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Excellent work is being done by organisations concerned with social care. The Wanless review from the King’s
Fund underpins much of the current debate. The Joseph Rowntree Foundation, Help the Aged, Age Concern, the Local Government Association and the International Longevity Centre UK have all led the debate, with organisations such as Carers UK and the Alzheimer’s Society, among many others, feeding in their experience. I pay tribute to those organisations and encourage them to continue to hold the Government’s feet—indeed, all parliamentarians’ feet—to the fire. I am sure that those of us present hope to do just that today.
The Minister has said that the issue poses as big a threat to the country as climate change; the Secretary of State for Health said the same of obesity. Clearly, that is the metaphor of choice at the Department of Health. The difference is that we have direct control over the issue of social care. We know how the policies that we adopt will affect the future. The question is: are the Government doing enough, or could they be accused of dragging their feet?
The enormity of the issue and the political impetus that it has gained has given rise to
“a large amount of political will at the moment to try and really solve this problem.”
That is what I said at the launch of the Caring Choices coalition report last year. The Minister said at that event that it was “absolutely crucial” to achieve political consensus, and the Liberal spokesman on that occasion, the hon. Member for North Norfolk (Norman Lamb), said that that “ought to be possible”.
Consensus will come about only through serious discussion of the issue, underpinned by meaningful, trustworthy research and consultation. It is fair to say that there is consensus in the analysis of the problem, as the Minister suggested. It is right to put it on record that I agree with a great deal of what the Minister said in his opening remarks about the elderly, those who have lifetime conditions and needs, children, disabled people and those who have to take advantage of mental health services. It is important to recognise that we in the House share our analysis of the problem—the need, the demand, the technological opportunities and people’s increasing anxiety to take control of their care and lead good, independent lives, often in their own homes, as far as is possible. We have to recognise that what is needed today is a Government proposal for a solution. It is on that point that there is anxiety, and on which I will focus much of my contribution.
If consensus is so important, we might start by placing it on record that it would perhaps have been helpful if a Liberal spokesman and I had been invited to the Prime Minister’s launch on the future of social care. The Prime Minister ended his speech on that occasion by stating that he looked forward to building a consensus on the best way ahead, but it is quite difficult to do that if one excludes the very people with whom that consensus needs to be built. I hope that the Minister is committed to consensus in deed, as much as in word. If so, perhaps he should start by getting his Prime Minister to be a little less tribal, and to start to look at the national, big picture, rather than the narrow, Labour party view.
Roger Berry:
The Conservative pledge at the last election to provide free residential care after three years would have benefited the rich and would be worth nothing to people on lower incomes, such as my
parents. In the spirit of getting rid of tribalism, will the hon. Gentleman assure the House that his party is withdrawing that policy and listening to the debate?
Mr. O'Brien: Given that I was at a meeting yesterday with the hon. Gentleman, who was there as chair of an all-party group, I am disappointed that he should take such a cheap approach. As it happens, in the 2005 election, our party—not his party or the Liberal Democrats—was the only one that had any policy on the issue. Furthermore, it is absolutely the case that Wanless applauded our limited liability model. The hon. Gentleman tries to suggest, from a sedentary position, that I have just said something untrue; I hope that he will withdraw that immediately, as Wanless went out of his way to praise our limited liability approach.
Mr. O'Brien: Before the hon. Gentleman tries to recover his position, I have said on the record that we are looking carefully at building on the policy that we were able to offer at the last general election—uniquely among all the main political parties—by saying that we are considering the partnership model. That is different, and we are also building on that, but at least we had something to put forward—something that does not just favour the rich, but which would give people certainty, in view of all the uncertainties, that at least some contribution would be made.
I will give way to the hon. Gentleman again if he wishes to correct his original intervention, which he got badly wrong. He should have tried very hard not to show that he was such a partial all-party group chairman.
Roger Berry: I am grateful to the hon. Gentleman for giving way. I am sorry—I was trying to correct what I thought was a tribal comment on his part. I was making a simple point about the Conservative policy at the last election. My question was whether they have withdrawn the policy which, in guaranteeing free home care after three years, would clearly benefit the better off and would mean nothing whatever to people on low incomes, like my parents who, after three years, would have seen their savings gone. In the spirit of trying to achieve a fair system, will the hon. Gentleman acknowledge that that proposal ought to be withdrawn? Yes, let us look at partnership models, but that was not one of them.
Mr. O'Brien: It was indeed one of them. The hon. Gentleman should read the Wanless report again. I am very surprised at his inaccuracy. I look forward to our forthcoming manifesto. There may well be a successor policy to the original one, but I am not suggesting that we are withdrawing a policy that made the British public proud that something was at last being offered to them at the previous election.
Mr. Lewis:
Is the hon. Gentleman saying that the current position is that there is no policy, or that the policy that was in his party’s last manifesto stands?
Does the Conservative party have a policy on the matter? Does the policy in the last manifesto remain its current policy?
Mr. O'Brien: The position is clear. As we approach the next general election, of course there will be a manifesto for that election. In the manifesto that we presented at the last election, there was an offer—uniquely, given that the other two main parties had no policy to offer, and have published no policy since. I shall describe why the Government have been so lacking in offering solutions.
Mr. Burstow: Will the hon. Gentleman give way?
Mr. O'Brien: No. None of us wants to give time to the Lib Dems until they can show where £2 billion comes from.
Tribalism is typically unfortunate as we try to develop a consensus. In the light of the political good will that I shall try to establish, the public interest and the high quality of the debate that has been conducted by third party organisations, it was disappointing that the document underpinning our debate, “The case for change—why England needs a new care and support system”, did not seem to come up with a proposal. It forms the basis for consultation and discussion, but it does not offer leadership and a way forward in an area where the third sector and the official Opposition have offered proposals.
The document offers no solutions and few facts, and barely outlines the problems. We were expecting the Government to begin grappling with the detail of the issue, but the document turns out to be, yet again, part of the consultation. I accept that the consultation is what the Government promised in the comprehensive spending review. We were promised continuous consultation, rather than action, and that is what we have. All of us hoped for more from the Government, and it is a shame that we have been driven by reviews. There have been 55 reviews since the Prime Minister started less than a year ago.
We are consulting in advance of a Green Paper, which itself is a consultation document. I am the first to recognise that consultation is important, but at some stage the Government must take action. The Minister said of the by-election in Crewe and Nantwich, the seat neighbouring mine:
“We face a stark choice. This is either the beginning of the end for Labour or a call to action.”
I hope he heeds his own call for action. He might say that the Government are consulting now and will publish a Green Paper leading, presumably, to a White Paper and perhaps some legislation. The Government, we hope, will not find themselves trapped in a constant cycle of consultation. I leave aside Tony Blair’s cry in his 1997 conference speech:
“I don’t want children brought up in a country where the only way pensioners can get long-term care is by selling their home.”
For 11 years, Labour has held to that promise and, for 11 years, has failed to do anything about it. The Prime Minister, in launching the consultation—
Mr. Lewis: Will the hon. Gentleman give way?
Mr. O'Brien: No, I will not give way. Let me finish the paragraph.
“Younger adults are aware that much of their parents’ hard-earned housing wealth may disappear... At some point in the future people may have to sell a treasured home to pay for their own care...Too many people fear the prospect of selling their homes.”
After 11 years, we are still in exactly the same position. I remind the House that we were led to believe by the Minister and his predecessors that the last CSR would provide some concrete proposals. That was last year.
Dr. Ladyman: Will the hon. Gentleman acknowledge that the Government have given a sum of money to all local authorities to allow them to put a charge on an individual’s home so it does not have to be sold in their lifetime if they do not wish it? The reason why so many Conservative MPs complain that people have to sell their home when they have a care need is because their constituencies are in Conservative council areas that do not bother telling people that this money is available.
Mr. O'Brien: The hon. Gentleman did not produce any figures to justify that. The Minister himself said that he was not clear how much of the deferred payment scheme had been taken up, but it has been very light. I take issue with the hon. Gentleman’s belief that that has made any tangible difference to people’s concerns about having to sell their own homes. He knows that that is the case; otherwise the Prime Minister would not have said what I have just quoted.
When Sir Derek Wanless published his report on 30 March 2006, the Minister’s predecessor, the Minister for Borders and Immigration, the hon. Member for Birmingham, Hodge Hill (Mr. Byrne), headed off the criticism of his Department by announcing his intention—supported by the then Chancellor, now the Prime Minister—to conduct what he called a “zero-based review” starting from scratch to reassess the whole social care budget for older people. The announcement was that the Department of Health would
“conduct a review of social care, starting from first principles on how social care is funded. We believe this is a once in a decade chance to undertake a fundamental review of social care costs.”
This review of long-term care funding
“would inform the Department’s plans for social care funding, which will be submitted to the Treasury as part of the comprehensive public services spending review in 2007.”
Building on the expectations raised by that, the Minister spent the 18 months before the CSR talking up what the Government would do through
“a new settlement in social care”,
a quote I have often used with him, in the CSR.
In February last year, the Minister said:
“We continue to negotiate with the Treasury to secure a fair and reasonable settlement as part of the comprehensive spending review.”
“We will assess the proposals for the future provision of long-term care services as part of the long term vision of the comprehensive spending review 2007.”
“We are arguing forcefully...with the Treasury about the importance of a good settlement for social care under the comprehensive spending review.”
Yet when the CSR came, there was no evidence of any zero-based review having been undertaken and little evidence of any impact of negotiations with the Treasury. There were certainly no solutions to the funding of long-term care.
Furthermore, I have asked a raft of parliamentary questions about the zero-based review. It has met only four times in total; in June, July, October and November 2006, concluding a year before the CSR. The Department did not quantify the work of the group; that is supported by a written parliamentary answer. I cannot track down any evidence of the work done, any report, any recommendation or any impact at all. I should also mention the concordat “Putting People First,” another bundle of paper with no firm commitments, proposals or bases for action.
Mr. Lewis: Will the hon. Gentleman give way?
Mr. O'Brien: Perhaps I could develop my argument a bit more; the Minister did very well to take a full 50 minutes. He was keen to paint a record that was very lopsided.
Mr. O'Brien: However, I shall give way very briefly.
Mr. Lewis: The “bundle of paper” to which the hon. Gentleman referred was signed up to by a gentleman for whom I have a lot of respect—Sir Simon Milton, who is a member of Boris Johnson’s cabinet. He is the most senior Conservative councillor in this country.
Far from being a “bundle of paper”, what the hon. Gentleman referred to is the beginning of a three-year radical transformation programme, supported by more than £500 million of Labour Government money in every local authority area in the country. Does the hon. Gentleman wish to withdraw his description of it a “bundle of paper”, given that it is in fact a three-year transformation programme supported by more than £500 million?
Mr. O'Brien: The Minister has admitted that he regards that not as taxpayers’ money, but as Labour Government money—a rather unusual approach to identifying other people’s hard-earned money. What is key is that there was no firm commitment or proposal as a basis for action on the issues that we are addressing today. That is the central point.
The Minister has said that the Prime Minister is “out of touch”; that may be why the Prime Minister and the Government are so desperate to consult. At least we have the promise, on the record, that the Green paper will be published in early 2009—given what has happened in the past, “early” means any time between January and July. Assuming a three-month consultation period thereafter, the White Paper will come out at the end of 2009 at the earliest. Will that really come five months before the last possible date for a general election? It would seem that legislation will be undertaken by the next Government at the earliest—nearly six years after
Wanless published his review. The inescapable conclusion is that the Government appear to have tried to kick the issue as far as they can away from the current parliamentary Session.
What the Government should be doing is simple: getting together good data on the issue, as we have been arguing, so that parliamentarians can make policy from an informed position. The Government should have done that in the past 11 years. All the forecasts of demand are predicated on morbidity remaining constant as the population ages. What assessment have the Government made of that?
More scandalously, the Government do not know how much is currently being spent across public and private purchasing, different Government Departments and local authorities. A cursory glance at the Official Report shows a raft of hundreds of questions, from me and many other hon. Members from across the House, that are answered with statements such as, “The information on numbers and costs is not held centrally.” The Government have also failed to do any modelling on how different funding structures might impact on public and private finance, consumer and provider incentives and the shape of the market.
The National School for Social Care Research, launched last week, will, we hope, provide some of the academic rigour needed to underpin this debate. We will be watching closely to see that it does. If it lives up to its billing, the school will be long overdue and much welcomed.
Sir Derek Wanless flagged up Kent county council’s long-term care insurance. It looked promising to him, but neither the Department of Health nor the Treasury would fund further study, as each said that it was the other’s responsibility. Other councils, such as the Conservative-controlled Isle of Wight council, have recently started to provide free social care to all those over 80. Why are the Government not investigating those? As we assess the Government’s action, it is fair to ask why in the past 11 years they have not done what was easily identifiable as necessary.
I shall move quickly over the Liberal Democrats’ free personal care proposals during the last election; the policy was unaffordable and their health spokesman called—
Sandra Gidley (Romsey) (LD): Boring! You’re so tedious!
Mr. O'Brien: Ah! I am pleased to see the hon. Lady in her place. She, the Liberal Democrat health spokesman, called that policy during an Adjournment debate, on the record, “dishonest”—an appellation that she went on to attach to all Liberal Democrat manifesto writers.
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