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17 Mar 2009 : Column 205WHcontinued
By the way, today is world social work day. I mention that in case hon. Members were not aware of it. It is a good opportunity for all of us to recognise the central role that social workers play in supporting individuals, families and communities. They do a very difficult job. The values that underpin the role of social work are central to the values that underpin our society. That applies not least to our desire to pursue personalisationensuring that services, whether in a care home, nursing home or out in the community, are tailored to meet the needs of individuals.
This issue applies to adults of working age as well as older people. Sometimes debates about care focus only on older people. We know the pressures in that respect, and the demographics and so on, but I want also to emphasisethis relates particularly to the social care Green Paperthat we need a social care system for the 21st century that meets the care needs of working age adults with learning disabilities, physical disabilities and so on, as well as of older people who have retired.
Those challenges will not arise at some distant point in the future; they are with us now. The ageing population is one of the most profound social changes of our time. It is fantastic that we are all living longer11 years longer on average than we were many years agobut that makes demands of and puts pressure on our system, not least in respect of funding and quality of care. Building a consensus about the future of the care and support system presents a significant policy challenge not only for the UK Government but for every nation in the world that is grappling with it.
I agree with the hon. Member for Sutton and Cheam (Mr. Burstow) that an ageing society is not a decaying society. He is right to emphasise the positive aspects of becoming older. The fact that we are living healthier and more active lives, as well as longer lives, should be celebrated. I am talking about older people as active citizens, having more choice and control. However, when care needs arise, care has to be provided in a way that supports people to maintain that independence and to have that choice and control.
Before I talk about the detail, I want to emphasise, in relation to the social care Green Paper, that because of the pressures, the changing expectations and the transformation of social care that is going on today, we need a radical rethink of the care and support system. The Green Paper is the vehicle for that debate, and it will be published soon. That will be an opportunity for us to have these debates in the way in which the hon. Member for Eddisbury (Mr. OBrien) has requested.
I want to put on record again the deferred payment scheme. People can go to their council and ask that they do not have to sell their home in their lifetime to pay for their residential care. They can defer that payment, if they approach their local authorities. That is an important point that the hon. Gentleman often misses out in his contributions.
Standards have been a key theme throughout the debate. The hon. Member for Leeds, North-West (Greg Mulholland) reminded us of the 169 homes that failed the inspection by CSCI. No one should have to experience what was described in a home. I agree with him about that. I will add, though, that although those
169 homes failing the inspection is unacceptable, it is good that 10,208 other care homes are not providing a service of that kind; they are providing a service that does meet the standard that we would expect.
The performance of care homes measured against all national minimum standards has shown improvements each year since those standards were introduced. In 2007-08, care homes for older people met on average 82 per cent. of the standards, compared with 72 per cent. in 2004-05, which is a big improvement. Care homes for younger adults met on average 85 per cent. of the national minimum standards, compared with 76 per cent. in 2004-05. We all recognise the work of CSCI and providers in bringing about those improvements. I am confident that the new Care Quality Commission, which the hon. Member for Teignbridge mentioned, will continue where CSCI left off.
I understood the point that my hon. Friend the Member for Stroud (Mr. Drew) made about inspection and the inspection process, but it is vital that we continue to drive forward and improve standards in our care system. In 2008, 82 per cent. of homes for older people met or exceeded the national minimum standard for hygiene and infection control, compared with 77 per cent. in 2006 and 66 per cent. in 2004, so work is going on and improvements are being made.
Current regulations require care homes to ensure that staff are adequately trained. Hon. Members have mentioned the key issue of training. The regulations and the registration requirements being prepared now will include similar provisions. The CQC, as a regulator, will have a role in inspecting against those, as well as enforcing compliance.
The hon. Member for Sutton and Cheam has mentioned the nutrition action plan. Nutrition is another element of care quality in homes. I have seen examples of excellent practice on nutrition, such as printing menus with pictures so that people can easily identify the food and then want to eat the food that they can see, but clearly more needs to be done. The nutrition action plan delivery board was launched by my predecessor, my hon. Friend the Member for Bury, South (Mr. Lewis). Its chair is Gordon Lishman. It has been meeting for the past year, and it is due to give me a full report in about a months time. I shall examine the report and make decisions on its findings.
Staffing issues have been raised. I appreciate the concerns about immigration, but I do not think that the new points-based system will mean that care home
providers cannot recruit enough care workers. Our policy objective is to be more reliant on the domestic labour market.
Richard Younger-Ross: Will the Minister give way?
Phil Hope: I do not have time to give way; I apologise to the hon. Gentleman.
It will take time to improve local supply, so we are planning to produce a work force strategy for adult social care this spring. Part of the remit of that strategy will be to set out what the sector needs to do to attract, develop and retain a suitably shaped, skilled and qualified work force to fulfil our policy objectives on delivering personalised care. Much of that will mean recruiting from relatively untapped employment markets across existing communities. Delivery depends on activity at the local employer level, which will take time to work through the sector, but I assure the hon. Gentleman that we are on the case. As he will know, most care homes are private businesses, and they agree their terms and conditions of service with their staff, subject to national employment legislation. Of course, it was the current Government who introduced some of those national minimum standards, including the minimum wage and working time directives.
The hon. Member for Sutton and Cheam raised the question of the personal expenses allowance, which was a difficult decision. The question was where we should put our resources. The estimated cost of raising the allowance to £40 a week is £250 million a year. We chose to put £520 million a year into local authorities over the next three years. If we had reduced that by £250 million, it would have meant less money for local authorities to improve the quality of care in their areas, and they would not have had the resources to undertake the essential transformation of social care. The allowance is increased in line with average earnings, but that issue will form part of the debate on the social care Green Paper, because it is a fundamental part of the system that is in place to provide financial care and support for people in our communities.
The dementia strategy was mentioned. I do not have time to
Mr. Edward O'Hara (in the Chair): Order. Indeed you do not, Mr. Hope. We must turn our attention to the next debate.
Meg Munn (Sheffield, Heeley) (Lab/Co-op): I am pleased to have secured this debate on St. Helena and its transport links with the rest of the world. I welcome colleagues from different political parties who have come along to show their support for the people of the island.
When I put in for the debate, my intention was to press the Department for International Development to make a decision on building an airport on the island and to go ahead with this vital project. We now know that DFID has once again decided not to make a decision, but to put the issue out for yet more consultation, engage yet more consultants and spin things out until the turn of the year. No doubt the Minister will try to put a positive gloss on that, but, in reality, these events have more to do with trying to avoid a judicial review of the Departments handling of the scheme.
DFIDs history on this project is shameful. It has used delaying tactics and done anything it can to avoid settling the issue of St. Helenas transport links with the outside worldlinks that could mean life or death for any one of the thousands of British citizens on the island. Those people are British citizens because St. Helena is a UK overseas territory. Just because it is situated in the south Atlantic does not make those people less British, although it perhaps makes them more forgettable for DFID.
St. Helena is one of the most isolated places in the world. It is approximately 1,400 miles west of Namibia, 1,800 miles east of Brazil and 700 miles south of Ascension Island. The only way to get there is by ship, with the island being served by RMS St. Helena, the last Royal Mail ship still in service. This purpose-built ship was constructed in 1989 and is obviously towards the end of its operational life, rather than the start.
That raises the question of how to ensure that the islanders have reliable transport links in the future. Replacing the ship with another purpose-built vessel is possible, but expensive. The jetty at St. Helena would also require remedial work, but that, too, would be expensive. In addition, the islanders are concerned about that option because they remember what happened in 1999 when the current ship broke down, leaving them stranded until repairs had been made.
Let us be clear: if the supply ship breaks down, people and supplies, including vital medical drugs and equipment, cannot get to the island. It also means that islanders cannot leave, including those requiring urgent medical attention that is not available on the island. Even as I speak, the ship is on its way to the UK and will not return to the island until 11 April, but the shops have run out of potatoes.
The obvious answerit has been obvious for a number of yearsis to build an airport. Of course, there is the cost. Building an airport anywhere is an expensive undertaking, and building one on an island in the middle of the south Atlantic, with all the problems of supply, would not be cheap. Until recently, however, the Government supported building an airport. The Foreign and Commonwealth Office supported the project, and we can take it that the Ministry of Defence would welcome an additional landing strip for its air bridge to
the Falkland Islands. Incidentally, those islands have fewer residents than St. Helena, but they have flourished thanks to British Government support.
No doubt the Minister will say that the recession provides a new context for delaying the airport project. Taken on its own, that argument might appear to have some worth, but this is at least the ninth year that DFID has appeared unwilling to give the project the go-ahead. Although the Government have continued to give British citizens at home commitments about infrastructure projects, this vital project for British citizens abroad is once more being delayed. Given the positive support, or acquiescence, elsewhere in the Government, it is not surprising that minds begin to wonder why DFID is the one Department of State that prefers to park the scheme. It will not say yes, but will not say no either.
The Government have accepted that overseas territories should be self-governing as far as possible, that they can remain UK overseas territory as long as they wish and that Britain will continue to fulfil its responsibilities to each territory, as set out in each constitution. Citizens of the overseas territories have also all been granted British citizenship and the rights that come with it. When DFID was set up, it was also recognised that the overseas territories would have first call on its funds. To my knowledge, no one in the Government has suggested that the relationship between the UK and the overseas territories should change or that the right of such territories to have first call on DFID funds has been rescinded.
St. Helena is an overseas territory and the islanders are British citizens. The islands economy is weak and deteriorating, and life is becoming increasingly desperate for the population. The infrastructure is poor and not sufficient to realise the islands potential or to sustain the population without subsidy. In 2007-08, the Governments bilateral aid to the island was £17.5 million. In addition, the RMS St. Helena requires an annual subsidy of at least £3 million. The average salary is £4,500, with goods and food being more expensive than in the UK because of freight charges. Many people are forced to leave families and work abroad.
Anne Snelgrove (South Swindon) (Lab): I thank my hon. Friend for securing this important debate. A number of the islanders have friends and family in the St. Helena community in this country; indeed, Swindon has the second largest number of people from that community. Would not an airway allow those people to visit their friends and family? At the moment, they are isolated from them.
Meg Munn: My hon. Friend is correct. Indeed, one of our Doorkeepers in the House of Commons comes from St. Helena.
Since 2000this very much illustrates my hon. Friends pointthe population has fallen from approximately 7,000 to fewer than 4,000. As a result, more than 150 children and young adults are in informal foster care. The population increasingly comprises the elderly and children.
The health department has to select which seriously ill patients qualify for further care and treatment in Cape Town or the UK, and that practice will only increase with an ageing population. Access to medical
supplies is poor. Residents rely on supplies delivered by RMS St. Helena. As we saw in 1999, when the ship broke down, the island is vulnerable.
Mr. Fraser Kemp (Houghton and Washington, East) (Lab): I congratulate my hon. Friend on introducing the debate. Does she share my concern about the fact that the hospital has been unable to use a scanner for a number of months because of the difficulty in getting an engineer from Siemensthe company that provided the scannerto look at it? That is another example of how the lack of access impacts on every walk of life, whether in health, education or the economy.
Meg Munn: I entirely agree with my hon. Friend, who has had the opportunity to visit St. Helena, although many of us have not, because of the time it takes to get there. By contrast, the scanner in the hospital on the Falkland Islands, which I have visited, is state of the art. The hospital can scan patients and send the scans to Brazil for advice on what treatment to use. The fact that the scanner on St. Helena cannot be used is an indictment of the current situation.
Discussions about building an airport first took place in 1947, but the current project goes back nine years to 2000. Over those years, there have been many twists and turns, feasibility studies and consultants reports. I will not spend time discussing all that, suffice it to say that it does not reflect well on DFIDs ability to develop and implement projects.
The Government have already earmarked £234 million for the airport and associated infrastructure improvements. DFID has selected an airport contractor via competitive procurement and spent substantial amounts of taxpayers money in the process. The contractorImpregilohas already invested significantly and has a team on the island ready to start work. Significant inward investment is ready to go as soon as the airport scheme is given the go-ahead.
Shelcothe St. Helena Leisure Companyhas been set up specifically to develop the leisure facilities to support the development of St. Helenas economy. It has substantial investors in place to underwrite between £80 million and £100 million of investment. Shelco has acquired options on an area of St. Helena and the Oberoi group is its hotel partner. They propose creating low-volume, high-value tourism, including a six-star eco hotel. That is the local preference, and it was recommended in a UN report and supported by two DFID-commissioned reports. That would create jobs and future income for the island.
Developing St. Helena and building an airport would be in the UKs strategic interests in the south Atlantic. It would substantially help the economies of other British overseas territoriesthe dependencies of Tristan da Cunha, Ascension and the Falkland Islands. Opening the island to low-volume, high-value tourism would create opportunities for new local business ventures.
The infrastructure and economy needed to support the influx of tourists would provide the many islanders working abroad with the opportunity to return to the island, which would help to generate a self-sustaining economy. That would enable the island gradually to reduce its financial dependence on the UK. We understand that the modelling undertaken by DFID economists shows that the airport is the best-value option to achieve
the Governments policy of creating a sustainable economy. I would be grateful if the Minister confirmed that that is the case.
It is not an overstatement to say that DFIDs recent decisions threaten the viability of the airport project. They also threaten the regeneration project put forward by Shelco. Impregilo, the preferred airport contractor, needs certainty. If that does not happen, DFID will lose the company, and the lengthy and expensive airport tendering process will have to start again. It is most unlikely, given its history, that other parties will come forward. The delay will exacerbate the difficulties faced by the islanders, who are already dealing, month by month, with economic decline.
Building an airport is the choice supported by the people of the island. In a 2001 public referendum, 72 per cent. of the islanders voted in favour. Without an airport, there are no positive prospects for St. Helenanothing except continued, steady economic and social decline. At the same time, the UK taxpayers subsidy will be steadily climbing, but the people of St. Helena do not want UK handouts. As British citizens, they deserveand needthe Government to take them seriously, and to support them in a way that will open up possibilities for developing their economy and securing their future.
The airport option would do that, and do so immediately. The stimulus to the economy once the project started would be substantial. These are dark economic days for most of the world. By keeping the long-standing promise to build an airport, we would stimulate recovery and hope in one of the poorest British areas of the world, and we would do so in a manner that created growth and self-sufficiency. The recession provides an additional reason to get on with the project, not a lame excuse to delay it further. At this late stage, I urge DFID to support St. Helena, agree to the building of the airport and invest in the future of the island.
Bob Russell (Colchester) (LD): I speak as chairman of the all-party group on St. Helena. If the Minister is not aware of the fact, I advise him that last week hon. Members and many of the Saints living in the United Kingdom presented a petition to 10 Downing street. We await a response with great interest. What we did not expect was the shameful ministerial statement, made yesterday and published this morning, to which the hon. Member for Sheffield, Heeley (Meg Munn) referred. I congratulate her on her measured speech, but this is not the first time that we have had an Adjournment debate about the island of St. Helena. The sense of betrayal cannot be understood, but if the Minister had been present last week, he would have witnessed it.
I offer the Minister an invitation. No Minister has ever visited the island. Royalty has been there, but no Ministers. If the Minister, or a member of his ministerial team, were to visit St. Helena, things could be seen at first hand. Perhaps the dead hand of the Treasury, rather than DFID, is involved. However, the only future for the island and its residents is the airfield, as was well set out by the hon. Lady. Such a betrayalafter all these years and when the contract was about to be letis inexcusable.
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