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"We welcome the Prime Minister's high-level commitment to homecare and look forward to the detail of how people will be able to access free personal care. Home-based care is an excellent service which keeps many people out of hospital and...enables people to return to their communities quickly following hospital discharge."
Mr. Dorrell: The Minister has said several times that the Bill concentrates money on those with the greatest care need. Is that true? The resources are in fact being channelled to those with the greatest care needs that can be met at home, but those with the greatest care needs are those whose needs cannot be met at home. Their needs must be met in residential care, and for them the means-tested system will continue to operate.
Phil Hope: We go around the same arguments that we have been having all afternoon. The right hon. Gentleman fails to acknowledge the importance of supporting people independently in their homes, which I thought all parties accepted. The people with the highest needs are the people to whom we have given priority, as a step along the road to a national care service that will meet the needs of all older people-indeed, all adults over the age of 18-over the years to come. His party recognises that that is a huge challenge, and we are endeavouring to propose measures for it.
Mr. Dorrell: I am grateful to the Minister for his patience in giving way, but he again spoke about people with the highest care needs. We all agree that we should encourage as many people as possible to live at home and introduce a system to enable that-there is no argument about that. However, it is simply untrue that the Bill focuses resources on those with the highest care needs. Those who need residential care have the highest care needs, but the Bill does nothing for them.
Phil Hope: The right hon. Gentleman simply continues to dig himself into a bigger hole. The question before the House is this: do we support a Bill that will help those people living at home with the highest care needs-yes or no? To Labour Members, the answer is clear and unequivocal, but the Opposition have continually put forward obstacles, objections and amendments, and describe the Bill as perverse and anomalous.
As the Bill continues through Parliament, I will be clear in telling my constituents how proud I am that over 10 years, we have been developing and improving care services in this country. The Bill is one more step along the road to creating a comprehensive solution to the care needs of the people of this country. Amendment 42 would simply put another barrier in the way and we do not need it. No separate commencement order is needed and no other obstacle or hurdle is required: they would simply add more work and time to the process in general.
We do not intend the regulations to come into force within two months of Royal Assent, and that is acceptable. It is time for the games to stop and for the Conservatives to give the Bill unalloyed and clear support.
Mr. Stephen O'Brien: This is slightly depressing. The Government have chosen to discuss what they regard as a prime ministerial flagship Bill for only one day on the Floor of the House. The Bill was put together at short notice and flies in the face of the processes that the Government had already set up through a Green Paper. All sorts of people outside this place, including those who give a lot of their time to caring for vulnerable people and the many people in the various categories of need, have grave concerns about it. There is a big question mark about the legitimacy of the Bill. We have properly asked questions about its compliance with the European convention on human rights and my right hon. Friend the Member for Charnwood (Mr. Dorrell) rightly identified and reinforced those discrimination issues in his argument. However, after all that, we end up with the Minister somewhat charmlessly deciding that it is really rather an insult to subject the legislation that he is meant to be defending to scrutiny. Of course, the only way in which one can do that is by way of amendment-I dare say that that would be clear in the minds of most hon. Members. The fact that the Bill has been rushed out and is contrary to the run of the Green Paper means that many questions have to be asked.
In my introduction I simply proposed my amendment 42 and said how it is framed, so it hardly warranted the Minister's quite extraordinary rant. It is framed to allow the Committee an opportunity to test whether it feels that the process by which the Bill has come about, the time in which the consultation will take place-it will not finish until February-and the results of the assessment of that consultation, which will be important for so many people representing various stakeholder and constituency interests, have been sufficiently thought through and well framed for us to produce good legislation, which we can pass from this House to the other place to look at. We have set up a number of things that I hope those in the other place will find useful, as hooks for their discussions, so that their expertise can be brought to bear.
I hope that the record will show that, far from not being supporters of the Bill, we are indeed supporters of the Bill. We are also keen to ensure that it works for
the purposes that it is intended to work and for the people for whom it is meant to work. That is why we have done what we had to do in this Committee stage. That is precisely why we are all sent here: to do our legislative duty. I am surprised that the Minister found that insulting and felt that it warranted his outrageous rant, which I thought was undignified and not worthy of the office that he is privileged to hold.
Therefore it is vital that we give the Government and the Secretary of State a chance to pause for thought. Has this Bill been sufficiently well framed, in its timing and for the process by which we are drawn to this place to scrutinise legislation? Is it sufficient for a Government simply to say, "We want it to happen; therefore it will happen"? Or, at this late stage in this Parliament, should we be doing our duty, by looking at the constituency that the Bill is meant to represent? The Minister has not given an adequate answer to why 2,000 people becoming net beneficiaries is a sufficient benefit, as opposed to the costs, to warrant the £500 million being pledged, not least because money is to be scraped from savings by local authorities-local authorities are meant to be serious providers; they are also meant to have the opportunity to save-from budgets that are often already pared down to the bone.
It behoves us to give the Committee an opportunity to express its opinion. Had the Minister chosen to take a slightly different route in responding to this debate, we might have been more amenable to building a consensual approach, but that does not seem to be on offer. The Committee should have the opportunity to register its distaste at how the Government have sought to treat us in dealing with the amendment and at the Minister's response. I therefore seek to press the amendment to a vote.
This is a small Bill containing just one substantial clause, but, as has been remarked, it will have a great significance for thousands of the most vulnerable adults and older people in our constituencies. As was said, we know that social care needs a radical overhaul, and the Green Paper published last year reflects our commitment to taking decisive action. However, the promise of fundamental reform in the future must not prevent us from taking important measures here and now to help those with the greatest need living in their own homes.
The Bill means we can take action to reduce the unfairness and uncertainty that many people feel as their health worsens and their care needs grow. The Bill will provide support and financial relief to 400,000 older people with the greatest care needs, including those with conditions such as Parkinson's, dementia and motor neurone disease. Some 280,000 people who require high levels of intimate personal care on a day-to-day basis will now get these services for free in their own home. Many of them have faced the burden of paying large amounts of money for care as their conditions deteriorate, and this Bill will remove that millstone. In addition, a further 130,000 people will receive free reablement or rehabilitation to help them to recover their independence after a fall, bereavement or serious illness.
The Bill is practical and will be financially manageable for councils. Indeed, many local authorities already offer some form of reablement support, which is helping them to use their resources more efficiently. Because of that, we have a running start on many of the financial and logistical hurdles that were discussed in Committee, including recruiting and paying for the additional work force required to honour the commitment. We are consulting widely on how the system will work and how people will be assessed. I want councils to have flexibility over how they resource the free personal care offer, while we ensure consistency across the country over who receives it.
Above all, the Bill supports a simple principle-one that I must have reiterated in every intervention on the right hon. Member for Charnwood (Mr. Dorrell)-which is that we must do everything we can to help people to live as well as they can, for as long as they can and in their own homes. That is what people tell us they want
and why the Bill focuses on providing personal care for those who live in their own home, including sheltered or supported accommodation. Let us remember that the Bill will not only benefit older people but support their family members, many of whom face the difficult task of looking after an elderly relative while also bringing up their own family and holding down a job. It will bring wider economic and social benefits for carers, as well as long-term savings for the taxpayer by preventing hospital admissions and reducing care costs down the line. In other words, the Bill makes sense financially, as well as morally.
Social care is changing across the country thanks to the £500 million that we have put into the transforming adult social care programme. Today's Bill is another big step forward and a vital bridge to the radical proposals for funding social care heralded in our recent Green Paper. This is a significant moment for the House. By passing this Bill, we can extend the promise of a fairer, more affordable and more sustainable care system in the future, and we can make an immediate difference, here and now, to our most vulnerable constituents, giving a hand up to those laid low by age and illness. I commend the Bill to the House.
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