Preserved Right to Income Support

Part of Orders of the Day — National Health Service and Community Care Bill – in the House of Commons at 7:30 pm on 13 March 1990.

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Photo of Mr Alf Morris Mr Alf Morris , Manchester Wythenshawe 7:30, 13 March 1990

The speech made by the hon. Member for Maidstone (Miss Widdecombe) was a most powerful and, I hope in its effect, an influential contribution to this important debate. I am glad to note her return to the Chamber.

Much of my parliamentary life has been spent trying, both as a private Member and as a Minister, to improve residential and community care for frail elderly and disabled people. If we are to ensure humane standards the essential principle is that, in every case of need, the right care should be available in the right place and at the right time. Otherwise people in special need are left in despair, as happens in so many cases now when residential care fees cannot be met. The relatives share that despair.

After a decade in which the financing of residential care was shifted, in an unplanned and officially unpredicted way, on to the social security budget, the Government are returning in this Bill to the old system of local authority sponsorship. Although there were always tough negotiations between local authorities and voluntary organisations, the old system is now acknowledged to have been the best method of ensuring both value for money and special provision for those with special needs.

The new clause seeks to protect those who are trapped in the system that is now being discarded, which has proved to be a Procrustean bed. In the original format, which was introduced by the right hon. Member for Brent, North (Sir R. Boyson), payments were practically open-ended and costs expanded rapidly. A series of panic measures were introduced to cut the costs, but national yardsticks have proved just as insensitive as the old Greek bandit who either stretched his guests or cut off their limbs to fit the accommodation provided.

The new clause is concerned with those whom our modern Procrustes in the Department of Social Security has maimed. Almost half the residents on income support do not have their full costs met, as my hon. Friend the Member for Birkenhead (Mr. Field) said in oral questions on 5 March. In response to my subsequent question, from the Opposition Front Bench, asking the Minister at least to ensure that income support payments keep pace with the charges agreed by local authorities for new residents the right hon. Member for Chelsea (Mr. Scott) appeared to misunderstand the question, which he failed to answer, and he referred to extra resources for community care. No extra resources are being provided for existing residents. Moreover, in Committee Ministers resisted the imposition of any duty on local authorities to assess current residents for a possible return to care in the community.

Later amendments are concerned with rights to residential community care, where it is needed and desired. In reply to my question on 5 March, the right hon. Member for Chelsea referred to the perverse incentive for people to go into residential care"—[Official Report, 5 March 1990; Vol. 168, c.574.] But the Government seem determined to swing the pendulum too far the other way, in that there is now often a perverse ministerial insistence on sweeping under the carpet the needs of people for whom such care is a vital necessity.

7.45 pm

Very old and frail people, who have been in residential care for several years and who have grown accustomed to the idea that this will be their last home, need the assurance that the Government will continue to meet their costs until the day they die. The attitude of Ministers is causing extreme distress, not only to residents, but to their relatives, who are often poor and disabled themselves, and who are approached to make up the difference between fees and benefits. That piles handicap upon handicap for the very needful people this new clause seeks to help.

The record shows that I was one of those who repeatedly warned the Government where the policy that they are now discarding would lead. In the spirit of the speech made by my hon. Friend the Member for Livingston (Mr. Cook), however, I am not concerned tonight to say "I told you so." Give or take the speech made by the hon. Member for Brigg and Cleethorpes (Mr. Brown), there has been scant controversy in the debate.

The new clause is eminently fair. It has strong all-party backing and the House should accept it. I sense deep and widespread unease on both sides of the House about the problem that the new clause seeks to resolve. The only proper way to give effective expression to that unease is in the Aye Lobby tonight.