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Mr. David Curry (Skipton and Ripon) (Con): Care of the elderly is sometimes the hidden and often the unrecognised industry in my constituency and hundreds of others, but it cannot be delivered without a vigorous private care home sector. Will the Secretary of State recognise that the Government have their role to play in ensuring that they do not load costs on to that sector-for example, through the minimum wage or holiday entitlement-knowing that, in the decade of public expenditure austerity that we are about to enter, they have no hope whatever of recovering those costs from local authorities?
Andy Burnham: I am troubled by the right hon. Gentleman's remarks. If he is saying that the minimum wage or the standards that we introduced in care homes in the Care Standards Act 2000 have not helped to improve the quality of care, I would take issue with that very strongly. If he is also saying that care staff should not have basic entitlements to holiday, how will being run off their feet, not getting a proper break and not being properly paid enable them to give better quality care to older people? I find the logic of his question completely wrong, but I do accept that the private care sector has a huge role to play in delivering the vision that we have set out in the Green Paper.
Nia Griffith (Llanelli) (Lab): I very much welcome my right hon. Friend's announcement about the national care service and, in particular, the fact that he has been so explicit about the thorny issue of costs. Indeed, one of my predecessors, Jim Griffiths, would have been proud of this reform, which is the equivalent of his type of reform. However, the announcement obviously covers reserved matters and devolved issues. What talks has my right hon. Friend had with Welsh Assembly and Scottish parliament Ministers about how the reforms will work out in Wales and Scotland?
Andy Burnham: I am grateful for the generous welcome that my hon. Friend has given the Green Paper. Obviously any reform of benefits would have implications for the devolved Administrations. My hon. Friend the Minister for Care Services has had discussions with counterparts in the Welsh Assembly and we will continue to do that. However, the proposal in today's announcement is for England. The national care service would apply in England only, although we would encourage the Welsh Assembly to go down a similar route if it wanted to.
Mr. Peter Bone (Wellingborough) (Con): The Secretary of State has been very courageous with his proposals, particularly in suggesting that social care will be funded in future partly by the state and partly by private insurance. He also suggested a link with health. Does he see the future expansion of the national health service being partly funded by private insurance?
Andy Burnham: I am grateful for the hon. Gentleman's generous comments. I know that he has proposed some fundamental options about the privatisation of the national health service. That is not something that I would ever contemplate in this role, although we are saying that the funding of care and support should be on a different basis from the funding of the national health service.
Malcolm Wicks (Croydon, North) (Lab): Given that this has been a growing issue for hundreds of thousands of families for at least 25 years, and given also that we should acknowledge the cross-governmental failure to grasp the nettle of long-term costs, will the Secretary of State agree to be at least as bold as William Beveridge was in 1942, when he looked at the risks facing early post-war society in a radical way and came up with ambitious programmes that, by and large, have stood the test of time?
Andy Burnham: I must pay tribute to the huge experience and authority that my right hon. Friend brings to these matters, and to his long experience of social care in this country. If he reads the Green Paper, he will find the same boldness in this debate. The issues are similar, in that we are asking people to consider whether a system of mutual support is better than the status quo. The debates that were in play during the creation of the welfare state are very much alive now and at the heart of this debate. How far we go will obviously depend on how much support each option attracts in the country, and I hope that my right hon. Friend will join us in ensuring that the debate is a vigorous one.
Mr. Nigel Evans (Ribble Valley) (Con): There are more than 6 million carers out there, including family and friends, and 1 million of them look after more than one person. Fortunately, we have in our constituencies organisations such as Crossroads, which look after the carers and recognise that they have health needs themselves. What more can be done to support those who care for the carers?
Andy Burnham: The hon. Gentleman is right, and Crossroads is a wonderful example; I know the organisation well. Of course there is always more that we can do. The carers strategy was an innovation, and it has recently been updated and comes with a significant investment alongside it. We can never be complacent about what we do to help carers. However, my basic argument today is that if we can improve the services that older people receive, we can relieve the pressure on the carers and enable them to do more.
Ms Dari Taylor (Stockton, South) (Lab): I warmly welcome and support my right hon. Friend's statement today, but I would say to him that this area of policy is seen by all as being incredibly complex. It is invariably individual in nature, and its complexity can leave families with the most crippling problems. Will he assure the House that everyone's contributions to the consultation-including those of organisations representing the elderly and of families who care for the elderly-will be listened to? Will the consultation be publicised as much as possible, so that we can hear what all our people are saying?
My hon. Friend raises an important point. A positive development alongside the publication of the Green Paper will be the formation of a care alliance involving 31 national organisations representing the whole breadth of opinion in this area. We need to empower them to take the debate out to their members. My hon. Friend is also right to say that the lack of simplicity in the current system diminishes people's understanding of the issues. We need a much clearer
system in which people get more help to understand what is available to them, regardless of their background or their needs. Any proposals for reform must have that consideration very much at their heart.
Dr. William McCrea (South Antrim) (DUP): I am sure that the Secretary of State appreciates the fact that, across the United Kingdom, many people are concerned about growing old and feel vulnerable when they consider what care is going to be available for them. It is certainly unacceptable to force them to sell their homes to pay for their care. Speaking of national care services, is it not imperative to hold meetings as soon as possible between the Department of Health and the devolved Administrations, Northern Ireland included?
Andy Burnham: Of course, and we will continue our discussions with Michael McGimpsey and others in Northern Ireland. Perhaps we can learn from the system in Northern Ireland, which has always had much closer integration between health and social care. The hon. Gentleman is right to say that we want a system that will prevent people from having to sell their homes; that is a basic unfairness that we want to end. The current average cost of care is £30,000, and each of the three options that we have put forward today comes in at less than that amount. That is why we feel that they are doable and that they could possibly be made attractive to people. However, it is important that we have the broadest possible debate, not just in England but across the UK, about the choices that we all face in an ageing society.
Mr. Gordon Marsden (Blackpool, South) (Lab): Blackpool has above-average numbers of older people and care homes, and my constituents will be grateful for the breadth of vision and the sensitivity that my right hon. Friend has demonstrated today-compared with what has been rather sour waffle from the Opposition Benches, I am sorry to say. He has talked about the need to strengthen the role of social care staff. Will he tell us what opportunities there will be in the consultation to look at issues such as greater skills for social care staff and greater flexibility for them to visit people in the given time? At the moment, for example, travel time is not included in their working hours.
Andy Burnham: On my hon. Friend's first point, the investment in the work force is vital and the social care skill set is crucial. We have already begun work on that in the Department. Again, we want to take any new resources in the system to develop what we are doing further. On his point about the tone and nature of the debate, I think that on this particular issue we have to do better across the House than we usually do and ensure that we do not reduce the debate to a simplistic slanging match. It is important to give these issues the serious airing and hearing they deserve. We will do a greater service to older people by identifying a way forward between us that, if not ideal for everybody, at least provides a workable compromise that will make things better than they are today.
Bob Spink (Castle Point) (Ind):
The right hon. Gentleman is absolutely right to bring these bold options before us for the longer term and to have a genuine debate, which is long overdue. Does he accept that we urgently need,
right now, to look at how social services assess care and ensure that frail people, perhaps those who have suffered a stroke, are not charged for what should be viewed as health care rather than social care? That needs to be looked at for the people who are currently in care, too.
Andy Burnham: I understand the hon. Gentleman's concern. We have been revising the guidance to local authorities. As pressure has grown on local social services down the years, they have focused more and more on people with the highest needs, leaving lots of other people who desperately need help unable to access it. In revising the guidelines, we have put more investment-an extra £500 million-into the system. Any measures in the interim would be only preparatory to the major debate we are initiating today.
Lynne Jones (Birmingham, Selly Oak) (Lab): The Tories oppose the national health service, so it is not surprising that they oppose the national care service. The current lottery of life, under which one in three who develop a severe condition lose everything and the rest keep their wealth intact, is unfair and should not be tolerated in a civilised society. I favour an approach of solidarity. Should we not go out and advocate the comprehensive approach, which also seems to be the lowest-cost option, and develop a groundswell of public opinion behind that option so that no future Government can ignore it?
Andy Burnham: The challenge here-my hon. Friend puts it very well-is not just about what I put in and what I get out. We all have to look at our own extended families and recognise that across them there will be a range of care needs and that we have a mutual obligation to each other within our families and to others who, as she says, can face the calamitous cost of care if they develop the most serious needs. I note her support for the comprehensive option. If she would like to go out and bang the drum for the comprehensive option, she is absolutely entitled to do so and there is a very respectable argument in favour of it. People will need illustrations of how it could be made manageable. We have set out in the Green Paper various options on how people might pay either for the comprehensive or the voluntary option-by deferring the state pension, paying through retirement or paying after death. Those are the issues to be debated. If my hon. Friend is offering to join the debate, I wholeheartedly welcome it.
Laura Moffatt (Crawley) (Lab): Does my right hon. Friend agree that we in the House have a duty to get out there and consult people? Will he ensure that he and his team are available to receive representations from our constituents so that we know that the consultation will be full and that we will be able to stand by it?
For any MP who would like it, we would endeavour to set up a local forum in which these issues could be properly debated with informed speakers so that we can have a quality debate at the local level, too. We want to give people the depth of information for which they are looking. These are difficult issues and it is not always easy to take them on. In my view, however, MPs can play a crucial role in informing their
constituents and helping them to make a choice about what they think is the right way forward not just for Crawley, but for the country as a whole.
Mr. Ronnie Campbell (Blyth Valley) (Lab): How will my right hon. Friend's proposals help older people in Northumberland, where the leading Liberal Democrat-controlled council has set a policy of closing all old people's care centres and sacking all the workers in them?
Andy Burnham: I cannot say that these proposals will help in the short term, but that is not what we want to see in the future. Under any of the options that we are presenting, there will be a basic national entitlement. One of the unfairnesses of the system is that some councils withdraw money from social services in order to spend it on other priorities. That can leave some of the most vulnerable people in society with unmet needs, which should not please any of us.
Geraldine Smith (Morecambe and Lunesdale) (Lab): The mark of a civilised society is how well we look after the sick, old and vulnerable. This Government have done much to look after the sick. People can now obtain operations when they need them rather than having to die waiting for them, so they have a chance to grow old.
I welcome the statement, which is long overdue. I appreciate the reasons for that-the Government had a lot to deal with when the national health service was left in crisis-but we must now move as quickly as possible. This is a priority for many of my constituents, and for people all over the country. Can the Secretary of State assure me that the consultation will be genuine and the strategy will be introduced quickly?
Andy Burnham: I think that the Government have put the national health service back on its feet, and that people can take confidence from that and believe that we can build a fair national care service. I take my hon. Friend's point about the need for speed. As she said, the statement is long overdue, and I accept that people have waited a long time for our proposals. However, I can assure her that we do not intend to back off or flinch. We want to ensure that there is a good debate, leading to a White Paper before the general election. It is about time that these issues were seen as a serious matter of choice and subject for debate, as I hope that they will be during any forthcoming general election campaign.
Kelvin Hopkins (Luton, North) (Lab): The royal commission recommended free long-term care for everyone, paid for out of progressive taxation. I supported that view absolutely at the time, and I support it absolutely now. Moreover, opinion polling at the time showed massive public support for it-up to 80 per cent.-and I am sure that the position is the same now. I tabled two early-day motions calling for free long-term care, which were signed by more than 100 Members, mostly Labour. I can tell my right hon. Friend that I shall continue to campaign on that basis, and that I hope he will accept it as an additional option.
I welcome my hon. Friend's contribution to the debate. Nothing rules out his campaigning for that particular option, but we have ruled it out because
we do not feel that it would be fair between the generations to ask the working-age population today to continue to provide all the costs. We think that a partnership approach is fairer to all, given that many people of working age face considerable pressures in relation to housing and all the costs of bringing up families. We feel that our proposals represent a fairer spread of the burden across the whole population, but of course my hon. Friend is entitled to argue for a different approach in his constituency.
Fiona Mactaggart (Slough) (Lab): On Friday I spoke to an elder constituent who was contemplating suicide as her savings ran out. This morning I received a thank-you card from her which read: "I now feel there is light at the end of the tunnel. When I start getting anxious again I shall remember your words 'Eat your house.'" The good thing about today's statement is that it gives older people a better option than eating their house, and gives others a better option than using it to pay for care for the elderly. Will the Secretary of State ensure that those anxious people are informed at every stage about how he conducts the debate, rather than its taking the form of an air war, as it is already doing in the Chamber?
Andy Burnham: I strongly agree with my hon. Friend. People do become anxious about these issues. That is why I said at the outset that I hoped we could manage a better debate than we normally manage, because such an important issue deserves it.
Perhaps my hon. Friend can relay this to her constituent. Both the voluntary and the comprehensive option would provide people with a pathway to protect their assets, savings and houses in retirement. That may indeed give light at the end of the tunnel, not just for my hon. Friend's constituent but for many other people who genuinely feel anxious and seek peace of mind in their later years.
Mr. David Anderson (Blaydon) (Lab): I return to the point made by the right hon. Member for Skipton and Ripon (Mr. Curry). Staff are the key to delivering this service. If we go back to what happened in the 1990s, when compulsory competitive tendering and privatised care homes were introduced and training and other budgets were cut, we will be unable either to recruit or to retain quality staff. The one way to make sure that the system falls apart is to follow the programme that the Conservative party followed 20 years ago.
It was quite astonishing that one of the Conservatives' proposals as a way of helping with social care was to end the minimum wage in care homes and the existing terms and conditions of social care
staff. In more recent days, the shadow Health Secretary has been proposing the abandonment of national pay structures in the health service, so I think we know where they stand on these matters. Investing in and respecting the work force, and understanding how a motivated and well-rewarded work force provide a quality service to the public, has got to be at the heart of any proposals for change.
Mr. Edward O'Hara (Knowsley, South) (Lab): I congratulate my right hon. Friend on introducing this long overdue Green Paper, and on his obvious commitment to the subject in his presentation and answering of questions today. May I put it to him that one part of his statement is not negotiable-is not an option? He talks about improving the quality and status of care staff, and without that, we will have a framework, not a system that delivers a national care service.
Andy Burnham: I thank my hon. Friend for his generous comments. Through him, I pay tribute to the good people of Knowsley, who have led the way in this area down the years. The Minister for Care Services was in Knowsley just last week looking at the fantastic work done by health and social care staff in integrating services. They genuinely-I know we say this a lot, but in this case I mean it-offer a model for others to follow. I am happy to endorse what my hon. Friend the Member for Knowsley, South (Mr. O'Hara) says: without investment in the staff, we do not have the basis of a national care service. We can learn from how we have offered a better career progression for staff in the national health service, and transfer some of those principles to improving the social care work force. That is not to say that today we do not respect what they do; we do, but I do not believe they get the recognition for what they provide in all our communities and to all our families.
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