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Baroness Cumberlege: My Lords, I regret that the answer to both of the noble Lord's requests is, no.
Lord Carter: My Lords, is the Minister aware--I am sure she is because the point has been made to her on a number of previous occasions--that standards in residential and domiciliary care around the country are a cross between a patchwork quilt and a lottery? Is there not, therefore, a very strong case for national care standards as regards domiciliary and residential care and for much greater regulation of domiciliary care?
Baroness Cumberlege: My Lords, I agree with the noble Lord that it is a patchwork. However, if one takes the average cost involved, the average cost of a private home is £246 a week while the average cost of a council-run home is £283 a week. It is quite interesting to see where the value for money is in that comparison. I should also point out that the Government will shortly be producing a White Paper on social services which will address the issue of regulation.
Lord Pearson of Rannoch: My Lords with reference to the costs of long-term care for the mentally handicapped, can my noble friend the Minister say
whether the Government will ensure that an accurate comparison is made between the costs for community care on the one hand and, on the other hand, the costs for residential and village communities? Above all, will they ensure that all departmental costs are included in that comparison?
Baroness Cumberlege: My Lords, it is up to local authorities to decide what is good value for money. However, guidance is also given to local authorities on the question of choice. Local authorities have to take into account the individual's choice as to where he or she wishes to be looked after, provided that that produces value for money.
Lord Boyd-Carpenter: My Lords, is my noble friend the Minister aware that many noble Lords are very anxious to have proper discussion on the costs of long-term care? Indeed, there is real anxiety as to its costing at present. It will be very helpful if my noble friend could give any lead whatever as to the future handling of this difficult and controversial subject.
Baroness Cumberlege: My Lords, my noble friend is absolutely right. I think the country is concerned. That is why my right honourable friend yesterday produced a policy paper, A New Partnership for Care in Old Age, which is a partnership between the Government, the private sector in terms of the insurance industry, and also those who need the care.
Baroness Farrington of Ribbleton: My Lords, can the Minister give information to your Lordships' House about staffing levels in local authority homes and staffing levels in the private sector and access to those with training and appropriate qualifications, including nursing qualifications where suitable?
Baroness Cumberlege: My Lords, they vary both in the private sector and in local authority homes. As I have pointed out, when one takes the average cost one gets better value for money in the private sector.
Lord Ashley of Stoke: My Lords, is the Minister aware that long-winded answers are not welcome in this House, but neither are monosyllabic answers especially on such an important issue for disabled people? Why cannot the Minister explain why the Government pass an Act--admittedly an enabling Act--and they do nothing about the twisting of it by some local authorities? They are failing to meet their responsibilities to severely disabled people. Setting an arbitrary limit is something that the Minister ought to say something about. To say simply no is not good enough. What is the explanation?
Baroness Cumberlege: My Lords, the question that the noble Lord, Lord Ashley, put to me was whether we were going to set limits. I have to tell the noble Lord that we are not going to set limits. He then asked if we would give advice to local authorities that they should be more flexible in their approach. As I have said, it is
up to local authorities. We passed the Act and all the advice is in that Act. We are not going to put out further advice to local authorities.
Baroness Turner of Camden: My Lords, is the Minister aware that, when approaching local authorities for care in the community, one is frequently told it is within available resources, but, if those resources are overstretched, the care that one expects is often not forthcoming?
Baroness Cumberlege: My Lords, local authorities have had their resources doubled in real terms since 1990-91 for the funding of community care services. They now spend £7.5 billion per year. That is a huge sum of money. We have invested enormously in social services and it really is up to them to use it to best effect.
Lord Richard: My Lords, the Minister, if I may say so, is being uncharacteristically unhelpful this afternoon. I wish to ask her a specific question: when is the White Paper coming out and will the report of the Audit Commission be with it? Will we have the opportunity of seeing the report of the Audit Commission on this matter at the same time as the White Paper is published?
Baroness Cumberlege: My Lords, I say, in danger of being monosyllabic, yes. I say in answer to the first question, as soon as possible.
Thames London Bridges: Funding
2.53 p.m.
Lord Wilberforce asked Her Majesty's Government:
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What is their policy on the construction, maintenance and financing of road bridges over the River Thames in the Greater London area.
Lord Wilberforce: My Lords, I thank the Minister for that Answer. I wish to pursue it both generally and in the particular. Generally, having regard to the size of this problem, there being 25 plus bridges in the London area, not including tunnels, and having regard to the fact that a number of new bridges are planned, some of a somewhat controversial nature; that there is likely to be increased demand on the bridges in connection with the millennium; and that the maintenance and care of the bridges have sadly deteriorated since the GLC was abolished--I do not know whether the Minister has seen a letter in the Evening Standard last week which said
that London's bridges which ought to be London's treasure are now London's disgrace--do not the Government think it right to establish at this time a strong co-ordinated body responsible for the planning and financing of all the bridges either within a general London framework along the lines that we discussed a fortnight or so ago, or perhaps in the Ministry itself under the London Minister for Transport? As to the particular--
The Earl of Courtown: My Lords, before attempting to answer the supplementary questions of the noble and learned Lord, Lord Wilberforce, on behalf of the whole House I wish him a happy 90th birthday. The noble and learned Lord mentioned the requirement from some quarters for a strategic authority for London to take care of London bridges. The noble and learned Lord is most probably aware that the £22 million the 1997-98 Transport Policies and Programme settlement made available for strengthening and assessment has been reserved in the name of the lead authority of the City of Westminster. The lead authority in consultation with sector leaders and individual authorities is responsible for advising the Government Office for London how the funds should be distributed and for monitoring and reporting on the programme. A framework has been devised under the auspices of the London Bridges Engineering Group which is co-ordinating this approach through the lead authority. Prioritisation of bridge works is in progress through LoBEG which will pave the way to financial allocations being established for individual authorities.
Lord Campbell of Croy: My Lords, is my noble friend aware that because of restrictions on Hammersmith Bridge commuters and others are having to drive round by Chiswick adding to traffic congestion and to delays for passengers trying to catch flights from Heathrow? Could millennium money contribute to a new bridge or tunnel instead of being spent on an unnecessary riverside ferris wheel?
The Earl of Courtown: My Lords, millennium funding is the concern of the Millennium Commission. However, initial fears of traffic congestion on adjacent roads have proved largely unfounded although I acknowledge there have been problems. The effects of the closure are being monitored at local level. As regards increased bus services while the bridge is not able to carry its normal range of traffic, this matter has been taken up with London Transport which has arranged for increases in the frequency of services across the bridge.
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