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Lord Clement-Jones: My Lords, is the Minister denying that we have lost 50,000 care home places in the past five years? Is that not a significant problem?
Lord Filkin: My Lords, I would need to wade through my mountainous file to find out whether I agree with that. As I do not want to detain the House any longer than I am already doing, I shall write to the noble Lord about that.
I respect the important points that have been made about the implementation of care standards. The last thing that anyone wants to do is implement clumsily the improved standards and damage the market in the short term. Jacqui Smith wrote to the National Care Standards Commission to give it guidance that homes that provide care of a high standard should not be penalised because of specific environmental standards. We always expected that the NCSC would operate flexibly to reassure home owners and other interested parties. The changes will be implemented with care and intelligence, rather than blindly.
I was asked what we were doing to support carers. A new grant was introduced in 1999-2000. There will, progressively, be £20 million, £50 million, £70 million, £85 million and £100 million a year. DWP improvements to financial support for carers bring in extra resources through the carers allowance.
The noble Lord, Lord Addington, spoke powerfully about the important issue of what we do for young disabled people. There is a particular concern to achieve the better co-ordination between partner agencies that he seeks, hence the New Deal for Disabled People to help them into employment and local welfare-to-work joint investment plans. I hope that the noble Lord will also be pleased to hear that we will shortly publish guidance on fair access to care services. One of the eligibility criteria for all adults who seek help will ensure that people receive care fairly, regardless of their age, health condition or location. That was the noble Lord's particular point. That should facilitate the movement of disabled people around the country.
The noble Baroness, Lady Greengross, spoke about the abolition of residential allowances. I am pleased that she welcomes the change. It will simplify complex benefit rules and will help customers and families to understand what they can claim. Many practical details are still to be worked out, and the DWP is consulting about that. The noble Baroness also referred to mandatory property disregards. They are already there for wives and immediate dependent relatives. It is up to local authorities to go further if they wish, as the House knows. The Government will keep under review the question of whether it would be appropriate to take mandatory disregards further.
The noble Baroness, Lady Masham of Ilton, asked what CHI would do if it found a hospital that was failing. It will highlight a problem in a particular service, comment on it, analyse the problem and make recommendations such as modernisation to address it, if appropriate.
The noble Baroness, Lady Howarth of Breckland, like one or two other noble Baronesses, spoke with some of the greatest experience of the issues that exists in the House. I endorse her comments about the importance of trust, recognition and support, if we are to get the investment in social care to work effectively. Staff must be valued, supported and trained. We must move away from a culture of vilification towards one that recognises talent and commitment. That cannot, of course, be blind trust; there must be standards, values and inspections. The noble Baroness recognised that and is playing a full part in that.
The star rating that I mentioned would significantly reduce for those authorities the need to produce plans and targets. We are signed up to reducing the number of separate grants to be made to local authorities in the next few years. That is sensible.
I think that I have answered the question asked by the noble Lord, Lord Astor of Hever, about consultation with the Swedes. He asked a good question about the cost of delayed discharge. We do not have the figure to hand, but we will make an estimate and share it with him.
The noble Earl, Lord Listowel, spoke about promoting more partnerships between child and adolescent mental health and other services. The Government have invested an additional £85 million in child and adolescent mental health services over the past three years. We will invest an additional £5 million in 2002-03 in the CAMHS mental health grant for local authorities. That takes us up to £20 million per year. CAMHS has a development strategy. I cannot go into it now, because of time constraints, but I shall write to the noble Earl with more detail.
Building partnerships with the NHS is an issue that we need to mark. It was touched on by some noble Lords in the debate. It is about recognising that there is value in the involvement of local government and the voluntary sector and there is value in having a National Health Service, which very few in this House argue against. It ought to be possible in the future for those separately accountable agencies to work better together, without the need to enter into yet more organisational change. That point was made by the noble Baroness, Lady Howarth. The serious challenge facing us all is to try to prove that that will be possible. Therefore the issue of how to adopt a whole-systems approach, referred to by the Audit Commission, focused around the needs of the public—the client—rather than in response to institutional defensiveness, will be a challenge. In the past, public sector bodies have not had a strong track record on this.
I cite here the problems of interface, where difficulties can arise. The needs of many of the people referred to in the debate sit on the interface between
public services. Unless we can find non-organisational and institutional ways of changing those defects, people will face problems. Therefore the issue of instituting more joined-up inspection processes is relevant here. That will involve the Commission for Patient and Public Involvement and the local authority overview and scrutiny committees mentioned by the noble Baroness, Lady Masham. I shall spare the noble Baroness and the House a repeat of all that has been said in the debates on NHS modernisation. It is possible, of course, that we may have a future opportunity to debate the matter.The other side of the penny is resourcing for the NHS. I shall not go into detail, but noble Lords know well that the NHS has had a sustained level of significant real increase in resourcing, matched by a guarantee of a future funding platform stretching five years ahead. Arguably that is as significant as the current increases. Along with the slightly shorter elevated platform for social services at three years, we hope that that will offer a significant opportunity to build capacity and strengthen our provision of services for those who are most vulnerable.
In conclusion, I have argued that we need to look at this not only in terms of money, but in terms of how we can make better use of those resources, how organisations can work better, how we will build capacity in staff—a great deal is being achieved through social workers now moving to a three-year professional qualification and other significant increases in training—and through the work of registration and standards that the General Social Care Council will provide. As the noble Baroness, Lady Pitkeathley, pointed out, an effective inspection and improvement mechanism will also play an important part.
Above all, we have to put resources to better use. We have to focus on the needs of the public, not on the interests of organisations. Furthermore, we have to move beyond describing the problem and then simply throwing money at it. We cannot solve the problem merely by throwing more and more money at it. Money will play its part, but simply to claim that the difficulties concern only money does not do justice to those whom all in the House seek to serve.
7.53 p.m.
Baroness Barker: My Lords, as I anticipated at the beginning, this has been an extremely interesting debate filled with wonderful contributions from knowledgeable and experienced people. One theme ran throughout the speeches; that is, there is a need for a review of social care. That is extremely important. Such a review must be undertaken on its own terms. I do not think that we have asked for increased spending commitments; we have asked for a coherent whole-systems review. I thank all noble Lords who have contributed in their own ways to that request.
I should like to call for Papers, but I suspect that if I did so at this point then I would be hanged by a silken cord. Perhaps I may say, as a Scot, that in the interim before a whole-systems review and papers come
forward, a great deal of what is now happening in England is resting on the experience of the Swedes. Let us hope that the World Cup does not let us down and let us hope also that the Swedes have their healthcare system right. I beg leave to withdraw the Motion for Papers.Motion for Papers, by leave, withdrawn.
Sex Discrimination (Amendment) (No. 2) Bill [HL]
7.55 p.m.
Clause 1 [Amendment of the Sex Discrimination Act 1975]:
Lord Borrie moved Amendment No. 1:
- Page 1, line 8, leave out "25" and insert "1500"
The noble Lord said: My Lords, the threshold for the operation of the Bill as it stands is a mere 25 members. Any club of modest size, perhaps a working men's club or a public house darts club with a mere 40 to 50 members which allowed women members to join with some form of membership would be required by law to give women their club memberships on absolutely equal terms with men, entitling them to use the same facilities, the same bars and so forth, at all times.
The proposers of the Bill seem in no way troubled by what I consider to be the gross intervention of the law into freedom of association that members of private clubs and private associations normally enjoy. When we discussed a similar amendment in Committee, I conceded that clubs with a very large membership, such as a substantial golf club set up in an area with no alternative publicly-owned or commercially provided golf links for many miles around, perhaps ought to be required by law to treat men and women equally. The probing amendment tabled in the names of the noble Lord, Lord Henley, and myself at that stage sought to increase the threshold to 2,000 members.
My noble friend Lord Faulkner of Worcester, the proposer of the Bill, was quite unwilling to compromise or to meet us half way. So we are probing again on Report with an amendment to raise the threshold to 1,500 members. I noted that in Committee my noble friend Lord Faulkner said that the average membership of working men's clubs is 900. I accept that figure.
I state as a matter of principle which I hope will be agreed by many noble Lords, that the law—legislation and statute—has no business telling the men running modest working men's clubs with few resources and small premises that if they accept women into some form of membership, they must provide equal facilities, equal rights in the governance of the club, and so forth. According to the Bill, such clubs must even treat women guests in precisely the same way as they would treat male guests.
On Second Reading my noble friend Lord Faulkner gave the facts about working men's clubs which belong to the Club and Institute Union, the CIU. My noble friend told us that 40 per cent of all working men's clubs, some 1,080, give women full membership rights equal to men. A tiny number—only eight clubs—are single-sex clubs that do not admit women at any price, as it were. But the largest proportion of working men's clubs, 60 per cent or 1,612 clubs, allow women to join with a different class of membership and a lower subscription.
I understand that the national executive of the CIU seems to want all clubs to give women full equality, but the noble Lord, Lord Faulkner, has admitted that the members in local clubs up and down the country in the group comprising 60 per cent of all clubs do not want women to have full and equal rights with men in their clubs.
What moral or other right do we, as legislators, have to impose equality by law contrary to the wishes of members? What is the evil? What is the mischief that calls for such a disproportionate response as to impose by law the requirements of the Bill as it stands? It can only be the mischief of male members setting aside some part of the premises for male only drinking or, perhaps, male only snooker. That must be the mischief against which this heavy-handed Bill is brought to bear.
If the cause for which my noble friend Lord Faulkner fights is equality between the sexes, he is going too far. In any case—I regret repeating what I have said on other occasions—it may be counter productive. It may cause clubs which have agreed to open the doors somewhat to women members and women guests to close their doors firmly shut once more.
I know that many noble Lords, especially women Members of the House, feel that since the Sex Discrimination Act 1975, matters in the field of clubs have moved too slowly. There is no doubt that they have moved too slowly in their minds—in all our minds—in other fields, but I still say that clubs and private associations are closer to private life and what one does in one's family and one's private home than what should be done by public and commercial organisations.
I believe that matters should be allowed to evolve—as everyone must admit they have done—irrespective of the speed at which change has taken place—in relation to working men's clubs, golf clubs and St James's clubs which used to be exclusively men only. Big clubs with big memberships—the noble Lord, Lord Henley, and myself are suggesting those with memberships of more than 1,500—are difficult to distinguish from public or commercial bodies providing services to the general public. Private clubs, in my view, are not places for legal intervention. I beg to move.
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