helping more people to stay at home. Many cases can be cited from around the country in which an older person who lives at home needs a small adaptation but cannot get it until they fall over, end up in hospital and social services come to the rescue. It seems that the system is skewed and is reactive rather than proactive.
The Minister said earlier that people can have home improvements, but in many cases those will take six months to happen, and those six months can be six months of misery. A constituent of mine told me about her husband whose situation meant that they had to have a downstairs toilet. In the interim before it was built, the only way in which they could cope was to have a commode in the main downstairs room. This lady felt that she could not invite any friends home. Is the Minister happy to preside over a situation in which people must wait months to receive the help and care that can help them get on with their lives? I think not. He will surely admit, however, that his priorities are skewed.
I do not want a glib response from the Government saying that the matter is in hand and that all will be well because the National Care Standards Commission now has responsibility for this important area. In theory that is right, because the commission theoretically took over responsibility in April last year. All domiciliary care agencies operating before 1 April last year should have registered by 31 March, and any agencies wanting to set up after that date had to be legally registered before they could begin providing care[Interruption.] I do not know what the hon. Member for South Dorset (Jim Knight) finds so amusing, but perhaps his constituents can enlighten him as to the reality of some of what I am talking about[Interruption.] I apologise if he was actually coughing, but I am not sure about that.
The Government made arrangements so that existing domiciliary care agencies can continue operating until their application is determinedgranted or refusedand no inspections would take place in the first year. At first glance, that is all very sensible. I draw the House's attention, however, to the reply to a parliamentary question that was tabled on 1 December last year but only answered on 5 January. It asked how many domiciliary care providers have, first, applied for, and secondly, met, the registration standards. The answer was interesting, because although as of 30 November 4,322 domiciliary care providers had applied for registration, only 3,155 of those had been validated and were being processedwhich sounds a little vague. Only 243 domiciliary care providers, however, had met the registration standard. That gives rise to the following questions. How many had not met the registration standard? An answer to that would be very useful, and if I do not get one I shall table a parliamentary question
This morning, I rang the commission, but it could not tell me how many domiciliary care providers had failed the assessments. I hope that the Minister has that information at her fingertips when she sums up. I also searched the commission's website to try to establish the date by which all applications must be processed. The search proved fruitless, but when the question was put directly to commission staff, I was told, "There is no date." I am sure that the Government will admit that this endless procedure is completely unacceptable. Can the Minister explain why no date has been set, and what plans there are to rectify the situation?