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Health and Social Care Bill

I am pleased to support the amendments, which my hon. Friend the Member for Hendon (Mr. Dismore) tabled so competently and ably. Indeed, they reflect amendments that I tabled in Committee, although I tried to go slightly further than my hon. Friend in that they would have covered all residents of private care homes. Of course, I understand my hon. Friend the Minister's concern about the difficulty of covering self-funders because the Human Rights Act specifically covers relations between the individual and the state, and self-funders are, by definition, private residents paying a private concern to care for them—the state is not directly involved. However, I believe that we should find a way to ensure that all residents of care homes are covered by the Human Rights Act. At the moment, if one is in a care home that is privatised, or moved from a public to a private care home, one is removed from coverage of the Human Rights Act, and that is unacceptable. Even if the Government tabled amendments along the lines suggested by my hon. Friend the Member for Hendon, the self-funders would still not be covered. I have a possible solution, which I will urge on the Minister later, but I will not spring that surprise on him just yet. The problems arise from two fundamental factors, about which I was not happy when they occurred. The first is the privatisation of care homes. If they had stayed in the public sector and all care homes were in the public sector, there would not be a problem. The second is means-testing funding. If all funding were public, without means-testing, there would not be a problem. I urge the Government to reconsider the recommendations of the royal commission on long term care for the elderly that all care home residents should be publicly funded out of taxation—progressive taxation at that. There would be no problem with coverage by the Human Rights Act if the Government ensured that all residents of care homes were publicly funded. When the royal commission produced its recommendations, it estimated the cost to the Exchequer at £1 billion a year. That is not much money in the great scheme of things—it is the equivalent of one third of a penny on the standard rate. I have spoken to many people, in meetings and privately, and asked whether anyone would object to the equivalent of a third of a penny extra taxation to pay for long-term care for everyone, including us. Many of us, because we will live longer and are much healthier than we were, will probably finish up in care towards the end of our lives. Indeed, some people might even choose to enter long-term residential care, which should also be an option, rather than having to enter it because of ill health or infirmity. If we could all be assured that, whatever happened, we would be guaranteed long-term care at the end of our lives that was properly funded by the state, we would all be greatly relieved. Indeed, I have heard no one object to that proposition in all my conversations. The other issue is the privatisation of care homes. Personally, I was deeply opposed to the privatisation of care homes and opposed the effective privatisation of care in my constituency, encountering some difficulties with the local authority at the time. Nevertheless, the changes went ahead, under pressure from the Government and through the use of legislative and financial means to press the authority to move care into the private sector. In effect, that is how things happened—there are still some public care homes, but as the hon. Member for Romsey (Sandra Gidley), speaking for the Liberal Democrats, pointed out, 90 per cent. of care is now in the voluntary and private sectors. That is a matter of concern. I believe profoundly in the public service ethos—the idea that when people work in care, they do so not for profit, but to care for their fellow human beings, out of a commitment to their interests. If care is in the public sector, that is indeed what happens. One of the care homes in my constituency that closed down was in the middle of a large community from which people went into residential care. The home was staffed by people from that community who were long-term workers there and was democratically accountable to the local authority. That was the ideal situation, yet the home was closed and the care moved into the private sector. I know that we are not talking about bringing all care back into the public sector at this stage, although there is a mood of nationalisation abroad today that I welcome very much. In the longer term, I hope that the Government will look to public ownership once again and make long-term care part of the overall health provision envisaged by everyone from Nye Bevan onwards, based on the principle of universality so well expressed by Beveridge, Bevan and many other socialists of that time, but perhaps put most brilliantly by Professor Richard Titmuss, who influenced me in my youth in setting out the case for universal provision. I have made my point. I hope that the Government will consider the possibility of providing free long-term care, which would overcome the problem, and, in the longer term, bringing all care back into the public health service.