I congratulate Mrs. McGuire on saying that she would sit down well within her allotted time, and then sticking to her promise. I shall try to emulate her in that regard.
The right hon. Lady began by saying that the occasion for the debate was good news-the news that more elderly people are living longer-and that we should all celebrate that good news. I entirely agree with her, but the other aspect of the background to the debate is less happy. Although it has been recognised from 1997 onwards, and indeed was recognised by the previous Government-in which, as Secretary of State for Health, I was responsible for these issues-the fact that people are living longer, and have higher expectations for their care in old age, creates a real policy challenge when it comes to paying for the care that, when we are younger, we all want for elderly people and that we want for ourselves as we grow older. The current Government came to office, and the then Prime Minister promised action on this subject, in autumn 1997, yet all we have had are repeated commissions that have, in truth, failed to address the issue.
The most accurate assessment of the issue was provided by the Wanless report, which said that merely to stand still-merely to deliver the same quality of care to elderly people as now-would require the proportion of gross domestic product committed to this area of care to rise from 1.1 per cent. to 1.5 per cent. over the next 15 years, and that that would represent an increase in the cash cost of providing that care of £14 billion. That is how much it would cost merely to stand still. A parallel report by the Commission for Social Care Inspection pointed out that to stand still is not to deliver on our aspirations. The background to our debate is, therefore the fact that for 12 years we have failed to address the question of how we as a society will fund our aspirations for elderly care.
Twelve years on, the Government produced a Green Paper this summer, which is the immediate background to the debate, because it tabled the suggestion that attendance allowance and disability living allowance should be put into the pot to square the circle of paying for this area of care. It also tabled the suggestion that "a National Care Service"-capital N, C and S-should be developed, but it set out almost no details of what such a service should look like, beyond saying that disablement benefits should be part of the funding solution for paying for reshaped care for elderly people.
Since that Green Paper was published, two fundamental conflicts have developed at the heart of policy in this area. They have now started to bubble to the surface, and I want to address those two conflicts this afternoon. My hon. Friend Mr. Lansley has already discussed the first of them: should we develop a policy that is based on a preference for the payment of cash benefits, or one that allows greater flexibility for commissioners of service to provide a package of care that is, in their opinion, tailored to meet the needs of elderly people, but that does not necessarily reflect the wishes of the elderly people themselves?
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