Disability Benefits for the Elderly

Part of Opposition Day — [1st allotted day] – in the House of Commons at 5:09 pm on 8th December 2009.

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Photo of Stephen Dorrell Stephen Dorrell Conservative, Charnwood 5:09 pm, 8th December 2009

The hon. Gentleman is absolutely right, and what he says is relevant to the point made by my hon. Friend the Member for South Cambridgeshire about the way in which a local authority-commissioned service relates to carers. A local authority-commissioned service runs the risk of being less accurate in meeting what elderly people want and demand of such services, and therefore of being not merely more expensive, but less good value for money. There are therefore many reasons for choosing to have a policy that prefers, accentuates and develops direct payments, rather than officially commissioned services. That is why we passed the direct payments legislation before 1997, and it is why we have supported the development of that concept since. I believe that any move to put disablement benefits into the pot to pay for the national care service would be a big step in the wrong direction.

The Ministers say, "Don't worry about it. Local authorities will still have the same encouragement to pay direct cash payments." Who do they think they are kidding? They are clearly not kidding the next generation of elderly people. I accept entirely that there will be no cash losers in the current generation of benefit recipients, but we are concerned here about the development of policy for the future. I simply do not believe that if we take a system that provides an entitlement to a cash benefit and give that cash to a local authority commissioning body, we will have entrenched or developed the policy of preferring cash payments to commissioned services. It flies in the face of common sense, and particularly so when we all know that we are going into a decade in which there will be severe resource pressure.

Of course, it is true that, against that background-even if the Department of Health does not prefer such an approach-the Treasury is encouraging this policy direction to create more flexibility to free up resources that, in its mind, are now being devoted to a demand-led programme so that it can put those resources at the disposal of a priority-led programme that will be subject to a cash limit in the way that the disablement benefit programme is not. All those reasons should, I believe, commit us to opposing a development of policy that takes an existing demand-led cash payments programme and puts it into a local authority cash-limited priority-led programme. That simply will not deliver the core policy objective that has been consistently developed since before 1997 and, to give them credit, by this Government since 1997 to build up a preference for cash payments over commissioned services. That is one fundamental conflict that I believe to be at the heart of the development of the policy for a national care service.

The other conflict that is equally at the heart of this policy has not yet been raised this afternoon. It is the unresolved conflict caused by the question of whether we are seeking to develop greater local flexibility, local choice and local management of these services or a single national blueprint, rolled out across the country. The Department of Health talks about putting the disablement benefits at the disposal of the national care service in order to fund and develop its vision of a national care service with national assessment, a national entitlement programme and the development, therefore, of a policy that moves social care for the elderly from being a local authority service to a national service on the model of the national health service. The Secretary of State made it entirely explicit that that was the agenda of the Department of Health.

At the same time, in this Chamber, only a few weeks ago, we were debating with the Department for Communities and Local Government the development of the Total Place programme, which embraces the idea that disablement allowances should be put into that programme in order to take funds that are currently determined by a national programme with a national entitlement prescription and to put them at the discretion of local authorities so that they can create a more flexible local model of service delivery that reflects more accurately the local circumstances of individual local authorities.

Which approach are the Government supporting? Are we putting attendance allowances and disablement allowances into the local pot in order to develop a national care service? There is something tautological about taking a national programme and putting it into local authorities in order to develop a national care service. That is a bit like listening to a Frenchman explaining the game of cricket. Are we developing the programme in order to develop a national care service or are we taking these benefits and putting them at the discretion of the local authority in order to develop local flexibility and Total Place? Again, this comes back to a point that I made earlier. Is this about putting those moneys into a cash-limited programme to create greater discretion, as would be the Treasury's agenda, or is it about the national payment of cash benefits according to a national entitlement programme, which would be my preference?

My central point is that, against the background of the Government having failed for 12 years to address the resource challenges in the care of the elderly, they published a Green Paper this summer that said that the solution was the development of a national care service-three words with no policy behind them. That was a good headline, but behind it is an unresolved muddle of unresolved conflicts. All that is unresolved after 12 years of failing to rise to the challenge that was clearly there 12 years ago. Hon. Members need not take my word for that: in 1997, Tony Blair said that it would be a disgrace if this matter were not addressed. Those were his words, not mine.

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