Southern Cross Healthcare

Paul Burstow Excerpts

Tuesday 6th September 2011 Written Statements

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

I wish to update the House further on the situation regarding Southern Cross Healthcare.

Throughout, the Government’s overriding concern have been for the welfare and safety of the 31,000 residents in Southern Cross’s care. We are clear that this must be the paramount concern for all parties involved in the discussions about the future of the company.

Over the summer, officials have kept in close contact with Southern Cross’s senior management, landlords and lenders as the negotiations to achieve a consensual and solvent restructuring of the business have developed.

I have previously told the House that the intention is that the company will be wound up and its business transferred to other care operators. This will be done in such a way as to have minimal impact on the residents and staff of those homes. Until a new operator is registered and takes over the services in any care home. Southern Cross will continue with full responsibility for continuity of care.

In the last month, each of Southern Cross’s landlords has been considering which new care operator it will work with. Those discussions have progressed well and now all bar a handful of landlords are coming to the end of finalising the commercial arrangements that will apply in future. Within the next few weeks, we expect agreements to be signed that will effect the transfer of the business and assets of each home operated by Southern Cross to the new operators. The expectation is that formal transfer of care homes will be achieved in two waves, with around 330 homes transferred at the end of September and the remaining 400 homes transferred at the end of October. At that point Southern Cross will no longer be responsible for providing care anywhere in the country and the company will be wound up. Throughout, the Government have strongly urged all parties to agree their plans as swiftly as possible so as to offer reassurance to residents, staff and families. The company has informed all Southern Cross staff, together with residents and their families, of these plans in order to provide reassurance.

Last week, the Association of Directors of Adult Social Services published information for each of Southern Cross’s homes about the position it has reached in its transition to a new care operator. The information also included details of any inquiry or helplines set up locally or regionally by the company and by local authorities which can be accessed if further information is needed. As the new care operators are settled, their names will be added to the information. Within the next few weeks we expect the complete picture to emerge for each care home, and it will be clear who is the landlord and who is the new operator. Members may wish to draw this information to the attention of any constituents that are concerned or have relatives in Southern Cross’s homes. A link can be found at:

www.dh.gov.uk/health/2011/09/transfer-of-southern-cross-healthcare-to-new-operators/

The process to register the new care operators with the sector’s regulators in each part of the United Kingdom and to cancel Southern Cross’s registration has begun. No transfer of homes will take place without new operators having been approved and registered. Alternative operators will need to demonstrate to the regulator that they are capable of delivering high-quality care and of meeting all regulatory standards in the homes they take over. It is important that this process moves quickly and smoothly and, in respect of operators in England, the Care Quality Commission have assured us that they have the resources to complete the necessary regulatory work in time. However, regulators will not lower the regulatory threshold or reduce the rigour of the registration process to achieve that. Standards will not be compromised.

I understand that staff consultation under the TUPE regulations has also commenced and that the staffs elected representatives and the incoming operators are to be invited to attend a series of meetings to discuss these arrangements.

Notwithstanding the good progress that has been made, it is important that I restate the Government’s commitment that whatever the outcome, no one—state-supported or self-funded—will find themselves homeless or without care. We remain in close touch with the Association of Directors of Adult Social Services to ensure that in all parts of the country they are ready to respond to any potential disruption to the continuity of care and to ensure that all residents are protected.

I have previously told the House that the Government will be considering what measures may need to be put in place to prevent similar situations from arising again. Options for financial regulation or other measures will be considered as part of the development of the forthcoming White Paper on social care. To that end, we will shortly publish a policy paper setting out an analysis of the possible options and seeking views.

I will update the House as the situation develops.

Suicide Prevention (Consultation)

Paul Burstow Excerpts

Tuesday 19th July 2011 Written Statements

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

Today I am publishing a consultation on a new suicide prevention strategy for England. “Consultation on preventing suicide in England: a cross-Government outcomes strategy to save lives”, has been placed in the Library. Copies are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office. The document is also available at: www.dh.gov.uk/en/Consultations/Liveconsultations/DH_128065.



Suicide rates in England have been at a historical low recently and are low in comparison to those of most other European countries. However, there were still nearly 4,400 suicides in England in 2009, the latest year for which national data are available.

Suicides are not inevitable. An inclusive society that avoids the marginalisation of individuals and which supports people at times of personal crisis will help to prevent suicides. Government and statutory services also have a role to play. We can build individual and community resilience. We can ensure that vulnerable people in the care of health and social services and at risk of suicide are supported and kept safe from preventable harm. We can also ensure that we intervene quickly when someone is in distress or in crisis.

In developing a new national all-age suicide prevention strategy for England, the Government have built on the successes of the earlier strategy published in 2002. Real progress has been made in reducing the already relatively low suicide rate to record low levels. One of the main changes from the previous strategy is the greater prominence of measures to support families—those who are worried that a loved one is at risk and those who are having to cope with the aftermath of a suicide.

There is no single approach to suicide prevention. It needs a broad co-ordinated system-wide approach that requires input from a wide range of partner agencies, organisations and sectors. People who have been directly affected by the suicide of a family member or friend, the voluntary, statutory and private sectors, academic researchers and Government Departments can all contribute to a sustained reduction in suicides in England.

The draft strategy sets out our overall objectives:

a reduction in the suicide rate in the general population in England; and

better support for those bereaved or affected by suicide.

We have identified six key areas for action to support delivery of these objectives:

reduce the risk of suicide in key high risk groups;

tailor approaches to improve mental health in specific groups;

reduce access to the means of suicide;

provide better information and support to those bereaved or affected by a suicide;

support the media in delivering sensible and sensitive approaches to suicide and suicidal behaviour; and

support research, data collection and monitoring.

The new health and wellbeing boards will become the local forum for determining local needs. These boards will be able to support suicide prevention by bringing together local authorities, clinical commissioning groups, directors of public health, adult social services and children’s services and local Health Watch. This presents a unique opportunity for local agencies to look at the wider context and agree how best to marshal resources across agencies to have the greatest positive impact on local health and wellbeing.

The draft strategy has been developed with the support of leading experts in the field of suicide prevention, including the members of the national suicide prevention strategy advisory group, under the chairmanship of Professor Louis Appleby CBE. I would like to thank all members of this group for sharing their knowledge and expertise.

The consultation period will close on 11 October 2011.

Southern Cross

Paul Burstow Excerpts

Tuesday 19th July 2011 Written Statements

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

I wish to update the House further on the situation regarding Southern Cross Healthcare.

As I have always made clear to the House, the Government’s overriding concern is the welfare and safety of the 31,000 residents in Southern Cross’s care. We expect all parties to work together to secure a consensual, solvent restructuring of the business that meets their collective responsibility to secure the welfare and care of residents. I am pleased to see that Southern Cross, its landlords and lenders continue to share that view.

Officials continue to maintain close contact with Southern Cross’s senior management, landlords and lenders. Government continue to be actively involved in discussions with all parties. When I last updated the House on 12 July, Southern Cross had the previous day announced their expectation that the end of the restructuring process would see the operation of all the company’s care homes being transferred to the landlords and alternative providers of care. This represents a step in the ongoing process, agreed between the company, its landlords and lenders on 15 June, for a consensual, solvent restructuring. Discussions to resolve the remaining steps continue.

I appreciate that residents, families and staff are anxious to know what will happen next. Let me repeat the assurances I have given to the House previously: whatever the outcome, no one—state-supported or self-funded—will find themselves homeless or without care. We have made clear to all parties involved in the restructuring discussions that they have a collective responsibility to ensure a way forward that covers all homes and assures continuity of care. In addition, we will continue to work with the Association of Directors of Adult Social Services, the Local Government Association, the Care Quality Commission and others to ensure that they are ready to respond to any potential disruption to the continuity of care and to ensure that all residents are protected.

The announcement made on the 11 July by Southern Cross has no immediate effect on the provision of care or the operation of care homes. Southern Cross remains in operation, and will continue to operate all its care homes until transfers to new operators have taken place. I understand that this process is expected to be completed by the end of October or earlier. That does not mean however that it should take that long to make clear what each landlords plan is and how homes will be run by new operators.

Each of Southern Cross’s landlords is settling its arrangements regarding which care home operators to work with. This is a key part of the ongoing discussions. The Government are strongly urging all parties to set out their plans as swiftly as possible so as to offer reassurance to residents and families. As these arrangements are finalised, we understand that updates will be issued. NHP the biggest of the landlords, owning 249 Southern Cross homes, announced its plans on 18 July to contract with an alternative provider of care and to transfer Southern Cross care home staff. The Department is being kept up-to-date on developments.

I want to make it absolutely clear that no transfer of homes will take place without new operators having been approved and registered by the Care Quality Commission. Alternative operators will need to be reputable and experienced care providers that can satisfy the CQC that they are capable of delivering high-quality care and of meeting all regulatory standards. A number of landlords which will take over the running of Southern Cross homes are already registered with CQC as care providers in their own right and there are established processes to allow these providers to extend their current registration to include additional homes.

For providers not currently registered with CQC, it will require a new application, which will be subject to full scrutiny and a determination of fitness to provide the service. CQC is committed to ensuring continuity of care, but it will not lower the regulatory bar or reduce the rigour of the registration. CQC’s principal concern is the safety of service users and it will not compromise on the standards required. I have been assured that CQC will ensure that resources will be made available to handle any registration work that is needed and they have been working with Southern Cross for some time to prepare for this.

The transfer of care homes to alternative operators will be a managed process that ensures continuity of services. The company has withdrawn its statutory redundancy notice and given an undertaking to care home staff that they will transfer to new operators on their current terms. All parties involved in the negotiations have given a clear commitment that the continuity of care will be paramount throughout the process.



For the future, I would like to assure the House that the Government will be considering what measures may need to be put in place to prevent similar situations from arising again. Options for financial regulation or other measures will be considered as part of the development of the forthcoming White Paper on social care. The Department of Health is already working with the Department of Business, Innovation and Skills to consider ways to ensure a diverse and dynamic social care market, but with the right safeguards for stability and continuity of care. I will update the House as this work develops.

With the forthcoming recess, I appreciate that hon. Members will want to be informed of developments. I undertake to write to hon. Members to keep them informed as the matter progresses.

Winterbourne View and Castlebeck Facilities

Paul Burstow Excerpts

Monday 18th July 2011 Written Statements

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

I promised to update the House about ongoing activity in relation to Winterbourne View private hospital.

The House will wish to be aware that the Care Quality Commission (CQC) has today published its compliance report on Winterbourne View.

All patients have now left the premises and Winterbourne View is now closed. CQC undertook a responsive review of Winterbourne View following the abuse uncovered by Panorama. This review found serious concerns about the safety and quality of the service and CQC decided to take enforcement action to remove Winterbourne View from Castlebeck Care’s registration, closing the service permanently. CQC regulatory action in relation to Winterbourne View concludes with the publication of the compliance report today.

CQC has now inspected all Castlebeck Care services in England (23 in total). Individual reports on the findings are being drafted. These reports will be published separately and followed up with appropriate regulatory or enforcement actions where necessary. The final summary report and individual reports will be available on the CQC website by the end of July.

CQC’s own internal review is progressing with interviews of staff involved currently taking place. This information will provide the evidence for CQC’s individual management review as part of the serious case review, led by south Gloucestershire council. The internal review is expected to be completed by late summer.

CQC will be carrying out a focused inspection programme which will review care provided for people with learning disabilities by hospitals. The review will be in two phases:

phase one will consist of the inspection of 150 services that provide care for people with learning disabilities;

phase two will use the learning from phase one to look at a sample of other registered services covering alternative models of provision for people with learning disabilities.

South Gloucestershire council has appointed Margaret Flynn, chair of the Lancashire safeguarding adults board, as independent chair of the serious case review and the rest of the panel are now in place.

The panel for the NHS serious untoward incident review has been appointed with members from NHS South West, NHS South Central and NHS West Midlands. The review will be led by Dr Gabriel Scally, South West Regional Director of Public Health.



Arrangements are being put in place for family, carers and self advocate representatives to be involved in the review as part of a reference panel.

The first phase of the review has started. This involves gathering information from all commissioners of care and treatment at Winterbourne View since 2006.

The Department of Health review will be led by Bruce Calderwood, Mental Health and Learning Disability Director. The review will be advised by a panel of experts including Professor Jim Mansell, Mark Goldring and Anne Williams. Its activities will be informed by the views of service user and carer representatives including the National Forum for People with Learning Difficulties, the Challenging Behaviour Foundation and the National Valuing Families Forum.

I have today placed in the Library a copy of the Winterbourne View compliance report. Copies are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office. I will update the House further at the earliest opportunity.

Oral Answers to Questions

Paul Burstow Excerpts

Tuesday 12th July 2011 Commons Chamber

[Roberta Blackman-Woods (City of Durham) (Lab)]

15. What assessment he has made of the conclusions and recommendations of the recent report by the Commission on Funding of Care and Support.

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

As the Secretary of State said in his statement to the House last week, the Government welcome the report of the Commission on Funding of Care and Support and will consider its recommendations carefully.

[Bill Esterson]

The Government may say that they welcome the report, but can the Minister explain why the White Paper on social care will now be published in spring 2012 rather than in December 2011, as the commission’s report recommends? Do the Government want it to be kicked into the long grass because of Treasury interference?

[Paul Burstow]

The hon. Gentleman is entirely wrong. The Government’s approach is to have discussions with the official Opposition and to engage fully with stakeholders from Age UK, Carers UK and many other organisations, not just about funding reform—which is an important part of our reform of social care—but about questions of quality and law reform.

[Chris Ruane]

My constituency in central north Wales contains a high percentage of pensioners, many of whom come from the industrial cities of the north-west and Birmingham. What protocols exist to deal with cross-border issues involving pensioners’ care?

[Paul Burstow]

That important question must be partly addressed by the hon. Gentleman's colleagues in the Welsh Assembly, but one of the issues raised by the Law Commission’s recommendations on law reform that we must address is that of ordinary residence tests to ensure that people have access to the right care at the right time and in the right place.

[Ms Stuart]

The Minister said that he was engaging fully with stakeholders. Does that include the Treasury, given reports that the Dilnot proposals are being strangled at birth?

[Paul Burstow]

Cross-government discussions take place about any matter that requires legislation and funding—and of course the Treasury plays its part in those discussions.

[Roberta Blackman-Woods]

Does the Minister agree that the Government need to act quickly on the commission’s report, not least because the Southern Cross situation, which is affecting many people in my constituency, has shown that the current model, which involves relying largely on private care, is simply not sustainable?

[Paul Burstow]

We will return to that important matter later, with the urgent question. However, we must examine the position of Southern Cross and the business model that underpinned it very carefully, in order to understand how such a model was agreed to under the arrangements for regulating care providers that existed before the establishment of the Care Quality Commission.

[Mr Stephen Dorrell (Charnwood) (Con)]

It is now more than a decade since Sir Derek Wanless first identified a funding gap in long-term care for the elderly. I welcome the Dilnot report, but will the Government act quickly to establish a partnership arrangement enabling private money contributed through insurance to be added to some public money, so that that funding gap can be filled?

[Paul Burstow]

The answer to the first part of the right hon. Gentleman’s question is that the Government are already committed, through the spending review, to the provision of an additional £7.2 billion for social care over the next four years, which will involve an unprecedented transfer of resources from the NHS to social care. As for the second part of his question, the Dilnot report makes many recommendations, and the Government will work through them and present their conclusions next year.

[Duncan Hames (Chippenham) (LD)]

The question of who benefits from the proposals, and by how much, depends on the assumptions made about the potential maximum outlay on care home residence under the existing arrangements. That may change as the length of time for which people live in care increases. Does the Minister accept that if the implementation of the proposals is to be progressive, both now and in the future, the Government will need to test, and keep under review, their assumptions about the longest likely duration of care in homes?

[Paul Burstow]

That is an important point. One of the factors that will change those assumptions is the extent of our effectiveness in preventing and postponing the need for such services. “A vision for adult social care”, which we published last year, emphasised the need for more investment in preventive measures. That is why we have provided, and continue to provide, additional resources for reablement, which not only does the individuals concerned a great deal of good but saves money for social services authorities.

[Sarah Newton (Truro and Falmouth) (Con)]

Does my hon. Friend agree that in the months before the White Paper is published it will be important to take time to build the necessary all-party cross-House support for long-lasting reform?

[Paul Burstow]

My hon. Friend is absolutely right, and the exchanges on the Secretary of State’s statement last week made it plain that we are committed to having those discussions and working to secure a long-lasting reform. That is the only way in which such a reform can secure the necessary changes, both in law and funding, for this country.

[Rachel Reeves (Leeds West) (Lab)]

The Southern Cross crisis is causing extreme anxiety to the people who live in the homes, including the one at Hopton Mews in Armley, in my constituency. How will the Government ensure that local authorities and the Care Quality Commission have the necessary resources to oversee the transfer of homes to their new operators?

[Paul Burstow]

I shall certainly elaborate on how we are doing that in greater detail later. For some months we have been working with the landlords, the lenders and Southern Cross, and making sure that local authorities are fully prepared for any likely contingency and the CQC is ready to deal with re-registrations, should that become necessary.

[Emily Thornberry (Islington South and Finsbury) (Lab)]

The Minister of State has told us that one of the reasons why the publication of the White Paper has been delayed is to allow cross-party talks, so I wonder whether he can help us: when will the meeting between the Prime Minister, the Deputy Prime Minister and the Leader of the Opposition take place?

[Paul Burstow]

I am surprised that the hon. Lady does not know. As I understand it, there is a date in all three people’s diaries, but it is not for me to share that date. Although we do need to have cross-party talks between the leaders and the health spokespeople involved, we should also look back and draw some lessons from the royal commission on long-term care. What surprises me is that when that report was published by the right hon. Member for Holborn and St Pancras (Frank Dobson), all that was offered was a debate—not a debate that the Government would lead, but a debate that would take place across the country. We are still waiting for the end of that debate. This Government have a timetable and a commitment to engage.

[Mr John Baron (Basildon and Billericay) (Con)]

3. What arrangements he plans to put in place to ensure clinical commissioning groups are held accountable for their performance in respect of cancer outcomes.

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[Stella Creasy (Walthamstow) (Lab/Co-op)]

12. What estimate he has made of the change in net public expenditure on older people’s social care since April 2010.

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

The latest available data on social care expenditure are for 2009-10, when net expenditure on social care for older people was £7.5 billion.

[Stella Creasy]

Many of my constituents will have been deeply concerned by the admission of Peter Hay, the president of the Association of Directors of Adult Social Services, that nearly £1 billion is being taken out of social care budgets following cuts to local government, and by his warnings about the consequences for provision. When will the Minister deliver interim funding relief, so that patients are not stuck in hospitals because they cannot be discharged, and so that we can be sure that we will avoid a crisis in social care?

[Paul Burstow]

If the hon. Lady had read on, she would have found that £700 million of the £1 billion is to be found not through cuts in services, but through efficiency savings, for example through the use of telecare, which significantly reduces costs, and investment in reablement services, which save resources and help people to get back on their feet. That is all in the report that she is waving around. When it comes to investment, the Government have already made clear their commitment through the spending review, and are investing, by the end of this Parliament in 2014-15, an additional £2 billion—something that her party did not do when in government.

[Bob Blackman (Harrow East) (Con)]

The extra money being given to adult social care should be good news, but in Harrow, the council, which is Labour-run, has applied the £2.1 million additional funding to redundancies in general areas, rather than passing it on to the weak and the vulnerable. Will my hon. Friend take action to ensure that the new money provided by the Government reaches the people who need it?

[Paul Burstow]

I am absolutely determined to make sure that the additional resources that the NHS is transferring to social care deliver real benefits for people who need social care services, protect services, and allow local authorities to make the right decisions about how they continue to support not just investment in prevention, but those most in need.

[Pat Glass (North West Durham) (Lab)]

It is disappointing that we will now not see the Government’s White Paper until the spring, but will the Government agree to take forward the commission’s recommendations on national eligibility criteria and portable care assessments? The Minister will understand that that is now urgent, given the Southern Cross crisis.

[Paul Burstow]

The hon. Lady raises a question about eligibility; of course, we know from the latest figures in an ADASS survey that the majority of local authorities moved, under Labour, to “substantial” needs being the test for access to social care; that happened on her watch, not this Government’s watch. When it comes to portability, the Law Commission has made recommendations that the Government have to consider, and yes, we need to look to legislate on that.

[Hazel Blears (Salford and Eccles) (Lab)]

The Minister was present this morning at the launch of a report on dementia care by the all-party group on dementia. He will know that the key recommendation is to shift resources from acute hospital care to more preventive services in the community. What steps will he take to ensure that that shift really happens, over and above the £1 billion that has been allocated, much of which has already been spent by local authorities on plugging the gaps caused by other cuts in their budgets?

[Paul Burstow]

As the right hon. Lady was at the presentation, she will know that it was also identified that we currently spend about £8 billion on dementia services, and the Audit Commission identified that we could save at least £300 million through better use of preventive and early-intervention services. The Government have set out a very clear approach. First, we need to invest in services to provide for earlier diagnosis, because that is the best way to plan for dementia. Secondly, we need investment in services in our hospitals that shorten the length of stay and deliver good quality. Thirdly, we need care homes with the right training for staff, so that they can manage dementia and behaviour problems effectively.

[Alun Cairns (Vale of Glamorgan) (Con)]

13. What progress he has made in reducing the use of mixed-sex accommodation in the NHS.

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[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

18. What steps he is taking to improve cancer care for older people.

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

We are working with Macmillan Cancer Support and Age UK on a £1 million programme to improve cancer care for older people. The programme consists of 13 pilot sites across the country to improve intervention rates for people over 70 who have a cancer diagnosis. Pilots will introduce new ways of assessing older people for cancer treatment, offer short-term, practical support for older people undergoing cancer treatment and will address any age discrimination in cancer services by identifying and addressing the training needs of all professionals working with older people.

[Mrs Hodgson]

I am sure that the Minister will have seen the report published today by the Roy Castle Lung Cancer Foundation, which reiterates the considerable research showing that older lung cancer patients do not receive the same level of treatment as younger lung cancer patients. In fact, it shows that a 60-year-old sufferer is six times more likely to be given surgery than an 80-year-old sufferer, which obviously means that their outcomes are considerably worse. How does the Minister explain that inequality and how can it be tackled?

[Paul Burstow]

I am grateful to the hon. Lady for highlighting that further piece of evidence that shows why the Government have already given a commitment to ensure that there are no exemptions for the NHS from the application of our duties in respect of age discrimination, as there should be no place for age discrimination in the NHS. In addition, the work we are doing with Macmillan Cancer Support and Age UK is the way forward to ensure that we learn the lessons and drive up standards for the care of older people.

[Rachel Reeves (Leeds West) (Lab)]

T1. If he will make a statement on his departmental responsibilities.

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[John Healey (Wentworth and Dearne) (Lab)]

I want to say to the Health Secretary directly that it is a disgrace how he and his Ministers have ducked responsibility for reassuring more than 30,000 elderly and vulnerable residents whose homes may be at risk because of the financial crisis at Southern Cross. Today’s urgent question is the second time in a month that this House has had to drag Ministers to Parliament to explain what is going on. Southern Cross is set to close down completely by October. Will the Secretary of State give a commitment this afternoon to the residents of Southern Cross, their families and 40,000 staff that Ministers will in future show leadership and make public statements to this House?

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

I am grateful to the right hon. Gentleman for his question. He will of course know that when the first urgent question was asked, the Government had already provided a written ministerial statement setting out these matters in great detail, and we are happy to answer the questions that hon. Members will want to put in the urgent question later on. We have also said throughout that we do not help the welfare or interests of residents by an ongoing running commentary on these matters.

[Mr Rob Wilson (Reading East) (Con)]

T6. Despite the Government making available an additional £400 million for primary care trusts to support carers, I understand that my local Princess Royal Trust carers service is finding it very hard to engage with the local PCT in my constituency. Will Ministers remind PCTs to follow guidance and work with local carers’ organisations to develop plans for using the additional Government money that has been provided?

[Paul Burstow]

I share the hon. Gentleman’s concern. The NHS operating framework that the Government published last December makes it abundantly clear that primary care trusts need to work with their local authorities and care organisations to agree a budget and, where possible, to pool it so that it can be provided to individuals to enable them to get respite in the way that suits them best. I will certainly be pursuing this through the Government’s normal assurance processes to ensure that these things happen through the operating framework, but the hon. Gentleman might also want to invite his local overview and scrutiny committee to call to account local commissioners for the way in which they are behaving at the moment.

[Mr John Spellar (Warley) (Lab)]

T3. NHS West Midlands is cutting nurse training next year by a fifth and predicting a reduction of 7.25% over five years in the qualifying work force—not bureaucrats, but nurses—thereby denying youngsters in this country training for a worthwhile profession and career. Is not this a scandal and a shambles, and what is the Minister going to do about it?

--- Later in debate ---

[Paul Burstow]

That is exactly what the Government are doing. We have had those discussions with the devolved Administrations, and officials are engaged with the landlords and lenders to ensure that they are doing just that. I look forward to answering the urgent question shortly.

[Andrew George (St Ives) (LD)]

It is acknowledged that the rising rates of norovirus are worse where there is a shortage of acute hospital beds. How does the Secretary of State square the understandable desire to get on top of hospital-acquired infections with his zeal to reduce acute hospital beds?

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[Mr Pat McFadden (Wolverhampton South East) (Lab)]

The Secretary of State will be aware that there has been a tripling of prescriptions for drugs such as Ritalin, or to give it its generic name methylphenidate hydrochloride, in the past decade. He will also know that National Institute for Health and Clinical Excellence guidelines state that those drugs should not be prescribed to children under the age of six. Why cannot his Department give a breakdown showing how many of those prescriptions are going to children under the age of six? Will he heed the call from the Association of Educational Psychologists for a review of the growth of the prescription of those powerful psycho-stimulants to very young children?

[Paul Burstow]

The right hon. Gentleman raises a very important point. We need to ensure that we have the right data to understand prescribing practice properly, so that we can both challenge bad practice and ensure that the NICE guidance is properly followed. I would like to look more closely at his points and then write to him in detail.

[Mr David Evennett (Bexleyheath and Crayford) (Con)]

Will my right hon. Friend join me in congratulating advisers working for Bexley stop smoking service, who helped more than 1,600 people stop smoking last year? Does the Minister agree that helping people stop smoking should remain an important public health priority?

Southern Cross Care Homes

Paul Burstow Excerpts

Tuesday 12th July 2011 Commons Chamber

[Emily Thornberry (Islington South and Finsbury) (Lab)]

(Urgent Question): To ask the Secretary of State for Health if he will make a statement on the future of Southern Cross Care Homes.

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

As the House will be aware, Southern Cross has been working with its landlords and lenders to agree a restructuring process to secure a viable way forward for the future. As I set out to the House on 16 June, the Government have made it clear that our overriding concern is the welfare and safety of the 31,000 residents in Southern Cross’s care, and that we expect all parties to work together to secure a consensual, solvent restructuring of the business that meets their collective responsibility to secure the welfare and care of residents.

When I last updated the House on 16 June, Southern Cross, its landlords and lenders had the previous day announced an agreement to work through, over a period of four months, arrangements for a consensual, solvent restructuring. Yesterday’s announcement was one step in that ongoing process, and discussions to resolve the remaining steps continue.

I know that there is concern about what yesterday’s statement might mean, and that residents, families and staff are anxious to know what will happen next. Let me repeat the assurance I have given to House before: whatever the outcome, no one will find themselves homeless or without care. We will not stand by and let that happen. We will continue to work with the Association of Directors of Adult Social Services, the Local Government Association, the Care Quality Commission and others to ensure that there is an effective response to any potential disruption to the continuity of care and to ensure that all residents are indeed protected. A consensual restructuring that assures a smooth transition to new arrangements will mean that those contingency arrangements will not be needed. We all want that to happen.

Let me reassure hon. Members about some of the questions that I know they will have. First, yesterday’s announcement stated that at the end of the restructuring process the Southern Cross corporate entity will cease to exist. That has no effect on the provision of care or the operation of care homes. Southern Cross remains in operation, and will continue to operate all its care homes until any transfer to new operators takes place.

Secondly, the transfer of care homes to alternative operators will be a managed process that ensures continuity of services. Yesterday’s statement makes it clear that care home staff will transfer on their current terms, and that the service that residents receive should be unaffected by the transfer. All parties involved in the negotiations have given a clear commitment that the continuity of care will be paramount in that process. Local authorities are already working to ensure that they can assist in the smooth transfer of arrangements in respect of homes in their areas. The Department has been working with ADASS and the LGA to support that.

Thirdly, no transfer will take place without new operators being approved and registered by the CQC. There has been speculation that companies with no experience in the care sector will take over the running of homes, but that will not happen. Alternative operators will need to be reputable and experienced companies that can satisfy the CQC that they are capable of delivering high-quality care and of meeting all regulatory standards. The CQC will not drop its standards in ensuring that requirements are met. I understand that each of Southern Cross’s landlords is settling its arrangements regarding which care home operators to work with, which is an essential part of the ongoing discussions. That will cover all landlords, so that there is a clear way forward for all homes.

Finally, I assure the House that the CQC has been working with Southern Cross landlords and other stakeholders for several months to ensure the smooth transition of services, and that it has processes to deal with re-registration, and to undertake the essential checks that are needed as a priority. It is having ongoing conversations with Southern Cross, landlords and other providers on the timing of applications.

The Government’s priority is to ensure that the current problems with Southern Cross are resolved and that a sustainable way forward can be secured, but, as the Prime Minister has previously stated to the House, we must all be clear on what future action is taken and draw lessons from what has happened.

I said earlier that yesterday’s statement from Southern Cross was one step in a process that will be ongoing in the coming weeks and months. Until all future arrangements are settled, Southern Cross will continue to operate and to provide care in all its homes. Only at the end of the process, when all transfer arrangements have been completed, will Southern Cross as an entity cease to exist. By then, all homes will have a clear plan for future operation, and the continuity of care will have been secured. That is the approach that the Department of Health has taken. Officials are in daily contact with all relevant parties. This Government are not sitting back; we are fully engaged.

[Several hon. Members]

rose—

[Emily Thornberry]

I thank the Minister for his response to my urgent question. Yesterday’s Southern Cross announcement that responsibility for managing 752 homes will pass back to the 80 landlords who own them has created a vacuum. I was interested to hear him say that that was part of a managed process, because it does not look like that—it has been a source of terrible uncertainty and great anxiety among residents and families. We have had so little information.

I am grateful for the information that the Minister has given today, but we need much more. Can the Government publish a list of all 80 landlords, or are the rumours correct that some of them have yet to be identified? Yesterday it was further announced that control of 250 of the homes would be handed back to the landlords immediately. We need to know which homes they are so that people living in them know who is running their home. Many of these landlords have little or no experience of running care homes. Does he have any information on the intentions of property companies such as London and Regional homes, which owns 90 former Southern Cross homes, or Prestbury, which owns 21?

I understand that the Association of Directors of Adult Social Services is doing its best to support its members, who will have a key role in ensuring that the operating companies can provide good quality care, and also that local authorities know how to perform financial stress tests to ensure that the new businesses have sound financial models, but what assistance is the Minister giving? Does he intend to provide additional resources to hard-pressed local authorities in order to help them? What advice can he give to local authorities if, for example, the new company is an offshore company? If the Department of Health does not have the expertise to assist ADASS, will he give that organisation access to officials from the Department for Business, Innovation and Skills, who might be able to provide that assistance?

Presumably, the new operators taking control of the homes will need to be registered with the Care Quality Commission—the Minister has assured us that that will happen—but given the staff shortages at the CQC will he assure us that the registrations will be completed quickly? The House has heard him guarantee that the new operators will honour the previous terms and conditions of the 44,000 employees, but how does that square with the announcement of 3,000 job losses? Does he know how many homes are likely to close and what the timetable is for such closures? What will happen to the 50 former Southern Cross homes owned by Lloyds properties, which is in administration? What about NHP, which owns 250 former Southern Cross homes and which is at a standstill with its bondholders? These problems must be addressed. We need a home-by-home plan from the landlords, and he must give us that plan. The buck stops with him. Will he now accept his responsibilities?

[Paul Burstow]

My slightly-longer-than-it-should-have-been answer to the hon. Lady’s question was an attempt to set out as much detail as was possible about the steps being taken to achieve a consensual, solvent restructuring of the business so that the homes can continue to operate. That is what my answer was all about. She asked about the role of the CQC, which, as I said to her, has been working for some months with the landlords to ensure a smooth process of re-registration as new operators are identified to take on the running of individual homes. I also said in response to her initial question that every home will be transferred. There is a plan in place that will lead to all homes being transferred over the next four months. She asked about engagement with BIS. Of course, as part of the ongoing work, the Department of Health is engaging with BIS to ensure that we have the very best advice in dealing with these issues. The Government have been—and remain—fully engaged with the process.

[Mr Stephen Dorrell (Charnwood) (Con)]

For the avoidance of doubt, will my hon. Friend confirm that the Government’s policy since the beginning of this saga has been motivated by a single and paramount concern—to secure the continued and orderly delivery of care to the right standards to the residents of these homes—and that, in that respect, this Government are operating unchanged precisely the policy operated by their predecessors?

[Paul Burstow]

My right hon. Friend is absolutely right to make that point, which allows me to make another point. The Health and Social Care Bill is currently before this House—Members are enjoying the Committee stage at this very moment—and it contains the very provisions that will allow us to put in place a regime, which currently does not exist, to ensure proper oversight and engagement with those issues from a central Government perspective. The previous Government did not leave such a regime in place, nor did they put in place the necessary tools to allow the Government to do everything that they might want to do and that the hon. Member for Islington South and Finsbury (Emily Thornberry) might like us to do.

[Frank Dobson (Holborn and St Pancras) (Lab)]

Does the Minister accept that if any elderly people are moved out of their homes, there will be an increased incidence of death and a reduction in people’s mental and physical health? What measures is he taking to ensure that as few people as possible are moved from those homes?

[Paul Burstow]

The right hon. Gentleman is absolutely right: we are working hard with the landlords, lenders and others to ensure that those risks are minimised, because the trauma of a hasty care home move and a forced closure leads to exactly those consequences. The Association of Directors of Adult Social Services has published new guidance for its members to manage those difficult decisions and processes and to minimise that risk as far as humanly possible.

[Mr Stewart Jackson (Peterborough) (Con)]

This is not a time for party political point scoring. The House will have been reassured by the Minister’s comments, as will the many residents of Astoria Park Southern Cross home in Park crescent, Peterborough, along with their families. The only point I would make to the Minister is that when the immediate crisis has been resolved, there should be a mechanism to work with key stakeholders such as the Care Quality Commission to understand the lessons of the flawed business model that Southern Cross pursued.

[Paul Burstow]

My hon. Friend is absolutely right, and that is indeed one of the many issues we need to consider as we proceed towards publishing a White Paper next year on social care reform. We have to ask questions about the regulatory framework that existed when that business model was established. We also need to ensure that we have the necessary tools to deal with large care home providers of this sort, where an individual local authority might be unable to cope with the consequences. Those are the issues that we are working with and that we shall continue to work with.

[Glenda Jackson (Hampstead and Kilburn) (Lab)]

The Minister gave a list of consultations and apparently daily meetings of his officials with care home providers and landlords. The one group that was markedly lacking in the process was the residents of the homes and their families. When will they be included in this process? Who will be responsible for informing them of the timeline if there have to be moves, and will they be in a position to object strongly if, for example, an elderly person does not wish to be moved from the home in which they are resident? Who is responsible for informing those people?

[Paul Burstow]

The first thing to say is that everything I have set out for the House today is about minimising the numbers of closures and moves. It is about ensuring continuity of care and continuing care in existing care homes. However, having said that, I made the point in response to her right hon. Friend the Member for Holborn and St Pancras (Frank Dobson) that there is new guidance for local authorities on how they engage with the residents of care homes and their families, and it is the responsibility of local authorities to do just that.

[Andrew Percy (Brigg and Goole) (Con)]

Were it not for my two county councils, information about the two homes in my constituency—Windsor Court in Goole and St Mary’s in Scunthorpe—would not have been forthcoming at all. Given that it has also taken me several weeks to try—unsuccessfully—to get Southern Cross to allow me even to visit their homes, can the Minister give me an assurance that he will do everything he can to ensure that we are given home-specific information as quickly as possible? If such information is not being made available to Members of Parliament, it is probably not being made available to residents or their families.

[Paul Burstow]

Yes, and I gladly undertake to ensure that if further information needs to be shared during the summer recess, hon. Members in all parts of the House will receive it in a timely fashion, so that they can address their constituents’ concerns.

[Hywel Williams (Arfon) (PC)]

There are 1,772 people in 35 Southern Cross homes in Wales, but I did not hear the Minister refer to them at all in his answer. Where does the buck stop, as far as they are concerned? Is it with Welsh local authorities, with the Welsh Government, or with him, even though this matter is devolved?

[Paul Burstow]

I have had, and continue to have, contacts with the Ministers responsible for policy in this area in the devolved Administrations, but the legal responsibility for continuity of care from the point of view of the public purse rests with the local authorities. That is where the legal powers sit, and it is where the legal responsibility has to be placed. We are working with the Local Government Association and others to ensure that the local authorities are able to put contingency plans in place.

[Ben Gummer (Ipswich) (Con)]

Lombardy Park in my constituency provides residential care for extremely vulnerable young adults with severe learning difficulties. They, and especially their parents and families, are extremely concerned about what is going on. What reassurance can the Minister give them that those residents will be protected and looked after?

--- Later in debate ---

[Paul Burstow]

I understand entirely the point that my hon. Friend and other hon. Members are making on behalf of their constituents. The nature of the reporting of the announcement yesterday, and other announcements before it, is a source of worry for residents, staff and families. I hope that today’s statement will go some way towards giving them some reassurance. Equally, it will not help the successful, solvent restructuring of the business, which will provide that continuity of care, if we have an endless commentary on it. What is important is that the necessary actions are taken, and they are being taken.

[Vernon Coaker (Gedling) (Lab)]

Does not the Minister understand that it is not endless commentary that we want from him but some reassurance for residents in these homes? Also, it is not continuity of care that they want, but continuity of the place in which they live. These are not just residential homes; they are places where people live, and they form a valuable part of the community. What reassurance can the Minister give us that this is not only about continuity of care for those people but about their having continuity of residence in the home they live in?

[Paul Burstow]

The hon. Gentleman is absolutely right; this is about people’s homes and their futures. That is why the Government have been working to make it abundantly clear to all those involved in the process what their responsibilities are, and what the local authorities’ responsibilities are. We have also made it abundantly clear that in no circumstances will the Government do anything other than ensure the future continuity of care for people. No one will be made homeless, and no one will wind up without the care and support they need.

[Greg Mulholland (Leeds North West) (LD)]

Considering the real concern in areas around the country, including Leeds, and the clear duty of local authorities in this role, does the Minister agree that it is inappropriate and irresponsible for councils such as Leeds city council to pursue a raft of closures in their own care homes while this problem clearly exists?

[Paul Burstow]

My hon. Friend tempts me to comment on an individual local authority’s decisions, the details of which I do not have. It seems to me that that is an area that the council in question will have to look at carefully. The key thing has to be that local authorities are responsible for looking at the availability of good- quality care home placements in their area and to supply individuals who are funded by the local authority and who need a decent care home with just that.

[Dame Anne Begg (Aberdeen South) (Lab)]

I have nine Southern Cross homes in my constituency, and they are sitting on some very expensive real estate. The problem for Southern Cross was that its rents were too high. What negotiations has the Minister undertaken with the landlords to ensure that that problem does not continue and beset the new operators who we hope will take over the running of those facilities?

[Paul Burstow]

I do not know the particulars of the homes to which the hon. Lady refers, but if she would like to write to me with more details, I will certainly look at that matter. Many of the homes that Southern Cross owns have been specifically built and designed to provide residential care for older people, and there is therefore no other purpose for which they could usefully be converted—[Interruption.] Opposition Members might chunter about that, but that is why a consensual, solvent restructuring is now the best and most likely outcome of the process.

[Mr Robert Buckland (South Swindon) (Con)]

The residents, staff and families of the King’s Court home in my constituency will be encouraged by what they have heard today, but will my hon. Friend write to me with all the relevant information about the key issues of continuity and quality of care provision at King’s Court?

[Paul Burstow]

My hon. Friend is right to bring to my attention, and that of the House, the concerns of his constituents. I certainly hope that the statement I was able to make today is of some reassurance, along with the commitment I made to continue to keep both the House and individual hon. Members informed as this matter goes forward.

[Nick Smith (Blaenau Gwent) (Lab)]

This is the second time this month that this Minister has been dragged to the Dispatch Box to answer urgent questions about Southern Cross. The Government need to get a grip. May we have a ministerial taskforce from across Government to manage and monitor the transfer of homes to landlords? We need to ensure stability and give peace of mind to Southern Cross residents and their relatives.

[Paul Burstow]

I note that the hon. Gentleman seems to be a bit like a stuck record, repeating the point that he made last time. The reality is that the Government are taking the necessary steps, are exercising their responsibilities correctly and are making others responsible and accountable for discharging their legal responsibilities as well. What the hon. Gentleman left out from his question was any suggestion of what specific powers his Government put in place that would have allowed us to deal with this issue. There are no such powers.

[Glyn Davies (Montgomeryshire) (Con)]

Does the Minister feel that there would be value in considering the financial regulation of care homes and the care home sector so that this sort of situation does not occur again in future?

[Paul Burstow]

My hon. Friend is absolutely right. I hope that we can learn the necessary lessons about what regulation should exist at the national level and what powers are in place for regulators to intervene in these circumstances. The reality is that the regulatory powers that this Government inherited from the previous Government are next to non-existent. That is one reason why hon. Members have been able to drag Ministers to account, as has been said, before the House. What we have said as a result is that as we work to produce the White Paper, we will address these issues to make sure that we have a system in place.

[Mr Dennis Skinner (Bolsover) (Lab)]

Another day, another Tory disaster. We have frail, elderly men and women who do not even know what day it is, yet this Minister, because he is so obsessed with the private sector, fails to tell us that he is going to restore the cuts to local authorities that would enable them to handle the crisis.

[Paul Burstow]

I thank the hon. Gentleman for his comments. He should just reflect on the fact that this company and this business model were established during the 13 years when his party was in office, and on the fact that his party did not put in place the necessary regulatory measures that would have allowed anything other than the very measured approach that this Government are taking— working with the lenders and the landlords to ensure a consensual restructuring of this business. That is what the residents of these homes want, and this is what we are doing to make it happen.

[James Morris (Halesowen and Rowley Regis) (Con)]

I recently visited Roxburgh House in Cradley Heath in my constituency, where a number of vulnerable elderly residents are concerned about their future. Does the Minister agree that we need not only to address the continuity of care in those homes now, as he has described, but seriously to review the situation, once this crisis has been managed, to make sure that it does not happen again? Will he outline the steps he will take to ensure that that happens?

[Paul Burstow]

I am grateful to my hon. Friend. That is exactly what we also need to work on, which is why we are providing in the Health and Social Care Bill the necessary powers for regulations to be made that would allow such a regulatory approach to be developed. During consideration of those ideas in Committee, it was far from clear whether the Opposition believed that this was a worthwhile approach to adopt.

[Mrs Madeleine Moon (Bridgend) (Lab)]

Before entering this House, I was a care standards inspector in Wales. Part of the problem is the fact that we are not willing to pay properly for the appropriate registration and inspection of care homes. One thing that worried me about the Minister’s statement was when he said that the registration of the new management bodies for these homes would be completed quickly. It should not be “quick” registration; it should be thorough and effective registration. May we have an assurance that the registration will indeed be thorough and effective? Secondly, may we have an assurance that the care standards inspectors will not be diverted from carrying on the ongoing inspection of other homes, and thus protecting other frail and vulnerable adults in care homes around the country?

[Paul Burstow]

I said in response to the original question that there would be no relaxation of the standards when it came to the registration of new homes, and that there would be no rush but a smooth transition to the running of the businesses by new operators. There was no suggestion that the process would take place in a rushed way. I urge the hon. Lady to read the record later.

As for the role of the CQC, we made it clear last year that we would allow it to recruit the necessary staff, and that there would be no limit to its ability to recruit staff whom it felt that it needed in order to do its job.

[Andrew George (St Ives) (LD)]

What other lessons have the Government learned from this case? The new regulatory measures in the Health and Social Care Bill are welcome, but if greater proportions of both health and social care are being exposed to this level of speculative capital, do the Government not need to reflect on whether further measures are required?

[Paul Burstow]

I am keen not to start leaping to lots of conclusions. About 77% of all social care provision in England is already in the private sector. This is not an experiment, but a fact of life that has evolved over the last 20 and 30 years and has been overseen by Administrations of all colours. What we do need to do is ensure that we have effective, proportionate regulation that safeguards the interests of residents who see these homes as their homes, along with robust arrangements on the ground to safeguard good quality.

[John Mann (Bassetlaw) (Lab)]

Can the Minister confirm that elderly people could now be forced out of the homes in which they have lived for years and be stuck in homes that are inferior, or are situated many miles from where they live?

[Paul Burstow]

I believe that the hon. Gentleman has been in the House for a considerable time. He will know that the secret that he appears to be sharing with the House, and with others who are following our proceedings, is not something totally new. He knows that care homes close already, and he knows that, as a consequence, people do face such terrible circumstances. That is why the Government, working with ADASS, have ensured that the necessary arrangements and good practice advice are in place, which is something that his party did not do.

[Alison McGovern (Wirral South) (Lab)]

Residents of Bebington and the rest of the Wirral are extremely concerned about the Southern Cross experience. Will the Minister say more about the specific lessons that we need to learn from it, given the Prime Minister’s announcement yesterday about the wider opening up of public service delivery?

[Paul Burstow]

As I said to my hon. Friend the Member for St Ives (Andrew George), 77% of adult social care is already in the private sector, and as we said in “A vision for adult social care”, we want a more vibrant, diverse market which includes voluntary sector providers. We want to examine the role of regulation, to ensure that it assists with the management of that market and, fundamentally, to ensure that it protects the rights and best interests of those who use these services.

[Mark Durkan (Foyle) (SDLP)]

Will the Minister assure me that consultation with the devolved authorities will take account of the different mix of landlords and lenders there? On a wider issue, will he assure the House that the undertakings he has given in respect of older residents will apply, at least equally, to much younger residents who are receiving bespoke care packages for conditions such as acquired brain injuries, often on a different contractual basis and outside the normal Southern Cross business model? Will such people be fully taken care of?

[Paul Burstow]

I am grateful to the hon. Gentleman for his question, which allows me to deal with an earlier question on the same subject. The answer is absolutely yes. The continuity of care will be not just for the benefit of older residents of care homes, but for the benefit of any individual who relies on the services provided by the company.

[John McDonnell (Hayes and Harlington) (Lab)]

I have been raising concerns about the management of Southern Cross in the House since 2007, in early-day motions and Adjournment debates. Despite assurances from the Care Quality Commission and from the company itself, the system resulted in neglect and abuse in my borough, which, at one point, suspended all placements in Southern Cross homes. I therefore view with some scepticism the assurances given today by the commission and participants in the company. Will the Minister be able to empower local authorities to take control of homes if they are threatened with closure and residents may be forcibly moved?

[Paul Burstow]

The hon. Gentleman has been raising those concerns in the way that he has, and I will certainly look at the points he has raised in the past. Local authorities have certain statutory powers in respect of their ability to respond to the closure of a care home by managing and resourcing that. We have been, and continue to be, in discussion with local authorities on that, so that they are able to respond in the event of a closure. I return to my key point, however, and the key reassurance we have not only from the company, but from the landlords: this is a solvent restructuring of the business, so that the care homes continue to operate and to provide homes for their residents.

[Barry Gardiner (Brent North) (Lab)]

It is not only the residents of the Birchwood Grange and Coplands homes in my constituency who are concerned about their future; so, too, are the people who work in those homes. Can the Minister guarantee that the new operators will honour the terms and conditions of those workers, so that they can see that their future is also secure?

[Paul Burstow]

There is an undertaking that the TUPE regulations would apply: there would be a transfer on the current conditions. That is what all the staff have been told, and I am certainly happy to repeat the undertakings that have been given by those responsible for those undertakings.

[Jack Dromey (Birmingham, Erdington) (Lab)]

Shameful speculation brought Southern Cross to its knees, but local authorities will now have a key role to play in rescuing the homes of 31,000 people in a year when, according to Age UK, the social care budget is being cut by 8.4%. What discussions has the Minister had with the Department for Communities and Local Government, because it cannot be right to ask local authorities to accept public responsibility for a private failure and to deny them the necessary resources?

[Paul Burstow]

As I have made clear, given the current stage of the announcements on this solvent restructuring, we appear to be in a position where the scenario the hon. Gentleman asks about will not come to pass.

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

There are more than 300 residents in seven Southern Cross care homes in Salford, and their quality of life is our primary consideration. What assurance can the Minister give to those residents and their families that future providers will not play for short-term profit, but will truly consider their quality of life? Reassurances will not mean much if a new provider gets into the same business model and same way of carrying on as Southern Cross.

[Paul Burstow]

The hon. Lady is right. As we move forward and achieve a successful conclusion to this process, we must put in place the necessary measures to ensure that this cannot happen again. We must take a critical look at the regulatory environment in which this particular business model was allowed to grow—a business model that thrived during a boom, but that was predicated on the assumption that there would never again be a bust. There was a bust however, and that is why the company is in this mess.

[Mr Brian H. Donohoe (Central Ayrshire) (Lab)]

The great majority of these homes were given landlords, but the one in my constituency was owned by Southern Cross and the title deeds have been passed to the bank. I have no confidence in the banks doing anything else but selling such deeds for the maximum profit. Does the Minister agree?

[Paul Burstow]

I would reassure the hon. Gentleman on that point by repeating that we are engaged with not only the landlords, but the lenders too, about all their responsibilities on the fundamental issue of the welfare of the residents of these care homes. We continue to make that point. That is the legal obligation that local authorities have to honour, and we are working with all those parties to make sure that that is what happens.

[Lindsay Roy (Glenrothes) (Lab)]

There are four Southern Cross care homes in my constituency. Does the Minister agree that in terms of care provision people should be treated first as people, not as sources of potential profit?

[Paul Burstow]

Yes.

[Grahame M. Morris (Easington) (Lab)]

There seems to be a measure of agreement among Members on both sides of the House about the need for proper regulation, oversight and management of these homes. Will the Minister therefore take the opportunity to dissociate himself from the remarks made and position adopted by the Minister of State, Department of Health, the right hon. Member for Chelmsford (Mr Burns) on 7 January 2004? He moved an Opposition motion deploring the then Labour Government’s

“over-prescriptive, expensive and bureaucratic regulation of the care home sector”—[Official Report, 7 January 2004; Vol. 416, c. 324.]

That statement is reminiscent of the neanderthal, neo-Conservative approach adopted by his right hon. Friend the Chancellor in his remarks on deregulating the banking sector.

[Paul Burstow]

I am going to stay focused on the welfare and interests of the residents of these homes, and we will have those political debates on another occasion.

[Mr Pat McFadden (Wolverhampton South East) (Lab)]

Just a few weeks ago, I visited Bellevue Court, a home run by Southern Cross in my constituency, where I was told that the home would stay part of the restructured Southern Cross group and that there would be no redundancies. We now find that there is to be no restructured Southern Cross group, so does the Minister understand the scepticism that will be felt by families and staff involved in Southern Cross if the guarantees given a month ago did not last the month?

[Paul Burstow]

What we have is a process that is working towards that solvent restructuring of the business to ensure that each home is able to be taken over by an operator or a group of operators so that good-quality care can continue to be provided for the people who live there. That is what this process involving the landlords, the lenders and Southern Cross is all about. What we know from the statement made by the company yesterday is that it has given an undertaking for the TUPE transfer of the staff. We also know that the company will be working over the next four months to ensure that smooth transition. As my statement said, the public authorities—the Care Quality Commission and the local authorities—are working with the company to ensure that that happens.

[Mr Jim Cunningham (Coventry South) (Lab)]

The Minister knows as well as I do that local authorities may have a legal obligation to intervene in this situation but they cannot do that without Government assistance with the resources. It is no good the Minister blaming a previous Labour Government or local authorities; he is passing the buck to local authorities. I thought that Pontius Pilate died 2,000 years ago, but we have just seen his resurrection.

[Paul Burstow]

What I would say to the hon. Gentleman is that there is not a question of funding these homes, because they are not insolvent. The business is not going into administration—it is going through a restructuring—so there is no request for funds and there is no need for those funds in order for local authorities to be able to carry out their current legal duties.

[Ann Clwyd (Cynon Valley) (Lab)]

I do not know whether the Minister heard the excellent Radio 4 programme “You and Yours” earlier this week, which included a long discussion on care homes and care in the community. The programme gave the impression that more care home problems are in the pipeline and that we are dealing with Southern Cross today, but several others are in a similar situation. Can he give us any assurances on that point? Will he also examine care provision in the community, because many care companies also provide that service to local authorities and it would be an absolute catastrophe if the same thing were to happen to care in the community?

[Paul Burstow]

It is for those very reasons that this Government last year set out a vision of reform of social care based on greater personal control and personalisation of the services that people need to sustain them in the community. It is also why we have committed to produce a White Paper that will focus on issues of quality and regulation, and that will bring together the other issues associated with how we reform the laws in this country, which have evolved in a piecemeal fashion over the past 60 years and which make the system opaque and hard to navigate. Those are the commitments that we have entered into and will continue to prosecute.

[Gordon Banks (Ochil and South Perthshire) (Lab)]

The Minister talks about every home being taken over, but it is obvious from his earlier remarks that he expects closures. That is a worry for me, given the two care homes in Tullibody and Crieff in my constituency. Just how many closures are acceptable to him?

[Paul Burstow]

Closures in their constituency are of concern to any hon. Member, and I suspect that that is why we have made it clear that we have been working with the Association of Directors of Adult Social Services. I am not going to come up with an arbitrary threshold below or above which something is good or bad; we need to focus on the needs of the individuals, which is why I have made it clear, in response to some of the hon. Gentleman’s colleagues, that we now have best practice advice on how such closures are to be managed. That did not exist, and was never drafted, under the previous Government.

[Mark Lazarowicz (Edinburgh North and Leith) (Lab/Co-op)]

The Minister said that he had been in discussions with the devolved Administrations, as I would expect him to be. What assurances can he give the House based on those discussions for residents in constituencies in Scotland, Wales and Northern Ireland about their future under the plans he has announced today?

[Paul Burstow]

The approach is one that I have rehearsed quite clearly today before the House. We as a Department continue to work closely with the devolved Administrations, sharing information about our contact at a national level with the landlords as a landlord committee as well as with individual landlords. If the hon. Gentleman has specific concerns about Scotland, he should contact the Scottish Government, too.

[Tony Lloyd (Manchester Central) (Lab)]

My local authority does not know who the successor landlords are in some of the cases in Manchester. The people I represent do not know who their landlords will be. This most complacent of Ministers ought to be able to come to the House and tell us the answer to this question: does he guarantee that every one of these offshore financial companies will agree to take over the running of these homes? That is what my constituents need to know.

[Paul Burstow]

What I have told the House is that the process in hand, following the statement made yesterday by Southern Cross, will ensure a smooth transition of every home to a new operator over the next four months.

[Bill Esterson (Sefton Central) (Lab)]

This will be of great concern to many people who live and work in homes that are not run by Southern Cross. Many other people will be affected. The Minister has spoken about regulation and care home standards. Will he bring forward proposals to consider the business regulation, and can he tell us when he will do that? That is the way to provide reassurance and security for many people who live and work in homes other than the 31,000 in Southern Cross.

[Paul Burstow]

My right hon. Friend the Secretary of State for Business, Innovation and Skills has already made statements and commitments about looking at the business model and at why it was thought to be appropriate for this sector.

[Roberta Blackman-Woods (City of Durham) (Lab)]

I met my local authority a few weeks ago to discuss the Southern Cross situation and it was obvious that it was not totally prepared for the complete withdrawal of Southern Cross from the social care market. Will the Minister tell the House whether he has issued or intends to issue guidance to local authorities on how to deal with this situation?

[Paul Burstow]

It is not a question of trying to write guidance in Whitehall. This is about our engagement with the Association of Directors of Adult Social Services about how directors discharge their statutory responsibilities. Writing guidance does not deal with the immediate changes. We need to ensure that local authorities’ existing legal obligations to ensure continuity of care are properly exercised.

[Chris Leslie (Nottingham East) (Lab/Co-op)]

Is it not obvious that if the Government are implementing swingeing cuts in the money they give to local authorities, they in turn will give less money to the care homes, and that this is only the beginning of a set of care home closures that could be catastrophic? Does the Minister seriously believe he can wash his hands of all responsibility?

[Paul Burstow]

In the spending review last year, the Government took our responsibilities very seriously. As a result, we identified and agreed that by 2014-15 an additional £2 billion would go into social care to support those budgets. We know from the work that has been done by others that with efficiency savings, such as those I was talking about earlier as regards reablement and telecare, that resources are sufficient to sustain the system while we do the necessary work to reform it.

[Andrew Gwynne (Denton and Reddish) (Lab)]

There are nine Southern Cross homes across Tameside and Stockport and still more in adjacent Manchester. Although some good work might be being done at an individual district level, I am not convinced that much contingency planning is being done across city regions such as Greater Manchester. What encouragement and, more importantly, financial assistance, can the Minister give local authorities to ensure that there is cross-city regional co-operation so that residents are certain of keeping their homes?

[Paul Burstow]

It really is not a question of financial assistance; it is about the co-ordination of the Association of Directors of Adult Social Services and the Department’s regional directors of social care, who are working with those colleagues at local authority level, and about making sure that they are co-ordinating their activity with the Care Quality Commission. All those things are happening, have been happening and will continue to happen to ensure that we do what the Government are committed to doing—ensuring continuity of care and that people can stay in the homes they are currently in with the knowledge that the Government really are committed to making sure that they have no doubt that they are not going to be thrown out on the streets as a consequence of this business’s restructuring.

[Mr Speaker]

I am grateful to the Minister of State and to colleagues.

Neuroblastoma

Paul Burstow Excerpts

Tuesday 5th July 2011 Westminster Hall

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

It is a pleasure to take part in the debate. I congratulate the hon. Member for Tiverton and Honiton (Neil Parish) on securing it. A quintessential feature of Adjournment debates is that they give Back-Benchers the opportunity to bring to the attention of the House and a wider audience issues that are of real importance to the lives of our constituents—literally, in this case. I therefore thank the hon. Gentleman for bringing this issue before us.

Few things are more distressing for a parent than learning that their child has cancer. Everyone’s heart would go out to any family that found itself in the same circumstances as Sam’s family, and I shall say more about their case in a moment. First, however, I want to say a little about the Government’s overall approach to paediatric cancer. I then want to say something about neuroblastoma and the Government’s approach to it. Finally, I want to say something about this case.

On paediatric cancer services, the Government are committed to improving outcomes for all cancer patients, especially children and young people who have to deal with this disease at such a young age. That means ensuring that patients have timely access to high-quality treatments based on the best available clinical evidence. That is very much the Government’s ambition and goal. We want to deliver care that is safe and effective and that provides the best possible experience for young patients. Let me highlight a number of things to demonstrate that commitment.

First, we will ensure that the recommendations in the guidance from the National Institute for Health and Clinical Excellence on improving outcomes for children and young people with cancer continue to feature in all commissioned services.

Secondly, one of the recommendations includes ensuring that children and young people with cancer are offered entry to any clinical research trial for which they are eligible and that adequate resources should be provided to support such trials. We expect providers and commissioners of services to be mindful of that recommendation, and that goes to the heart of the hon. Gentleman’s concerns about the lessons that need to be learned from this case.

Thirdly, NICE guidance recommends that children who are not eligible for clinical trials should be treated according to agreed treatment and care protocols based on expert advice and that resources should be provided to monitor and evaluate progress and outcomes for the patient.

Fourthly, we have committed more £150 million over the next four years to the expansion of radiotherapy capacity and to ensuring access to proton beam therapy for all high-priority patients who need such treatment. Evidence shows that, compared with standard radiotherapy, PBT leads to improved outcomes and reduced acute and late effects, such as growth deformity, loss of hearing and lowered IQ, which can lead to learning difficulties. We are exploring options for developing PBT facilities in England to treat up to 1,700 patients a year.

Through the national cancer survivorship initiative, we are improving the quality of services supporting the long-term needs of children and young people. That needs to provide for a seamless transition from children’s to adult services and a constant focus on outcomes.

We are demonstrating the affordability and efficiency savings that one-to-one support for cancer patients can bring. Based on the emerging evidence from test sites and the core principles defined by the children and young people group, four models were identified and are being piloted in four sites to help to bring innovation to the delivery of support for children with cancer. Those models include a primary treatment centre aftercare model; a shared care model of aftercare, in which care is shared between the primary treatment centre and GP and primary care services; and a nurse-led model of care, which may include variations such as a telephone or text message model of aftercare.

The Royal Marsden hospital, in my constituency, has tested the benefits for the patient experience of introducing a clinical nurse specialist to their late-effects set-up. That has been combined with developing psychological screening tools to improve access to appropriate psychological therapy services. A number of things are therefore being done, as we strive generally to improve paediatric cancer services.

Let me turn now specifically to neuroblastoma. As the hon. Gentleman said, neuroblastoma is a cancer of specialised nerve cells involved in the development of the nervous system and other tissues. It can occur anywhere in the body, but it most often occurs in adrenal glands, particularly in the tummy, as he said.

About 100 children, usually under the age of five, are diagnosed with neuroblastoma each year. Of them, about 50 are in the high-risk group, with the most serious forms of the disease. We want to give every one of those children the best chance to beat the disease by ensuring that they have access to specialist oncology centres and good access to clinical research trials.

The UK has a good and long track record of achievement in basic cancer research, and the Department of Health invests more in cancer research than in any other area of human health. We now have the highest national per capita rate of cancer trial participation in the world. That is relevant to the debate, because there is now wide clinical agreement nationally that all children with high-risk neuroblastoma who might benefit should have access to a trial of monoclonal antibody treatment.

For the benefit of the hon. Gentleman and others who are following the debate, I should explain that the monoclonal antibody is not available as a normal drug supplied by a pharmaceutical company. To obtain it, a production run must be commissioned and produce enough doses to treat a large number of children. Most UK patients will now access this treatment through the Cancer Research UK-supported European phase III trial. The trial is led in the UK by Dr Penelope Brock from the Great Ormond Street hospital, as part of the UK Children’s Cancer and Leukaemia Group.

On 12 May, my ministerial colleague Lord Howe was privileged to visit Great Ormond Street to see at first hand the impact of Dr Brock’s work on families affected by neuroblastoma, as well as the real hope it offers to those most seriously affected. The national cancer research network of the National Institute for Health Research provided the NHS support for the trial, which is running in all 20 childhood cancer clinical trial centres across the UK. It is anticipated that the trial will recruit 160 children between 2009 and 2013, and it is estimated that about 40 children a year in the UK will be eligible for the treatment.

The hon. Gentleman was right to raise concerns about children, particularly those with high-risk neuroblastoma, who have unfortunately been considered ineligible for the first trial. Dr Brock is now setting up a second trial, which should benefit those five or six patients a year who do not meet the strict eligibility criteria for the first study. The Department has agreed to fund a second batch of antibody for that purpose. I understand that Dr Brock is planning to run the second trial in five centres in England, from this autumn—not next year.

The proposal is with the clinical trials academic review board for Cancer Research UK, and once it is approved it will go to the Medicines and Healthcare products Regulatory Agency for approval. While the trial proposal is progressing, Dr Brock’s colleague in the European monoclonal therapy trial, Professor Holger Lode, has been piloting the new trial at the SIOPEN centre in Germany, which the hon. Gentleman mentioned. It is perhaps inevitable that one or two patients will be identified as needing the treatment while the trial proposal is going through the necessary approval stages. The hon. Gentleman highlighted in that regard his own constituency case and that of the hon. Member for Wellingborough (Mr Bone).

I am aware that some PCTs have paid for patients who meet the eligibility criteria to go Germany for the treatment. Non-routine treatment abroad will usually be considered in exceptional circumstances and primary care trusts may at their discretion take into account the individual circumstances of the patient and authorise treatment abroad that they do not normally fund. Each case needs to be considered on its merits as issues such as progression, relapse and the use of second-line treatments can all affect an individual’s suitability for treatment, including clinical trials. Each case needs to be discussed carefully with experts in the field.

The hon. Gentleman talked about his case experience and Sam’s diagnosis and mentioned the good news that the PCT has further considered the matter and, I understand, has taken into account Dr Brock’s views about the way the trial will work. I think that that has materially affected the judgment that the panel made originally and allowed it to make a new decision to allow for the funding of the monoclonal antibody treatment in this case.

I hope that the treatment, which, I understand, may already have started, will be a success and that that will be further good news for the family and offer them hope for the future. I hope that the hon. Gentleman will pass on my best wishes and those of my ministerial colleagues for Sam’s future and the success of the treatment and that we shall draw lessons from the case to ensure that, when other PCTs consider cases with exceptional circumstances, they are properly aware of the criteria that they should use.

Musculoskeletal Diseases

Paul Burstow Excerpts

Monday 4th July 2011 Commons Chamber

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

I congratulate the hon. Member for Blackley and Broughton (Graham Stringer) on securing the debate and bringing to the House’s attention an important issue. He has rehearsed the statistics, but behind them are people with real lives, in some cases suffering in agony and having difficulty getting on with their lives as a consequence of musculoskeletal disease.

Let me make it clear from the outset that the Government fully recognise the impact that musculoskeletal disease has on individuals and society as a whole and that, although there are excellent services in some parts of the country, there is still far too much variation in the availability of services and the outcomes they secure for people. This debate is about how we will respond to that evidence and to the concerns that the hon. Gentleman has brought to the House tonight, and about how we will deliver the change on the ground that we all want to see as constituency Members.

The hon. Gentleman argued for a national outcomes strategy on musculoskeletal conditions. He made some important points and I will try to address directly some of the concerns that sit behind them. The 34 organisations in the Arthritis and Musculoskeletal Alliance, which he has spoken on behalf of this evening, make some important points. They have been in discussions with the Department of Health about their concerns over how we will ensure that the differences between services around the country are addressed so that people get access to the right services at the right time.

On 19 April, officials wrote back to the alliance to confirm that we would

“ask the National Quality Board to look at this area as a potential topic for a national outcomes strategy”.

By that, we mean that it will consider whether there are problems in our approach to these conditions that go wider than the NHS. It is important to understand that an outcomes strategy produced by the Department of Health looks out from the NHS to wider impacts on health and considers how those might be influenced to improve health outcomes for people. It will also look at what needs to be done about efforts that are already in hand, to ensure that the NHS is more responsive to patients’ needs and that there is an uptake of good clinical practice.

I do not believe that the case has been fully made for such an outcomes strategy, and I want to explain to the hon. Gentleman, and through him to members of the alliance, why that is. A number of steps have been taken in the past 12 months that have moved us on significantly from the debate that the hon. Gentleman spoke about at the beginning of his remarks. I understand that the National Quality Board will consider its future work programme at its meeting this month. It will decide whether it is appropriate to commission the necessary work to look at the case for a Department-led outcomes strategy. I assure the hon. Gentleman that I will ensure that not only this debate but the debate that took place in 2010 are cited by the members of that board.

I will spend a little time describing what is happening now. The hon. Gentleman referred to the musculoskeletal framework that the Department published in 2006. He spoke about the impact of that strategy, and I will say more about that in a moment. The document was developed in collaboration with a wide range of patient and professional organisations. It set out a vision for services based on the concept of an integrated care pathway—exactly the sort of pathway that the hon. Gentleman talked about. The clear aim was to help the NHS to organise services so that patients could access a variety of primary and secondary care services according to their need, including physiotherapy, clinical psychology, specialist rheumatology and surgery, and have a seamless transition from one service to another.

The model proposed depended on the idea of a multidisciplinary clinical assessment and treatment service, or CATS, for musculoskeletal services. That would bring together clinicians from primary and secondary care, assess patients’ needs, treat them locally where possible, and where necessary refer them on for specialist hospital care. The document recognised that different health communities would implement the framework in different ways, and that it should be possible in some circumstances to offer patients a choice of pathways.

Three years after the publication of that document, in spring 2009, the British Institute of Musculoskeletal Medicine held a symposium to review progress in implementing the framework. Today’s debate echoes the frustration that was felt there. Although the symposium found that a number of excellent services had been developed, incorporating the vision of services integrated around the needs of patients, which this Government strongly endorse, interestingly it also found that those services were very different from one another. Some were still based in hospitals, some were in the community. Some were a see-and-treat type of service, but others had triage-based systems to refer people on to the most appropriate service. However, as the hon. Gentleman identified, there was still a patchiness to the provision.

The hon. Gentleman touched on the need to integrate services, which the Government are determined to drive forward in order to deliver better results for patients. We need to do that at the same time as acknowledging that people want to be able to exercise the maximum possible control and choice over their treatment. We set out our course clearly last year in the White Paper on the NHS, and just recently in the response to the NHS Future Forum we made it clear that we would be placing explicit duties on clinical commissioning groups to promote integrated services for patients. We will also further strengthen existing duties planned for the NHS commissioning board. We will amend the proposed duty of Monitor to make it clear that its core duty is to promote and protect the interests of patients, rather than to promote competition as an end in itself.

We intend those amendments, taken together, to create a strong incentive for local commissioners to take forward more integrated services, which I think all of us in the House wish to see delivered for people with musculoskeletal disorders and other patients. However, we have to go beyond just health integration and ensure that we achieve integration across health and social care. The hon. Gentleman was right about the concept of “no decision about me, without me”. We need to ensure that it is hard-wired into the way the NHS works.

[Nic Dakin]

The Minister has spelled out the Government’s position carefully. Will they publish a response to the Public Accounts Committee’s report, which responded to the National Audit Office, in taking forward the matter of musculoskeletal disease?

[Paul Burstow]

As ever, there is a clear obligation on us to respond to reports and recommendations of the Public Accounts Committee, which we happily fulfil. I am sure that we will do that if we have not already done so, and I am grateful to the hon. Gentleman for asking.

I turn to the specific issue of outcomes. The Government believe that a focus on outcomes is key to how we can drive improvements in the NHS. It is also how we can hold the NHS to account. That was why we published the NHS outcomes framework, to which the hon. Member for Blackley and Broughton referred, in January. It has five key domains that are populated by measures that will be used to judge outcomes. They are preventing people from dying prematurely; enhancing quality of life for people with long-term conditions; helping people to recover from episodes of ill health or following injury; ensuring that people have a positive experience of care; and treating and caring for people in a safe environment and protecting them from avoidable harm.

The second domain, improving the quality of life of people with long-term conditions, is clearly the most relevant to the debate. It includes an instrument known as EQ-5D, which is to measure people’s quality of life in a number of respects including mobility, pain and the ability to carry out the usual activities of daily living. The inclusion of that measure was the result of feedback from the public consultations last year on the outcomes framework. It is clear from the analysis done by the Department’s economists that almost half the total burden of disease, as measured by that instrument, is due to musculoskeletal disease.

In other words, the inclusion of that instrument in the NHS outcomes framework highlights clearly the importance of musculoskeletal conditions to the population, and why commissioners and clinicians need to focus their efforts on designing and delivering care pathways of the type outlined in the framework in 2006. It shows how that can have a significant impact on the aggregate score in the outcomes framework on enhanced quality of life for people with long-term conditions. It will not be possible to achieve success, as set out in the framework, without making progress in that way. There is a powerful new lever in the system as a consequence of the outcomes framework.

The hon. Gentleman talked about the atlas of variation, which is also a powerful tool for identifying outliers and allowing the appropriate challenge of commissioners and others on the decisions they have made. We intend it to be used by commissioners in that way, to drive improvements in the service.

I welcome the fact that the hon. Gentleman sees quality standards as a useful tool. NICE has already developed a quality standard for osteoarthritis, and we are looking at the scope for the development of a quality standard in pain management. We are about to see a further consultation on a range of subjects for the next batch of clinical quality standards. We have the hon. Gentleman’s suggestions on a musculoskeletal condition standard in mind.

This short but timely debate has highlighted an important area of health policy in which we need significant improvements on the ground. The evidence and clinical advice to provide excellent services is there, but we need clinicians to use their leadership role in the NHS to drive change, and we need to take the opportunities of changes in clinical and commissioning leadership to drive forward those reforms. I shall certainly ensure that the debate is referred to those who need to take such decisions, and I thank the hon. Gentleman for bringing the matter to the House tonight.

Question put and agreed to.

Winterbourne View Private Hospital

Paul Burstow Excerpts

Tuesday 21st June 2011 Written Statements

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

I promised to update the House about ongoing activity in relation to Winterbourne View private hospital.

The House will wish to be aware that steps to assure the welfare of patients at Winterbourne View are progressing well. Commissioners are arranging alternative placements. Most patients have now been moved and the remainder will leave Winterboume View shortly following a full review of each individual’s needs. There will be no new admissions to this hospital and enforcement action is being taken by the Care Quality Commission (CQC).

The multi-agency safeguarding process led by South Gloucestershire council is well under way. There is a range of advocacy arrangements in place and Castlebeck Care report that it has commissioned advocacy services for all patients in its care. Support is being considered on an individual basis at Winterbourne View through a multi-agency care planning process and independent advocacy.

The House will know that Castlebeck Care, South Gloucestershire council, the NHS and CQC have initiated investigations into their procedures and actions. The Department of Health will review the results of these and I will report back to Parliament at the completion of that review.

CQC expects to complete its investigation of all Castlebeck Care’s registered services by 1 July. Additionally CQC has started an internal audit and a human resources investigation, which will be finalised shortly. CQC will inspect rigorously a sample of hospitals for people with learning disabilities.

Following these inspections CQC is also exploring how it might do a wider review of the different models of learning disability provision. CQC is being advised on this work by a stakeholder group and will share the proposals on its planning and methodology with the Department of Health and Ministers as soon as possible.

CQC will also conduct an organisational review of actions which will look at the implications of events at Winterbourne View for the way in which CQC operates.

The South West strategic health authority is consulting the Department of Health on proposed terms of reference for its work to co-ordinate serious untoward incident investigations for all the English patients in Winterbourne View. This will investigate the NHS processes that operated in relation to the organisation of the care of patients treated in Winterbourne View.

Castlebeck Care has commissioned PricewaterhouseCoopers to undertake an independent review of all its provision, and Debra Moore Associates to undertake a clinical review of its services.

South Gloucestershire council has appointed Margaret Flynn, chair of the Lancashire safeguarding adults board, to chair the serious case review, which will take evidence from all the agencies involved. The indicative time scale is four to six months.

I have today placed in the Library the terms of reference for the Department of Health’s review. The review will receive independent advice from a range of experts in the field.

Southern Cross Healthcare

Paul Burstow Excerpts

Thursday 16th June 2011 Commons Chamber

[Nick Smith (Blaenau Gwent) (Lab)]

(Urgent Question): To ask the Secretary of State for Health what action the Government are taking in respect of the crisis in Southern Cross.

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

The Government have made it very clear that the welfare of residents living in Southern Cross homes is paramount. We appreciate that recent events and media speculation have caused concern to residents in Southern Cross care homes, to their relatives and families and to staff. I very much regret that.

I should like to reassure everyone that no one will find themselves homeless or without care. The Government will not stand by and let that happen. Department of Health officials have been in frequent contact with Southern Cross’s senior management over the past three months, and that will continue. We are engaged with the company, the landlords and the lenders, and we are monitoring the situation closely.

The Government are acting to ensure that all parties involved are working towards a swift resolution with a comprehensive plan for the future, which must have the welfare of residents at its heart. It is for Southern Cross, its landlords and those with an interest in the business to put in place a plan that stabilises the business and ensures operational continuity of the care homes. That work is happening, and we must let it continue.

Let me be clear: this is a commercial sector problem, and we look to the commercial sector to solve it. All the business interests involved fully understand their responsibilities, but the Government also have a role to play. That is why we are working closely with the Association of Directors of Adult Social Services, the Local Government Association, local authorities and the Care Quality Commission to ensure that robust local arrangements are in place to address the consequences in the event that the company’s restructuring plan failed to put in place a business that was on a stable footing.

Yesterday, a meeting took place between Southern Cross, lenders and landlords in a committee. They agreed to work together to deliver a consensual solution to the company’s current financial problems over the next four months. They also made it clear that continuity and quality of care for all 31,000 residents will be maintained and that every resident will be looked after. That is a welcome development and the Government are encouraged by that positive agreement by the main stakeholders.

The exact details of the restructuring plan over the next four months will be set out over the next few days and the following weeks. The joint statement issued yesterday by the company, the landlords and the lenders provides further reassurance that the continuity of care of the residents is at the centre of this consensual restructuring. The Government will continue to keep close contact with all involved in the process, and I will continue to keep the House informed.

[Nick Smith]

I thank the Minister for his statement. In recent months, we have seen a drip, drip, drip of negative news stories about the financial stability of Southern Cross. After yesterday’s meeting with the 80 different landlords, the company’s future is still very uncertain. However, residents of Southern Cross, their relatives and the directors of social services will need further information—sooner rather than later—on what comes next for the company.

Residents and their relatives need peace of mind, and they need it now. The company appears to be hanging by a thread; the numbers speak for themselves. It has reported half-yearly losses of £311 million and its share price has dropped by 97% since 2006. Forty thousand staff work for the organisation, but 3,000 redundancies have been announced. There are 31,000 residents in 750 care homes; this is a UK problem, with 400 constituencies affected in Wales, Scotland, Northern Ireland and England.

The Government have been too slow to get a grip on the situation. The issue has been live since last December, but Age Concern says that the Government have allowed it to reach this crisis point. Questions that need answering include the following. Newspaper reports say that Southern Cross owes Her Majesty’s Revenue and Customs £20 million. Will the Government allow the company to be dragged down by that £20 million debt? What banks are owed money by Southern Cross? How much is owed and what actions will the banks be taking? How are the Government working with the company’s landlords—particularly NHP Ltd, whose parent company is hidden in a fog of complex overseas equity holdings? What are the Government doing to ensure financial probity in this crucial sector? We need to stop the get-rich-quick merchants preying on our elderly relatives.

Who will lead on this issue at the very highest level? This is a cross-Government matter that needs health, business and regulatory intervention. We need reassurance that residents will be safe in their homes, that continuing care will be of the highest standard and that, in the coming months, the Government will focus on ensuring stable financial governance for companies that care for our old and our vulnerable.

[Paul Burstow]

The hon. Gentleman asks a number of questions, some of which are for Ministers and others of which are for the landlords. He asked about NHP Ltd, and he is right to identify the fact that it is the largest landlord. He also asked about bank lending; obviously, the lenders have a key part to play in a solvent restructuring of the business, and that is why they were at the meeting yesterday. He mentioned HMRC, which, as an autonomous Government body responsible for making these decisions, is considering those matters at the moment.

The hon. Gentleman asks about the financial problems and the seeds of the problems. I urge him, in looking at the history of this, to look back several years to the restructuring of the company and the business model that was established and that caused the problem, and to ask himself who were in government at that time.

[Mr Stephen Dorrell (Charnwood) (Con)]

Does my hon. Friend agree that the Government have just one priority in this set of circumstances, and that is to secure the interests of residents? Will he assure the House that he will send a clear message into the system that there will be zero tolerance of any slippage in the quality conditions that are imposed on the providers of care to residents, and that he will continue to keep his eyes firmly focused on the day-by-day quality of care that is delivered to residents?

--- Later in debate ---

[Paul Burstow]

The right hon. Gentleman is absolutely right. The Government’s paramount interest—it is the interest that all of us in this House should have—is to ensure the welfare of residents. That has been the message that I, as a Minister, and officials have been giving, and will continue to give, to Southern Cross and to the landlords, and the CQC will have the responsibility of ensuring that that is carried out. It is absolutely clear that we all have to ensure that the restructuring succeeds, because that is in the best long-term interests of the residents.

[Emily Thornberry (Islington South and Finsbury) (Lab)]

I thank the Minister for his statement, limited though it is. I congratulate my hon. Friend the Member for Blaenau Gwent (Nick Smith) on being granted this urgent question on an issue of great importance to Members of the House.

This is not the first time that Members have tried to bring the Minister with responsibility for care services before them to respond to their concerns. The lack of leadership and information from him during this period of uncertainty and anxiety for Southern Cross residents and their families, as well as its employees, has been notable. As a result of the agreement reached yesterday, we now appear to have a period of relative stability. However, great uncertainty remains for residents and employees at Southern Cross homes. We have heard that Southern Cross will now begin a period of restructuring, with reports of around 300 homes changing management, but contracts have been ripped up and it seems that 3,000 jobs are being lost. What assurances can the Minister give on security of employment for those working in Southern Cross?

On safety, last week we heard that Southern Cross is making 3,000 people redundant. We have also heard from the Care Quality Commission that Southern Cross has breached standards at 164 care homes—the equivalent of 28% of its English estate. Can the Minister guarantee the safety of and standard of care for residents, and how will he do this? Will the CQC carry out more frequent inspections?

There has been widespread condemnation of the business practices that led to Southern Cross’s financial problems. It is all very well for the Minister to point fingers at what might have happened many years ago, but this problem exists now, and the Minister is in government now. When people are treated as commodities with no thought to the consequences for them of this risky business model it is important that Government step up to the plate and do something about it. Southern Cross is not the only company in this industry to have financial difficulties. We have heard from the Business Secretary that the business model of Southern Cross and others in the residential care industry will be looked at by his Department. Will the Minister provide more details on the timing of this review and how Members will be told about its findings?

On cuts, the Minister says that there will be robust local arrangements, and I am sure that local authorities will step up to the plate if asked to do so. He must recognise, however, that local authorities are already under enormous strain as a result of the cuts imposed on them by his Government, including the cuts that they are already having to make to adult social care. How can they be expected to pick up the pieces of this national problem without assistance nationally from Government? In other words, are they to be given more resources to deal with the problem of Southern Cross if they are expected to be involved in plan B?

[Paul Burstow]

The hon. Lady is long on critique but very shallow when it comes to how she would approach this differently. Last week, I set out in a written ministerial statement the approach that the Government were taking. We also dealt with this extensively at last week’s Health questions.

The hon. Lady asked about the 3,000 job losses that are being proposed as part of redundancy measures by Southern Cross. Let us be clear: it has a statutory obligation to declare a ceiling for the number of job losses that may—I repeat, may—take place in the business. I have asked the CQC to undertake additional inspections to address concerns arising from the proposed job losses, and that has already been put in place.

The hon. Lady talks about cuts in social care spending but glosses over the fact that this Government, through the spending review, agreed to an unprecedented transfer of resources from the national health service to support social care, with £2 billion extra going into social care by 2014.

We might agree that we need to learn lessons from what is happening to Southern Cross, in respect of regulation and how we ensure a stable and successful social care sector for the future. That is why the Government are committed to an overhaul of social care and to bringing forward a White Paper to set out the plans in due course.

[Neil Carmichael (Stroud) (Con)]

Does the Minister agree that the fundamental problem was a flawed business model that was allowed to exist for far too long under the previous Government?

[Paul Burstow]

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.

[Mr Michael Meacher (Oldham West and Royton) (Lab)]

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?

[Paul Burstow]

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.

[Mr Bernard Jenkin (Harwich and North Essex) (Con)]

I thank the Minister for the information he has given the House and congratulate the hon. Member for Blaenau Gwent (Nick Smith) on his urgent question. There are two such homes in my constituency. This matter is of great concern not just to residents, but to staff. The impact on staff morale has an impact, in turn, on the care given to residents. I urge my hon. Friend to facilitate a speedy resolution as best he can, and to look at the model that we expect local authorities to adopt for buying care. Residents, their families and their advocates should be consulted more and be more involved in the process, so that care is more tailored and there are not such enlarged packages that can be exploited by large organisations, which may not be run as openly and transparently as they should be.

[Paul Burstow]

I am grateful to my hon. Friend for that important question, which points to the need for greater personalisation in the delivery of social care in the longer run. At the moment, in concert with our local authority colleagues, we must be clear about what happens in the event of failure, but also focus on ensuring that this business successfully ensures its future, and that of its employees and the residents who live in its homes.

[Mr Dennis Skinner (Bolsover) (Lab)]

A lot of people know that running care homes has been a licence to print money. This is the second such case in a fortnight, the first being Winterbourne View. There are billionaires in the background making a ton of money. There is evidence that it is not just Southern Cross that is in this position. The goose might have stopped laying the golden eggs, so it is time to go back to what we had in the old days: local authorities being in charge and owning care homes. What is more, would it not be wonderful if everybody was able to go to care homes, like hospitals, free of charge?

[Paul Burstow]

It is important to put on record that something that the hon. Gentleman said is not, and never has been, the case. Social care in this country is not free. That is one of the big inequities of our current system and one of the big challenges that the Government are determined to address through the review that Andrew Dilnot is undertaking.

On the hon. Gentleman’s question about the good old days, I have to say that many people did not see those days as good, because the care was not personalised and individualised, and it was not always of good quality, either.

[James Morris (Halesowen and Rowley Regis) (Con)]

Will the Minister say something more about the specific steps he is taking to see that the Care Quality Commission ensures that standards of care are maintained during the transition period in homes in my constituency owned by Southern Cross? What steps will he take to ensure that the CQC takes its responsibilities seriously?

--- Later in debate ---

[Paul Burstow]

That is rightly a key preoccupation of all Members who have constituents who are Southern Cross care home residents and their family members. We have been very clear in our discussions with the CQC that it has to maintain a clear focus on the behaviour and conduct of those homes during the transitional period, and particularly during the restructuring. As other hon. Members have rightly said, the CQC has already identified problems and is addressing them through its enforcement powers, and it will continue to do so.

[Meg Munn (Sheffield, Heeley) (Lab/Co-op)]

The Minister will know that many residents of Southern Cross homes, including in my constituency, have dementia, and that a lot of people with dementia cope very poorly with changes. What may happen is therefore of enormous concern to their relatives. May I therefore press the Minister—he must have had discussions with his officials—on what the Government’s legal position is, what the back-stop is if the worst case scenario develops, and what he will do now to reassure my constituents and many others that the Government really will ensure that their relatives do not face changes that will dramatically affect their quality of life?

[Paul Burstow]

rose—

[Mr Speaker]

Order. By my reckoning the hon. Lady posed three questions, but I know that there will be an immaculate and beautifully tailored single reply from the Minister.

[Paul Burstow]

Thank you very much, Mr Speaker.

I can assure the hon. Lady that, first and foremost, clear arrangements are in place to deal with a catastrophic failure, which I think is now increasingly unlikely. More importantly, we need to ensure that we learn lessons from past care home closures and take them into account in future. However, we can also be clear that the underlying viability of this business is very strong indeed. We need care homes, and that is why we now have a route towards a solvent restructuring of the business.

[Andrew Percy (Brigg and Goole) (Con)]

My concern is for the residents of the two care homes in my constituency, one in Goole and one in the Skippingdale area of Scunthorpe. It would be wrong if anyone tried to use the situation as a shield for making cheap political points.

Given that there are going to be up to 3,000 job losses, what measures will the Government take to monitor the quality of care and the staff ratio at individual homes, to ensure that there is no negative on impact on the residents? We are all concerned about that.

[Paul Burstow]

The hon. Gentleman asks an important question about the impact on the quality of care if there are staff losses. When it became clear that the company was posting a figure of 3,000 redundancies, I instructed the CQC to undertake additional assessments to ascertain any likely effect and ensure that there is no impact on the quality of care.

[Mr Jim Cunningham (Coventry South) (Lab)]

What is the Minister doing to beef up the CQC? As I understand it, there have been a number of redundancies there, and if he wants to maintain the quality of care he has to beef it up. Does he know that the Coventry Evening Telegraph recently conducted an investigation into 10 homes in Coventry, which were found greatly wanting in their standards, hygiene and medicine distribution?

[Paul Burstow]

On the hon. Gentleman’s question about the staffing of the CQC, I can confirm that last October I authorised an additional 75 inspectors’ posts to be filled by that organisation to strengthen it in the very way that he asks for.

[Miss Anne McIntosh (Thirsk and Malton) (Con)]

Given that the change in business model seems to have led to the current difficulties, what procedures have the Government and the Department put in place to prevent similar business collapses? Is the Minister convinced that the CQC has sufficient investigative, as opposed to enforcement, powers should the problem sadly recur in future?

[Paul Burstow]

There are certainly issues arising from the current situation that we will want to consider as we go about reforming social care. However, I think it would be wrong, while we are in the midst of the restructuring that the company is undertaking, to bring forward a hard and fast set of solutions to ensure the long-term stability of the social care sector.

[Mr Pat McFadden (Wolverhampton South East) (Lab)]

Tomorrow I will visit Bellevue Court in my constituency, one of the many Southern Cross-run homes around the country. I note what the Minister says about the Government guaranteeing that no one in the care of Southern Cross will be left without care as a result of what is happening. Clearly it is preferable for Southern Cross and its landlords and lenders to reach a solution that ensures that, but may I press him a little harder on what will happen if that does not come about? How will he live up to the guarantee, which the whole House has noted today, that if the rescue plan that Southern Cross is trying to achieve does not come about, the Government will ensure that no one is left without care and no one’s care is compromised either in Bellevue Court or in any of the 750 homes throughout the country?

[Paul Burstow]

I entirely understand why the right hon. Gentleman wants to press for further details about what would happen in the hypothetical circumstances that he is keen to explore. However, given the nature of the commercial discussions that are going on at the moment, to give credibility to hypothetical situations is to create the possibility of their becoming a reality. I do not want that to happen.

[Jake Berry (Rossendale and Darwen) (Con)]

The previous Government’s failure to regulate the banks led to a crisis in that sector. Is the national disgrace of Southern Cross, to which Members of all parties have referred, caused by a similar dereliction of duty through their failure to regulate the care sector?

[Paul Burstow]

I am entirely focused on ensuring, through the facilities and offices of the Government, that all the parties involved are clear about their responsibilities, which they are, and that they understand the reputational damage to them if they do not do what they must, which is to ensure a timely, thorough and effective restructuring of the business that secures the continuity of care for residents.

[John Mann (Bassetlaw) (Lab)]

In opposing the proposed sell-off of care homes by Nottinghamshire county council, I have been warning the council for 18 months about the crisis in Southern Cross, but that is not the only big care home provider with problems. As Mimosa, another major provider in my constituency, is also now in crisis and threatening to throw people out of Forest Hill care home, is the Minister prepared to meet families from my constituency so that he is ahead of the game on the next occasion rather than behind it?

[Paul Burstow]

rose—

[Mr Speaker]

Order. I will of course ask the Minister to provide a brief reply, as I know he will be happy to do, but we must focus on the very specific question of Southern Cross. This is not a general debate, whatever the temptations experienced by the hon. Gentleman.

[Paul Burstow]

In the spirit in which the question was asked, if the hon. Gentleman were to write to me I would be only too happy to consider his request.

[Andrew Stephenson (Pendle) (Con)]

The residents of Brierfield House care home in Brierfield and Hulton care home in Nelson will welcome the Minister’s reassurance that no one will end up homeless as a result of this fiasco. Will he say more about how we will learn the broad lessons of this situation and ensure that something like this can never happen again?

[Paul Burstow]

As I have indicated, in the work that we are currently doing preparatory to producing a White Paper later this year, we are engaged with many stakeholders in discussing quality and regulation. We want to ensure that we are clear about the right questions to ask in framing policy, and that we then get the right policy to deliver a more sustainable, high-quality social care system for the future.

[Kevin Brennan (Cardiff West) (Lab)]

The point that my right hon. Friend the Member for Wolverhampton South East (Mr McFadden) made is the key one. The Minister has been very careful not to say what he should be saying, and I understand why—his officials will have told him not to. Will he pledge to the House that if there is a catastrophe of the kind we all want to avoid, every vulnerable person who should not be moved will be able to stay in their residential home? That is the pledge that we need to hear from him today. He needs to show some leadership as the Minister responsible.

[Paul Burstow]

The pledge that I can give to the House today is that all local authorities with Southern Cross care homes and responsibilities for residents whom they have placed there are clear about their statutory duties to guarantee and provide care, not just for state-funded residents, but for those who are self-funded. That is the clearest guarantee that I can offer—it is the essential guarantee of continuity of care.

[Mr Philip Hollobone (Kettering) (Con)]

My constituents are unclear about what effective regulatory early warning system exists to detect financial weakness in care home providers. In the light of the Southern Cross experience, how can any such mechanism be improved?

[Paul Burstow]

A number of hon. Members have asked how we ensure that we improve the system. Indeed, one question that the Health and Social Care Bill rightly raises is the future role of Monitor in effective regulation of the social care sector. We are exploring that issue with colleagues in the Department for Business, Innovation and Skills, and we continue to discuss it with other stakeholders. That could well offer us a longer-term solution.

[Ann Clwyd (Cynon Valley) (Lab)]

As the Minister says, the care sector is increasingly reliant on private sector providers. The sector includes not only people who run care homes, but care agencies. I suspect that they will be one of our next problems.

As a significant proportion of care home and care agency income comes from public funds, I believe that the Government and local authorities have both the right and the responsibility to assess the financial stability of providers, which they entrust with the care of very vulnerable people. Why has that not been done?

[Paul Burstow]

I should take this opportunity, because it has not been asked of me, to say that I have this week spoken to Ministers in the devolved Administrations. My officials maintain contact and dialogue with them. There are real concerns in Wales, where 17,000 residents in 54 care homes are affected.

The right hon. Lady is right that we need to look at wider issues in the sector. Of course, under the current legislative arrangements, the CQC has a duty to examine financial viability. We will look at that issue further.

[Mr Peter Bone (Wellingborough) (Con)]

Following the remarks made by the right hon. Member for Oldham West and Royton (Mr Meacher), directors have very specific duties in the stewardship of a company. Has the Minister had any discussions with the Business, Innovation and Skills Secretary about referring this matter?

[Paul Burstow]

I have not had those discussions—the need has not arisen—but I can be clear that the company feels that the consequences of yesterday’s meetings are important in terms of its ability to carry out a restructuring that safeguards the interests of residents.

[Gloria De Piero (Ashfield) (Lab)]

My constituents ask me specifically whether their elderly and sometimes frail relatives face the prospect of moving. I realise that my hon. Friend the Member for Cardiff West (Kevin Brennan) raised that issue, but what reassurance are we to give to our constituents in that respect?

[Paul Burstow]

I have tried to give the House a number of reassurances on that point. I would add that there have been home closures over a number of years, from which we must learn lessons. One lesson is that we must minimise the possibility of closures and ensure that when they take place they are handled sensitively, slowly and carefully. That is why I welcome the work that the Association of Directors of Adult Social Services recently published—it sets out strong, clear, evidence-based guidance to assist local authorities in managing any closures in future.

[Diana Johnson (Kingston upon Hull North) (Lab)]

I have one Southern Cross home on Kesteven way in Hull and I am concerned about what the Minister said and the complacent attitude that the Department of Health is showing on the role of local authorities. Is there a co-ordinated plan for the whole country, bringing together all the local authority plans, so that we know that there is coverage for the whole country if the worst happens? I am not sure that there is.

[Paul Burstow]

Such work is in hand and has been for some time.

[Emma Reynolds (Wolverhampton North East) (Lab)]

There is concern among Members on both sides of the House that 31,000 of the most vulnerable people in our country face having to move care home, with all the risks to their health that that involves. The Minister should not introduce a White Paper but sense the urgency of the matter. He should introduce regulations to ensure that the sector is more tightly regulated, and that such a situation does not happen again.

[Paul Burstow]

I understand the desire of all hon. Members for urgent action and a rapid resolution that secures the interests of residents, but I did not hear the hon. Lady suggest what those changes to regulation should be. When she cares to offer such suggestions, we can look at them.

[Ian Mearns (Gateshead) (Lab)]

I am grateful for the Minister’s reassurances, but I am afraid that they ring a little hollow, because I was aware of a great many shortcomings in the level and quality of care in Southern Cross homes in Gateshead before its financial crisis became a matter of public record. It seems that the CQC is looking at homes on an individual basis, and that it is not drawing a national pattern of the rotten care ethos within the whole of that organisation. When will the Minister address this as a national problem?

[Paul Burstow]

I am doing that, and shall certainly make it my business to look up past correspondence from the hon. Gentleman raising those concerns, so that we ensure that they are properly addressed.

[Several hon. Members]

rose—

--- Later in debate ---

[Paul Burstow]

Two contributors to this debate have conflated two completely separate issues. Yes, the business is in serious financial stress—it is working its way through to being a viable business in future—but this is not about the abuse of older people in those homes. We should not conflate the two. It is unhelpful. We need to have a sensible debate and secure a sensible restructuring of the business.

[Mr Tom Watson (West Bromwich East) (Lab)]

I must tell the Minister that he is displaying a remarkable complacency in this crisis, which—like it or not—is his responsibility now. Hon. Members on both sides of the House will be holding surgeries this weekend and meeting the families and loved ones of the vulnerable people who live in those care homes. He has failed to give any guarantee about their future and he has not convinced the House of what lessons he has learned in the short term. This weekend, who can we phone—who will be in the Department?—if there is a problem?

[Paul Burstow]

I made it clear in my statement that the Department has taken steps, working with landlords, Southern Cross and others, to ensure that each party is clear about its responsibilities, and clear on what actions they would take in the event of business closure. However, I also want to be clear that as we move forward, we need to ensure that we learn lessons from this in the context of regulation, and to ask how this was allowed to occur in the first place. Now is not the time for those questions. My focus, as the Minister, is ensuring a successful restructuring of the business, and ensuring that the business remains focused on the welfare of residents.

[Lilian Greenwood (Nottingham South) (Lab)]

I am sorry to press the Minister again on this, but I think he recognises that changes to care, even when well planned, have a serious impact on the health of care home residents. Can he guarantee that if those commercial discussions fail, residents will continue to be cared for in their existing homes?

[Paul Burstow]

The Government have made it clear that in no circumstances will we allow the residents of any of those care homes to find themselves made homeless without good continuity of care. That is the pledge that we make.

[Joan Walley (Stoke-on-Trent North) (Lab)]

But is not the real question how the Minister will secure that guarantee? There is a real tension between care and commerce, and it seems to me that the restructuring could well affect certain areas disproportionately. We need briefings from the Care Quality Commission to ensure that Members in their constituencies can have feedback and reports on exactly how this matter is being dealt with.

[Paul Burstow]

I have already said that I take seriously the need to keep the House informed as we progress these matters. I am also clear that the paramount interest—the interest that the regulator has a statutory duty to enforce—is residents’ welfare. That is what we are doing, and what we will continue to do.

[Nic Dakin (Scunthorpe) (Lab)]

I welcome the Minister’s comment that every resident will be looked after. Will he further reassure residents of Baytree Court in my constituency that they will suffer no detriment as a result of this situation?

[Paul Burstow]

I can say that of course we need to make it absolutely clear to landlords and the company that their actions have consequences, and that their actions now must be focused on a speedy resolution to the restructuring of the business that ensures it can continue to employ good-quality staff and provide care for the 31,000 people who live in its homes.

[Cathy Jamieson (Kilmarnock and Loudoun) (Lab/Co-op)]

I heard the Minister say that he had had discussions with the devolved Administrations. In his discussions with his Scottish counterparts, was he made aware of the very real concerns of the Convention of Scottish Local Authorities that should there be a catastrophic outcome, as he described it, they would not have the funding or resources to deal with the consequences? What is he going to offer to help in that respect?

[Paul Burstow]

That catastrophic outcome is by far the most unlikely of all the outcomes for Southern Cross. The most likely outcome is a successful restructuring with some of the business being moved to other operators that currently are the landlords of some of these homes. When I spoke to Nicola Sturgeon earlier this week, we discussed all the issues that concern her and me, and we agreed on the need to pursue the path of a consensual, solvent restructuring of the business as the best way of securing the welfare of the residents in those homes.

[Katy Clark (North Ayrshire and Arran) (Lab)]

Eighty per cent. of Southern Cross’s income comes from the taxpayer, yet attempts seem to have been made to offshore as much of that money as possible. Age UK says that in the future all care home providers should have to demonstrate to the regulators that they have a solid business model. In his answer to my hon. Friend the Member for Wolverhampton North East (Emma Reynolds), the Minister seemed to imply that there had been no suggestions for how regulation could be strengthened. Will he seriously consider Age UK’s suggestion over the coming months?

[Paul Burstow]

I am grateful for that question because it allows me to make the point that Age UK was very welcoming of the Government’s proposition to look at Monitor’s role in the social care sector. We are in discussions with it and will continue to consider the idea.

[Mrs Mary Glindon (North Tyneside) (Lab)]

I understand that the Department of Health was invited to yesterday’s meeting with Southern Cross. With 31,000 vulnerable people facing the possibility of losing their homes, why did no one from the Government attend?

[Paul Burstow]

The character of the meeting has changed significantly over the past couple of days. The meeting is now focused on reaching a clear agreement between the lenders, the landlord and Southern Cross. We wanted to ensure that they were focused on that, which is why no representatives of the Department of Health were at the meeting.

[Jim McGovern (Dundee West) (Lab)]

All the contributions today have concentrated mainly on the rights and plight of residents, which is entirely understandable—I would not expect it to be any other way—but we should also think about the work force of Southern Cross. Just yesterday I was in touch with the local GMB organiser in Dundee, John Moist, who told me that at the homes in Dundee the work force are totally demoralised, which I think the Minister would agree is not the best atmosphere in which to provide care. Further to what was said earlier, will he consider setting up a helpline for MPs? Hon. Friends have talked about family members of residents coming to their surgeries this week; I have had employees at my surgeries, and it would help if I had someone to contact.

[Paul Burstow]

Just two days ago, I had a meeting with GMB officials to discuss their concerns about this and other issues in the social care sector. Of course we will consider the appropriate arrangements that might need to be put in place in the event of the scenarios that the hon. Gentleman talked about.