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The great thing that made that building work was that it had a good number of staff. It was a very staff-intensive unit, but because of that it worked. Sadly, however, because it was the early 1990s, we also had to face the reality of the budget constraints that our authority was working under. It was being told that it had to put a price-not a value-on care, and the price of the care that we delivered was, sadly, not in line with the price that the private sector delivered. That is hardly unusual, when we consider that legislation at the time said that there was a £50 disincentive on each bed in a public home as opposed to in a private home. We
started off with that loss. If we then consider that staffing and training levels were lower in the private sector, and that their terms and conditions were much lower, we see that it was obvious that the public sector, on a purely comparative basis, could not compete.
We, as an authority, tried to set up an employee share option plan, which would have taken the homes out of direct public ownership and into an arm's-length body that the staff would run. I was unhappy with the plan ideologically, but practically we tried to pursue it. Despite that, the plug was pulled by the then Secretary of State for Social Security. He did not believe that the plan went far enough into the private sector, and the reality was that 25 homes closed in Newcastle and we were left with a rump of four. Home care workers had to pick up the pieces, but at the same time there were too many people to look after. The circle was squared by a change in the criteria for accessibility to care. The criteria for vulnerability and frailty were increased, as was the age level, and people could not access care. Those choices were enforced; they made people such as Brian Roycroft and Jeremy Beecham despair; and they made the staff and the families we took care of despair. So the truth is that, with the piece of work that we are all talking about today, we have the chance to rectify some of those mistakes.
As I said to the Conservative spokesman, the position we reached in the mid-1990s was the result of a programme of 16 years before, from 1979 onwards, when the people of this country made a choice that they wanted tax cuts. The Conservative party delivered those tax cuts, but one cannot give tax cuts and keep on giving quality services-it does not work. If the money is not there, the service cannot be delivered in the way that the people of this country deserve. There was less money to spend, so there was less money to be given out for care services, as well as for other areas.
The policy was also, clearly, ideologically driven. It was not a mistake that care homes were closed-it was direct destruction of the public sector. In the same way, it was not a mistake that public transport was taken away from council ownership and put into the private sector, or that council housing was taken out of the remit of councils. We had two choices back then, and now we have a chance to move forward and make choices in the other direction.
Since 1997, we have seen some improvements. For example, there have been huge improvements in how we look after people at work. The national minimum wage has been a huge positive for people working in the care sector. We now give people guaranteed holidays, people have better maternity rights and paternity rights, and to some extent we have levelled the playing field between private and public sector provision. We have increased resources and support to local authorities and the national health service, and we have supported and developed independent providers. There have been positive changes to training, skills and the registration of staff, so that caring is seen as a professional job.
All that has been important, but it has not been enough. The sad reality is that underneath it all, as the hon. Member for Leeds, North-West (Greg Mulholland) said, we are under-resourced. That is the nettle that we have to grasp, whether we like it or not. My hon. Friend the Member for Crawley (Laura Moffatt) said that care cannot be done on the cheap. In fact, low-cost, nasty,
inefficient, unsafe and dangerous care can be done on the cheap, but quality care cannot be done on the cheap. We need to realise that.
I am sad that the hon. Member for Glasgow, East (John Mason) has left the Chamber, because I thought that he would engage in a debate about what has been done in Scotland, where the introduction of free care has been accepted. I believe that there have been problems and that there is debate between the Scottish Executive and local authorities about who picks up the tab. The royal commission came up with some positive views. If we, as the United Kingdom Parliament, had taken up the challenge back then, the problems that have arisen in Scotland would not have been an issue. We could have said, "We'll provide for this need across the whole United Kingdom, and we'll do it in a way that avoids these potential problems." It is a shame that that did not happen.
We have a national health service that ensures that someone who is out walking and gets run over by a bus will be taken to a hospital and looked after. But if someone cannot look after themselves, not because they have been run over by a bus but because they cannot go to the toilet on their own, fasten their shoelaces or feed themselves, they are told, "Sorry, you need to sell your house and give us everything you've got except £16,000." I cannot for the life of me see why that is; it is not fair.
This Government, to their credit, went to the people of this country with a 1 per cent. increase in national insurance contributions, directly to support improvements to the health service. I do not recall anyone-perhaps the Conservatives; I am not sure as I was not here at the time-opposing that. The public never complained about it: they said it was a good thing to do, and that was proven. I believe that we should be looking at doing that again. It is nearly a year since we had a 2.5 per cent. VAT cut, which apparently amounts to £12.5 million. Just think-if we put 0.5 per cent. on VAT, that would create £2.5 billion. Perhaps my sums are wrong; if so, someone brighter than me can put me right. That is the sort of mental attitude that this House must have in saying that there are ways to square the circle but they will have a cost.
I want to focus a little on the Tory proposals. I am sceptical, but genuinely interested, and I want to try to work out what the Tories have brought forward. The £8,000 proposal is worth looking at, if taken as a purely mathematical argument. I understand that they said at their conference that if five people pay £8,000, one person gets two years of care out of that £40,000, and the other four will not need it. How many people will have to pay before it becomes effective? Will it be five, 50, 5,000 or 50,000? If people do not buy into the scheme, it will not get off the ground, and what will we be able to do in the meantime? There have also been rafts of reports that the costs are being underestimated as they will be not £20,000 but £26,000 a year, and that the average stay will be three and a half years rather than two. If that is the case, the figures will obviously be inflated.
As I said to the hon. Member for Eddisbury (Mr. O'Brien), I believe that people will go into care earlier in future. When people are assessed now and
told, "You should be in care", they say, "I am not going into care". They go into care at the last moment because of the pernicious impact of losing their home and not being able to leave it to their children, which is understandable. In future, if they realise they need care, they will say, "Yes, I will go in early, because my home is now safe". However we square the circle, people will go into care earlier and stay in longer. They will get the care they need at the front end rather than have to go in when they are on their last legs. The average period in care will be much longer.
Angela Browning: If those people were self-funding, would they not be subject to assessment to see whether they needed to go into care? They could not just go in voluntarily without a full medical need to be admitted.
Mr. Anderson: I agree absolutely. They would need medical, social and financial assessments, but my point is that that happens now and people are told, "The best place for you is in care". They say, "I know that, but I am not going in." In future, they will say, "I will go in, because my family is going to keep my home." There will be an incentive, whereas there is a disincentive at the moment because they want to protect the assets that they want to leave to their children. To a certain extent that is why we are having this debate, and the Opposition should bear that in mind and address it. The hon. Member for Leeds, North-West spoke about consensus, and if we are having a genuine debate a consensus has to be hammered out. We need much more data to show whether the £8,000 proposal is a runner.
The proposal is a private insurance scheme. I do not know whether private insurers will be full of the milk of human kindness all of a sudden and say, "We will run the scheme free". It hardly seems likely of a company such as Aviva, which has just announced almost £3 billion of profits. It might say, "We can afford to absorb this; we will do it for nothing", but I doubt it very much.
The crux of the matter is that some people will not be able to find £8,000, some people will choose not to pay it and some will not have a pension lump sum. Why say to someone, "On the day you retire, give us £8,000"? Why not say, "Give us £3 a week for 50 years while you are at work"? That is how we fund the national health service and most of the public services in this country. It is how we should have been funding care for the past three decades and how we should fund it going forward-it is called collectivism.
We have good quality caring staff who put a lot of trust in us to find a way forward for them. That is the whole team-ancillary workers, home care workers, domestics working in homes, social workers and people classed as backroom staff who do the paperwork and ensure that things are right and proper. They need to know that they are in a service worth working in. They are professionals and we need to treat them as such. We need to respect them and reward them in a way that clearly has not happened in the past.
The royal commission reported that we should pursue various things. Ministers said that the report did not get consensus, but I can inform them that when it came out, I was the chair of the policy committee for the trade union, Unison. We set up the right to care group, which involved campaign groups including one of the main ones, led by Claire Rayner, user groups, carers and
workers. The group was clear that the best way to address the problem was for the service to be directly funded by tax. If we had done that then, it would have been embedded in the culture of this country by now and we would not have been having this debate. If we had bitten the bullet at the beginning of this century, the Opposition would have seen the system work and been converted in the same way as on the minimum wage and the other positive things that we have done. We should go for the fully funded option and, if we cannot do that, we must ensure that it plays a huge part in future.
We have been here before and we did not make the right choices. We must now make the right choices-it is the mark of a civilised society. The shadow Chancellor said in his speech at conference, "We're all in this together." The Conservative party's programmes are not about us all being in this together, but about us all being individuals. I believe that we are in this together because none of us knows where we will end up if we are fortunate enough to live into old age. We should provide collectively.
In the past three decades, we have failed to provide for the people of this country. It was interesting to hear the hon. Member for Eddisbury describe how he is trying realise Tony Blair's promises. I lived about 10 miles from Tony Blair for 25 years, though politically we are probably a million miles apart. However, I agreed with him when he said that we are best when we are bold. I say to my hon. Friend on the Front Bench, "Be bold, comrade."
Mr. Speaker: Order. There is plenty of time left for Back-Bench contributions before the Minister of State winds up, but I hope that the Member who has the floor will have regard to the fact that others also wish to contribute and do not want their contributions to be unreasonably squeezed.
4.56 pm
Mr. Mark Harper (Forest of Dean) (Con): I am grateful for that guidance, Mr. Speaker, and I will endeavour to live by it.
First, I want to say something in response to the way in which the Secretary of State opened the debate. Given that he began with some rather cheap remarks about my hon. Friend the shadow Secretary of State and that he said that the subject of the debate was the most important in his in-tray, it is extraordinary that he left at 3.24 and has not stayed to the end.
On a happier note, I listened carefully to the remarks of the right hon. Member for Croydon, North (Malcolm Wicks) about our ageing society and the comments of my hon. Friend the Member for Tiverton and Honiton (Angela Browning) about the number of people in our society who are over 100. That reminds me that this year on 6 August I had the great pleasure of being invited to the 105th birthday party of my constituent, Mrs. Lily Strugnall, who lives in Hanover court in Cinderford, in a home where her daughter, who is in her 80s, also resides. That provides some interesting lessons about our ageing society. Mrs. Strugnall received her sixth 100th birthday card from Her Majesty the Queen and I noted that this year Her Majesty had changed her outfit. As an interesting aside, someone in Gloucestershire
who had received four 100th birthday cards from Her Majesty and noted that she had worn the same outfit in each one wrote to the palace to complain and had a personal visit from one of the royal princes with a revised design showing a different outfit. That shows that the palace can listen to our constituents as well as we can.
Given that I do not have much time and that I want other hon. Members to have an opportunity to speak, I shall focus specifically on the benefits in the Green Paper, to which several hon. Members referred, that cause our constituents concern. The Green Paper mentions attendance allowance, which, according to the Library briefing, is the main social security benefit that goes to people over 65. Although one cannot apply for disability living allowance once one is 65 or over, it continues after 65 for those who are already getting it. It is worth spending a moment on those allowances.
Two rates of attendance allowance currently apply. The lower rate is £47.10 and the higher rate is £70.35 a week. They are significant amounts. I am sure that many who receive them would say that they are not high enough, but they are significant amounts that make a significant difference to the quality of people's lives. They are based on need and not means-tested using income or capital. They are tax free and non-contributory. They are therefore very different in nature from the social care support that one receives through a local authority, which is means-tested. That is one of the reasons for the debate.
Given that the Secretary of State mentioned DLA, it is worth noting that whereas attendance allowance has only a care component, assessed on personal care needs, DLA has a care component and a mobility component. For many people, the mobility component, which under the higher rate is enough to fund a car through the Motability scheme, makes a huge difference. It sometimes makes the difference between a person being independent or otherwise. Will the Minister refer to that in his remarks?
Those benefits are quite distinctive, because if someone meets the conditions and receives them, they can spend the money as they choose. Effectively, it gives them all the advantages of an individual budget. In a sense, attendance allowance and disability living allowance are individual budgets par excellence, because the funds go to the individual, who can then decide how best to spend them. The concern of many organisations and disabled people is that if the allowances were effectively folded into the social care system, the funds would become means-tested, cash-limited and rationed.
My hon. Friend the Member for Tiverton and Honiton gave some examples of how that could be damaging, and I am pleased that my hon. Friend the Member for Eddisbury (Mr. O'Brien), who speaks for the Conservatives on these matters, made it very clear that we are not tempted to go down that road. In the time that the Minister has available, which I know is increasingly compressed, will he dwell on how the proposals to fold attendance allowance and other disability benefits into the social care system seem to be a step in the opposite direction from the welcome moves and his agenda towards a more personalised approach?
We are saying to local authorities, "We want you to assess people and agree on an amount of financial support, and ensure either that they have the opportunity
to take the money in cash to spend themselves or that you continue to provide the services while allowing the individual to be in the driving seat about what the services look like," yet folding benefits that people already receive and control into the local authority system takes us in the opposite direction. The Minister will know as well as I do that getting the personalised approach working and getting local authorities to adopt it with enthusiasm is not as easy as it ought to be. Anything that takes us in the opposite direction is not to be welcomed.
It is worth remembering that a significant number of people get those benefits. As of February this year, nearly 1.6 million people receive attendance allowance, and almost 1 million people above pension age-65 years-get disability living allowance. If we add those numbers and divide the sum by the number of parliamentary constituencies, we see that every hon. Member has on average 4,000 over-65s who get one or other allowance. That is a significant number of people who may be concerned about the proposals in the Green Paper.
I draw the Minister's attention to what the Secretary of State said at the beginning of the debate. He said that, often, talk of change is unsettling for people, which indeed it is. That is not a reason for not changing something, but the unsettling nature of change is made worse when the Government's intentions are not clear, so will the Minister clear up this matter? On 30 September, in Disability Now, he said:
"All the models that"
"have done have not included DLA...DLA is not under threat and people can be very happy."
On 13 October-just a couple of weeks later-his colleague Lord McKenzie of Luton said that the Government were not ruling out any options. After being pressed a number times, he explicitly said that the Government
"are considering all disability benefits."-[ Official Report, House of Lords, 13 October 2009; Vol. 713, c. 112.]
However, the Secretary of State told a conference of directors of adult social services in Harrogate that he wanted to close down the controversy over DLA and made it clear that the Government had ruled out any suggestion that DLA for under-65s would be brought into the new national care service. Given that the Minister said that DLA was not being considered, that his colleague in the other place said that it was, and that the Secretary of State implicitly accepted that it was being considered because he ruled it out for the under-65s, I do not think that the Government have been very clear. That is partly why people find change unsettling. They are given mixed messages and they do not know what is going on.
It is also worth asking what would happen to carer's allowance in those circumstances. Some 500,000 people receive carer's allowance, but in order to qualify for it a claimant must be caring for a disabled person. The definition of a disabled person in that instance is someone who receives the middle or higher rate care component of disability living allowance, or attendance allowance-or, in a smaller number of cases, constant attendance allowance paid with a war or industrial disablement pension. If changes are made to attendance allowance, they could
have an impact on whether someone is entitled to carer's allowance. The Minister needs to set people's minds at rest about whether the changes in attendance allowance will trigger changes in entitlement to carer's allowances.
Hywel Williams: Many people receive carer's allowances for caring for people who receive attendance allowance, because they need regular and substantial care-more than 35 hours a week-so there would be several knock-on effects on people's income if changes were made to attendance allowances.
Mr. Harper: The hon. Gentleman makes a sensible point that supports what I have said.
Many groups that represent disabled people are very concerned about the proposals and have submitted responses to the consultation. For example, the Royal National Institute of Blind People and Action for Blind People have said that they are strongly opposed to the loss of attendance allowance. RADAR has said that it is
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