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Hon. Members have set out cases in which residents of sheltered housing schemes across the country are concerned about changes to resident warden schemes, especially how those changes are being implemented. I want to spend some time addressing that important and complex matter. It is fair to say that changes in support services for sheltered housing and the replacement of resident wardens by alternative service models are not a new phenomenon. Those changes have been taking place for two decades, as was acknowledged in the campaign report by Help the Aged entitled "Nobody's listening", to which the hon. and learned Gentleman referred.
There are several reasons for those changes. An independent review of floating support services conducted for the Department last year identified a range of factors. It found that there was less demand for sheltered housing, as people tend to move into sheltered housing later in life; that a large number of sheltered housing schemes are not up to modern standards, perhaps providing only bedsit accommodation; and that a significant number of sheltered housing residents do not require support services and are defined as the "active elderly". That is also reflected in the correspondence we have received from residents of sheltered housing, as they complain that they are sometimes required to pay for services that they do not want. As a result, some administering authorities are commissioning flexible, mobile support to sheltered housing tenants, based on an assessment of support needs, and they are extending that mobile support to older people in other types of accommodation. That is a key benefit of the Supporting People programme, which makes housing-related support services accessible to all vulnerable people, regardless of where they live or their type of tenure.
Other factors driving those changes include problems recruiting resident wardens, which have arisen in several areas, as sheltered housing is not immune to the wider demographic, technological and economic challenges and changes that society faces. We need to encourage innovative ways of caring for and supporting people to provide a more personalised service and make the most of emerging technology. For example, greater use of telecare can bring substantial benefits, including assisting people to remain in their own homes. It can reduce inappropriate admissions to hospitals, facilitate discharge from hospital more quickly and provide advance warning if someone's condition deteriorates.
The "Shaping the Future of Care Together" Green Paper, published earlier this year, sets out the Government ambition for a national care service in England. It recognises that Supporting People put in place structures that enabled partnerships of local authorities, health services and probation services to make decisions about improvements and local investment in housing for vulnerable people. It demonstrates the opportunities for increased innovation in the joint commissioning of those services. Supporting People contributes to the developing work on the national care service, as it shares the same aims of improving service user choice and control and keeping service users at the heart of the programme and its local implementation.
Hon. Members will be aware that my ministerial colleague, Lord McKenzie, is chairing a working group on sheltered housing, providing precisely the sort of leadership that has been called for in the debate, and I
will take this opportunity to update hon. Members on that work. The group was established in April by Baroness Andrews, and brings together a range of interested organisations, including representatives of service commissioners, providers and residents, to consider how best to support good local decision making and practice. It is taking forward several projects on resident engagement and consultation and on service models, and that addresses the second and third questions asked by the hon. Member for Wycombe (Mr. Goodman).
The National Housing Federation is leading work on good practice guidance in the implementation of any changes to current support services, including case studies on a variety of successful models for support services for older people, whether flexible community-based support, a scheme management service, the innovative use of technology or a hub-and-spoke model. That work will look at the costs and benefits of the various models-not just the financial costs, but the psychological costs to residents as well. By identifying value for money and overall benefits for older people, the case studies will present providers and commissioners with a sound evidence base for commissioning support services for older people.
Consultation is an absolutely vital part of any service, and that cannot be emphasised too strongly. I do not condone the examples of bad practice that the hon. and learned Member for Torridge and West Devon gave. As the report "Nobody's Listening" points out, if an organisation has really involved and consulted its service users, often change might not be such a contentious or frightening issue, and that is why consultation should happen before those decisions are made, rather than after.
Consultation should also be a proper two-way process, ensuring that the provider is able to portray the situation it faces and offering the opportunity to discuss why those changes are being considered and all the options available. It is for those reasons that consultation and engagement with residents is a critical issue for the ministerial working group, which is doing precisely the
sort of work that the hon. Member for Brent, East (Sarah Teather) called for. The Centre for Housing Support is leading work on a good practice guide for providers and commissioners of services on how to engage and consult residents. The guide will improve providers' ability to consult meaningfully and engage people. It will help service users to understand what they can expect of consultation, and it will provide a benchmark so that they can make comparisons with what happens in their own organisations.
The ministerial working group is also looking at a key concern raised by Help the Aged: the lack of clarity over the complaints procedures for residents of sheltered housing. The Chartered Institute of Housing is leading work to produce a guide providing clear and concise information about the roles and responsibilities of the different regulatory agencies; when, how and by whom those services can be used; how the agencies relate to each other; and the type of information they require to act. The complaints guide will enable tenants and residents in sheltered housing and their families and carers to judge who to complain to and how to do so if they have exhausted the landlord's internal complaints processes. Those three guides will be published early in 2010.
This debate has raised several serious issues about the way in which residents in supported housing schemes are treated, as well as their concerns about the changes that they face. I thank the hon. and learned Member for Torridge and West Devon again for securing the debate, which has provided me with an opportunity to show how seriously the Government take those concerns and our determination to ensure that older people can live safely and independently in their own homes, wherever they may be. As I have explained, the key decisions on the provision of services such as warden support must be a matter for local authorities, but we have always made it clear that any changes to the way in which services are provided should be designed to meet the needs of residents and take account of their views through proper engagement and consultation.
Dr. Nick Palmer (Broxtowe) (Lab): This Adjournment debate is something of an experiment. Traditionally in Adjournment debates, as colleagues know, Members seek to press a particular viewpoint and persuade colleagues and the Government to change policy in the direction that they favour. What I shall try to do with this debate is discuss a process that the political system as a whole demonstrably does not handle very well. I apologise to those who may have come here on the assumption that I would speak about prisoner release in general. The specific issue that I wish to deal with is the release of prisoners who have developed serious illnesses, in particular fatal illnesses.
Hon. Members will be familiar with the cases that arose in the summer of the Libyan bomber Megrahi and Ronnie Biggs. Both attracted considerable controversy, and I do not think they showed any of the parties in an ideal light. Rather than a serious and compassionate analysis of the situation as it affected the prisoners and the victims of their crimes, what we got was a good deal of manoeuvring for position between political parties, a good deal of feverish media speculation on what the real motives were and all the usual stuff that we associate with everyday party politics.
That situation seems unfortunate, not just in those cases but more generally. If someone has committed a serious crime and been convicted-we have to work on the assumption that they were guilty-we owe it to the victims, the justice system and the individuals concerned to treat their case rationally and to try to apply consistent principles that stand up in difficult cases.
One of the fundamental questions I would like to raise is whether it is appropriate that such decisions be taken by a politician in the first place. In many other sensitive areas, Parliament sets up guidelines for how a decision ought to be taken, but the final decision does not actually rest with the senior Minister responsible, whether in Westminster or a devolved Government. We are all familiar with cases where a constituent wants treatment that has not yet been authorised by the National Institute for Health and Clinical Excellence, and which is remarkably expensive. It might extend their life-such cases are very emotional. They are not decided by the Secretary of State for Health but by the primary care trust, occasionally with the involvement of the law.
I would like to put forward for consideration the proposal that such decisions should ultimately be made by a High Court judge. They should be based on criteria set down by Parliament but should not involve ultimate referral either to the Home Secretary, in the case of Westminster, or to his counterparts in the devolved Governments.
What might such criteria look like? I consulted constituents on that last week and heard a wide range of views. A significant minority simply say that if somebody has been sentenced to life imprisonment, it needs to mean life, and, if they are dying, that is part of life. Basically, prisoners should be kept in prison until they are dead. The argument is that life imprisonment itself is a compromise, that we have abolished hanging for the reasons that we all know but if, in addition, we were to water down life imprisonment so that it did not really
mean life, we would send a signal to potential offenders that they will not actually face the threat that they would appear on paper to face. However, if, even in hard cases, we say that a prisoner has to stay in prison for the rest of their days, that sends a strong message.
The counter to that, which, again, a significant minority of my constituents argued, is that no useful purpose is served by keeping somebody in prison at considerable public expense-the average prison place costs around £36,000 a year-when they obviously pose no further threat to society. We can think of cases where that was provable beyond reasonable doubt. There has been some discussion in the cases of Megrahi and Biggs about how firm the medical opinions were and so on, but I do not want to get bogged down in those cases.
Let us assume that we have a case involving a serious offence, and the perpetrator is now bedridden with cancer and expected to die within weeks. It is obvious that if we release him he will not start rushing around and committing more crimes, so the immediate concern is probably not applicable, and few people would think of his position as enviable. Very few would say "Life imprisonment is not really for life" if a prisoner who is bedridden and about to die is let out. They would not feel that that was so bad.
David Taylor (North-West Leicestershire) (Lab/Co-op): Section 30 of the Crime (Sentences) Act 1997 deals with the power of the Secretary of State to release on grounds of compassion a prisoner who is suffering from a terminal illness and likely to be dead within three months, but do not some of my hon. Friend's constituents have reasonable cause to point to past cases? The case of Ernest Saunders is not directly parallel, but all those years ago he was supposed to be suffering from dementia but suddenly recovered as soon as he was released from the court process. There were suggestions that Ronnie Biggs would be out celebrating in the pub within a few days, although he was not, but how can people be reassured?
Dr. Palmer: I am grateful to my hon. Friend for that question. It anticipates another point, which several of my constituents made, about the possibility of recall. We do not want to swarm like vultures around someone who is released on the basis that he or she is fatally ill, checking every moment that they are really dying, but there is appropriate public outrage if there is a miraculous recovery. An argument that several constituents made, with which I agree, is that if we are going to do this, one of the conditions should be that the person remain in the jurisdiction of the British Government, or whichever Government have made the decision, so that if they prove not to be nearly as ill as they appeared to be, they can be returned to prison. In effect, the reason for their release would have been proved to be invalid.
The parallel is people who are released on probation on the basis that they are thought no longer to be a threat. As my hon. Friend knows, if they were to commit a further crime, they would be sent back to prison to serve not only the sentence for the new crime but the rest of the sentence for the old crime.
Mr. David Drew (Stroud) (Lab/Co-op): My hon. Friend has not as yet mentioned the victim or the victim's family. I always think that the greatest hurt when early release takes place is caused by a lack of communication with those affected. If that were got right, matters would become much easier. Too often, the last people to hear about what is happening are the victim or their family. Does my hon. Friend agree that that is a great weakness of the present scheme?
Dr. Palmer: Yes, I strongly agree. I, too, have come across cases where the victim of individual violence-not in high-profile cases like Megrahi-has only been informed at the very last moment, if at all, and then feels under immediate threat.
More generally, the feelings of the victims are clearly relevant. A number of judicial authorities have said that the judicial process is not about the victim but fair justice. However, when we talk about compassion we are talking about representing the feelings of the general public and the values of society. It is appropriate for the victims of the crime to be consulted before the decision. It was noticeable that, in the Megrahi case, victims' families had mixed feelings. Some felt strongly that he ought to continue to be detained; some felt that, yes, it was reasonable to release him to show that our values were better than his; and some said that they wanted to move on and did not want to express an opinion either way. In such cases, before making a decision it is appropriate for the victims, in so far as they can be identified, and their families to be informed that the matter is under consideration, so they have the opportunity to make representations.
Mr. Alistair Carmichael (Orkney and Shetland) (LD): I commend the hon. Gentleman for the thoughtful, measured way in which he is approaching this matter. He has spoken about compassion and justice. May I put it to him that compassion is just one element in justice? If justice serves any purpose, it is surely about the reconciliation of offenders and victims. Does he not think that that is the yardstick we should use when measuring the impact of these decisions and deciding whether what we have got, at the end of the day, is justice?
Dr. Palmer: Ideally, yes, there would be reconciliation. Realistically, there will be cases where that is not going to be practical. If someone blew up a relative of mine, I might, if they were dying in prison, say, "Yeah, okay. I won't insist that they stay in prison till their dying day." But I would not want to meet them and make friends. We cannot make the process entirely contingent on that. If we can do it in a way that encourages that, that would be great. If, as in the Megrahi case, some of the victims' families are in favour of a release, and if the offender is willing to acknowledge that and express some gratitude for it, we have made a step forward in terms of civilization.
There is a parallel here with the Brighton bombing, where the perpetrator has, as I understand it, expressed regret for what he did. He is now a free man. Some of the victims feel that they accept the process and some, perfectly understandably, do not. But the fact that we get such a dialogue going is a step forward. I agree with the hon. Gentleman.
I should like colleagues to consider a number of criteria that we might use for such cases. The first is the gravity of the offence. If somebody is in prison for burglary and dying of cancer, for example, it is probably inappropriate, even if they have a relatively short sentence, that we keep them in prison till their dying day. In a serious case, we are more likely to feel that, at least for the deterrent effect, we will want to keep them in prison.
We should consider the question of how long the prisoner has already served. We are all aware of cases where apparently pretty serious offenders have been released after 10 or 15 years on the basis that they are no longer a threat to the public, and that would apply with additional force if the person concerned is dying.
Another point, which relates to what my hon. Friends have said today, is that we should consider how soon a prisoner is expected to die. Medical science is not exact, so a doctor will never say, "He's going to die in two months and seven days", although they may say, "He's not going to last more than another 48 hours." However, if we are talking about three months, as my hon. Friend the Member for North-West Leicestershire (David Taylor) mentioned, we have to allow for the possibility that it is going to be three months and three days or slightly less. We do not need be too finicky about the precise number of days, but we need to be clear that the position is as described, which means that in any such case at least two doctors with absolutely no connection to the prisoner need to give a concurring opinion.
How confident can we be that the offender will not offend again? Someone's having a fatal illness does not necessarily prevent them from committing certain types of crime. For instance, a gang leader who is resentful about the person who got them into prison might feel that revenge should be one of their dying acts-one of their last acts on earth. They might feel that they could do that better outside prison. Issues such as that need to be considered. We need to consider whether a person is safe to be released, regardless of the other considerations.
Does the prisoner show remorse? There is a general problem in the justice system that hon. Members will be familiar with, which is that if someone denies that they committed an offence they are treated as not showing remorse, because they say they have not done it. There will be cases, given that everything is fallible, including the justice system, where people really have not committed an offence. We probably do not want to make a decision dependent entirely on the prisoner's confessing and showing remorse, but it is obviously helpful if the person involved says, "Yes, I did it. It was right that I was imprisoned for it. I'm grateful for any compassion shown, but I appreciate that it was right to sentence me." Personally, I would be inclined to count that in his favour, without completely ruling out a release if he says, "No, it's all unfair. I didn't do it."
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