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"those receiving the affected benefits at the time of reform would continue to receive an equivalent level of support",
which is the same language used in the Green Paper and the same language used by Health Ministers in responses to questions. There is a complete difference between those two things. If it is cash, what is the point of taking away a cash benefit from people in order to give them the cash back? If it is not cash and it is paying for the national care service, our precise point is that there will be a difference between what people use disability benefits to pay for now and what will be provided to them as personal care services under a national care service. There is a major discontinuity between those two things, which Ministers do not seem to understand at all.
David Taylor (North-West Leicestershire) (Lab/Co-op): Further to the point raised by the hon. Member for Northavon (Steve Webb), it is a full 20 weeks since the publication of the Green Paper and the start of the present campaign on attendance allowance and disability living allowance, so will the hon. Gentleman confirm the rumour that the leader of his party will sack the head of the section for opportunism and scaremongering in Tory party headquarters for tardiness and incompetence?
Mr. Lansley: I am astonished at the meaning or purpose of that intervention. The hon. Gentleman signed early-day motion 1, and what we have tabled for debate on the Order Paper today is couched in exactly the same terms and it seems to me to be perfectly reasonable.
Lembit Öpik (Montgomeryshire) (LD): My constituents have a simpler concern than the one about how the Conservatives choose to organise their party. If the Conservatives form a Government, will the hon. Gentleman give an assurance that my elderly and disabled constituents would not be materially worse off? I am more concerned about the sums, however delivered, than the process of delivery, and I am sure that my constituents are, too.
I think the hon. Gentleman is right that people are concerned about that, and I am glad that he also signed the early-day motion, which makes an important point. I do not know why the Government should think that our argument is just about those currently in receipt of attendance allowance and disability living allowance, as we are debating what should be the long-term future of social care. The Green Paper was not about what is going to happen in the next six months, but about what ought to happen in the longer term. I am looking to find out what should happen in the long term for obvious reasons. I am making clear on behalf of my party our belief that the continuation of disability benefits, such as attendance allowance and disability
living allowance in their current form, will give current recipients of such benefits and those who will be recipients in the future an opportunity, on a non-means-tested basis, to gain access to cash benefits that will enable them to buy a wide range of services such as informal care, family care, support for travel and support for house improvements on the basis of their own personal choice and control.
I find it astonishing that today is the day on which the Department for Work and Pensions chose to publish a document relating to other disability benefits, entitled "Making choice and control a reality for disabled people". It is clear from that document that the reason the Government did not include attendance allowance, for example, in the "right to control" policy is that it is already a cash benefit. People receiving a cash benefit gain personalisation and choice, but if a Government were to withdraw direct access to that cash benefit and distribute it through the national care service, by definition they would create a lack of personalisation.
I have always considered that to be an agreed common objective. It has been our objective since the 2006 White Paper, and the Government have also moved in the direction of direct payments and personal budgets for social care. More recently, they have moved in the direction that we urged them to follow, which included access to some aspects of health care as part of an overall personal budget. The point is that the budget is a cash budget, and there is an issue over how it should work.
"We know that disability benefits such as Attendance Allowance are highly valued by the people who receive them, and that they give people control over how they spend their money to meet their care and support needs. However, we also recognise that there are inconsistencies of approach between disability benefits and social care within the current system. This is because the social care and disability benefits systems have developed in isolation from each other and these two largest portions of government care and support expenditure are being allocated on different bases. This can lead to inconsistent and unfair outcomes."
To me, the issue seems perfectly straightforward. If there are two sources of support for people and if one relates to social care and is means-tested while the other is based on an assessment of need, is not means-tested and is in cash form, and if there are inconsistencies between the two in relation to the assessment, what is the answer? The answer is to adopt a common process applying to both the assessment of need for the disability benefits and the assessment of need for access to social care. The answer is not to abolish the cash benefits and combine them in a single system. The Government have said-and it is in the amendment-that there should be a single assessment process; I hope they mean that, as we have agreed, there should be a common assessment process.
"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."-[ Official Report, 14 July 2009; Vol. 496, c. 160.]
That seems to me utterly consistent with the view-which the Government have apparently supported, in rhetoric-that there should be personalisation, that whenever possible there should be cash budgets over which people have more control, and that abolishing access to disability benefits would be a retrograde step.
John Mason (Glasgow, East) (SNP): The hon. Gentleman has been making a powerful point about the advantage of cash benefits in giving individuals control. Does he accept that even if the Government concede that current recipients will continue to receive the cash, there will be a huge loss to future generations who will not receive it?
Mr. Lansley: I agree that it is important to have in mind the longer term, and to bear in mind those who may be recipients of benefit and care support in the future. However, I do not think the Government have said-and they do not say it in the amendment-that current recipients will receive the same cash support. They say they will
"receive an equivalent level of support."
Alistair Burt (North-East Bedfordshire) (Con): My hon. Friend might care to know that the hon. Member for Northavon (Steve Webb) is a master of the lurid headline. His website reveals that he has issued press releases entitled:
"Docking alcoholics benefits fundamentally inhumane"
"New benefits scheme shunting ill onto lower support",
"Benefits changes will leave millions without social security".
Part of the argument on this matter is that attendance allowance is effective; it works. The Secretary of State for Work and Pensions said much the same thing last month to the Select Committee on Work and Pensions:
"One of the things we have said is that Attendance Allowance provides very important support for an awful lot of people across the country in a way that they hugely value. In particular it gives people control; it gives them control themselves over the way in which they get support and it is a budget that they can spend themselves."
"found no evidence that Attendance Allowance is paid long term to significant numbers of people who do not have accompanying health problems".
Those people who use this allowance often do so to save some money to meet higher occasional payments, such as for a wheelchair. An Age UK survey of older people who received attendance allowance found that the allowance supports older people
"to live in their own homes for as long as possible with a reasonable quality of life given their health...it would be no exaggeration to say that Attendance Allowance transforms people's lives."
In summary, people use the attendance allowance and disability living allowance to help them, under their own control, to create a quality of life for themselves that helps them to remain independent. That is precisely in line with the policy we are all trying to pursue. It is clear that if one narrowly focuses only on care needs, we will miss out much that goes to constitute well-being, and there is no health without well-being, and there is no independence, without sustaining people's quality of life.
The Secretary of State for Health (Andy Burnham): I am listening carefully to the hon. Gentleman's remarks, and now that he has come to the core of his argument, I have to respond to him. His motion suggests that anybody in receipt of attendance allowance would receive no help from a national care service, and he is repeating that suggestion in the House, whereas in fact we are proposing to replicate the cash control in a new system so as to give people who would receive those benefits the same control and cash in the future. The central plank of the hon. Gentleman's argument is therefore knocked away, and I would be grateful if he would acknowledge that his motion's comments about no help for so many million benefit recipients are simply not true.
Mr. Lansley: I am sorry, but the Secretary of State is completely wrong about that. We are not asserting that people will get no help. We are asserting that existing recipients will not get access to cash benefits in the form in which they currently do, and they will therefore be able to exercise less choice and control because this will be routed through the national care service, which will have its own parameters and will not necessarily enable them to spend that money in the same form as they can now. Ministers have not said in their amendment that current recipients would get cash. Besides, the point is not just about current recipients; it is about future recipients and future reform. The last part of the motion
"urges the Government to ensure that attendance allowance and disability living allowance for people aged 65 years and over are secured and not abolished as part of any future reform of the social care system."
"further notes with concern that approximately 2.87 million people in the UK who receive disability living allowance or attendance allowance are not eligible for social care services".
The crux of his argument is his scurrilous campaign to frighten those people and to suggest that they would receive no support under a national care service. He knows what he is doing-he is raising concern and, frankly, it is gutter politics.
Mr. Lansley: That is rather astonishing, is it not, Mr. Speaker? We have never said anything remotely like that. We always make it absolutely clear that we are opposed to the scrapping of attendance allowance and disability living allowance and their incorporation into the Government's proposed social care service. We want to give people access to cash benefits, personalisation and choice.
"fight against Gordon Brown's plan"-
"fight against Gordon Brown's plan to scrap benefits for the disabled."
Mr. Lansley: The Government's Green Paper is clearly intended to propose that disability benefits should be "scrapped", which is the word I used, in order to fund a national care service. That is something that the Government have proposed. I know and respect the hon. Gentleman, but he is trying to find a way not to vote for the early-day motion that he signed.
I have not come to ask the House to endorse my press releases. I have come to ask the House to settle this issue. If it is the Government's view- [ Interruption. ] No, I will not withdraw the motion. The Government should withdraw the amendment, which is clearly flawed, as they are saying that their policy is different from the amendment. If the Government believe that their policy would be consistent with our motion, they should vote for the motion. The debate is on our motion, not on something else.
Roger Berry: Does the hon. Gentleman seriously believe that proclaiming that the Government are planning to scrap disabled people's benefits is not causing enormous concern among the most vulnerable individuals and communities in our society? Should he not be ashamed of saying that?
Mr. Lansley: I am not ashamed. We are doing the job that the Government should have done, which is to get out there and explain to people what is in the Green Paper. What is shameful is publishing a Green Paper, at the heart of which is the major proposal of the abolition of cash benefits and their incorporation into funding a care service. The Government are happy to put out a proposal that states, "Would it be a good idea if the Government were to pay a quarter to a third of your care costs upfront?" and people say, "Yeah, that would be a good thing. That would be very nice, thank you." What the Government do not tell them is that, in the process, if they are in receipt of disability benefits, they will lose those benefits in order to pay for it. That is a completely different debate. Fortunately, we have organisations such as Age UK, Carers UK and the Parkinson's Disease Society who went out-we did not do it-and said, "Have you seen what is in the middle of this Green Paper?" They argued against it.
If the hon. Member for Kingswood (Roger Berry) and the Secretary of State want to put a stop to this now, they simply have to vote for the motion. Then the House will have spoken. There are a range of issues, including the impact on the overall income of pensioners. Some 40 per cent. of all attendance allowance recipients would be living below the Department for Work and
Pensions poverty threshold if their disability benefits were removed. As for taking away a cash benefit and providing a care service instead, Ministers talk about equivalent support but they do not talk about equivalent support for future recipients. If the benefits were to be taken away and replaced by the care service, there would be a serious potential impact on the disposable income of many pensioners. Those issues are not explored in the Green Paper. There is no economic modelling associated with the Green Paper and no understanding of what the overall impact on people's disposable incomes would be. There is no evidence about the relationship, in detail, between disability benefit recipients and those who would be the recipients of the national care service so that we can understand the implications for poverty and well being. I am afraid that that simply is not good enough.
The Government's response has been first to deny that they are going to do that, then to get angry and now to engage in abuse. It is like when someone cuts you up when you are driving and then swears at you; first, we get injury from the Government and then insults. It is no good Ministers blaming people's anxieties on us. The organisations that represent disabled people have been at least as voluble as we have been in making this point and in urging the Government to change their policy. We have been clear about the policy that we pursue, but we question whether the Government will be clear. Scrapping disability benefits to pay for the national care service would be a serious mistake and a retrograde step. It would undermine personalisation and control for care users, which they say they are in favour of, and it would undermine family and informal care as opposed to formal and council-arranged care. Members of the House who have followed the consultation on the Green Paper have the right to say no to that. Ministers should accept the motion and move on. That would not be such a big retreat after all the retreats that we have seen in recent months. I say to the Secretary of State, "Just do it. It will only be only painful for today, and tomorrow you will be in a better place as a result." I urge Members on both sides of the House to help the Government to get off this hook. I commend the motion to the House.
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