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Mrs. Turner made an excellent point to me. She said, "I'm not badly off. I was well before I became ill, and the level of care that I have been able to secure through the DLA has ensured that we have a decent life together. We enjoy each other's company and we do not feel as though we are impoverished." We need to protect such people too. Through the empowerment that the DLA has given that couple, she has managed to keep well in herself and to remain active and engaged with many other people.
This is an issue of trust. I have listened carefully to the contributions from Opposition Members and the undeniable stoking up of anxiety to ensure-
John Barrett (Edinburgh, West) (LD): The hon. Lady is making an interesting and well considered argument. Does she agree that the fear generated by the draft press release from the Conservative party makes life even tougher for constituents whose lives are already often difficult?
Laura Moffatt: I am grateful for that intervention, and I agree that the press release will make life tougher for people who will be anxious and concerned by it. Those who blindly follow the party lead and stick their name into a press release and put it out without thought or consideration need to think very carefully. I am very much aware that I have the most marginal seat in the country and I am proud of my 37 majority-and I have the tattoo to prove it. If our opponents issue press releases just to stoke up some concern, that is an issue of trust, and those people should reflect on what they are doing.
It seems to me that this campaign began with a deeply held desire to engage with constituents on the future of social care, but it has been turned into a bandwagon campaign, and that may have something to do with the fact that the Opposition proposal-hastily put together at the party conference-for a one-off payment for those willing to go into residential care, has bombed. There is no question about that. None of my constituents is talking about that proposal-the only game in town is about how we can provide care at home for family members. It is not about people who are well at present signing up to go into a nursing home in the future. There is a connection between those two events that has caused the Conservatives to jump on this bandwagon.
I hope that when we have the Second Reading of the Bill that will be the first step towards the national care service, our constituents will understand that they can trust the proposals and their benefits will not be affected. We need to have a proper debate, as many hon. Members have said today. We cannot go on avoiding the issue of providing care for elderly people with dignity and decency. I hope that after this robust debate today we will be able to make progress and look in detail at how we ensure that everybody can be confident that they will be able to live in a decent, happy and secure home in the future.
6.6 pm
Chloe Smith (Norwich, North) (Con):
The reason for today's debate is the Government's failure to be entirely clear about how they will fund their three proposed options for a national care service in their Green Paper. My hon. Friend the Member for Putney (Justine Greening) pointed out that all of us-at least on this side of the
House-have been victims of smear campaigns in elections that we have fought, whether in relation to TV licences, pensions or Sure Start, and now this issue. Our campaign is not a smear campaign and I agree with those hon. Members who have said that the subject is far more serious than that. We should treat it with the respect that it deserves.
If the Government think that they can achieve something in their last six months, let us take them at their word. Let us have that debate on behalf of our vulnerable constituents. Let us proceed with caution, but also with clarity. We need a debate that contains costs and decisions-I hate to break that news to Labour Members. I hope that when he sums up the Minister will answer the question posed by my right hon. Friend the Member for Maidenhead (Mrs. May) about cash benefits. She asked whether, if there are to be no cash losers, the benefits will be available to be spent as people want to spend them.
Jonathan Shaw indicated assent.
Chloe Smith: That is good to know. Earlier, the Secretary of State seemed to be having a Bill Clinton moment, in which we were not sure what the meaning of "is" was, or a Lewis Carroll moment in which the words were to mean what he said they were to mean. Perhaps instead it is one of those irregular verbs from a comedy programme that we all know and love, in which the Minister proposes a policy, we scrutinise it and the people outside think that the Government are in chaos. I would not want anybody to think that.
People receive attendance allowance or DLA because they need it. Many of us have pointed out that those benefits are based on need, not means, and that is an important point. Age Concern, which does great work in Norwich and Norfolk as a whole, as it does across the country, supports those benefits because they help older people to meet the daily living costs of disability. There is no question in anybody's mind that these benefits are undeserved or that they should be tossed around as discretionary options. In fact, they are essential to anybody's idea of social justice.
People in my constituency use those benefits for vital daily activities, such as assistance with washing, dressing or eating. They use them to carry on life in an enjoyable and meaningful way, and we all agree about that-the Minister nods again. A younger constituent came to my surgery on Saturday: he is totally blind, and he uses DLA to get around the city. He is another example of those who use it for enabling activities.
I recently met with carers and I hosted a web chat on Friday for a forum called Chill 4 Us. I spoke online with carers who, day in and day out, give up their time to care for others. Their passion on this issue was clear and powerful. None of them wants to lose DLA and AA because they need and appreciate them greatly as cash benefits. Sadly, however, I got the impression that the only chance they have to say that is through such virtual forums-we were there tapping away. That is one of the difficulties in this debate. It can be very constricting for people who need us to take the subject seriously and treat it with respect and maturity. Quite simply, living with the kind of care needs for which DLA and AA cater is hard and can be expensive. They are needs-based benefits. It is one small piece of help that society can
give, so it should hardly be controversial to say, "Let's not abolish something that the elderly, disabled or ill need and value."
I want to highlight the vulnerability that comes with such need. Fooling around with such benefits carries a weighty risk. A younger constituent aged, say, 35 might be able to plan for the future if changes are made to the system now. Many today have mentioned the needs of the future cohort; from what Ministers have said, it seems that today's cohort might be fine. However, the many people who receive DLA or AA after 65 might be less able to accommodate change. In many cases, they have made financial choices for their retirement that leave them and their families little room for manoeuvre. In other cases, people are already living on precarious means-we have heard plenty of figures today-and the abolition, if enacted, could represent a loss of up to £60 a week. That would be serious in many cases.
Some recipients of DLA and AA are physically ill or disabled, and their lives could become severely restricted without that assistance. People suffering from dementia or other mental illnesses, too, are particularly vulnerable to change. Making any changes that affect those social groups is difficult and complex. Getting the change right is paramount, and of course we are all taking that seriously today. However, debating the changes without causing immense anxiety is another thing entirely. The uncertainty generated by the Government's proposals in July's Green Paper has caused enormous concern and distress for people who are already vulnerable. Many Members have recounted what they have heard in their constituencies.
Forgive me for saying this, but it is incumbent on the Government to exercise caution and clarity in their approach. We also need flexibility and personal and local control at the end of whatever proposal emerges. I am sure that no one has an argument with a system that aims to be fair, simple and affordable. That is wonderful. However, we have serious concerns about a system that removes or reduces older people's ability to choose what to do. Choice and control must shine through any reforms that we make to the care system.
By choice and control, we mean the support that people need to choose how they overcome their concerns in their own way. Abolishing AA and DLA is a serious risk to such individual control. I would like a Minister to explain the paradox clearly. If the wording that has rather tortuously been made available still leaves open the option of abolishing AA and DLA, we need to know why the Government think that that maintains choice and control for individuals. That question is still on the table.
I would also like Ministers to explain, even after today's twists and turns, a policy that seeks to reallocate a cash benefit that grant money to people who need it and allows them spend it how they want, and to add it instead to a nationalised system that could simply eat it up through the weight of bureaucracy.
Chloe Smith: Quite right, as my hon. Friend says.
Let us turn to the ground on which the Government might like the debate to take place. If there are to be no cash losers, why are we talking about abolishing two benefits-or not abolishing them; I may have to grant the Minister that, although I do not think that he is
guaranteeing not to abolish them-and replacing them with the same? If there will be no cash losers, and some cash winners or cash neutrals, at the end of the process, why are we having much of this debate at all? That key question, too, is still on the table.
The Green Paper appears to contain a further argument that the aim is to reduce complexity for older people by merging funding streams. The paper states:
"Having two different funding streams means that older people have to apply separately",
which can be off-putting. The Green Paper states that there is a case for integrating those streams
"to improve the effectiveness of state funding."
I would like the Minister to explain what kind of state funding can be more effective than meeting the rawest needs of people in a way that gives them power over their own solutions.
I would also like the Minister to acknowledge that, by his own argument for reducing complexity, there is so much more to do to help not only that group of people, but the millions in the UK who despair of ever getting what they deserve from the state. I am talking about the country we live in, where almost daily in the past 12 years, we have had application forms, means tests, quangos, queues and hoops added to every conceivable aspect of the public sector. It is no wonder that we are talking again about a group of people who are vulnerable to change and worried about more burdens being added as they simply try to get on with what they want to do.
To make a constructive point, it is essential to provide good information to people in any new care system. I shall mention one local example. Norwich has several day care centres provided by the local authority. I am sad that the Secretary of State is not here to hear this point, because judging by something he said earlier, I think he knows about it. He will also know that Norfolk county council is consulting on its options and he may know that I, as a local MP, will be standing up for my constituents on those options, rather than playing party politics.
The local authority is facing ever less funding in future, in a period of a staggering national deficit, and a move to personalised budgets. Under the pressure of at least two burdens from national Government, therefore, the council is seeking to focus its limited means on those who need its help the most. In particular, we are talking about dementia needs and so-called re-ablement requirements. Most people have no problem with that. The rub has come as the council has reviewed against its projected future requirements the usage of three day care centres that it runs. The elderly members of at least one of those facilities-the Silver Rooms-in my constituency are extremely anxious about their future. They are frail and some have physical and mental disabilities.
I raise that example not only because, if local facilities are to close, losing AA would in many cases be a double blow for those people, but because their plight illustrates particularly well why a national care service would do well to excel in the provision of good information. If the personalisation of care budgets moves from being a twinkle in a planner's eye to a fully workable, local scheme, my constituents will need to know where they can spend their money. That remains true in a world with or without AA and DLA, and with or without any
of the options provided in a national care service. My constituents will want the comfort of knowing that, with their personal budget in hand, their day centre, or whatever they choose to spend their future benefits on, will still be open for business. If a national care service can provide such information and support, that is wonderful. However, if it cannot and only succeeds in removing cash benefits that might be seen as an effective forerunner to personal budgets and gobbling them up in a monster of a scheme that provides no improvement, we really are in trouble.
I emphasise the gravity of getting this right. It is clear that reform of social care is greatly needed. My right hon. Friend the Member for Charnwood (Mr. Dorrell) referred to the Wanless report. Others will be familiar with the statistics on exactly what we will be facing in 10, 20 or 40 years, when perhaps even I will be retiring. Perhaps more shocking, in a survey conducted by the Department of Health in July, I understand that more than half of those asked thought that the total cost of a residential care home for an elderly person would be £10,000 or less and that more than a quarter assumed that it would be free, so in addition to the demographic bomb going off, we are also battling a problem of public information. People need that information. Any proposals in the Green Paper will not be implemented until 2014, which should give us time to pin down the Secretary of State to some clear language. The Government must act now to alert people to that bomb.
Given that so many people rightly fear for the future of social care and are vulnerable to changes in the system, I want answers to some questions in addition to those put so ably by my hon. Friends. Why would the Government seek to remove an obvious area of stability, in the shape of AA and DLA, for vulnerable people? Why would we seek to abolish the only area of clarity for many people in the care system at present? Why would we do away with a cash benefit that goes where it is most needed? We need a clear definition of "no cash losers". Why would we seek to reduce people's independence and open the door to an unwieldy and ever larger bureaucracy? Finally, before they talk about the serpentine amendments that we have seen today-or afterwards, or indeed during that discussion-will the Government give the proposals in their Green Paper the gravity and maturity of decision that they deserve? Will they be able to emerge from all that and talk about social justice on the other side?
6.20 pm
John Mason (Glasgow, East) (SNP): I want to concentrate on the proposal to abolish attendance allowance, apparently now only for new claimants, and disability living allowance for the over-65s. As we know, that would affect 2.4 million vulnerable pensioners, including 1.6 million who currently claim attendance allowance and 800,000 over-65s who are on disability living allowance. However, whatever happens to the current claimants, presumably we are talking about higher numbers in future, so those are the minimum numbers at least.
We have received various reassurances from Ministers in recent weeks and months. They have suggested that people will receive similar services, rather than money. Previously, we were told that
"people will be guaranteed an equivalent level of support".-[ Official Report, 19 November 2009; Vol. 501, c. 241.]
One of the problems in this debate is the lack of clarity about the phrase "equivalent level of support", because frankly it can mean absolutely anything to absolutely anyone. The hon. Member for Crawley (Laura Moffatt) said that reassurances had been given, but the first reassurances that I heard were given yesterday, at Department for Work and Pensions questions. I am not sure when she thought she had heard reassurances before that.
Quite a lot of concerns have been expressed, not least today, about some of the statements that have been made and the phrases that have been used. The Secretary of State said that the present system was "not sustainable" and that the cost could rise by 50 per cent. A number of hon. Members, including the right hon. Member for Stirling (Mrs. McGuire), have talked about a demographic time bomb, which the hon. Member for Norwich, North (Chloe Smith) also mentioned. I feel that those statements are slightly over the top, because the reality is that we, as a Parliament, and the Government need to set priorities. The question is: what priorities are they to be? If we are saying that the present pot of money that looks after the elderly and vulnerable will continue to be the same pot, despite an increasing number in those groups, I would very much question whether that is the right priority.
Yesterday we received clarification that those already receiving the benefits in question would get
"the same level of cash support."-[ Official Report, 7 December 2009; Vol. 502, c. 6.]
The Secretary of State said today that he had "said it all along" and that there would be no cash losers. However, to reiterate what other Members have said, we did not really hear that, and it might have been helpful if he had said it a bit earlier. Although that statement seems to be reassuring, it still leaves new folk looking ahead and wondering what will happen if they do not receive attendance allowance in future. That seems to go in the opposite direction from the Welfare Reform Act 2009, in which I was involved in the Public Bill Committee. Great play was made of the right to control and all parties agreed on that.
I would like to make a number of points. The first is that attendance allowance and DLA do a lot of good. I should like to quote again-I have quoted from this before-from a paper that I received from SAMH-the Scottish Association for Mental Health. What SAMH says is probably typical of what a lot of similar groups would say. SAMH refers to the 194,000 people of working age in Scotland and the 145,000 over-65s who receive attendance allowance and to the 110,000 older people who receive DLA. The advantages that SAMH quotes are similar to those that we have heard about already this evening:
"For example, people with mental health problems can experience much smaller social networks and can feel isolated and alone. Anxiety may mean that a person feels unable to leave their home by themselves. People can choose to use their DLA to use a taxi to access social activities and cover the costs of an informal carer to provide the additional support and assistance needed. Without this additional support the person could experience greater anxiety and social isolation, increasing the potential of a period of hospitalisation or more intensive and costly community support."
"Disability benefits and free personal care enable older people in Scotland to remain independent in the community, providing
older people with a personal budget to help with their care and support needs. This could include covering the costs of a friend or family member coming to the home in the morning to help the person get out of bed, prepare meals or do shopping and cleaning. Any changes to disability benefits could affect the provision of this care and support and result in an older person needing more costly forms of social care in the home, or lead to a person moving into residential care if they were not able to manage their household."
It has been said before, but it is worth re-emphasising, that much of the present system involves unpaid carers, of whom we hear a lot, and that the danger of just transferring even the same money to local authority or to any other control is that we will get less of a service.
I enjoyed being involved in the Public Bill Committee on the Welfare Reform Act 2009, in which other Members who are present were also involved. It is worth quoting again from the then Bill and from a clause in the part dealing with the right to control. It said:
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