Social Services

Electronic Devices (Madam Speaker's Statement) – in the House of Commons at 3:34 pm on 12 March 1997.

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Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health 3:34, 12 March 1997

With permission, Madam Speaker, I should like to make a statement about the Government's White Paper on the future of social services in England and Wales.

Local authority social service departments were created in roughly their present form in 1971. They are responsible for social care services for a wide variety of people, among them elderly people, those with physical or learning disabilities and mentally ill people, as well as children who would otherwise be at risk of neglect or abuse. The many local authority members, directors and staff who over that long period have built those services deserve credit for what has been achieved.

The Government believe that the growing size and importance of social service departments make necessary a major reassessment of their role and structure. Today's White Paper sets out a package of proposals for the reform of social service provision. The Government will implement those proposals in a social services reform Bill that we shall introduce early in the next Parliament.

Social service departments currently combine three responsibilities that sit uneasily together: first, they assess care needs and use public money to commission care; secondly, they provide directly a range of social care services; and, thirdly, they regulate private and voluntary sector providers of social care services. The centrepiece of the Government's social services reform Bill will be the separation of those three functions.

The Bill will provide that social service departments should in future concentrate on their role as assessors of care need and commissioners of care services. It will require each social service authority to publish separate accounts for its assessment and commissioning function, and it will provide for the making of secondary legislation that will set out the quality and value-for-money issues on which social service departments will be required to publish performance indicators. Those indicators will allow council tax payers to examine the performance of their own social service department and to compare its performance with that of other equivalent departments.

The Bill will also amend the power of social service authorities to provide social care services. At present, social service authorities have a general power to provide such social care services as they think fit to meet local needs. The Government propose to amend that power to provide that, in respect of residential and domiciliary services for adults, the power can be used only when an authority can show that direct provision of service by the local authority is necessary to meet a need that cannot be met locally by the non-statutory sector.

The legislation will require formal reviews of existing direct provision for adults to be conducted periodically by each authority; those reviews will be transparent and the views of local interested parties will be sought. The law will place a strong and clear onus of proof on authorities wishing to retain existing direct provision or to expand their commitment to directly provided services. The criteria against which the review will have to be carried out will be set out in regulations.

The third element of the social services reform Bill will be a new structure for the regulation of social care and nursing home provision. The Government believe that it is important that that function is separated from others currently carried out by social service departments. We also believe that the standards that are required by regulation should be applied to both public and private sector provision, and that separate regulation of care homes by health and social service authorities, which can currently lead to wasteful duplication of effort, should be brought to an end.

The legislation will therefore require local health and social service authorities to create joint statutory bodies in each area, with membership drawn from the participating authorities. Those bodies will regulate both the social care services now regulated by local authorities and the nursing homes currently regulated by health authorities. The scope of regulation will be extended to cover private sector domiciliary and day care services and small children's homes, as well as the public sector social care services that are currently free of regulation. Health authorities will continue to regulate private hospitals and certain other specialist health facilities, as they do now.

The creation of a single regulatory authority for social care raises the question whether it is right to maintain the legal division of adult care homes into residential homes and nursing homes. The Government see the attraction of moving towards a single category, in which each care home would be assessed and licensed according to the needs of the clientele it is intended to serve. That more flexible structure would make it easier for people who become more dependent to move to a different level of care without having to move to a different care home. The details of such a change will need full assessment, and the Government will consult further on those issues.

In addition to those important changes to the structure of social service departments, today's White Paper takes forward some other important aspects of social service provision. Under the Children Act 1989, the child's welfare is the paramount consideration. The Government believe that that is the correct focus. They do not believe, however, that emphasising the wishes of the individual child should be allowed to become an excuse for distorting the proper relationship between children and adults. We should not blindly ascribe to all children the capacity to make mature decisions about their interests, which are the proper responsibility of adults.

The chief inspector of social services in England recently issued revised guidance to the managers of children's homes, which underlined their responsibility to provide a disciplined framework for the lives of children in their care. The Government will continue to monitor the operation of the Children Act 1989, and they will act again if it can be demonstrated that there is a need to reassert the proper balance between the rights of the child and the responsibilities of adults.

The social services reform Bill will also place a new obligation on the local authority collectively, not just on the social service department, to prepare a full children's services plan. Those plans will be required to show how social services, education, health and housing authorities, as well as the juvenile justice system, will co-operate to identify children who are at risk and to take the action necessary to safeguard their interests.

Finally, on children's services, the White Paper sets out the Government's intention to improve the training provided to social workers who work with children. The Government believe that social workers who undertake that most difficult area of work with children should receive specialist training, as do approved social workers who are entrusted with powers under the mental health legislation.

Today's White Paper is the third element in the reform package for key elements of the modern welfare state that the Government have unveiled in the past 10 days. Last week, my right hon. Friend the Secretary of State for Social Security set out the Government's plans to improve pension provision over a generation. Earlier this week, I set out our plans to assist many of today's generation of pensioners in planning for the costs of dependency in old age. In today's White Paper, the Government show how social service departments need to evolve to provide high-quality, good-value services.

The changes proposed in the White Paper reflect the Government's view that, in a modern society, the principal responsibility for meeting social care need rests on individual citizens, who should plan to meet their own needs and respond to the needs of their families and their neighbours. The role of statutory social service departments is to act as a support to those, including carers, who meet social care needs in those ways. Statutory social services provision is an essential function in a modern society, and today's White Paper shows how the Government intend to ensure that it continues to be delivered to a high standard.

Photo of Mr Chris Smith Mr Chris Smith Shadow Secretary of State

Despite all the hype about radical reform, does not the statement merely amount to the enforced privatisation of those relatively small parts of residential care not already carried out by the private or voluntary sector? Coupled with that was the sabre rattling of the Secretary of State about political correctness on children's services, with precious little action to back it up.

Does the Secretary of State acknowledge that well over three quarters of residential care is provided by the independent sector? Surely the last thing that is needed is ideologically imposed privatisation from Whitehall. Should not those decisions be made locally, taking into account local circumstances? Decisions should be made by the local director of social services, and should not be dictated by the Secretary of State.

Is not the right hon. Gentleman making an automatic assumption that the private sector is always good and the public sector is always bad? Surely such dogma is as outdated as if we on the Opposition Benches tried to argue that the reverse was so. Is not the common-sense approach to secure a mix of accommodation appropriate to the needs of the elderly people concerned?

Will the Secretary of State confirm that his figures about cheaper private sector costs do not compare like with like? Has he not simply taken the total gross expenditure and divided it by the number of residents—taking no account whatever either of the dependency of the resident in each case, where the higher levels of dependency are overwhelmingly concentrated in the local authority-provided sector, or of the standards of accommodation, food and care provided?

Is not that point strongly borne out by the report that has just been produced jointly by the Audit Commission and the social services inspectorate from the Secretary of State's Department, after carrying out an independent evaluation of services provided by Stockport metropolitan borough council? Does not the report say: Care for older people was particularly well organised and of good quality"? Does not that report also specifically commend Stockport metropolitan borough council for having developed a mix of providers for older people's services"? I should like to ask the Secretary of State three further specific questions. First, in paragraph 2.17 of the White Paper, he envisages the development of a voucher scheme for nursing homes. Can he tell us what the cost of administering that scheme will be? Will we not simply get the same shambles as has occurred with nursery vouchers? Secondly, in paragraph 2.30, he says that a local authority can provide its own care only where there is "insufficient independent sector provision". Does that in effect mean that, no matter what the comparable quality of care, if there is space in the private sector, it must be used? Thirdly, is not an inevitable consequence that, as local authorities are forced more and more into the use of private sector spaces, local authorities' own accommodation will become emptier and unviable, and in a relatively short period, elderly residents will have to be forcibly moved out of their homes?

With regard to what the White Paper has to say on children, is not all that we have had from the Secretary of State rhetoric—rhetoric, I suspect, aimed at the right wing of his party? If one searches for action in the White Paper, one finds a Labour policy for better training for social workers and the preparation of children's services plans, and otherwise only paragraph 3.4, which grandly states: The Government will continue to monitor the influence of the Children Act on social services departments. There is not much action there. If the Secretary of State wanted to take arms against political correctness, why on earth has he not brought forward the adoption Bill, which was ready at the time of the Queen's Speech, was supported by Members on both sides of the House and takes a common-sense approach to adoption and parenting issues?

We are all concerned to ensure good value for money in social services, and high standards of care for some of the most vulnerable people in our communities. May I therefore welcome the commitment to independent regulation and monitoring of residential care across all sectors—private and public—for which we have long argued? That must be the way forward—but there is no need to privatise in order to achieve it. Why also, however, have the Government not embraced the idea of a self-financing council of social service, to regulate the profession and provide reassurance on safety to the public? We shall legislate for those measures in our social services reform Bill after the election.

In short, does not this whole White Paper represent the triumph of dogma over common sense? Will we not see precisely the same internal market imposed on social services, which has caused so much damage to our health service in the past six years? What we want is a sensible mixture of private, voluntary and public provision, decisions taken locally, not dictated by Whitehall, strong and independent regulation to ensure high standards, and the needs of service users put first, not those of providers, from whatever sector they come. In short, we need a Labour Government.

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

The hon. Gentleman is clearly in need of a message, electronic or otherwise, from the hon. Member for Hartlepool (Mr. Mandelson). In that tirade, he has just demonstrated how thin the veneer is that covers the true face of the Labour party. Show it any concept that there may be a way forward to improve services through choice, and it runs a mile. It opposed the introduction of choice and the private sector through the 1980s in a wide variety of measures; it now says that it was right. A few weeks ago, it opposed the introduction of the private sector into London Underground. It is now opposing the further development of the private sector in the provision of social care. Old Labour shows through, the moment it is given the remotest opportunity to do so.

The hon. Gentleman prefers to believe that the higher cost of residential care provision in the public sector is related to dependency. The problem for the hon. Gentleman is that the evidence simply does not bear that out. When we consider the average age of people in independent sector homes, we find that it is higher than the average age in the local authority sector, so to argue that dependency is higher in the local authority sector is not borne out by the evidence. He still has to explain why any social service department should prefer to use its own care homes at an average cost of £283 a week, when the average cost of providing the same service in the private sector is £246 a week.

Let us move away from averages to the social service department in the constituency of the hon. Member for Stockport (Ms Coffey) and the report to which the hon. Gentleman referred. There we do not need to consider averages; we can consider specific facts in that local authority. It is true that it delivers good-quality services to some of its users. So it should: it spends 37 per cent. above standard spending to do so.

Furthermore, I should have hoped that the hon. Member for Stockport would want to know why that authority is placing people in residential care at £330 a week when, as the report shows, in that specific authority, there are private sector places available at £230, a price difference of £100 per week per place. Furthermore, this involves not only residential care, but day care and domiciliary services provision. The rate per hour for domiciliary services in Stockport is £10 for the public sector and £8 for the private sector. Let the Labour party explain why, against those facts, it maintains its blind commitment to the view that the public sector must always be protected.

The hon. Gentleman asked me where there are ideas for the development of vouchers in the planning for these services. The answer, among others, is in Bradford, an authority that I should have thought he might be interested in supporting. Bradford social service department wants to use vouchers to improve the services available to service users in Bradford. He just shot his own supporters in Bradford in the back.

I made it very clear that, after the legislation is changed, the onus of proof will be on social service departments that want to sustain provision of care, to show that the need can best be met through public sector provision. If they can discharge that burden, public sector provision will of course remain an alternative. Against the barrage of facts about the real choice between the public and private sectors, however, the hon. Gentleman's blindness is the outstanding feature.

I welcome the hon. Gentleman's endorsement of the approach that the Government intend to take in reforming regulation of the sector, and I am grateful for his support of our plans for improving training for social workers working with children.

The hon. Gentleman's final point again reflected his approach. He said that he is in favour of a general social services council—a huge new quango, and an extra cost. Is he really suggesting that we should introduce compulsory registration for every one of the 1 million workers who engage in the delivery of social care? If he is really suggesting that, let him cost his proposal, and let him explain it to those who would have to pay for that huge and unnecessary bureaucracy.

Several hon. Members:


Photo of Miss Betty Boothroyd Miss Betty Boothroyd Speaker of the House of Commons

That first exchange has taken more than 20 minutes. Therefore, I now want hon. Members to ask direct questions of the Minister, and I expect very brisk answers from the Minister.

Photo of Mr James Couchman Mr James Couchman , Gillingham

My right hon. Friend will know that I chaired the Social Services Committee in the 1970s and 1980s, when I also chaired a health authority. He will also know that I was a member of the Central Council for Education and Training in Social Work. Will he say something about the future role of the director of social services, which is a statutory function and particularly important in the care of children in local authority care? I also welcome the initiative to co-ordinate the activities of health and social services, particularly in the regulation of homes.

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

I am grateful to my hon. Friend. The key point is that, within the legislation, the focus of the director of social services will increasingly be on assessing and commissioning care that meets the needs of the people in his area. Responsibility for managing services will increasingly pass to others, as will responsibility for regulation. The principal responsibility of the director of social services will be—as I believe that it should be—focused on assessing the need for care in the area covered by the social service authority and on meeting that need in the most cost-effective way open to him.

Photo of Mr Peter Thurnham Mr Peter Thurnham , Bolton North East

I welcome the Government's long-overdue interest in social services. However, after all the recent abuse scandals, why are the Government not doing more to raise standards for those in care who are most vulnerable? Surely the Government should be addressing the issue of what they should be doing themselves. Why are they not doing more to reform community care law? Why do they not appoint regional ombudsmen to investigate cases of child abuse, such as the recent Rikki Neave case? What does this inadequate White Paper do to raise standards for those who are most vulnerable, especially children in need?

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

The White Paper focuses social service department management on assessing the need for social care provision for people in the area, and on giving the director of social services and his staff the freedom to secure the services that are judged best to meet those needs. That is what it does. It focuses social service departments on quality and on value for money—which is where the focus of their activities should be.

Photo of Mr Peter Fry Mr Peter Fry , Wellingborough

Does my right hon. Friend accept, first, that the true picture in Labour-controlled Northamptonshire is totally opposite to that painted by the hon. Member for Islington, South and Finsbury (Mr. Smith)? We have a situation in which elderly people have been denied a place in the home of their choice, or that choice has been delayed for many weeks. Some of them have died before they have been admitted to a residential home.

Secondly, does my right hon. Friend accept that, at a minimum, about £2 million could have been saved and released to stop unnecessary cuts in social services? Not the Government but Labour-controlled Northamptonshire county council has been dogmatic and doctrinaire on the issue.

Finally, we should like to know—

Photo of Miss Betty Boothroyd Miss Betty Boothroyd Speaker of the House of Commons

Order. I asked for brisk questions. As many hon. Members are waiting to ask questions, will they each put one question, rather than three or four?

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

My hon. Friend's impatience, on behalf of his constituents, with the incompetence of Northamptonshire county council will repeat itself many times around the country, when my hon. Friends consider how local social service departments prefer to put people in expensive local authority accommodation rather than equivalent, but cheaper, private sector accommodation. The only effect of those decisions can be to provide less care to local people and waste the council tax payer's resources as a consequence. My hon. Friend is angry on behalf of his constituents and many of our hon. Friends will share his anger.

Photo of Mr David Hinchliffe Mr David Hinchliffe , Wakefield

As someone who spent nearly 20 years in personal social services before entering Parliament, I am sorry that the Secretary of State is putting the boot in to some dedicated, decent and hard-working professionals. He is doing so for blatant political purposes relating to his bid for the leadership of the Tory party. I do not think that he believes what he is saying. Where is his evidence that privatisation improves the quality of care? I can give him an example from my constituency, where a woman in a private care home choked to death because not one person on duty that day had basic first-aid training. Yes, it costs more to care for people in local authority homes, because the staff get basic first-aid training and other training, too. That is the difference.

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

The hon. Gentleman is simply letting his prejudices get the better of him. The public sector, not the private sector, is free of regulation. It is the public sector where costs are higher and standards too often have been found wanting. The Government are determined to be relentless in the pursuit of good-value, high-quality services, and that is what the Bill will provide.

Photo of Mrs Elaine Kellett Mrs Elaine Kellett , Lancaster

Does my right hon. Friend agree that all that he seeks to achieve in the White Paper is already being achieved by the Abbeyfield Society, which provides extremely good value for money and charges £100 a week less than many other providers? It also moves people seamlessly from one form of care to another, virtually until the end of their days. Those who use its services are extremely happy, and it represents the best value for money that one could possibly get.

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

My hon. Friend refers to a valuable society that happens to be very active in my constituency. I can certainly vouch for the value of the service that it provides. The Abbeyfield Society and many other voluntary bodies play a key role in the provision of residential and day care facilities and domiciliary support. The Government are taking steps to extend the role of voluntary community support. The options that the Government are seeking to encourage are already being followed up by many local authority social service departments. The difficult question is why some are not. The Government are taking measures to ensure that every social service department applies those lessons, to the benefit of its local community.

Photo of Mr Dafydd Wigley Mr Dafydd Wigley Leader and Party President, Plaid Cymru

Does the Secretary of State accept that value for money does not necessarily mean accepting the lowest price for a service? Does he further accept that private provision came on stream to provide choice? Some people choose to receive care from a public sector-provided home or facility. Will he guarantee, therefore, that no individual who chooses to receive care in a public sector home will be denied that choice?

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

What I give is the assurance that, when people provide money to the public sector through taxes, those responsible for managing the resources should have proper regard to securing good value in the services secured with taxpayers' money. I do not believe that the taxpayer will understand if authorities continue to buy places at £283 a week, when the same provision is available at £246 a week.

Photo of Mr Patrick Nicholls Mr Patrick Nicholls , Teignbridge

Given the attempts made this afternoon to misrepresent what my right hon. Friend has said, will he confirm that we are not talking about a reduction in quality? The same quality standards that apply to the public sector apply to the private sector. In many cases, the standards demanded of the private sector are higher. People in Devon can now look forward to real choice, and not having their choice of care in the private sector denied and abrogated by the local authority.

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

The White Paper guarantees an increased focus on quality in two respects. First, it ensures that public sector homes will have to meet the same regulatory standards that private sector homes already have to meet. It is a scandal that we should ever have regarded it as reasonable to exempt public sector homes from the standards expected of private sector homes. Secondly, by ensuring that we do not waste money, we shall have more money available to deliver better-quality services to people in need.

Photo of Dennis Skinner Dennis Skinner Member, Labour Party National Executive Committee

Is the Secretary of State aware that I have heard nothing in recent months so calculated to cause concern among people who work in the public sector and the social services and to make them turn out and vote against the Tory Government? They know what he is up to—he wants to cut services and cut wages to £1.50 or £2 an hour for all those who are getting above the minimum wage. Does he not realise that privatisation is rapidly becoming a dirty word? The Government privatised rain, and now they are proposing to privatise grannies.

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

This afternoon we have seen the hon. Gentleman reunited with his Front Bench. He need not worry about the veneer that covers the new Labour party, because the voice of old Labour came from the Opposition Dispatch Box this afternoon.

Photo of Peter Bottomley Peter Bottomley , Eltham

I thank my right hon. Friend for his tribute to the staff in homes—public, private and voluntary. I advise him not to re-read some of the scandalous involvements in Greenwich over the past 20 years, where the deputy head of a home was also the branch secretary of a public sector union and exercised unhealthily close control over local Labour councillors. In his consultations, will my right hon. Friend pay attention to the stress on some residents and staff who find the prospect of change difficult to cope with?

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

I understand that any process of change causes uncertainty. That is why it is important, when contemplating changes such as those that I have anticipated this afternoon, to give people the absolute assurance that there will be increased safeguards of quality and an increased commitment to ensure that the resources available to social services are used to deliver high-quality care to those in need. The people in need suffer when those about whom the hon. Member for Bolsover (Mr. Skinner) was concerned have their excessive costs met. We have to deliver efficient, cost-effective services, because that is the way to respond to my hon. Friend's concerns, by assuring those who work in the sector and, most important, those who rely on its services that the services will be delivered cost-effectively and to a high quality.

Photo of Mr Bruce Grocott Mr Bruce Grocott , The Wrekin

Given that for 18 years the Government have been driven by the dogma of privatisation, and given that in the past fortnight they have told us that they will privatise pensions, if they get the chance, and are now planning to privatise social services and force people into the private sector whether they like it or not, why should we or anyone else in the country be in the slightest doubt that, if the right hon. Gentleman and his friends had half a chance, the next target for their privatisation mania would be the national health service?

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

That is an irresponsible scare, because I have said clearly, categorically and repeatedly that that is not our policy. Our policy is to introduce the benefits of more flexible, high-quality provision into social care, as we have done over a wide range of other activities over the past 18 years. Just go and ask the people who use British Telecom services, or those who benefit from the increased efficiency of the electricity and gas industries: they have all benefited from the improved efficiency of those services. The Government seek to bring those benefits to those who rely on the social care services. The hon. Gentleman is simply wrong about the national health service.

Photo of Iain Duncan Smith Iain Duncan Smith , Chingford

Does my right hon. Friend agree that the key to his proposals is the fact that people should have the choice of quality that is affordable? Is not that demonstrated in the private as opposed to the public sector? Does not the Labour response demonstrate that, far from old Labour being in residential care, it is alive and well and receiving care in the community?

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

My hon. Friend is right. The most striking aspect of this afternoon's exchanges is the instinctive reaction of almost every Labour Member who has spoken. If there is any prospect of introducing greater choice, greater variety and greater opportunity to improve services, Labour Members' instinctive reaction is that it must be resolved through the public sector. That is the reaction of Dr. Pavlov's dogs. We get it every time from the Labour Benches.

Photo of Mrs Alice Mahon Mrs Alice Mahon , Halifax

Will the Minister confirm that, if his plans become law, every public sector home will close down? What chance will there be for people to be cared for in the public sector once his proposals are implemented? May I reiterate what my hon. Friend the Member for The Wrekin (Mr. Grocott) said? If the people are unlucky enough to have the Conservative Government re-elected, the next privatisation will be the national health service, because that is at the bottom of this.

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

The hon. Lady is simply wrong. What we are doing is carrying on the policy that we have been pursuing since we introduced the community care legislation in 1990. We have seen a substantial growth in the provision of residential and nursing care in the public sector. The Government have delivered a huge increase in the range of services available to elderly people who need social care. The White Paper shows how that growth in the quality and range of social care provision for elderly people, and for every other user of social care services, can be extended in the future. The Labour party simply refuses to face any of the fundamental questions that confront those who care about the future of welfare provision in Britain.

Photo of Nicholas Winterton Nicholas Winterton , Macclesfield

My right hon. Friend made a statement with vision; much of what he said is already operating in my county of Cheshire. Does he accept that, if we are to involve the private sector to the extent that he outlined, it is important to gain public confidence in it, and there will have to be proper monitoring and a regulatory system, to ensure that the public have confidence in my right hon. Friend's proposals?

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

I agree with my hon. Friend that there must be proper safeguards, which is why we have had in the past the regulatory structure for the provision of residential care. I announced today the extension of that regulatory function to cover domiciliary and day services, because I want to see the provision of those services by the private and voluntary sectors extended.

That is why the regulatory standards must be extended to cover public sector residential care. Many of the homes that have failed to meet the regulatory standards have been in the public sector. Homes that have exploited their freedom from regulatory standards are in the public sector. I announced the uniform regulatory approach contained in the White Paper, to ensure that everyone in residential care enjoys proper protection through regulation, which my hon. Friend says they should have.

Photo of Paul Flynn Paul Flynn , Newport West

Have not the Government proved again today that Whom God would destroy He first sends mad"? Is the Secretary of State really trying to contrive a Canadian-style wipeout in the general election? Does not he realise that the announcement will strike fear into the hearts of everyone who might be in residential care in the future—that is all of us, and almost everyone in the country—because they have seen the reality of what he calls cost-effectiveness: care on the cheap, with restricted diets, shared rooms and poor service from underpaid staff? Has he gone mad?

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

What I am doing is pursuing the policy that we have developed over the past 18 years, which has delivered the most radical extension of residential and nursing care for the elderly that has ever been seen in this country. I want the standards that people currently enjoy in the regulated private sector, and the opportunity for access to those services, to be extended more generally.

One of the biggest restraints on access to those services is the fact that too many authorities preserve and protect their own expensive and unregulated homes in preference to using public money to buy high-quality services in a competitive private sector. That sector has grown over the past 18 years and people can see for themselves the standards that are delivered. The evidence shows that the overwhelming majority of those homes have delivered a high standard of care, at a price that the public sector has not been able to match. That is why I want access to those services to be extended.

Photo of Charles Wardle Charles Wardle , Bexhill and Battle

Is my right hon. Friend aware that in East Sussex the cost of care beds in the county council's homes is £152 per person per week more than in comparable available care beds in private sector registered care homes? The extra cost to the council tax payer is £4.7 million a year. Is not that ample reason for the proposals?

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

My hon. Friend makes his own point in an extremely cogent way. As I have said in answer to one or two other questions from my hon. Friends, that basic analysis is repeated time and again in social service departments the length and breadth of the country. I have introduced the White Paper today precisely to ensure that the questions raised by the figures cited by my hon. Friend are answered. Those figures simply demonstrate that the local authority is more concerned to defend its own institutional interest than to deliver services to people in residential care.

Photo of Martin Smyth Martin Smyth , Belfast South

While there may be helpful proposals in the White Paper, I regret the fact that the Minister has run away from introducing a social services council. The basis for that was given at least three years ago by people such as Sir William Upping; it would be self-funding and would involve in the end perhaps 1 million people, but in the beginning it should surely involve the key workers in social services. I regret that the opportunity has been missed.

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

The hon. Gentleman raises an important point. For the reasons that I gave earlier, I am not in favour of moving in the direction of universal registration of people who work in the social care sector. I am strongly in favour of working with employing authorities in both the public and the private sector, to make certain that there are proper standards, that those standards are enforced, and that there is co-ordination of the standards that are applied around the country. That is the route that we are taking. I issued a consultation document on the subject last autumn and I am certain that a focused approach to problems where they exist is a better way than a general registration system to address the concerns that the hon. Gentleman rightly expresses.

Photo of Mr Keith Mans Mr Keith Mans , Wyre

My right hon. Friend's proposals will be widely welcomed in Lancashire, especially by those of my constituents who are currently resident in inferior-quality, high-cost, badly regulated Lancashire county council care homes for the elderly, who will be given a choice that they did not have before. They will also be widely welcomed by those of my constituents who should have care but are not getting any at all, because of the high-cost policies of the county council.

My right hon. Friend will also be interested to know that, judging from the people whom I saw standing outside No. 4 Millbank earlier this afternoon, the shadow Chancellor is already preparing to rubbish the statement of the hon. Member for Islington, South and Finsbury (Mr. Smith).

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

My hon. Friend may have seen Mr. Charlie Whelan doing his rounds. He may not always go into the studio, but we can reliably expect to hear his views about the performance of the hon. Member for Islington, South and Finsbury (Mr. Smith) and other Labour spokesmen.

My hon. Friend asked about the interests of people who rely on the social care provided by Lancashire county council social service department and other such departments the length and breadth of the country. He is right to say that the issue is one of quality, cost and the use of resources for those who currently do not get care because resources are wasted.

Photo of Ronnie Campbell Ronnie Campbell , Blyth Valley

Will the Minister guarantee that the wages paid in the public sector will be transferred to the private sector? Will people get the same wages?

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

When an undertaking is transferred from the public to the private sector, the agreement comes under the normal regulations. That is how the system works, as the hon. Gentleman knows. It is interesting that he, the hon. Member for Bolsover and other Labour Members sitting on the Front Bench below the Gangway, are concerned only about the people who provide the services. We have not heard a word from them about the interests of those who need social care. They are concerned only with the producer interest; they are not interested in those who need social care.

Photo of Edward Garnier Edward Garnier , Harborough

Does my right hon. Friend accept that private providers in Leicestershire, which we both represent, will be pleased with today's announcement? Is he aware that over the past few years, representatives of East Midlands C.A.R.E—the private providers consortium, which he and the Under-Secretary, my hon. Friend the Member for Chelmsford (Mr. Burns), have met—have complained about discrimination by the county council social service department in refusing to recommend private placements? Is it not significant that when the official Opposition are presented with a new idea, they are not capable of dealing with it, and change the subject?

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

The official Opposition always deal with the suggestion that we should introduce a more varied and flexible system by relying on the public sector alternative. That is their repeated reaction, whatever the subject. My hon. and learned Friend is right that, for the people of Leicestershire, as for the people of Lancashire, Northamptonshire and every county in England and Wales, this package provides more resources to deliver better-quality care for those who need residential, domiciliary day care services. We are interested in the better use of resources to deliver quality care. That perspective has been barely heard from Labour.

Photo of Neil Gerrard Neil Gerrard , Walthamstow

May I draw the Minister's attention to paragraph 2.30 of the White Paper, which says that for authorities to continue to provide homes directly, they will have to prove that there will be insufficient independent sector provision (either currently in existence or which could be developed in time) to meet planned need? Does not that imply that a private sector provider could say that it intended to provide something, with no guarantee that such provision would ever come into existence and no way of judging quality or cost, because it would not yet exist? However, that would be enough to force local authorities to shut directly provided provision and close places that were being run successfully. People living in such places would be flung out.

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

The terms of that paragraph are clear. The local authority retains a power to provide residential or domiciliary services, if it is necessary to meet a need that will not be met by the non-statutory sector. That underlines the Government's view that the function of a social service department is to act as a safety net, to provide a floor, and to make certain that provision will be there, but not to interpose itself if the normal system can provide care to meet the need. That is the Government's view of the proper role of social service departments, and that is why we have introduced the policy in this way.

Photo of John Whittingdale John Whittingdale , Colchester South and Maldon

Is my right hon. Friend aware that in Essex, the policy of the Labour-Liberal Democrat-controlled county council of using its homes rather than independent sector homes will this year cost £10 million? Does he agree that that is £10 million that could be used to provide extra care? Is not the policy of counties such as Essex an example of the triumph of dogma over common sense?

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

My hon. Friend is precisely right, and the figures that he quotes demonstrate the scale of resources currently being wasted by authorities that will not look for better-value solutions to their problems and which prefer always to fill their own homes.

Photo of Mr Terry Lewis Mr Terry Lewis , Worsley

Does the Secretary of State really believe that including old people in his closing-down sale will enhance their conditions? Does he think that the breweries that own many of the care homes in my constituency are better than local authorities at providing homes?

Photo of Stephen Dorrell Stephen Dorrell The Secretary of State for Health

We are giving an assurance to elderly people, and others who rely on social service departments for social care, that we shall provide the resources and management disciplines to deliver proper high-quality services. The Labour party, driven by dogma, prefers to meet producer interests, rather than the needs of the people who rely on social service departments.

Several hon. Members:


Photo of Miss Betty Boothroyd Miss Betty Boothroyd Speaker of the House of Commons

Thank you. We now move to the second statement.