Social Care and Military Compensation

Jane Ellison Excerpts

Wednesday 25th March 2015 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

I am grateful to the hon. Member for Blackpool South (Mr Marsden) for bringing this important issue before the House. It provides me with an opportunity to clarify our current position. I hope the hon. Gentleman will allow me first to place the issue in the broader context, particularly the context of reforms in social care.

To make some sense of that broader context, at the turn of this century there were 25 times as many people aged 85 and over than there were at the turn of the last century. Although this is something to be celebrated, it also means there are more people needing care and support, and three quarters of us can expect to need long-term care.

Care and support is an issue that has, I think, been ignored for far too long, and I am proud to say that this Government have taken steps to put that right. The Care Act 2014 is a bold and historic piece of legislation that for the first time places adult care and support law in a single clear statute. The Act puts people at the heart of the system by enshrining the principle of individual well-being at its core. It will ensure that people themselves will be able to shape their care and support, focusing on what they want to achieve and the outcomes that matter to them, and it will support them to maintain their well-being and independence for longer.

The Care Act focuses on acting early to prevent people from reaching crisis points, and will ensure that everyone can access information and advice to help them understand the new system and what it means for them. This means services for the broader community—not just those with assessed needs—further supporting our aim to help people to stay independent for as long as possible. When we do need care, the Act provides for a single threshold for eligibility to care and support in England, ensuring transparency and consistency, irrespective of where we live. I am pleased that this historic legislation will come into force exactly one week from today.

We do not intend to stop there. How we pay for health care and support is just as important as the care we receive. Most people do not realise that care and support has never been free, unlike health, and we have always been asked to contribute what we can afford. Those who have the greatest needs and the longest care journeys risk losing nearly everything simply to meet that cost.

For all the other areas of life where we face such risks, we are protected by the welfare state or we can protect ourselves through insurance. When it comes to care, however, successive Governments have taken a different view. We are often left alone at the point when we are most vulnerable. That is clearly not good enough, and I am proud that we will be introducing the biggest reforms of how we pay for care in over 65 years. We do so through the cap on care costs, which will put an end to the risk of catastrophic costs, and we will provide greater financial help for those who need it most.

The detailed proposals of how the new system will work are currently out for consultation. With just under a week still to go, I am pleased that we have already had over 700 responses and have engaged with over 1,000 people through a series of events helping to ensure that we take account of a wide range of views. The new cap system will play a critical role in helping people to plan and prepare for the risk of needing care and support, and create the right conditions for the financial sector to create new products that could cover these costs.

When it comes to those who have served their country and have made a great sacrifice in the line of duty, this Government have given a very clear commitment to support members of the armed forces community, both serving personnel and veterans. The hon. Member for Blackpool South has illustrated exactly why that is the right thing to do. We have enshrined that commitment in legislation through the armed forces covenant.

As the hon. Gentleman outlined, for those who have been injured in the line of duty there are currently two different schemes that provide compensation, based on when the injury occurred. For those who were injured before the 6 April 2005, there is the war pension scheme; for those injured afterwards, there is the armed forces compensation scheme. While both schemes have the same goals—to offer financial support to those injured in the line of duty—they are ultimately both a product of their time and the social context in which they were developed. Under both schemes, personal injury compensation lump sums are disregarded when deciding how much someone can pay for care, provided the payments are placed in a trust—I noted the hon. Gentleman’s concerns about regular payments—but other sorts of payments may be taken into account.

The war pension scheme was created after the first world war in response to the large numbers whose lives had been irrevocably changed as a result of their service to their country. In 1918, however, there was no welfare state, no NHS and no benefits system. Most people did not have access to private pensions, meaning that for those needing care but without family or friends to support them, the outlook was often bleak. The scheme therefore provided for that. It provides a basic war disablement pension and a variety of supplementary allowances that would be equivalent to the modern benefits system, and it reflects the fact that people needed to pay for both health and care costs.

By contrast, the armed forces compensation scheme introduced in 2005 reflects the fact that we have an advanced welfare state. It therefore looks to the NHS and the benefits system to provide support, just as it would to anyone, ensuring the principle of “no disadvantage” enshrined in the armed forces covenant.

The scheme introduced a modern, fair and simple system that provides a strong basis for the future, but this is a difficult and complex issue. I note the hon. Gentleman’s frustration—as he said, there has been much discussion—but, as I have said, the issue is complex. Depending on the extent of their injuries, veterans can receive a number of different allowances under the war pension scheme, such as constant attendance allowance, an unemployability supplement, comforts allowance, age allowance, treatment allowance, mobility supplement, and medical expenses.

The Royal British Legion broadly accepts that the treatment of war pension scheme payments is complex. I am grateful to it for highlighting its concerns, and for continuing to working with departmental officials to help us to understand the issue better. It is vital for us to understand it fully before considering what is to be done next. We must understand how the two schemes work, and the implications of considering any changes, to ensure that there are no unintended consequences, and we must also understand any cost implications of change. I note what the hon. Gentleman said about the commitment of his party colleagues to reviewing the scheme, but that commitment to a review suggests that they too are cautious, and feel the same need to understand the possible implications.

[Mr Marsden]

I do not wish to intrude on the Minister’s time, and I agree that the process is complex. I recall Churchill’s observation that it was not the end or even the beginning of the end, but it might be the end of the beginning. Will the Minister tell us how far down the line we might be expected to be at this point, and what stage the Government think has been reached?

[Jane Ellison]

I will come to that, and will try to give the hon. Gentleman a bit of reassurance about the advanced and ongoing work that is taking place.

Social care is a priority for the Government, and, in the context of difficult spending decisions, we have taken steps to protect care and support services. For example, we have allocated extra funds for those services during the current Parliament. We have created a better care fund, which, next month, will introduce a £5.3 billion pooled budget for health and care that will provide much needed funding for care and support, and will break new ground in driving closer integration of services.

Although spending on care and support is ultimately a decision for local government, we must be mindful of the overall fiscal position. I think that Members on both sides of the House agree on that. We must ensure that if we change the charging rules nationally, the cost will be met. To that end, my officials are continuing to work with their counterparts at the Ministry of Defence—I hope that that gives the hon. Gentleman some sense of momentum, and deals with his concern about “silo” working—and with the Royal British Legion, with a view to considering the issue during the spending review that will take place after the election.

I hope that the hon. Gentleman—and, indeed, all hon. Members—will welcome the historic reforms that will come into force in just one week’s time. They are very significant in the context of the broader issue of care. This Government have been the first to prioritise care and support. I hope that Members in all parts of the House will feel able to welcome the clear plans that I have set out for the future. As for the specific issue that the hon. Gentleman has raised, I hope he recognises that this is ongoing work which is taken very seriously. His securing of what has turned out to be the last Adjournment debate of this Parliament has underlined the importance of the issue that he has raised. I think that, throughout the purdah period and beyond, the debate will give added momentum to the work that is being done.

Given that this has been the last Adjournment debate of the current Parliament, Madam Deputy Speaker—and you and I have shared a number Adjournment debates—let me take this opportunity to thank you and, through you, Mr Speaker and the other Deputy Speakers. I also thank all the staff of the House, and, in particular, those who have sat through some of our late-night health debates, of which there have been many. However, I especially thank the Chair, and all those who have supported the Chair during these important Adjournment debates, which give us a chance—as tonight’s debate has—to explore important issues in some detail, outside the heated atmosphere that the Chamber attracts on other occasions. I also thank Members in all parts of the House, some of whom are very regular attenders at these debates, for their attendance tonight, and for the interest that they have taken in these important matters.

[Madam Deputy Speaker (Mrs Eleanor Laing)]

I thank the hon. Lady for the gracious way she has thanked Officers of the House in respect of Adjournment debates. These debates are extremely important and she has taken part in many of them, as have I and the other Deputy Speakers and Mr Speaker, and we all appreciate how important they are. I also thank the hon. Member for Blackpool South (Mr Marsden) for introducing the final Adjournment debate of this Parliament.

Question put and agreed to.