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Continuing Care Report

Oral Answers to Questions — Health – in the House of Commons at 11:30 am on 22nd February 2005.

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Photo of Sandra Gidley Sandra Gidley Women and Older People, Non-Departmental & Cross-Departmental Responsibilities 11:30 am, 22nd February 2005

If he will make a statement on the Government's response to the Parliamentary Health Ombudsman's report on continuing care.

Photo of Stephen Ladyman Stephen Ladyman Parliamentary Under-Secretary, Department of Health

The written ministerial statement that was made to the House on 9 December 2004 outlined our plans to develop a national framework for fully funded continuing care. The framework will improve consistency and ease of understanding and will help to ensure that users' and carers' reasonable expectations are being met.

Photo of Sandra Gidley Sandra Gidley Women and Older People, Non-Departmental & Cross-Departmental Responsibilities

I thank the Minister for that explanation. There have been 4,000 complaints to the ombudsman since the February 2003 report, which recommended the establishment of clear national minimum eligibility criteria that are understandable to health professionals, carers and patients. It also stated that the local criteria are over-assessed and poorly applied. Why has it taken so long to draw up national minimum standards, and what will the Minister do to make sure that those are properly and transparently applied?

Photo of Stephen Ladyman Stephen Ladyman Parliamentary Under-Secretary, Department of Health

We started off with 96 different sets of criteria. We reduced those to 28, which we ensured were legally reliable and properly administered before we started the review. The review of the outstanding cases is complete in all but one strategic health authority area, and even that one will be finished shortly, so we have made substantial improvements. In developing the national framework, we must now make sure that we go down to one single framework that is easy for patients and carers to understand and can be reliably implemented by professionals. By establishing best practice, that is exactly what we shall do.

Photo of Mr David Hinchliffe Mr David Hinchliffe Labour, Wakefield

On the issue of long-term care, under the previous Administration there was a significant increase in the number of elderly people institutionalised in private care and nursing homes, and this Government have a proud record of moving in the opposite direction. Will the forthcoming Green Paper possibly set targets for a further reduction? Can my hon. Friend set out roughly how soon we will have the Green Paper and tell us what positive policies it will include on developing alternatives to the institutional care sector inherited from the previous Administration?

Photo of Stephen Ladyman Stephen Ladyman Parliamentary Under-Secretary, Department of Health

First, I can promise my hon. Friend that the Green Paper will be available shortly. Of course, as a Green Paper, it will not contain specific targets, but I promise him that it will reaffirm the direction of travel—the direction that older people themselves tell us that they want us to take. They want to stay in their own homes for as long as possible. If they cannot do so, they want to move to accommodation where they can maintain their independence. They do not want to be shuffled off into residential care, which is the policy of the Opposition parties.

Photo of Stephen Dorrell Stephen Dorrell Conservative, Charnwood

Can the Minister confirm that the continuing uncertainty and confusion about entitlement to residential care date back to the Coughlan judgment, which was handed down almost six years ago? Is this not a sorry tale of incompetence and bungling by the Government, compounded by the fact that the Minister promised that, by March 2004, all those who had overpaid their charges would receive back their overpayments? How many of those people are still waiting for overpayments that were declared illegal six years ago?

Photo of Stephen Ladyman Stephen Ladyman Parliamentary Under-Secretary, Department of Health

I will not confirm that it goes back to the Coughlan judgment. It goes back to when the previous Government ordered 96 health authorities to write separate sets of eligibility criteria. The right hon. Gentleman ought to know that; I rather suspect that he was Secretary of State at the time when it was ordered. The fact is that the ombudsman asked us to go back in our review to 1996 precisely because the confusion arose from the point at which the criteria were issued. We are cleaning up the Conservative party's mess, and we are doing so at great expense to the taxpayer.

Photo of Simon Burns Simon Burns Shadow Spokesperson (Health)

May I tell the Minister that he is living in cloud cuckoo land? This is a miserable episode for the Department of Health. His own deadlines for sorting out the problem have been missed eight times, and the ombudsman has accused the Government of bungling the cases, criticised the Department for issuing unreliable information to her about its review and found that, in half the reviewed cases that she has looked at, the reviews have not been properly carried out. Can the Minister tell us when there will be completion for all the people who have complained? Can he also tell us more about the compensation? Will it be compensation solely for the money that people inadvertently and wrongly had to pay? What will happen to people who had to sell their homes, when it now turns out that there was no reason whatever for doing so?

Photo of Stephen Ladyman Stephen Ladyman Parliamentary Under-Secretary, Department of Health

Let me deal with that last point first. Since 2001, we have allowed all local authorities to defer payments, so property needs to be sold only after people's death. That is available in every part of this country. It is a policy that means that people do not have to sell their homes, and it would be swept away by the policies of both the Conservative party and the Liberal Democrats if they were implemented. The simple fact is that we have a serious and complex problem to clean up. We had to go from 96 sets of eligibility criteria to 28 sets, and we had to ensure that people could understand them. All the cases in which people requested their review by the March deadline have now been completed. Other cases are coming in continuously, and we are paying compensation on the basis that, where the national health service received unjust enrichment, we are paying the money back to people. We are paying £180 million to clean up a mess left by the hon. Gentleman's Government.