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The proposals therefore raise questions for future recipients-that is what I am now talking about-and I hope that Ministers will address some of those questions. For example, if DLA is to remain for under-65s but perhaps not for over-65s, there will be a question about the transition from under to over 65. It is clear from research evidence that DLA is not just a care cost benefit, but a disability cost benefit. Is it not therefore the case that, in the future, if people on DLA who became disabled before pension age go on to the new
regime and receive support from a different package-I do not want to say "have it taken away from them"-that will presumably give them potentially less cash after the transition to spend on the other costs associated with their disability? I assume that that would be a consequence of the Government's proposal. Is there not a danger, therefore, that although those individuals' care needs might be fully met in the future, the compensation that society has given over generations for the additional costs of disability would thereby be undermined, because potentially all or a large part of that cash would be put into a bucket for care costs and their ability to meet other, extra disability costs might thereby be constrained? We need to understand the transition from under to over the pension age, compared with the position now. That is the first question that I hope the Minister responding will address.
The second question is about the current role of such benefits in passporting people on to other things. If a person receives attendance allowance, someone will be looking after them 35 hours a week and, in principle, will be passported on to carer's allowance. Could the Minister who responds to the debate say something about how such passporting might work in a world where new recipients receive a care package, but do not necessarily receive the benefits that passport them on to other benefits? One imagines that there are ways around that, but there would be consequences.
We all agree on the importance of cash benefits for personal control, personalisation and dignity. We would all want the cash to make our own choices and not to have the state decide what pattern of services we want. One of my concerns about the Government's proposal is that the new system will inevitably rely more heavily on means-testing than the current one. That is implicit in the Green Paper, which on page 102 describes attendance allowance thus:
"Attendance Allowance is not means-tested, so people get it regardless of how well-off they are."
Of course, that is simply a statement of fact, but why does the Green Paper say that and, by implication, "And this might be thought to be a bad thing. This is not money well spent"? At that point we part company with the Government, because our argument is that attendance allowance and DLA are designed to meet the additional costs of disability and people have those additional costs whether they are rich or poor.
We are talking about a universal benefit for people with disabilities. They will all face a set of additional costs on average, so we as a society compensate them all. Reading between the lines of the Green Paper and suggesting that, although there are additional costs, people who are well off can meet them themselves would be a worrying undermining of that principle. In our view, therefore, a continuing role for a disability benefit that is specifically related to the additional costs of care, but separate from the process for assessment and meeting care needs, is an important part of the system.
I admit that I was rather puzzled by what the hon. Member for South Cambridgeshire said about a single assessment system; his comment struck me as rather odd. At the moment, we have a system in which attendance allowance goes to millions of people who do not get social care services provided by their local authority. In a single assessment system, however, there are only two
possible outcomes. Either the outcome is as broad as attendance allowance, in which case we would bring all the people who get social care who do not currently receive the allowance into the system, which would presumably be hugely expensive; or it is as narrow as social care, in which case people would be knocked out of attendance allowance. If neither of those two things is done, the system is not a single system.
I suppose we could have a compromise, whereby a few fewer people receive attendance allowance and a few more people receive social care, but that is not what the hon. Gentleman seemed to be saying. I am therefore slightly confused. We have come not to expect alternative proposals from the Conservative Opposition, but this time there is one on the table, only it seems not to make any sense. If we are talking about a single process of assessment that is different from what we have now, either it is universal and based on need, like attendance allowance, or it is means-tested, like social care, but it is rather hard to see how those can be one, single system.
There is an important question about what I call the non-overlap group-the people who are disabled enough to receive attendance allowance, but who do not get local authority social care. Again, my concern is that either that set of people loses out if attendance allowance goes, or the Government do not save any money, because those people use their attendance allowance to pay for care, and if the allowance was not there, they would rely on local authority provision. The only saving would be achieved be through means-testing, which is a worry. We all know why means-testing happens-we cannot be generous to everyone, so we pick some people-but there is a balance to be struck between universalism and means-testing.
One of my worries about the present Government is that the balance between universal and means-tested benefits in, for example, the pensions system has gone very much in the direction of means-testing. We have on the Front Bench today a former Pensions Minister, who will know that, when there was spare cash, it went into the means-tested areas. That was an understandable choice, but the Minister says that social care needs to look more like the NHS, and one of the hallmarks of the NHS is that we as a society say that people who are sick are entitled to help whether they are rich or poor. In my view, the Government's model seems to be veering in the direction of means-testing, because if we roll attendance allowance into the local authority social care budgets, we will by definition be doing more means-testing. We all get letters from our constituents saying, "I've worked hard and saved hard, but what was the point, because I'm no better off?" If we make social care more means-tested, we will rightly get more of those letters, because needing social care is akin to needing health care; it is the same sort of thing. Our worry about the direction of Government policy is the greater emphasis on means-testing.
That brings us to take-up. We know that take-up, even of the universal disability benefits, is not brilliant. There are plenty of people out there who should be getting attendance allowance or disability living allowance but who are not doing so. If we were to impose a means-testing regime on all that to create a single system, the likelihood of people missing out on the whole lot would increase. In Work and Pensions questions yesterday, a question was asked about the length of the
DLA form. The Minister quite properly said that it was a complicated business and that we have to ask a lot of questions if we want to capture everything. If we tried to combine that with a means-tested system of local authority care, I imagine that the barriers would be even greater and we would therefore risk excluding vulnerable people. Having a mixture of the universal system that includes attendance allowance and, ideally, a less means-tested local authority system would create a better balance than what the Government are proposing.
My hon. Friend the Member for Colchester was right to table his early-day motion a few weeks ago. The motion before the House today accurately sets out our position, which is that attendance allowance and DLA for the over-65s have an important part to play in the system. We recognise that the Government have promised equivalent cash support for current recipients, but we believe that those benefits have a long-term future as well. That is where we part company with the Government.
Bob Russell: Does my hon. Friend agree that, despite the differences of opinion between Government and Opposition Front Benchers, the fact is that 105 hon. Members from all eight political parties represented in the House, plus independents, have signed the early-day motion? There is no reason why the 39 Labour Members who signed it should not sign up to the motion before the House today, especially as they outnumber the 21 Conservatives and 32 Liberal Democrats. There is no reason why the House should not be united on the motion.
Steve Webb: I share my hon. Friend's hope, but I am slightly torn. We are always glad when Members from other parties sign our early-day motions, and the last thing we want is to discourage them from doing so in the future. I take my hon. Friend's point that there is nothing in the motion with which they should have a problem. I was not planning to make a partisan point, but this reminds me that, as of yesterday, when I realised what motion had been tabled for today, I checked to see how many Conservative Members had signed the early-day motion. At that stage, the number was 16. Given the primary importance of the subject, I was rather startled to find that the early-day motion had been signed by only 16 of them-including the hon. Member for South Cambridgeshire and the right hon. Member for Maidenhead (Mrs. May), who presumably knew that this debate was coming. That was rather a surprise. I agree with my hon. Friend, however, that there is nothing in the motion that Labour Members should have any difficulty with.
The key points are that we, corporately-to put it generously-should cease as of now to cause alarm to 2.4 million disabled people, and that the message goes out that their benefits and their rights are protected and will remain intact. By all means, let us have a mature debate about the future, but in our judgment, attendance allowance and DLA will continue to have a specific role to play in the system, by meeting the additional costs that those of us who are fortunate enough not to be disabled do not have. Those costs are incurred regardless of means and those benefits should therefore have a long-term role in the system. Any attempt to make the system more means-tested discourages those who have worked hard and saved hard, and penalises those who have become disabled through no fault of their own. That is the wrong direction to go in.
I hope that this debate will be helpful in placing on the record the reasons why current recipients need not be alarmed, while also allowing us to encourage the Government to think again about the threats to those benefits whose purpose is to meet additional costs that are not met elsewhere in the system and should always be met in any future system.
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Mrs. Anne McGuire (Stirling) (Lab): I hope not to take up my full allocation of time. I have one or two points to raise, not least because I used to be the Minister with responsibility for disabled people and had to deal with some of the early policy issues and discussions about this development.
Perhaps we should be more optimistic about why we are all here today. The justification for the reform of social care is, as the Secretary of State indicated, that we are all living longer and, thanks to medical science, can be kept in our homes longer. That is the good news to start with. The bad news is that although the hon. Member for South Cambridgeshire (Mr. Lansley), who opened for the Conservative Opposition, said that there was a need for consensus, he then went on to scaremonger about the so-called attempt by a Labour Government to take away disability benefits from nearly 3 million people in Britain. Frankly, that is a disgraceful way to come at the subject, because the reform of social care is an important matter for all of us.
As the hon. Member for Northavon (Steve Webb) suggested, we should have a mature debate. [Interruption.] In some ways-I point this out to the Under-Secretary of State for Work and Pensions, my hon. Friend the Member for Chatham and Aylesford (Jonathan Shaw), who is the current Minister with responsibility for disabled people-our approach to pension reform should provide a model. That was about consensus and moving forward on the basis of certain principles. Frankly, however- [Interruption.] I think some Opposition Members should take a degree in chuntering, because they are getting very good at it.
I will not take lessons from an Opposition who, in October this year, said that their solution to social care reform was a one-off payment of £8,000, which would give people no guarantee that they would not have to pay a top-up if their social care costs were more than approximately £26,000. There were no guarantees either to people with a pre-existing health condition that their social care costs would be covered. I declare a vested interest: I wonder whether insulin-dependent diabetics who may have complicated health needs will get the benefits that they require if they pay that £8,000. The Conservative proposal was taken apart by every expert in the field because it was drawn up on the back of an envelope to please a Conservative party conference. I am delighted that my right hon. Friend the Secretary of State for Health clarified that there was absolutely no contradiction between the reform of social care and independence, choice and control for disabled and elderly people.
John Mason: I am listening to what the right hon. Lady is saying, but does she accept that the words "equivalent level of support" were, with hindsight, a little unfortunate?
Mrs. McGuire: I think that the Secretary of State has answered that question-today and previously-and we are now in the territory of working out how many semantic angels can dance on the head of a pin. The Secretary of State and the Government have been very clear throughout that there will be no cash changes for individuals.
To colleagues who are having difficulty dealing with the reform of social care or in engaging with a Green Paper consultation, let me explain that there is no independence for an elderly person living on attendance allowance in a local authority that does not see social care as one of its funding priorities. That is not about independence, it does not provide choice and it certainly does not give control. As for my friends in voluntary organisations such as Carers UK and the many others that have been mentioned, I have the utmost respect for them, but I think they know in their heart of hearts that we must have a genuine discussion about how to deal with the demographic time-bomb and the social care time-bomb that we all face. I understand exactly why they are advancing some of the arguments that we have heard today, but they need to become part of the ongoing discussion about how we can reform the system. Even the best of the voluntary organisations need to respond to the conundrum of how we should deal with a social care system in which two people are working for every one person over the age of 65.
Mr. Stephen O'Brien (Eddisbury) (Con) rose-
Mrs. McGuire: I give way to the hon. Gentleman.
Mrs. McGuire: The handsome one at the front.
Mr. O'Brien: I am most grateful to the right hon. Lady. She began by rightly championing the idea of consensus, suggesting that it would be helpful and that the pension process might prove to be a precedent in that regard. Does she accept, however, that although we in the official Opposition have always indicated that we would be receptive, we have never received an invitation even to discuss the issue, let alone an invitation to a round table with Ministers?
Mrs. McGuire: Perhaps the hon. Gentleman should reflect on whether the Opposition have made any effort to contribute to the consultation over the past few weeks. [Interruption.] Is the hon. Gentleman saying that they made a formal response to the formal response to the consultation document? I am not sure whether the answer is yes or no.
Mr. Burns: Will the right hon. Lady give way?
Mrs. McGuire: Very briefly. I did say that I would not take up all my allotted time.
Mr. Burns: Will the right hon. Lady briefly answer a very specific question? Why, in her view, did 41 of her colleagues sign the early-day motion which became the motion before the House today?
Mrs. McGuire: I think that colleagues sign early-day motions for all sorts of reasons and I do not wish to second-guess the motives of any of my colleagues. The purpose of signing early-day motions is to put on the agenda matters about which Members feel strongly. I do not intend to fall into any trap set by the hon. Gentleman.
As I have said, I believe that genuine discussions must take place with the organisations that represent the needs and ambitions of disabled people. Let me say this to the Government, and I say it with the utmost respect to my colleagues. I welcomed the Secretary of State's comments about cash support, but the Government know that disability benefits, including attendance allowance, are valued and that any proposed changes should be seen in the context of improving the lives of disabled and older people in the future-I recognise that we are talking about the future.
Unusually, I agree with the hon. Member for Glasgow, East (John Mason). Obviously, any discussions must take account of the impact in other parts of the United Kingdom. We must recognise that devolved Administrations will be involved if changes are made to what is currently a United Kingdom-wide benefit. The discussions must be meaningful and robust, and I hope that some of them have already begun.
This is probably the next great social agenda development, and I do not think any of us can run away from it. We cannot change the demography, certainly in the short term. The social care Green Paper sets out the questions, highlights some of the options, and gives people an opportunity to engage in the debate. What we cannot do is run away from that debate. We cannot simply pretend that it is not happening, or we shall have abrogated our responsibility to future generations whose social care needs will have to be met.
5.9 pm
Mr. Stephen Dorrell (Charnwood) (Con): I congratulate the right hon. Member for Stirling (Mrs. McGuire) on saying that she would sit down well within her allotted time, and then sticking to her promise. I shall try to emulate her in that regard.
The right hon. Lady began by saying that the occasion for the debate was good news-the news that more elderly people are living longer-and that we should all celebrate that good news. I entirely agree with her, but the other aspect of the background to the debate is less happy. Although it has been recognised from 1997 onwards, and indeed was recognised by the previous Government-in which, as Secretary of State for Health, I was responsible for these issues-the fact that people are living longer, and have higher expectations for their care in old age, creates a real policy challenge when it comes to paying for the care that, when we are younger, we all want for elderly people and that we want for ourselves as we grow older. The current Government came to office, and the then Prime Minister promised action on this subject, in autumn 1997, yet all we have had are repeated commissions that have, in truth, failed to address the issue.
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