Care (Older People)

Debate between David Simpson and Tracey Crouch

Tuesday 6th September 2011 Westminster Hall

[Tracey Crouch (Chatham and Aylesford) (Con)]

Thank you very much, Mr Streeter, for calling me to speak. It is a pleasure to serve under your chairmanship for, I believe, the first time, which is an honour.

I am grateful for the opportunity to hold this important Adjournment debate on care and services for older people. As part of the younger generation of MPs, I am proud to initiate a debate on a subject that I hope will be of interest not only to those who are in their third phase of life but to the next generation and to the generation after that who will one day find themselves in need of care and services. The statistics show that those of us who are in our thirties will fuel the ticking time bomb that is the ageing population, so it is incumbent on us to try to provide solutions to meet this challenge.

My initial interest in care for the elderly stemmed from my late grandmother, who worked in community care for much of her life. She strongly believed, as I do, that people want to live in their own home and community for as long as they can physically do so, and that the delivery of certain services can prevent people from entering residential care, which benefits both them and the state. It was with that in mind that I chose such a wide-ranging title for this debate. It is very easy to focus entirely on the issue of funding care, but there is more to looking after our older generation than the issue of how to pay for their care. Services for older people, whether delivered by volunteers, charities or local authorities, also need our attention if they are to be developed and improved.

I want to start, however, by expressing my very strong support for the campaign to appoint an older people’s Minister. I believe that if that post had a cross-departmental remit, as there is for equalities or for women and equalities, it would be of huge value to the Government. Some of the issues to which I will refer do not fall within the portfolio of the Minister of State, Department of Health, the hon. Member for Sutton and Cheam (Paul Burstow), and although I have the greatest respect and admiration for what he is doing to improve social care, he is not responsible or accountable for issues such as transport policy, local authority spending or the provision of financial products and education.

Having said that, if the Government maintain their opposition to the creation of another ministerial post, perhaps they would consider two other options. First, we could establish a new Cabinet Committee on older people’s issues that would effectively scrutinise emerging policies. Secondly, we could consider introducing a new test within regulatory impact assessments that would specifically examine the effect of proposals on the over-65s, as other tests do for other defined sectors of society. We need to pay much closer attention to the impact of national Government policies on the older generation, and I believe that a Minister for older people or a new Cabinet Committee would help to do that. However, there should also be a far greater assessment of the impact of policies at local level and I would welcome the Minister’s views on that matter when he responds to the debate.

The publication of the report of the Commission on Funding of Care and Support—the Dilnot report—was welcomed as a much-needed examination of how to fund care in the future. It is an accepted fact that we are all living longer and that our care needs are greater but that funding in social care has not increased by anywhere near enough to match our requirements. Significant demographic change is not something that should surprise us—it has been predicted for many years—yet the long-term care system has remained unreformed. Dilnot’s findings are very sensible, and hopefully they will achieve the better and fairer funding system that we need. However, there are some questions that arise from the report that I hope the Minister will address.

The Commission set out a reasonable timetable for the implementation of reforms. If we are to begin a new programme of funding, one that should perhaps be aligned to some of the other changes affecting future pensioners, we need to ensure that legislation is passed soon. It may be brazen for me to say so as a new MP, but Governments of all colours appear to be adept at pushing difficult issues into the long grass and waiting for the next Government to address them. We are seeing that at the moment on public sector pensions, which is another ticking time bomb issue that was ignored for decades; dealing with it now will cause more pain than if it had been dealt with sooner. We must not let the funding of social care become the next big but continuously ignored problem.

With that in mind, I should be grateful if the Minister provided us with an update on the public consultation on the Commission’s proposals and told us when he will publish the White Paper on social care. Does he expect a Bill on this issue to be included in the 2012 Queen’s Speech and will implementation of changes to funding begin in 2013, as per the Commission’s timetable? It would help all of those who are involved in delivering care and those people who are planning for their retirement if we received some clarification at the earliest opportunity about the timetable for implementing the Commission’s proposals.

The Dilnot report rightly focuses on the issue of financial advice, guidance and product availability. It is estimated that about 130,000 people enter residential care each year. Under the current system, around 41% of those people are self-funders—in other words those who have assets exceeding £23,250. The increase in the threshold will raise that figure to £100,000, but given how much wealth is tied up in fixed assets such as housing, that will not necessarily change the numbers dramatically.

I am concerned that self-funders deplete their assets paying for care and end up becoming reliant on local authorities for future care funding. Earlier this year, the Local Government Information Unit estimated that a quarter of all self-funders fall back on the state, costing local authorities up to £1 billion per year. The unit’s own report indicates that key decision makers in councils are unaware of the problem or underestimate its cost by 50%. I was shocked to read that 61% of authorities did not know how many self-funders they have or how many self-funders fall back on state funding.

While we need to improve local authorities’ understanding of funding liabilities, it is also clear that those who are in a position to fund themselves need much better financial advice and planning to mitigate the premature exhaustion of funds. Dilnot mentions the variety of financial products that are available, and I should say at this point that although I entered Parliament after working for an insurance provider I have no registered interest in the sector. Nevertheless, from my time in the industry, I think that it is fair to say that there is an appetite for providing products in this area, but the market is not as wide or as competitive as it could be.

I recently met representatives of Partnership, a provider of immediate needs annuities, which is a product to which Dilnot refers to in his report. Like the Dilnot report, Partnership made it very clear that there is a need for improved advice and education. Raising awareness of long-term care needs is essential, not least because people’s expectation is that when they get old they will be looked after for free. I am not convinced that the Dilnot report changes that expectation. Although care costs will be covered, the so-called “hotel costs” of food and board will not be covered, so we need to improve individuals’ understanding of what they will be required to fund themselves.

[David Simpson (Upper Bann) (DUP)]

I thank the hon. Lady for giving way and I congratulate her on securing this very important debate. I have not read the Dilnot report, but I understand that it indicates that we may have to increase taxes or cut public spending to provide care for senior citizens. All right-thinking hon. Members will agree that it is paramount that we provide that care. I may have misunderstood the hon. Lady, but is she suggesting that we should consider having some form of insurance policy to provide for future care rather than increasing taxes or cutting public spending?

[Tracey Crouch]

I am suggesting that we need to look at various ways to fund care in future. I believe that a market exists for this type of care insurance. There are people who can afford to take out such insurance, but they do not necessarily know that there are products out there that could prevent them from having to fall back on the state. For example, they could afford to take out a premium. It may be a hefty premium at the outset, but it could prevent them from draining all the assets from their home and then relying on state funding for residential care. Such insurance policies are certainly an option that we should look at, and indeed Dilnot himself looks at the financial services sector as one that could relieve some of the burden on state funding.

Alcohol (Minimum Pricing)

Debate between David Simpson and Tracey Crouch

Wednesday 2nd February 2011 Westminster Hall

[Tracey Crouch (Chatham and Aylesford) (Con)]

I am delighted to speak under your chairmanship, Mr Sheridan. I congratulate the hon. Member for Blaenau Gwent (Nick Smith) on securing this important debate. As vice-chair of the all-party group on alcohol misuse, I believe that this is an incredibly important issue for all hon. Members, and I welcome the Government’s commitment to tackling the serious issue of alcohol abuse. The proposal to introduce a minimum price for alcohol is undoubtedly a small step in the right direction, although I say that having listened to the hon. Member for Leeds North West (Greg Mulholland), who says the opposite.

I want to say clearly and early in my contribution that minimum pricing is just one aspect of what must be done to deal with increasing dependency on alcohol. I look forward to future statements by the Government on their alcohol strategy. In my view, treatment and rehabilitation services in this country are poor, availability is limited and service is disjointed across agencies. Little is done to help individuals and families ripped apart by alcoholism. The availability of cheap alcohol has undoubtedly encouraged the kind of drinking and antisocial behaviour that blights town centres each weekend. A culture, which is exclusive in many respects to British streets, has emerged in which it is fashionable to drink more than one is capable of. As a consequence, ill health and antisocial behaviour have become common.

The cost to the NHS of alcohol-related harm resulting from that culture is alarming. The statistics are well known, but one indication of strain on the NHS can be seen in the proxy services dedicated to treating binge drinkers. An SOS bus patrols Medway towns on Friday and Saturday nights, providing services to inebriated revellers. I visited it recently, albeit early in the evening, as I did not particularly want to see the consequences of heavy drinking. The dedicated volunteers are amazing and divert pressure away from the blue-light services, keeping vulnerable and very drunk youngsters safe. I certainly intend to try to protect that service during these financially constrained times, but it is a sad indictment of our weekend drinking culture that it is needed in the first place.

On minimum pricing, evidence points to a link between cost and sales. The theory is, obviously, that as cost rises, demand will fall. That might be a basic economic mechanism, and in principle it should make minimum alcohol pricing an effective policy for driving down dangerous levels of alcohol consumption, but the decision to set the base at the low rate of duty plus VAT is clearly controversial, and it remains to be seen whether it will work.

I share the concerns expressed by colleagues and others that such a policy will do little to help our beleaguered public houses, which must now compete with supermarkets rather than each other. I was interested to hear the price statistics quoted by my hon. Friend the Member for Burton (Andrew Griffiths), but I do not believe that the proposal will help tackle long-term alcohol dependency. It will be a small step in the right direction, if its aim is solely to clamp down on aspects of binge drinking such as pre-loading, which other hon. Members have discussed and the sole motivation of which is keeping the costs of a night out to minimum. Most leave their homes already very drunk, which prompts the question why they are allowed to continue consuming alcohol in licensed premises having already drunk enough before they arrive. As others have pointed out in this debate and others, one of the good things about public houses is that responsible landlords tend to prevent overly drunk and disorderly behaviour by stepping in and refusing to serve those whom they believe have had enough to drink.

As my hon. Friend, drawing on his experience, has pointed out, minimum pricing will, in theory, abolish the deep discounting that encourages that kind of drinking, thus equalising the cost of a night out and driving down alcohol consumption. However, the low minimum price proposed will only stop the very worst cases of discounting, and it may play out differently in practice. Therefore, bolder proposals should still be considered, targeting specific drinks associated with binge drinking, such as strong lagers, white ciders and alcopops.

It is important that we in this Chamber give credit where it is due. I was pleased to learn that Heineken, which produces White Lightning, recently discontinued the product due to its binge-drinking connotations. It should be commended for acknowledging the need to reinforce its stance on responsible drinking.

We must consider the limited scope of the policy and the likelihood that it will make headway only with a certain type of drinker. There is a growing dependency culture, and it is often hidden behind the closed doors of houses throughout the country. They are difficult to identify and affluent enough to absorb any increase in price, especially something as low as duty plus VAT. However, just because the minimum price does not impact upon them directly, that does not make them any less of a concern or any less dependent on alcohol and at risk of serious health issues in years to come. Current research reinforces that concern, because wealthy districts dominate the top of hazardous-drinking league tables. Although minimum pricing will target the binge drinkers who do it on the cheap, it is clear that it will do little to tackle alcohol dependency as a whole.

I appreciate that the Government have to balance their strategy of introducing a policy that meets their stated aims of reducing dangerous levels of alcohol consumption while not penalising the vast majority who enjoy alcohol sensibly. The question is: does this minimum price do that?

The pricing of alcohol is only part of the problem. It must be introduced in conjunction with a review of the late-night licences available to establishments, stricter alcohol-control zones and a close examination of the quality of treatment and rehab offered to those with a high dependency.

[David Simpson]

Will the hon. Lady join me in congratulating the Scottish Health Minister, who introduced a price structure in relation to vodka last September? As has been mentioned, the minimum price used to be £7.97, but it is now £11.81 under the new structure, which also applies to some beers. We encourage all the regions, including the Northern Ireland Assembly, to do the same.

[Tracey Crouch]

I thank the hon. Gentleman for his intervention. I have read about the new proposals in Scotland, which are currently being debated. We should look at what is happening in Scotland. Indeed, we should have looked at what was happening there in relation to the 24-hour drinking culture before it was introduced here. The evidence that the police had gathered in Scotland should have been made available to the previous Government before they introduced the licensing extension.

In conclusion, we need to engage with the professional classes and young adults who regularly drink to hazardous levels, and target those establishments that prop up the binge-drinking culture through irresponsible sales and business practices. If we can in any way reduce the weekend strain on the NHS, the police and the local authorities that clear up the mess created by binge drinking, we can certainly hail this as a small step in the right direction. However, in order to reduce dependency on alcohol across the board and to stem the devastating effects that it has on the lives of individuals and families, let alone its financial cost to society, so much more needs to be done.