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Nursing and Residential Homes

Part of the debate – in Westminster Hall at 11:55 am on 3rd April 2001.

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Photo of Dr Peter Brand Dr Peter Brand Liberal Democrat, Isle of Wight 11:55 am, 3rd April 2001

I congratulate Mr. Hughes on initiating the debate.

The contributions of the hon. Members for Dumfries (Mr. Brown) and for North Thanet (Mr. Gale) made it clear that market forces have not worked and are unlikely to work, because in most cases the user of the service is not the commissioner of the service. I recognise that there is a move towards allowing more choice, but ultimately people tend to go where there is a space. In the early days, there was massive over-provision. When the tourism industry became less successful in seaside towns, people turned to granny farming, as the hon. Member for North Thanet said. Over-provision does nothing for standards. Matters started to improve only when standards were introduced through inspection and registration regimes. I am glad that some of the homes that I used to visit have closed, because their standards were appalling.

One cannot rely on market forces and not regulate. Regulation is important, and the Care Standards Act 2000 will make a big contribution to that--not only in terms of bricks and mortar, but through training and the way in which employees are valued as a result of the minimum wage. It is right that such measures were, and will continue to be, introduced. However, not every residential or nursing home can continue to subsidise its local authority placements through cross-subsidy from self-funders or top-up fees from relatives, which will be allowed in the near future. The essential point that the Government must recognise is that it is no good taking the view that local authority fees are similar around the country and are therefore right. My local authority justifies its fee levels by saying that they are comparable with those of all other local authorities in similar circumstances. I have had representations from at least six parts of the country in which that argument has been used. There appears to be a conspiracy among local authorities to keep fees down.

Market forces are beginning to work in a negative way. People are moving out of care home provision. Even a respectable organisation like Methodist Homes is shutting its care home on the Isle of Wight because it cannot be bothered to upgrade it. That is extremely worrying.