| Previous Section | Index | Home Page |
Mr. Ken Purchase (Wolverhampton, North-East) (Lab/Co-op):
I urge my right hon. Friend the Chancellor to continue with his present economic policy, remembering the chaos brought about by the Lady Thatcher Government through the cuts that they introduced in the immediate post-1979 period. Looking to the future, will he resist the idea that he should commit to an overview of the
future years, given that the Conservatives are simply looking for legitimacy for the planned cuts that they wish to announce?
Mr. Darling: My hon. Friend is quite right. Under the Conservatives, there would be cuts now followed by more cuts later. He is also right to say that they are looking for cover for what they have always wanted to do and for what they have always done.
Adam Price (Carmarthen, East and Dinefwr) (PC): Given that the Calman commission in Scotland and, last week, the Holtham commission in Wales have now produced their reports on the Barnett formula, will the Government publish their factual paper on the formula, which was first promised in January 2008?
Mr. Byrne: As the House will know, another place is looking in some depth at the whole question of the Barnett formula and how it should operate in the years to come. We will look very closely at what emerges from the Holtham commission, too. The next real bit of news will be the report from the ad hoc committee that was set up in another place.
Hugh Bayley (City of York) (Lab): It is right for our Government to have a commitment to gaining the same sort of benefit for Britain from the new technologies to limit carbon emissions as we gained from manufacturing in the industrial revolution. My right hon. Friend the Chancellor, in replying to the hon. Member for North Southwark and Bermondsey (Simon Hughes), said that he had introduced measures in the Budget. Has he any estimate of the number of jobs that might result from these measures to develop new low-carbon technologies?
Mr. Darling: I believe that there will be thousands of jobs created in the future through new green technology. That is all the more reason why we should resist calls to start cutting public spending now when public spending can be used to help our industries to compete in the future. That is another clear dividing line between the two sides in this House. We believe that Government have the power to influence things and to ensure that we can be at the forefront of these new industries, which will create thousands of jobs in the future.
Mr. Richard Spring (West Suffolk) (Con): Given the parlous state of the public finances and the need to borrow so extensively internationally, does the right hon. Gentleman not understand that the failure to bring forward a comprehensive spending review will make it even more difficult and uncertain to borrow from the capital markets?
Mr. Darling: No, I do not. If the hon. Gentleman looks at the international commentary and studies into our economy, he will see that most of them believe that what we do and what we are doing is exactly right and is in contrast to the policies that he and his fellow Conservatives advocate, which is to do nothing. I do not believe that that is a sensible thing to do at a time like this.
Andrew Mackinlay (Thurrock) (Lab):
Will the Chancellor take this opportunity to amplify that which he uttered on television a few days ago about adequate funding for our armed forces in the Afghanistan conflict? Will he make it abundantly clear at the Dispatch Box now what funding is immediately available to our armed forces
and what will be available in a reasonably immediate time scale-perhaps until the end of the year-so that there is no misunderstanding or ambiguity among all who are involved and all who are interested? Will he take this opportunity?
Mr. Darling: It is very important that we support our troops on the front line in Afghanistan and elsewhere. I can tell the House that in the year 2006-07, we spent £700 million on urgent operational requirements. That rose to £1.5 billion in 2007-08 and £2.6 billion in 2008-09. This year, we expect to spend more than £3 billion in support of our troops. Our commitment to our troops is essential, especially at this time when so many people are facing dangers-we have been reminded over the past few days of the tremendous sacrifice that has been made by so many people, not just for Afghanistan but for this country, too.
Mr. Nigel Evans (Ribble Valley) (Con): On Sunday, a constituent aged over 80 came to see me. He said that he was now receiving his 25p pension supplement, which he saw as a gross insult. It does not even buy a pint of milk. When is the Chancellor going to sort that out?
Mr. Darling: I know that the hon. Gentleman is not the only Member of this House to have had constituents raise the question of the 25p age addition. However, I am quite sure that he took the opportunity to point out that his constituent received the increased winter fuel payment-something that his constituent would not have received had there been a Conservative Government.
Mr. Philip Dunne (Ludlow) (Con): With this being the final opportunity for the Chancellor to address the House before it resumes in October, will he rise at the Dispatch Box and apologise to the House and the British people for presiding over the precipitate decline in our public finances? It is the worst fall of any OECD country, and his is the worst record of any Chancellor, ever.
Mr. Darling: The hon. Gentleman is talking nonsense, and I suspect that he knows it. Like every country in the world, we are facing the severest downturn for well in excess of 60 years. The difference between this side of the House and his side is that, faced with that, we took action to support our economy and stabilise the banking system. We then made sure that we put money into the economy to help us get through this. Most other countries believe that that is the right thing to do. It is only the Conservative party in this country that has made it clear that, far from supporting families and businesses, it would make cuts this year, next year and the year after.
Fiona Mactaggart (Slough) (Lab): Can the Chancellor confirm that there will be extra resources for constituencies such as mine, where the number of children seeking primary school places exceeds the number of places available?
Mr. Darling: My right hon. Friend the Secretary of State for Children, Schools and Families has made it clear already that there will be a guarantee in place from this September. He keeps what schools require under review, so that we can ensure that we maintain our commitment to the children of this country.
Care and Support (Reform)
3.32 pm
The Secretary of State for Health (Andy Burnham): With permission, Mr. Speaker, I should like to make a statement on the care and support Green Paper "Shaping the Future of Care Together".
Last year, the country celebrated the 60th anniversary of the national health service, an idea that emerged from the post-war consensus on the need for a fairer approach to health care. Today, as the NHS has improved health and life expectancy, a new challenge has emerged and is becoming more urgent.
The challenge can be summarised in three simple but striking facts. First, male life expectancy is now 78 years, compared to just 66 in 1948. Secondly, there are now more over-65s than under-18s and, thirdly, whereas there were eight working adults per retired person in the 1940s, today there are just four. By 2050, that figure will fall to just two. So the debate that we face as a country is how to provide support, dignity and independence for all, in a care system that is fair, dependable and universal. Today's Green Paper starts that debate.
Half of all men and two thirds of women will develop care needs after the age of 65. In many cases, their needs are met informally by the silent army of carers and family members who work so tirelessly, often under great pressure, behind closed doors. I want to start by paying tribute to their huge contribution to our society, and stressing that everything that we are proposing today must build on the solid bedrock of support that they provide.
The challenge that we face is that many more people are now developing more serious needs that demand specialist care over the long term. A typical 65-year-old can expect to need care costing £30,000 throughout their life, but that average masks a huge range. For about a fifth of people, the figure is less than a £1,000; for another fifth, it is in excess of £50,000, and for those with complex, long-term needs-such as those with dementia-the costs can rise above £200,000. So the time has come to meet this difficult challenge, and to see whether we can establish a broad consensus about the best way forward.
A country is defined by how it cares for its older people, and we need to acknowledge that as a society we can do better. We need a care system that people can rely on, that does not penalise people for their prudence and that ends the cruel lottery of older people facing financial hardship because they happen to get dementia, for example, rather than cancer. We must also address the inconsistencies-the fact that two people with the same needs living in different parts of the country can have very different experiences of care.
So today we propose a new national care service, which would correct the flaws of the present system and establish core principles on which to base this new system. Those principles are universality, simplicity, prevention and fairness. On the first, universality, people have told us that they want a universal system that offers everyone a basic package of care and support. Under the national care service, people will get the reassurance and confidence of a universal system, with the security to plan for the future, and the certainty that, whatever happens, they will get help with their
care needs. For the first time, everyone, regardless of their bank balance, would get some help to pay for their basic care; everyone would get the same entitlement wherever they live in the country; and everyone would get advice and information to help them to find the care that is right for them.
Secondly, we need a system that is much simpler for people to understand and use. A new standardised national assessment would mean that wherever people lived they could be confident that they would be treated the same way, and if they moved their entitlement would not change.
It is also time to say clearly that it is unacceptable and unfair for people to be denied any help to find the right services simply because they are over the current £23,000 threshold. Under a national care service, that practice will stop. Everyone will get information and advice, giving a clear point of entry into the care system and ongoing support to find the services that they need.
People also tell us that their experience is compromised by the fractured nature of care and support. A national care service must therefore build on the progress already made to break down boundaries between health, housing and care services so that people get the seamless, wraparound support that they need. In particular, it is time to make health and social care more equal partners, so that they can work together to put prevention at the heart of everything we do. We are therefore proposing a new entitlement to six weeks' reablement support for any older person leaving hospital with care needs as well as better co-ordination between housing and care, building on initiatives such as supported living, extra care housing, telecare and adaptations to homes or workplaces.
In this pursuit of higher-quality services, we must do more to improve the social care work force, raising their status as a profession, investing in front-line staff and sending out a clear message from this House today that we as a society place a value on what they do on behalf of us all.
Finally, there is the challenge of fairness. We need to create a system that is equitable for people of all generations and all backgrounds, and that shares out the risk and responsibility for care more evenly. Over the past 12 months, the Government have explored the full continuum of funding options-from completely private to completely state-funded. We rejected, on the one hand, a system in which everyone is responsible for paying for their own care, and on the other a 100 per cent. tax-funded system in which people of all ages contribute to the cost of the care service. In our judgment, the former would leave those on the lowest incomes stranded and those with high needs facing huge costs. The latter would saddle younger people with the lion's share of costs for older people's care, via higher taxes.
Instead, we are putting forward three options for consultation. The first is a partnership model in which both the state and the individual share responsibility for funding care. Everyone would get a set proportion-either a third or a quarter-of their basic care costs paid for by the state. They would then have to pay the remainder themselves. To fund this new entitlement, we will consult on plans to bring other benefits, for example attendance allowance, into social care funding. We would do this in a way that guaranteed that anybody currently receiving an affected benefit would continue to receive an equivalent
level of support. There would also be a progressive element to the partnership model. The less well-off would have a higher proportion paid for, while those on the lowest incomes would continue to get all their care for free.
The second option, a voluntary insurance model, is an extension of the first. People would get the same minimum proportion of basic care paid for through the national care service, but they could then choose to take out insurance against the cost of the remaining care, through either a state-backed insurance programme or a partnership between the state and private companies. Thirdly and finally, there is the comprehensive model. Under that model, everyone over retirement age would pay into a state insurance scheme, and would then get the full cost of their basic care met by the state. However, that would mean everyone over 65 making a contribution to the system, even though they may not ultimately receive any care.
At this stage, we are talking about the principle, rather than the detail, of those models, but to give the House a sense of the likely costs, and working with a £30,000 figure for the average cost of a person's care today, the partnership model would see someone paying between £20,000 and £22,500, although obviously some would pay a lot more and others a lot less. Under the insurance model, indicative figures suggest that people would pay a lump sum of between £20,000 and £25,000 for their cover. Under the comprehensive model, the figure could be somewhere between £17,000 and £20,000.
Under the insurance and comprehensive options, people could choose how to meet the costs. They could do so by paying a lump sum on retirement, by deferring their state pension, by paying in instalments during retirement, or by paying from their estate after death. In the longer term, we could develop a system whereby people who are still working could make regular contributions, so that they could pay their contributions on retirement.
These are radical and serious proposals. I recognise that many people care deeply about the issues that the debate raises, and we need a dignified discussion to do justice to their concerns. Such is the significance of the issues to every single person in the country that we would move forward only if a broad consensus were to develop around one or two of the options.
In conclusion, it is important that we do not flinch from this debate. A failure to act would mean a future of increasing pressure on services, a decline in the quality of care that we can offer the most vulnerable, and ever greater costs on the most unfortunate. That is not a prospect that I-or, I am sure, other hon. Members-wish to contemplate. I commend the statement to the House.
Mr. Andrew Lansley (South Cambridgeshire) (Con): I am grateful to the Secretary of State for making a copy of the Green Paper available to me an hour ago. Of course, there has been the usual ration of leaks; in this instance, they were mostly kites flown in advance. Ministers dithered for months on publishing the document. They seemed to spend most of the time between the planned spring publication and mid-July trying to get any of their kites to fly.
The Secretary of State has been wandering around the television studios this morning telling us that the standards of adult social care have gone down and down. He tells us how cruel the lottery of support for the elderly is. He tells us how unfair it is that people are forced to sell their homes to fund their long-term care. Which Government does he think has been in charge for the past 12 years? Which Government promised 12 years ago to stop people being forced to sell their homes to fund their long-term care? Which Government rejected the findings of their own royal commission? Which Government sidelined the King's Fund review? Which Government kicked the issue into the long grass in their 2007 spending review? Frankly, we do not need simply to start another debate. One debate always seems to roll into another with this Government. We need a decision, and we need serious, costed proposals to be the basis for that decision.
May I ask the Secretary of State where exactly he proposes that the funds should come from for the increased Government contribution to the costs of long-term care? If he is promising to provide a universal minimum care component, he must know how he will pay for it, so I have a simple question: what would be the additional cost to the taxpayer of having either a quarter or a third of basic care costs paid for by the state? I can see no evidence in the Green Paper of that crucial number. However, if Members look up page 108 of the Green Paper, when they can, they will find the following sentence:
"For example, everyone might have a quarter or a third of their care costs paid for by the state."
There is a footnote to that sentence, and in this Green Paper, as in most Government documents, the footnote is the most important bit. That footnote says:
"For the purposes of modelling the options, we have made assumptions about the level of funding that the state would put in, but these do not reflect a decision about central government investment in care and support."
In truth, the Government have not even published their assumptions about state funding.
When the Secretary of State comes to pay for the scheme, is he proposing to do so by cutting disability benefits? Can he confirm that he is proposing to scrap new entitlements to attendance allowance and other benefits to pay for the Government's contribution to social care? With reference to his voluntary insurance model, if the effective premium is some £20,00-plus per person, what is the Government's estimate of the likely take-up? By what means would the Government ensure that the risk pool is large enough to make the scheme effective? How can he avoid people opting into the system only if they are more likely to need care?
On the third option, the so-called comprehensive model, the Secretary of State surely means not comprehensive, but compulsory. Does he have any view as between voluntary and compulsory insurance? Is he in favour of compulsory or voluntary insurance?
I am sure the right hon. Gentleman will agree that we need national standards-some consistency of assessment. We have long argued for that, and of course there needs to be central Government support, but we do not need a nationalised social care service. It is surely a retrograde step to remove local government from the equation.
The Secretary of State spoke about the need for a consensus. If the Government were serious about that, they would long ago have consulted on costed options. All we have today is another document, long on options and short on costs and conclusions, published in the hope that it will see the Government through to an election, when it will no longer be their problem. That is not good enough.
| Next Section | Index | Home Page |