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15 July 2009 : Column 382

Over the next 20 years, the number of people in England over 85 will double, and the number of people over 100 will quadruple, yet we continue to have discussion after discussion on what we should do about the situation. The Government themselves estimate that over 1.7 million more people will need care and support in 20 years' time, yet we are seeing inadequate funding at local authority level from central Government, and a tightening of criteria. We have all heard stories in our own areas about people not getting the basic services that they need in order to lead a dignified and independent life.

Richard Younger-Ross (Teignbridge) (LD): Does my hon. Friend accept that one reason for pensioner poverty is that pensioner inflation is far in excess of the ordinary inflation that we feel? For instance, the increases in utility bills, water rates and council tax have far exceeded the rate at which pensions have increased. This has led to more pensioners being in debt and more being worse off than they were before. We need to address not only the level of the pension but the increase in costs that many pensioners have to bear. For instance, we could get rid of the council tax and replace it with-

Mr. Deputy Speaker: Order. I think that that is a long enough intervention.

Greg Mulholland: My hon. Friend raises an important point. Indeed, the issues relevant to this debate are covered by many Departments.

Social care in this country has been a Cinderella service for many years, and we have had very little apart from warm words to suggest that that is going to change. Recently we saw the publication of the NHS constitution, which once again entrenched the division between health and social care. Many of us find that division artificial, yet there it was again in black and white. I ask the Minister again, as I have asked before: when will that be addressed? Are we going to have a social care constitution, and why is social care not incorporated in the NHS contribution?

Dr. Ladyman: The hon. Gentleman seems to have missed the legislation that allowed the local NHS to create care trusts, in which social care and NHS funds are indeed pulled together and spent exactly as he suggests.

Greg Mulholland: There are some interesting pilots taking place in parts of the country, but that simply will not deal with the institutional divide in Whitehall, which I am afraid will take a lot longer to shift.

I now turn to the Green Paper, and I shall again quote the Prime Minister. Let us bear in mind that we are now nine months away from a general election, yet the Prime Minister says:

That is extraordinary. The Green Paper should have been published many years ago. If the warm words said before the 1997 general election meant anything, we would have had such a Green Paper published during the first years of the Labour Government.

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The Secretary of State made a big plea for consensus yesterday, saying that we must all work together. Frankly, I am afraid that nine months before a general election, in the dying days of a Government, is absolutely not the time to be talking about needing consensus.

Christopher Fraser: I assume that during the election campaign the hon. Gentleman will be explaining in his own words how his party is going to offer free social care to the elderly-and how that will be costed.

Greg Mulholland: I will, of course, tell the House what my party policy is-and, unlike the hon. Gentleman's party, we have one!

The reality is that the Government have no timetable. We are told in the Green Paper that there will be a White Paper in 2010. Will it be in January, February or March? If it is any later than January, are we not talking about a Labour party manifesto commitment rather than a White Paper? The Government know full well that they will be able to do absolutely nothing to implement the proposals.

Let me cite what Age Concern and Help the Aged have said:

let us face it, most of us have been engaged in that debate for many years-

Yet even in yesterday's statement, we did not manage to get that. What we now have is yet more warm words and more commitments to achieve things that the Government know they cannot deliver.

At least we achieved a U-turn on Monday on the mandatory retirement age. I welcome that, and the fact that the review will be brought forward. It is important, particularly in a recession, to allow older people who so wish the dignity of continuing with their working lives. At least that is now on the agenda, whereas when I questioned the Minister some months ago, the idea was directly rebutted. Let us hope that in this Government's remaining months, we will see further U-turns to bring about changes that will help older people.

The hon. Member for South-West Norfolk (Christopher Fraser) asked about my party's policy. I am very pleased to tell him; we announced our policy last year. As a party, we think it important to engage in the debate and say what our policy is. Our policy involves a universal care guarantee-a partnership model based on the excellent King's Fund Wanless report, which the Government ignored. [Interruption.] It is costed, absolutely. I would be delighted to send hon. Members a copy. We remain committed to ensuring that those who are least able to pay get all their care paid for, but that everyone receives a minimum entitlement to care. That is set out in the Wanless report and is now in the Green Paper, which is welcome, but it should have been in a Green Paper and up for discussion back in 2006.

Mr. Dorrell: I think that the hon. Gentleman may have made an inadvertent error in suggesting that the Wanless proposal for a guaranteed minimum financed by the taxpayer was in the Green Paper. It absolutely was not. The Wanless version of the partnership model is not one of the Government's canvassed options.

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Greg Mulholland: I thank the right hon. Gentleman for clarifying that technicality. I was talking about the partnership ideal, but I accept that our policy is a version, based on the Wanless model, of what we believe to be genuine partnership.

Let me quote the Prime Minister again. Back in 1993, at the Labour party conference, he said:

I am afraid that, twelve and a half years into the present Government, that is very much not the case.

Let me now turn to the Conservatives-

Mr. Drew: Will the hon. Gentleman give way, briefly?

Greg Mulholland: I will.

Mr. Drew: I thank the hon. Gentleman for his generosity. An argument that I have not heard advanced so far is that care should be about quality. I think that one thing that the Government have tried to do is drive up quality, although what they have done may not be perfect. It may, for instance, have resulted in the closure of facilities that, with the benefit of hindsight, the Government realised could have remained open. Nevertheless, we should be trying to ensure that our older people experience quality, rather than just thinking about numbers. Does the hon. Gentleman agree with that?

Greg Mulholland: I agree entirely with the hon. Gentleman's sentiments, but I am afraid that if he spoke to all the elderly people in the country he would find that they were not receiving quality services. What they are receiving is patchy services that are very different in different areas, along with different entitlements. All the surveys conducted by older people's organisations make it clear that the quality of care is as important as its funding, but the two must be seen together. It is simply not realistic to suggest that we can secure better quality services without facing up to the difficult issues of funding.

Mr. Graham Stuart: Will the hon. Gentleman give way?

Greg Mulholland: I will, although I am conscious of the need to allow others to speak.

Mr. Stuart: I will try to be brief.

The truth is that under this Labour Government, the local authority bar for access to care has risen repeatedly because of the funding position. Care has been removed from those with moderate or even quite serious needs. It is necessary for people to be at the top end of the care need scale before they have access to local authority care, thanks to the actions of this Government.

Greg Mulholland: Indeed. I do not think that the burden placed on local authorities is taken seriously enough in this place. We need mutual minimum entitlements for people throughout the country, to prevent a different quality of care from being provided in different areas.

One would think that the Conservatives-especially as they called for the debate-would want to lead it by revealing their proposals for care in this country. I must
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say that I find their attitude rather barefaced. Although I do not agree with the Government on many aspects of this policy area, the Conservatives' criticism of the Government for not having a policy is amazing, given that they have no policy whatever themselves.

The shadow Secretary of State for Health, the hon. Member for South Cambridgeshire (Mr. Lansley), said on the "Today" programme how late the Green Paper was, and of course that is true. He also said:

That, I think, exposes the reality of the Conservative position, which I am afraid is typical "substanceless" new Tory. It is very much like the Labour party's position in 1995-96. It is strong on warm words and spin, but very empty on policy. Of course, this is the party that abolished the link between pensions and earnings, and led us into the care system that we have now. The crisis with an ageing population was perfectly visible then, but the Conservatives did nothing to prepare for it.

We have approximately nine months left before the general election, and we are being asked to start a discussion about care. We are being asked to wait possibly six years for fundamental change to the pension system, such as a restoration of the link with earnings. This is not a time for discussions, let alone the start of discussions; this is a time for firm policy commitment.

The Secretary of State for Health tripped himself up yesterday. Having said that we want consensus-the title of the Green Paper is "Shaping the future of care together"-he said that at the next election all the parties would put their proposals to the electorate. Frankly, is that not what a Green Paper at this stage is all about, because it can deliver no change for people in our country before this Government leave office some time next spring?

We need real decisions that will affect older people's lives to be made now. We need to bring forward the decision to restore the link between pensions and earnings. We need clear policies for how we will deal with the care crisis that is ruining older people's lives now. We have heard quite enough warm words, but older people know that this country currently does not adequately value them.

5.35 pm

Kali Mountford (Colne Valley) (Lab): I have been a Member in this House for a little while now, and during that time I have discussed demographic change on many occasions. The hon. Member for Eastbourne (Mr. Waterson) has been in the Chamber for some of those debates, and we have had several exchanges about the need to look ahead at what we must do for people in the future. It is therefore a little remiss to have forgotten those occasions and instead to spend all our time talking about what we must do on pensions and pensioners as if that is all that needs to be addressed on the subject of elderly care-because the subject of today's debate is elderly care, not pensions.

I thought for a while that I had wandered by mistake into a session on leaflet-writing for the forthcoming Norwich by-election. That distressed me a little, because I had made a promise to people very important to me
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that on this rare occasion when I am able to speak in the House I would talk about elderly care, as that matters a great deal to me, partly because of members of my family, but also because of constituents of mine, some of whom have had good experiences and some of whom have not.

Having seen the Green Paper and some of the statements made in the House, I particularly wanted to take advantage of the opportunity given to me by the Opposition-I am grateful to them for that-to say what I think needs to be done on elderly care in the round. I want to pay tribute to the Government for what has happened already, because we would think from listening to today's debate that nothing had happened in the past 12 and a half years-but actually a great deal has happened.

I can remember-Members have to acknowledge this-a time when in homes we would think, "My goodness, I hope I never end up here." I still think that about some homes, and we have to do something about that. Having said that, however, there are homes in my constituency that have changed beyond recognition, and I pay tribute to those people in my constituency and the officers on the council who have worked closely together on that. The local authority and the staff of those homes have worked hard to change the system entirely. As a result, we now have assessment centres so that when people leave hospital they can be properly assessed and we can ensure that they get the proper care that they then need.

Sadly, that is not the case throughout the country. I have been very saddened when I have seen people who are not my constituents not receiving that level of care; some of them have been relatives of constituents of mine, who have asked me to intervene on their behalf. We have seen some high-profile cases on editions of the "Panorama" programme and elsewhere, so we cannot say with hand on heart that all our older people have had a life of dignity and care-the sort of life we would want for members of our own families. Some people have starved or have suffered elder abuse, and we must say that in this day and age that sort of thing must stop. It has saddened me a bit that this House has not taken just a little while to talk about that and what we need to do.

I have not had enough time to digest all of this Green Paper, but from what I have read I have seen the beginning of what could tackle some of the issues. This country has some fantastic people whose brains we ought to be using in order to bring together what we could be doing, but I still wish to make suggestions in order to take things further. The idea of having personalised care has been talked about for some time, but it has not been properly delivered. Such care has been delivered in some places, but it has not been delivered everywhere and it has not been delivered to the standard that all of us have wanted. We would all want the best for our mother if she was in care, yet we would have to say that we have encountered cases in our constituency mailbags where the care provided has not been good enough.

What in the Green Paper would make the situation better? Having one standard of care for everybody below which we cannot drop must be a good thing, but how are we going to make it work? Where the only other member of an elderly person's family is themselves old and frail, how could that person ensure that the care provided is top-notch? How could that person stand up to everybody in the system, given that the system sometimes
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feels overwhelmingly large? I think that the relevant body is now called the Care Quality Commission, but because there are so many names in the system these days people going into homes may not know the right name to give and may feel quite belittled by the system. Can the family member be sure that they are asking the right question? Do they know who to ask for? Are we really empowering people in the right way? Do we perhaps need something akin to what we have in the health service? Do we perhaps need a patient advice and liaison service in the social care system? Could we be considering that in this Green Paper, so that there can be advocacy for people in the care system and so that in future we do not have people who feel that they have not been fed properly?

My mailbag, like those of other hon. Members, has contained cases where someone has felt that their relative had not been properly fed, had not received enough drink and had not received the proper care. Those people may have felt that their relative died inappropriately and too soon because of the care that they did or did not receive. If such people feel that and then cannot obtain answers, they will never believe that their loved one died in the way that anybody would want their loved one to die, and we cannot have that in our system today.

Dr. McCrea: Would the hon. Lady give way?

Kali Mountford: I shall do my best to sit down, if the hon. Gentleman will give me a moment to do so.

Dr. McCrea: I thank the hon. Lady for giving way. Does the situation not grow worse, and is insult not added to injury, when some elderly people have sold or have had to sell their house to get that care, yet still find themselves in a situation where they are not getting nourishment, proper food and nutrition?

Kali Mountford: I understand exactly what the hon. Gentleman is saying, but I have read the Green Paper and I feel that the Government are making three interesting proposals. It is right for us to debate the new proposals and see what we can do to change the situation that he describes. The people in the cases in my postbag have been receiving NHS care, so that situation has not arisen because such care is paid for. I know that some people have not been in that position, but usually where someone is having to be fed, an NHS paid-for place is involved. I can see that he looks quizzical and does not agree with me, but the places in the cases I am discussing have involved NHS care. I understand the point that he is making, however. If he has experience of different cases that have not been funded by the NHS, I take his point.

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