Social Care Funding

Baroness Keeley Excerpts

Thursday 10th November 2011 Westminster Hall

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I congratulate the hon. Member for Truro and Falmouth (Sarah Newton) on securing this debate and on the way in which she opened it. I am sure that we all agree with her final comment about caring for those who served in and lived through the second world war. It is important that we not only debate social care here, but ensure that a much wider debate on the current and future funding of social care takes place across the country.

The Dilnot commission was tasked with making recommendations on how to achieve an affordable and sustainable funding system for care and support. No one here today will be able to go into too much detail about the report, but I should like to talk about some of the things that the report confirmed, including things that have been repeatedly said about social care for years. These are some of the key points. The current adult social care funding system in England is not fit for purpose and needs urgent and lasting reform. The current system is unfair and unsustainable. Without reform, it will deliver ever poorer outcomes for individuals and families. The funding of social care is inadequate—people are not receiving the care and support that they need. Indeed, there is an unacceptable level of variation in eligibility for services; we have 152 different adult social care systems. For a number of years, care has been rationed through the fair access to care system, but that system is now seen to lack transparency, consistency and clarity. Assessments for care are not portable. Given the variations in eligibility, the problem causes frustration and worse than that when people needing care have to move to a new local authority.

The provision of information and advice is poor quality and very limited. People struggle to find financial information and advice, and there is little information and advice for carers. While there are significant overlaps between funding streams for housing, benefits, the NHS and social care, the systems that administer them are not joined up, which means that we do not have integration, that we have poor co-ordination and that people have to suffer multiple assessments. Perhaps worst of all—Andrew Dilnot rightly drew attention to this—the system is so complex and difficult to understand that most people do not plan for or think about the future provision of care that they may need. I am sure that many right hon. and hon. Members will have had cases of constituents who thought that social care was free and were shocked when they discovered that it is not and that they will be faced with paying the costs of care.

All those points are a disturbing appraisal of the system of care and support on which millions of people depend because they are frail, elderly or have a disability or long-term condition. We have known about all those problems for some time and I have spoken out on these issues since I came into the House in 2005, with a variety of different people filling the role that the Minister now occupies.

In 2009 and after much consultation, my party brought forward plans to establish a national care service. Given the pressing needs of those people with the greatest care needs, we also passed the Personal Care at Home Act 2010 to provide free personal care at home for the 400,000 people with the greatest care needs. It was not a perfect solution, and I do not think that anyone thought that it was, but it would have provided financial peace of mind to 400,000 individuals and their families.

My party’s proposals were treated as political footballs during the general election campaign. There were some regrettable political attacks on the proposals for social care, which was unfortunate.

[Glyn Davies]

Does the hon. Lady not accept that the way in which those proposals were treated before the last general election was massively damaging? I was not a Member of Parliament then, but I was ashamed of some of the language that I heard coming out of the House. It is wrong to attribute the matter to any particular party. If we are going to deal with this issue properly, we have to set aside that sort of language because it serves no purpose and damages our reputation with the public.

[Barbara Keeley]

Indeed. As ever with interventions, that was almost the next thing that I was going to say. I was going to say that the whole incident was unfortunate. I am chair of the all-party group on social care and I want to see a consensus built in this Parliament to take forward a solution to the funding of care and support, so I very much agree with the hon. Gentleman.

We must set our minds to the fact that, this time, the debate must be different. We need to build consensus across the parties and across the country. The need for a solution is more pressing than ever. We know that requests for support are increasing. In 2009-10, there were 2.1 million contacts from new clients to social services, an increase of 4% from 2008-09 and of 8% from 2004-05. We also know that many hundreds of thousands of people never have their needs assessed.

At the Health Committee this week, I asked a question of the president of the Association of Directors of Adult Social Services about levels of unmet need. He seemed unable to quantify it. How can we plan for provision of social care if we do not know the levels of unmet need? Research by Age UK showed that 82% of local authorities now provide care only to those with “substantial” or “critical” needs. I am glad to say—I think that the hon. Member for Truro and Falmouth also has a council in her constituency that is perhaps doing a bit better—that my own local authority, Salford city council, is among the 18% of councils in the country that still provide care for those with “moderate” needs.

I welcome the commitment of my Labour council colleagues to try to meet the needs of the more vulnerable members in our communities. I understand how difficult the position is, but I value all those councils that are rightly taking the decision to protect social care. We know that vulnerable people in other areas are not so fortunate. Recent studies by the Office for National Statistics and the Economic and Social Research Council Centre for Population Change have looked at the issue of unmet need for social care. The centre concludes that, regardless of the data source used

“there is significant unmet need for care among older people.”

It gives the example of a group of people aged over 65 who needed help with bathing. Of that group, 66% were not receiving any help with bathing. That example was based on 2008 data. Since 2008, we have had front-loaded cuts to local authority budgets, which will have caused greater levels of unmet need.

My hon. Friend the Member for Lewisham East (Heidi Alexander) referred to local authority budget cuts and now the Association of Directors of Adult Social Services has reported £1 billion of cuts to social care budgets in 2010-11, with a similar or greater level of cuts being predicted for next year. What impact those cuts will have is of concern to us in Parliament.

The NHS Confederation reminds us that when people’s needs for social care are not met, they turn to the NHS. The NHS Confederation says that that will mean increasing numbers of unscheduled and emergency admissions to hospital, as well as delayed discharges from hospital. Indeed, recent figures from the Department of Health show that the number of delayed discharges from hospital was 11% higher in September and October this year than in the same two months in 2010. Clearly, delaying discharges from hospital is an expensive solution to the problem of inadequate social care. Indeed, the NHS Confederation says that, without reform, the NHS will ultimately buckle under the pressure of demand from patients who need social care.

The problem of unmet need is getting worse and of course much of the extra burden will fall on unpaid family carers, many of whom are already overburdened. I will cite two examples of unpaid family carers that Carers UK has told me about.

One is Eric from Lancashire, who has cared for his wife, Diane, for 20 years. She has multiple health conditions and needs constant support. Eric had to give up work 15 years ago to care for her full-time. When his local council provided 10 hours of support each week, Eric could get out of the house, have some time for himself, do the shopping and even do some volunteering with local charities. Earlier this year, however, council cuts meant that Eric and Diane’s care package was cut in half, despite the fact that Diane’s health has not improved. Eric is worried about his own health, because he needs to use all of the time that he has free from caring for Diane, which is now only five hours each week, to run basic errands, and he no longer has any time for himself. We can all imagine how difficult that must be.

The second example is of an unpaid family carer who is in perhaps an even more difficult situation. Joyce, aged 58, cares for her husband Robert, who is 71 and has dementia. She gave up work as an accountant four years ago to care for Robert full-time. With their savings and Robert’s military pension, they are over the means test threshold for local authority support. Robert is doubly incontinent, and easily confused and distressed, so he cannot be left alone. Just to go to the supermarket, Joyce has to pay £12 an hour for a sitter. For longer breaks, she has to pay £18 an hour for specialist care. Paying for a day of replacement care or for a weekend away means that costs escalate, because Joyce has to pay for multiple care workers and even a nurse. It is important to note that the charges that Joyce is paying have risen by 20% during the past four years. Joyce gave up work to care for Robert and her only income now is from the carer’s allowance of £55 a week. She knows that residential care, when Robert needs it, will cost thousands of pounds a month, which makes her very fearful of the future.

I said earlier, and I think that it is the case, that there is clear agreement that our social care system is no longer fit for purpose and that reform of the funding system is overdue. However, the important point is that none of the people I have referred to in those examples would be helped with their current issues by the Dilnot report’s recommendations, because they offer little for overburdened family carers who are caring for people at home.

A report by the Strategic Society Centre suggests that the “capped cost” model recommended by Dilnot will pose a dilemma to policy makers and could create resentment among family carers. Carers such as Joyce save the state many thousands of pounds by providing informal care. However, when the person they care for enters residential care, they will still be liable for the first £35,000 of care costs. That does not seem fair.

The recommendations of the Dilnot commission are an important step on the path to reform, but we must look widely at what is needed. We must focus on the gap in funding, which exists under the current system as well as in the projections of future funding needs. We must also have the widest possible debate on the options that are available. It seems that there is a problem in getting a debate on these issues that is wide enough to build the consensus that Members from all parties have talked about in Westminster Hall today.

I know that the Minister who is here today is involved in an engagement exercise and that leaders from the care and support community are helping to lead those discussions. However, I want to ask whether and how we can debate this issue more widely. There are 6.4 million carers who have a stake in the issue. There are 1.6 million staff who work in the provision of social care, which is more than the number of staff in the NHS. We should perhaps not be surprised that those people find it harder to be in contact with MPs and Ministers to give their views. They do not have the time in their busy and pressed lives to go along to consultation events; it is very difficult for them to do so. It says much about the isolation of carers and of the staff who work with people who need care that they have few opportunities to get together and put forward their views and comments, so it is our job to find out about that, and to talk to and build a consensus with those people.

After the launch of the Dilnot report, the all-party group on social care asked how the public debate on future funding of social care would develop. We asked a Health Minister—it was Earl Howe, as the Minister who is here today was unable to attend that meeting—whether Andrew Dilnot and the other commissioners could continue to play a role, and whether the secretariat for the commission would continue.

In July this year, I, as the chair of the all-party group on social care, and the chairs of 11 other all-party groups associated with social care wrote to the Prime Minister, the Health Secretary and the Minister with responsibility for social care, who is here today. The MPs and peers in those all-party groups stressed the need for action. We asked the Government to accept the urgent need for reform, but we also asked them to provide resources to support meetings across the country to promote the debate on social care, facilitated by members of the Care and Support Alliance, which is the umbrella group of more than 50 charities that represent older people, disabled people and those with long-term health conditions, as well as their families.

As we have already heard today, the future of social care is of national importance and it should involve the millions of people who depend on social care and the staff who provide care services. Can the Minister tell us what resources the Government will allocate to promote the debate on social care, including providing support to the members of the Care and Support Alliance to run meetings and take the debate forward?

Finally, can the Minister update us on the level of commitment that he believes exists in the Government and more widely to take forward the issues that have been raised today, and to take action to deliver what we said in our letter to the Prime Minister and others we want to see, which is a fairer system of charging for care that is matched by a financial settlement for local authorities so that they can deliver that fairer system?

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[Neil Carmichael]

Absolutely. I take the point that young people can also have dementia—that is certainly true—but the point I was making was that young people are caring for people once they return from school. That is a measure of the challenge we face in dealing with the role of carers, so the Government have to think carefully about the structures around carers and about the ability to give these people appropriate support and respite.

[Barbara Keeley]

It is good for us to be concerned about young carers, but is the hon. Gentleman concerned about the loss of education maintenance allowance? When I talked to the young carers project in my constituency, it told me that all but one of its young carers had been receiving EMA, and they were really afraid that they would lose all their incentives to stay in education. There is therefore an issue about support for young carers.

[Neil Carmichael]

This is certainly becoming a surprisingly wide-ranging debate. We have thrashed out the issue of EMA very carefully and thoroughly in the House of Commons—indeed, those of us on the Education Committee produced a useful report on the subject—but the Government have to think about wider issues in connection with post-16 education and so on. However, that is a separate issue; the important point here is that people who are going to school are carers, and I want the Department of Health to register that.

Another important aspect is the number of people with Parkinson’s. That problem is increasing all the time, and it is right that we focus our attention on it. The reason I mention such difficulties—not to the exclusion of others—is that it is important that we think carefully about personalised budgets so that people get tailor-made provision that they are happy with, and so that we join the NHS up with social care. I made that point in an intervention on my hon. Friend the Member for Truro and Falmouth but I want to repeat it, because part of the answer is to ensure that fewer people end up in hospital, and we can do that by ensuring that the social care structure spots problems before they become serious or overwhelming and prevents problems from starting in the first place. If the social care system dovetails completely with the NHS system and is accessible and transparent, people who need care, and families with members who require care, will feel they are being properly listened to.

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[Tony Baldry]

That is a helpful update for the House, and I am grateful to the Minister.

[Barbara Keeley]

Does the hon. Gentleman share my concern—this may be the theme that he is developing—that there is a conflict between localism, the removal of ring-fencing and ensuring that a local authority delivers adequate social care? I find it hard to see, when exhortations are clearly not working with local authorities, how we can ensure that some authorities do not just cut their social care budgets to the bone and give people inadequate services. It is quite clear, with £1 billion in cuts this year, that they are not doing as the Minister would like.

[Tony Baldry]

I see the situation rather differently from the hon. Lady. Local authorities such as Oxfordshire are committed to delivering good-quality social care for elderly people. The challenge for them is to ensure that the increasing number of elderly people, often with increasing needs, receive appropriate care, whether at home or in residential care. A tight budget presents them with a significant challenge, but it is a challenge to which they are committed.

I appreciate that the hon. Lady comes from a unitary authority, but for two-tier authorities in shire counties such as mine, social care is now their most significant contribution. Increasingly, schools and education are running themselves, so authorities are going to be judged on the quality and the way in which they deliver social care.

[Tony Baldry]

I am not entirely sure where the hon. Gentleman is going with that point, so if the House will excuse me, I will not follow him down that particular line.

I do not think there is any lack of local accountability as far as the national health service is concerned. The Oxfordshire joint health overview and scrutiny committee is meeting today and will consider, for example, possible service changes at Horton general hospital in my constituency. The committee will, I am sure, vigorously interrogate the senior management from the Oxford University Hospitals NHS Trust and from the Oxfordshire and Buckinghamshire PCT cluster.

In the debate on social care, we must not underestimate the burden or the toll on carers of the task of looking after elderly people with age-related difficulties. Carers UK has found that carers providing significant amounts of care are twice as likely to suffer from ill health as non-carers. In 2008, a survey of heavy-end carers showed that more than half of those caring were in debt, and nearly three quarters were struggling to pay household bills. A large number of carers, about 1 million, have given up work or reduced their working hours because of caring. The peak age for carers is between 45 and 65, which is often the age at which they would be at the peak of their training, skills and career experience. That can be a cost not only to the carer, but to businesses and employers as they lose key people who have to care for relatives.

We have seen some excellent organisations such as Employers for Carers, which was set up by Carers UK and seeks to bring together numerous employers, generally larger ones, to promote flexibility and workplace support for employees juggling work and care, but that is not always possible for small and medium-sized employers. There is also a cost to the NHS. Sometimes, if we are not careful, there is a trade-off between the quality of social care, the provision of sufficient beds in nursing homes and residential care homes, and the need to prevent delayed discharges and bed blocking in hospitals. We had a debate on that not long ago, to which I contributed. In Oxfordshire, we are grappling with the issue of delayed discharges. If we are not careful, the cost to the NHS of delayed discharges will be significant, particularly at a time when more and more hospital treatments can be offered as elective day treatments. Generally, people are spending less time in hospitals, so delayed discharges add particular cost to the NHS.

[Barbara Keeley]

I thank the hon. Gentleman for giving way again; he is being very generous with his time. Does he have any thoughts on the point that I made earlier about the Dilnot commission and the £35,000 that must be paid out by the individual in the shared-costs model, which does not recognise informal care? He is making the point that people are giving up work to become carers, which has a huge financial cost. They may be struggling to pay bills but, even so, when their loved one goes into a care home, they will still have to pay £35,000. There is no recognition of everything that they have done that has helped the state save money. Does he agree that that is not fair?

[Tony Baldry]

We all have to recognise that there is only so much, on a cross-party basis, that Ministers will be able to do in the White Paper, which I hope will come out next spring. If the White Paper contains a sustainable funding process for residential care, we will all consider that to be a substantial step forward. We must not forget, however, that a number of issues will still be relevant to carers, particularly because, in order to maintain costs and keep them down, most local authorities are trying to keep people at home for as long as possible. For example, in my constituency and in those of many of the other Members who are present, it was previously the case that frail, elderly, but mentally alert people lived at home, but that has become increasingly true of people with age-related illnesses such as dementia or Parkinson’s, and it will continue, because however much the funding for residential care is increased, there will still be that population at home.

Another point that I want to reinforce to the Minister—I am sure that he will take it on board—is that a number of organisations concerned with social care are in consensus in supporting the recommendations from the Dilnot commission, particularly the recommendation on protecting families from catastrophic care costs by capping lifetime care bills because, at present, families coping with long-term conditions can face bills of tens or hundreds of thousands of pounds to pay for home and residential care. There are fears of unaffordable bills forcing families to provide round-the-clock care, and two thirds of carers end up spending their own income to pay for the care of the person for whom they care.

Those of us on the all-party group on carers welcome the Dilnot commission’s clear recognition of the need for additional resources for social care, to overcome an historic shortfall and to recognise the growing demand. We need a new national system of eligibility and portable assessments to create a more standardised system across England and to remove some of the uncertainty that families face as they deal with different systems in different council areas. We also need a new awareness, advice, information and advocacy strategy, to help families plan for care and access private, state and voluntary sector support. I think that there is strong consensus on those points, and I hope that the Government will adopt the proposals in the forthcoming social care White Paper.

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[Heidi Alexander]

That is precisely the point. Families are asking questions about how this can happen. We need to have a fair system so that people know what to expect to pay for their care in later life, can have some peace of mind about it, and do not think that somebody else, who perhaps has a better knowledge of the system, can play it in a way that means that they do not have to pay out in the same way.

[Barbara Keeley]

My hon. Friend is speaking very well from her own personal experience about an issue that affects the whole country. Last week, one of my constituents questioned why he will have to pay all but £28,000 of the value of his father’s home—which, in Salford, was not a costly home—to pay for nursing care. He thought all along that nursing care should be paid for because it is nursing. He still does not understand it and is very distressed. I wonder if that example, and the example raised by my hon. Friend from her own experience, suggests that we need to get out there with this debate so that people do understand it and so that everybody is in the same place—as has been said, not just middle-class people who can plan, and people who have accountants—and knows what it might cost them and how to go forward and plan for it.

[Heidi Alexander]

I agree completely. I go back to what I said at the start of my contribution, which is that this is one of the biggest challenges we face as a society and as a country. We can talk about the crisis in the eurozone, international terrorism or climate change, but how we plan for the needs of our ageing population is incredibly important. It may not be the sexiest debate out there, but we need to get people talking about it so that they can understand and contribute to how we should legislate on this issue.

In conclusion, I was at the event that the Minister attended earlier, which was organised by the Greater London Forum for Older People. It was a packed Committee room, and I heard the Minister say that this Administration will not be the Government who do not face up to this problem, grasp the nettle and tackle it. I urge him to honour the commitment he made to the pensioners in that room. For far too long, we have not tackled this problem. I fear that it will be placed in the “too difficult” box. We have already heard the hon. Member for Banbury (Tony Baldry) talk about the need to publish the White Paper in the spring. I think the Dilnot commission report talked about a White Paper in December, so I put it to the Minister that perhaps we are already a little behind that timetable. The key issue, as I was discussing earlier with my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), is to have a Bill in the next Queen’s Speech. Will the Minister commit to that today? If he and the Government were to say that they will legislate on this matter in the next parliamentary session, that would be a sign that the Government take the issue seriously and that we can tackle the problem, which has, for too long, eluded us.

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[Liz Kendall]

I am under no illusion about the scale of the funding challenge to meet the needs of our ageing population. Funding the current, unfair and ineffective system of social care will cost £12 billion by 2025. The Dilnot proposals, on top of that, cost more than £3.5 billion. Dilnot is an important step that we want to have genuine talks about, but it will not solve the entire problem that we face about the future of social care. Yes, we can make a big difference by looking at how we join up health, social care, housing and other spending, but there are clear implications for all parties in taking the matter forward, and we all need to be aware of them.

[Barbara Keeley]

My hon. Friend is making a good argument, and I am heartened by what she is saying. However, if the implications that she has just helpfully outlined exist, the debate has to be taken out to people. If there are implications for taxpayers, they have to know what they are. Many Members who have spoken today have said that it is quite clear that people do not understand or plan for care, and then the costs hit them. The debate out there, in addition to the essential cross-party talks, is important.

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[The Minister of State, Department of Health (Paul Burstow)]

I congratulate my hon. Friend the Member for Truro and Falmouth (Sarah Newton) on securing the debate. By doing so, she has demonstrated the breadth and depth of her interest and expertise, and the breadth of interest across the House, in the issues. Such debates are not always as well attended as this one. As you rightly noted, Mr Bone, the Leader of the House also attended for a while to listen to our deliberations, which speaks volumes about the importance that the Government attach to the issue.

I am delighted that so many members and officers of all-party groups took part in the debate. This is the second time this week that I have had the pleasure of the company of the chairs and other officers from a number of those all-party groups. Earlier in the week, I hosted an event in the Department of Health with APG chairs to discuss with them their thinking about the way in which we need to respond to the challenging agenda and to input into shaping the White Paper that we will publish—in answer to the hon. Member for Banbury (Tony Baldry)—next spring. When I was asked at the meeting, I confirmed that we are aiming for April—that is what we mean by spring for this purpose—and I can reconfirm that today.

I very much agree with the remarks of the hon. Member for Worsley and Eccles South (Barbara Keeley), which were echoed in many contributions in this debate, about the need to have cross-party discussion and secure a cross-party agreement. One reason why we need to do that is that social care law has been very overlooked and neglected. The Law Commission report that came out this May quite rightly pointed out that our social care legislation has evolved over 60 years in a haphazard and piecemeal way. The confusing legal system is one of the reasons why social care has such a complex system, and why so many judicial reviews take place. We need a consensus to secure a legal reform that will last the test of time.

First, I would like to respond to some of the points made about the current situation of social care funding. I find it heartening that some of the points rehearsed in the debate acknowledged that the fragility of our social care system is not new—it did not start 18 months ago but is the pattern of many years, which we, as the coalition Government, are trying to address now.

I am not going to deny that things are tough, or that no council has had to make difficult decisions; it has not been an easy time for anyone. Difficult decisions have had to be made across Government because of the economic situation that we currently find ourselves in. However, the funding landscape is not as simple as I think some would like us to believe. The headline story of a Government intent on slashing social care services no doubt makes good copy, but it is not borne out by a closer examination of the facts.

In the previous spending review, which we announced last October, we provided an extra £7.2 billion over four years up to 2015 to protect social care, partly through councils and partly through the national health service. The aim was to alleviate the potential pressures on the adult social care system in what would be a challenging overall funding settlement for local government; that point has been rehearsed quite clearly by a number of colleagues in this debate.

We recognised that this year would be particularly tough. We have front-end loaded the funding for the first two years to insulate social care from cuts to local authority budgets, on which I will amplify a bit. Combined with a focus on efficiency, we believe that the additional funding that we have provided will enable councils to protect people’s access to care services. That is not just our view but the Local Government Association’s view, put forward in its submissions to the spending review. The King’s Fund also said in its report, “Social care funding and the NHS”, that central Government have put enough money in to protect adult social care services, provided that there are rigorous attempts to improve efficiency.

However, as the hon. Member for Leicester West (Liz Kendall) and other hon. Members have said, spending is falling. Budget data collected by the Department for Communities and Local Government from local authorities suggest that social care budgets are around £200 million lower than last year, which is a reduction of just over 1.5%. However, it is not inevitable that reductions in spending lead to cuts in front-line services. The hon. Member for Worsley and Eccles South quoted the Association of Directors of Adult Social Services, which had an interesting survey of their members that was published earlier this year. Boil it down a little further and what we find is that for every £1 that has been saved or taken out of spending in social care by local authorities, 70p can be attributed to efficiency savings. It is not about taking services out from the front line, but service redesign.

Yesterday, the Local Government Association released a prospectus inviting councils to take part in its productivity programme for adult social care. It said that there is scope for efficiency. In its foreword it said that if councils develop plans in line with policy objectives such as prevention and personalisation, they will minimise the impact of reduced funding for the front line, which is why I welcome the work that it is doing to recruit councils to its programme. From there, best practice can be shared with other councils to ensure that they are not making bad decisions when it comes to their budget choices.

[Barbara Keeley]

I understand the issues about efficiencies and the need to make changes such as the move to personalisation. However, from my experience—as I have said, I am in a local authority that is protecting social care—efficiency savings have caused our primary care trust to give up active case management for people with long-term conditions. Personalisation of personal budgets has meant that Age UK has not been able to conduct similar active case management for older people or to run drop-in centres for carers of people with dementia. Sometimes the change and the churn also cause loss. We have not touched today on the reorganisation of the NHS, but that has had an impact on things, too. I understand that we are in a system in which certain changes are good but can result in a loss of services that really impacts on people.

[Paul Burstow]

I am not seeking to hide or resile from that. What I am trying to do is demonstrate that the picture is not uniform or consistent. I want to quote some further evidence that supports that point of view, but first let me make it clear that of the £900 million that the ADASS survey identified as having been taken out of social care spend, 70p in every pound came not from cuts in front-line services but from service efficiencies and redesign. That very point was made by a number of hon. Members in the debate.