(12 years, 1 month ago)
Commons ChamberThe Minister, as always, sought to present a positive picture of his proposals, but I continue to be struck by the internal conflicts of the White Paper.
The whole thrust of this Government has been to shrink the state, but Dilnot will clearly expand it. The Chancellor, who torpedoed Labour’s social care proposals just before the last election by claiming that they represented a death tax, is now supporting his own death tax, only this time it will be £35,000 to £50,000, as opposed to Labour’s £20,000. Now the Chancellor has once again sabotaged a fair and reasonable inter-party settlement, which is plainly needed, by abruptly breaking off the talks and introducing a pretty vacuous White Paper with no costs in it—or, to use the words of Sir Alec Douglas-Home in 1964, a menu without the prices.
Furthermore, the Chancellor clearly wants the adult social scheme to be voluntary—I think this is what lies behind many of the difficulties—but the sums add up only if there is compulsory risk pooling. Yet the Chancellor—it is he, rather than the Secretary of State, whom we must deal with—still will not face up to the ineluctable logic of a mandatory adult social care system, and he is still trying to dodge it in two rather unscrupulous ways: first, he is kicking it into the long grass by postponing it to the uncertainties of the next spending review in 2014, even though gross neglect is endemic and reform is needed urgently; and secondly, he is evading today’s realities by ignoring any need for upgrading standards. The Minister referred to upgrading standards, and clearly he wants to, but the means with which to do so are incompatible with the White Paper. The Treasury’s £1.7 billion is purely a dead-weight cost to protect family inheritances. It takes no account of rising care costs or the imperative need to lift care standards, which in many cases shame a civilised society.
This is where we come to the crux of the matter. At present, many local authorities pay only for 15-minute or 30-minute visits, and many do not pay for the journey time, even though that is part of the contract, or the petrol costs, which care providers are obliged to provide themselves. Frankly, it is impossible in 15 or 30 minutes to get an elderly and often infirm person out of bed, to clean the sheets, which may well be soiled, to get him or her dressed, washed and fed, to clean and tidy up and, of course, to engage in some kind of conversation to generate some decent human relationship. Equally, it is impossible, as my hon. Friend the Member for Leicester West (Liz Kendall) pointed out, with the minimum wage rates paid by local authorities because of their squeezed budgets—a funding shortfall of at least £1 billion this year—for care providers to offer the higher standards the Minister talked about and which they want to provide and which the service users deserve.
How is the big black hole in the White Paper to be dealt with? The Local Government Association says that the gap between the money available this year and the predicted cost is about £1.4 billion, stretching to £16.5 billion by 2020, when spending on social care will exceed 45% of council budgets. Against that shortfall, the £300 million of extra funding announced by the Secretary of State in his statement last Wednesday looks derisory.
This dilemma is by no means insoluble. The long-term costs of Dilnot are estimated at about £3 billion a year. In his Budget four months ago, the Chancellor had a choice in the allocation of precisely such a sum, but he decided to spend it on the top 1% earning more than £3,000 a week by cutting the 50p rate of tax. For the same amount of money he could have funded Dilnot in full, but for this Chancellor the priority are the super-rich, not the elderly, infirm or disabled people in need of social care. The long-term answer to this problem is the introduction of a new social insurance scheme.
(12 years, 11 months ago)
Commons ChamberExtremely briefly, I want to put on record my view that the Government’s handling of this Bill has been a monumental abuse of the principles of accountability in this House. It was sprung on an unsuspecting nation after an election in which there was no mention whatsoever of these proposals, after an air-brushed Cameron advert said, “I will cut the deficit, not the NHS.” Despite those misleading signals, there has been no commission of inquiry to examine its philosophy or ideology, no proposal to pilot it—
(13 years, 2 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
My hon. Friend is right to draw attention to that. It is oft commented in the financial pages of our media that that is one reason why this company is in this position and why such a restructuring is necessary. However, I take heart from the joint statement that was issued yesterday following the meeting between the landlords, the company and the lenders. It suggests that a clear route map is being worked out that will ensure continuity of care. That is what all Members of this House must want. We must all be interested, ultimately, in the welfare and interests of the residents in those homes.
But is it not absolutely clear that the business model deployed at Southern Cross—selling off 750 freehold properties at colossal profit and then leasing them back, the state paying the fees to meet those rents, and the rental income being siphoned offshore by the landlords into tax havens, leaving the homes grossly underfunded for many years, with 164 homes failing basic CQC standards—is a national disgrace that must be replaced? Does that not mean that the Prime Minister’s commitment to sell off all public services to any willing provider must now be abandoned?
I think we need a reality check. About 78% of care in the social care sector in England is provided in the private sector. That transfer to the private sector has not happened just in the past 12 months; it is the product of successive Administrations’ policies over many years. We must draw lessons from the experiences of the last few months, but we must focus on the paramount interests of residents and ensuring that this restructuring is successful. That is what I am focused on.
(13 years, 2 months ago)
Commons ChamberMy hon. Friend is absolutely right, and that may be why Opposition Front-Bench Members have not told us whether they agree with the Future Forum. The truth is that they know they have to agree with it, because it makes good sense, but they are also trying not to let their political opportunity drift away from them. People will be deeply disappointed, and in some cases angry, that they cannot abandon trying to turn the NHS into a political football.
Will the new, revised GP consortia still be allowed to outsource commissioning, either in whole or in part, to private health care firms, many of them probably American, which would create a major conflict of interest?
(13 years, 2 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
My right hon. Friend poses a number of questions that are at the heart of the various current inquiries. He is right to say that to focus solely on the CQC is to miss the point, as the primary responsibility rests with the provider organisation to recruit, train and supervise the right staff in the first place. He is also absolutely right to ask about the role of the commissioners and the professional regulators. Those are the issues that we are looking at and will examine, and I will come back to the House with answers in due course.
As the CQC has been forced, by Government cuts, to reduce its inspections by no less than 70%, how are the Government going to prevent similar abuses from occurring elsewhere and going uninspected and undiscovered unless someone happens to blow the whistle or offer undercover photographic evidence?
Let me start by addressing the whistleblowing issue. Terry Bryan, the whistleblower in this case, is to be applauded for his tenacity in pursuing it. The Government have been clear about the need to strengthen the arrangements and safeguards for whistleblowers, because that is an essential first way in which we can make sure that the system protects those who are vulnerable. The right hon. Gentleman suggests that the Government have in some way cut the number of inspections, but he should reflect back to 2008 when his Government introduced the current mandate for the CQC and changed the basis on which it would inspect. That is what led to the changed inspection system. Perhaps he should ask some questions about that as well.
(14 years, 1 month ago)
Commons ChamberGiven the transfer of £70 billion of NHS funds from PCTs to 500 GP consortiums, the vast majority of which have neither the expertise nor the inclination for such a huge administrative task and will have to buy in specialists from the private sector to do it for them, is not it clear that the real motive behind the reforms is to enable US multinational corporations, such as UnitedHealth, or UK corporations, such as BUPA or Virgin, to parcel out health care to the private sector on a vast scale?