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Building the National Care Service

The Secretary of State for Health (Andy Burnham): Today the Government are laying before Parliament the White Paper, "Building the National Care Service" (Cm 7854).

We have listened to the views of the public and stakeholders through the 2008 engagement process and the 2009 Big Care Debate. The Big Care Debate received over 28,000 direct responses, with more than 40,000 people contributing to the debate through further research or events organised by stakeholders. The consultation showed that there was strong support for our vision of a National Care Service and while there was no clear consensus on funding, the comprehensive option was the most preferred. Today we have published an independent summary of the consultation alongside the White Paper and placed a copy in the Library.

We also held a Care and Support Conference last month with the Care and Support Alliance and other key stakeholders. They urged us to push forward with reform and favoured the comprehensive option.

We believe the time has come to build a comprehensive National Care Service. This will be for all adults in England with an eligible care need, providing free care when they need it-whoever they are, wherever they live in England, and whatever condition leads them to need care. It will give everyone the peace of mind that they and their families will be cared for should the need arise, and it will mean that no one need live in fear of losing their home or their savings to pay for care.

The Government's vision is for a National Care Service that gives people choice and control, and is focused on keeping people well and independent. It will ensure that different parts of the system work better together, with a new duty for NHS bodies and local authorities to deliver integrated care.

Millions of people care for a family member or friend. This is the hallmark of a civilised society. But we must do more to give support to those who provide such care. Building on the carers' strategy, the National Care Service will support those caring for others by improving the quality of formal care, and working with employers and Job Centre Plus, to help carers to live the life they want to live.

We recognise that building the new National Care Service will be one of the biggest changes to the welfare state since the creation of the NHS. We are also creating it during a period of fiscal consolidation. Reform to social care must be consistent with our plans for fiscal consolidation and reflect the tough decisions that will need to be made in the next spending review. This means we need to build the new service in stages.

The first stage is to create a step change in the provision of services in the home and in our communities. These services are essential if we are to ensure that more people are supported in their homes. Central to this is the Personal Care at Home Bill, to be implemented in 2011, enabling us to provide free personal care for people in their own home for those with the highest needs. The first stage of reform will also see reablement services available in every community, ensuring that
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there is a service by which people are supported to regain their independence and confidence when they need home care for the first time. As part of the first stage we will push forward with existing reforms that are already delivering real benefits for people such as the dementia strategy, the carers' strategy and Putting People First.

The second stage of reform, during the next Parliament, will be to put in place the building blocks of a national system of care and support, in particular the establishment of clear national standards and entitlements. We will introduce a National Care Service Bill early in the next Parliament as a major step forward. From 2014, care entitlements will be extended meaning that anyone staying in residential care for more than two years will receive free care after the second year. The first and second stages together will mean that the most vulnerable in our society, those with the highest needs, will be protected from very high care costs and that many more people will be supported in their own homes.

During the next Parliament, we will take further steps towards the full reform of the system-moving towards the third stage in which the comprehensive National Care Service becomes a reality, with care free when people need it.

To do this will require everyone to contribute through a fair care contribution. So at the start of the next Parliament, we will establish a Commission to help to reach consensus on the right way of funding the system. The Commission will determine the fairest and most sustainable way for people to contribute. It will make recommendations to Ministers which, if accepted, will be implemented in the Parliament after next. The Commission will determine the options that should be open to people so that they have choice and flexibility about how to pay their care contribution. Our expectation is that the Commission will consider all the various options for payment put forward by stakeholders and the public as part of the Big Care Debate and at the Care and Support Conference.

"Building the National Care Service" (Cm 7854) is in the Library and copies are available to hon. Members from the Vote office.

home department

Police Pensions

The Minister for Policing, Crime and Counter-Terrorism (Mr. David Hanson): The Police Pensions Additional Voluntary Contributions (AVC) Scheme, which was introduced in 1990, has served as a useful means by which police officers can top up their retirement pension. However, the opportunities now open to those who want to save for a personal pension reduce the need for an in-house AVC scheme. After consulting the Police Negotiating Board we have decided to close the police AVC scheme to new business from 1 October 2010, subject to parliamentary approval of the necessary changes to the relevant regulations.

Notice of this change has been given to the two providers concerned, Standard Life and Equitable Life. Regular contributions in effect on 30 September can continue to be made but the change will mean that no
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new or increased contributions will be possible from 1 October. We recommend the need in all cases for officers to satisfy themselves about whether AVC investments are right for them, if necessary by taking independent financial advice.

As part of our review of the current arrangements for topping up police pensions we are discussing with the Police Negotiating Board proposals for introducing a new facility, Added Pension, which will enable officers to buy specific amounts of pension, subject to set limits, on a cost-neutral basis for the police pension scheme. The introduction of Added Pension would be accompanied by the closure to new contracts of the current facility of buying added years. The aim is for this change to be made at the same time as the closure of the AVC scheme to new business but this is subject to confirmation.

Tackling Knives and Serious Youth Violence Action Programme

The Minister for Policing, Crime and Counter-Terrorism (Mr. David Hanson): This week marks the end of phase 2 of the tackling knives and serious youth violence action programme (TKAP). Over the past 12 months, we have targeted nearly £7 million of funding on 15 high priority areas and on the British Transport Police in order to reduce serious youth violence.

Last week's deaths of two young people in London was a stark reminder, if one were needed, of the need for our continued action in this area. We are committed to reducing serious youth violence to make sure that no families face the devastation that these young people's families are suffering.

We are focused on tougher enforcement, tougher sentences and new legislation to tackle violent crime and gangs. We increased the starting tariff for a life sentence for adults committing murder using a knife or other weapon taken to the scene to a minimum 25 years in prison.

We will publish detailed results from the programme in the summer, but across England and Wales as a whole the picture is encouraging. Recorded crime statistics show that in the period April to September 2009 covering the first six months of phase 2 of TKAP, there was a 7 per cent. fall in recorded knife crime, compared with the same period the previous year, including a 34 per cent. fall in homicide with a knife/sharp instrument -100 homicides involving a knife/sharp instrument in April to September 2009 and 152 in April to September 2008. These statistics build on annual figures for 2008-09 which saw a 7 per cent. drop in knife/sharp instrument homicides, compared with 2007-08.

Over 100 hospitals are now sharing A&E data with local police and community safety partnerships in England and Wales, to enable targeted local enforcement and other activities to reduce violence. The Home Office has provided £300,000 to eight TKAP police forces for nine Portcullis Operations, an intensive enforcement and prevention tactic. Increased police activity has led to 736 arrests, 23 knives and one shotgun being recovered, and over 20,000 people passing through knife arches. In addition, street based teams have worked with over 1,500 young people.

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But preventing serious violence is about more than tough enforcement; it is also about prevention. There have been over 22,000 after-school patrols in TKAP areas over the same period, engaging with over 67,000 young people and signposting over 13,000 young people to positive activities.

Where young people have been involved in knife crime, we have worked hard to ensure that they receive appropriate education and rehabilitation to teach them about the dangers of knives. The Youth Justice Board rolled out the knife crime prevention programme to all 97 youth offending teams in the 15 TKAP areas with the aim of reaching 2,000 young people cautioned or convicted of knife crime in the TKAP areas by the end of 2010, to bring home to them the consequences of carrying a knife.

All of this activity to tackle serious youth violence will not stop at the end of TKAP 2. A third phase of TKAP begins on 1 April 2010 aiming to continue our work to keep young people safe. TKAP 3 will make £5.5 million of Government funding available to local TKAP areas: £4 million to local community safety partnerships, on top of £1.5 million already announced for 150 local voluntary organisations receiving help from the Home Office community fund. In 2010-11, we will focus the TKAP programme on 52 community safety partnerships within 21 police forces. The British Transport Police will receive also TKAP funding and support. Agencies in these local areas know that serious youth violence matters to their communities and they want to do all they can to prevent and reduce it.

Home Department

Cyber Crime Strategy

The Parliamentary Under-Secretary of State for the Home Department (Mr. Alan Campbell): I am today publishing the Government's "Cyber Crime Strategy" (Cm 7842) which sets out the Government's proposals for tackling cyber crime. Copies are available in the Vote Office.

Cyber crime is a large and growing problem. It is responsible for a significant amount of social and economic harm, both financially and through threats to children; and is a threat to confidence both in the provision of services through the internet generally, and in the move of Government services online. As the UK becomes more dependent upon digital services, so the threat to the UK as a whole from cyber crime increases.

The overarching theme of the new strategy is that there is significant scope to extend our response to cyber crime, as part of the overall Government focus on cyber-led by the Office for Cyber Security.

The new strategy has five key elements:

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Visa Waiver Test

The Secretary of State for the Home Department (Alan Johnson): Today my right hon. Friend the Secretary of State for Foreign and Commonwealth Affairs and I are announcing the final stage of the UK's first global review of visa regimes in relation to the seven countries of the Eastern Caribbean-Antigua and Barbuda, Barbados, Dominica, Grenada, St. Kitts and Nevis, St. Lucia and St. Vincent and the Grenadines.

A visa regime is a very effective immigration, crime and security control measure. As part of our overseas defences our visa waiver test helps us determine whether our visa regimes are in the right places. Travellers from every country beyond the European economic area and Switzerland were measured against a range of criteria including illegal immigration, crime and security concerns. The test has been taken forward in close collaboration with other Departments across Whitehall. New full visa regimes were introduced on Bolivia, Lesotho, South Africa and Swaziland, along with a partial regime on Venezuela, in 2009.

Having initially considered the Eastern Caribbean states on a regional basis, we decided to examine them individually to ensure any potential regimes would be aligned correctly. Our evaluation highlighted a number of concerns with two countries, Dominica and St. Lucia.

We recognise that we have close historic, economic and political ties with Dominica and St. Lucia and are aware that the introduction of a visa regime would be a significant step. It is a decision we do not take lightly. As a result we will now enter a six-month period of detailed dialogue with the Governments concerned to examine what actions will be taken to address our concerns and mitigate the need for a visa regime to be introduced. During this period, Dominica and St. Lucia will need to demonstrate a genuine commitment to put into effect credible and realistic plans, with clear timetables, to reduce the risks to the UK, and begin implementing these plans by the end of the dialogue period.

Additionally we have written to the Governments of Antigua and Barbuda, Barbados, Grenada, St. Kitts and Nevis and St. Vincent and the Grenadines to advise that, while they will maintain their visa-free status for the time being, the decision will be subject to a further review.

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The UK Government remain committed to operating a firm but fair immigration policy. It gives a high priority to treating all foreign nationals coming to or present in the UK with dignity and respect, and the highest legal standards. However, it expects all visitors to the UK to play by the rules. The UK will always welcome genuine visitors, whether business, tourist, student or family, but will continue to take all steps necessary to protect the security of the UK.

International Development

HIV Prevention (East and Southern Africa)

The Minister of State, Department for International Development (Mr. Gareth Thomas): On 9 March I hosted a high-level meeting in the Houses of Parliament in London to review progress towards universal access to HIV prevention, treatment, care and support in East and Southern Africa, where there are high or rising HIV prevalence rates and AIDS remains a major health and economic burden.

Around 50 HIV leaders attended, including representatives from Kenya, Malawi, Mozambique, South Africa, Zambia and Zimbabwe. Ministers of Health and Gender, religious leaders, activists, people living with HIV, the heads of the Global Fund, PEPFAR, UNAIDS were present, as well as representatives of other donors and the pharmaceutical industry. We were delighted that a representative of the Canadian High Commission in London was able to attend and contribute.

In 2005, through our presidencies of the G8 and the European Union, the UK-led the world in a commitment to the historic goal of universal access. The UK is the second largest donor to the AIDS response globally and we continue to show leadership and commitment. This high-level meeting aimed to keep universal access high on the international agenda during 2010 and beyond.

At the meeting, participants spoke about the key factors that have led to progress at country level, the major challenges ahead and what needs to be done to accelerate progress towards the universal access goals.

The meeting celebrated successes but highlighted the need to provide HIV treatment for the estimated 10 million people still waiting for it, and "turn off the tap" of new HIV infections through evidence and rights-based interventions. Transforming harmful gender norms and stopping violence against women is central to achieving universal access. The group recognised the need for health systems that effectively deliver both maternal, newborn and child health services and services for women, men and children who are vulnerable to and living with HIV. We need to integrate efforts to achieve MDGs 4, 5 and 6. To achieve this we need financing for scale-up, through the Global Fund and other mechanisms. But equally we need leadership-political and at all levels of society.

The meeting resulted in a declaration of shared principles that calls for:

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