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Caring for the Elderly

We have had a wide-ranging debate that has been characterised by thorough and thoughtful contributions from both sides of the House. In addition to all our constituents, many of us have parents, grandparents, other relations and friends for whom these subjects are a genuine reality. In that spirit, I pay particular tribute to the measured, moving and brave speech by the hon. Member for Colne Valley (Kali Mountford). It was one of her understandably rare speeches in the House, and we all listened to it with great care. The debate has also been characterised to some degree by disappointment in the Government. That disappointment coalesces around the question: who has been in Government for the past 12 years? We must also ask who promised, 12 years ago, to deal with the very issues before us today. My hon. Friend the Member for Eastbourne (Mr. Waterson) opened the debate with an excellent speech that covered the economic issues affecting pensioners and addressed the aspects of the motion that cover care of the elderly in the round. He pointed out that the present Prime Minister promised to end the means test for elderly people, but had not done so. The Labour party promised in its 1997 manifesto that""all pensioners should share fairly in the increasing prosperity of the nation"," and, as we saw on countless news bulletins last night, Tony Blair told the 1997 Labour party conference that he did not want children to be""brought up in a country where the only way pensioners can get long-term care is by selling their home"." On that latter point of care, it is not as if the Government have not had chances to deliver. On the subject of caring for the elderly—the title of this debate—the Government set up a royal commission on long-term care as far back as 1999. In 2006 the King's Fund published the Wanless report, which set out the models and problems faced much more thoroughly than the Government's Green Paper published yesterday did. In response to the Wanless review, the then Health Minister, the right hon. Member for Birmingham, Hodge Hill (Mr. Byrne), who is now Chief Secretary to the Treasury, announced a zero-based review. There is no evidence of any serious work being undertaken as a result of that; it seems that it amounted to little more than kicking the problem into the long grass. Expectation then coalesced around the comprehensive spending review in 2008— fuelled by comments by the then Minister, the hon. Member for Bury, South (Mr. Lewis), who is now a Foreign Office Minister. He said that the Department would""secure a fair and reasonable settlement as part of the comprehensive spending review"—[Official Report, 21 February 2007; Vol. 457, c. 98WH.]" It did not: the spending review simply announced another consultation. That consultation was launched by the Prime Minister in May 2008, in a speech to the King's Fund, in which he said:""the government is publishing a consultation document setting out the challenges we face and why we must now look again at the options for reforming our current system of care and support."" I see that the Prime Minister also wrote a foreword to yesterday's Green Paper, which said:""What is now needed is a major debate about the challenge we face and the options for addressing it. This Green Paper sets out those options and the principles which we must now consider. This is the start of a process of discussion rather than the end"." It is thus a fair question to ask just how many starts the Government need. We rightly ask that question, as my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) comprehensively did in his response to yesterday's statement. Let me touch briefly on the question of consensus. Throughout this debate Ministers, including the Prime Minister, have deployed the word "consensus". The Prime Minister ended his King's Fund speech by saying:""I look forward to building a consensus in this country about the best way ahead."" But the Government's record suggests that their understanding of the concept of consensus is to use it as a cloak when they are in trouble. At no point have they approached vast numbers of people in the third sector, let alone the official Opposition, to discuss the ways forward. As far as I know, they have not talked formally even to the Liberal Democrats or others. One would have thought that that was hardly a way to build a consensus. More importantly, the Government have consistently withheld the work they have commissioned and paid for with taxpayers' money, using it for political leaks rather than for informing public debate. If this talk of consensus is to be more than warm words, the Government need to start building one, as urged by the hon. Member for Wyre Forest (Dr. Taylor) and by my hon. and learned Friend the Member for Torridge and West Devon (Mr. Cox), who spoke powerfully, informed by his experience of caring for his grandmother. They need to build consensus around agreement that social care in all its ramifications cannot be fully met from taxation alone. I turn to the so-called models or options set out in yesterday's Green Paper. On the first, which the Government call the partnership option, the House must be careful about the choice of words. Derek Wanless described a partnership model, but for him, the Government would pay a first section of the costs and would match-fund the next section—an element that has slipped away in the Green Paper. The insurance option is actually a partnership plus, with insurance coming in to fill the gap. This was favoured by my right hon. Friend the Member for Charnwood (Mr. Dorrell), who spoke authoritatively and reminded us that it has been 12 long years since a proposal was first promised by the Government. From the Government's presentation, it did not look as though traditional insurance solutions would work, so considerably more examination was needed. Inexplicably, however, the state-backed version of the insurance model has not been modelled. Indeed, an impact assessment, signed by the Minister of State, Department of Health, the hon. Member for Corby (Phil Hope) who is about to reply to the debate, said that all the benefits had been properly assessed for impact. When we get to the comprehensive model, however, it is equally problematic, and the impact assessment admits that this model has not been specifically modelled. According to the impact assessments, it looks as though all the Government's preferred solutions and schemes assume that money is to be taken from abolishing the attendance allowance. The Green Paper is blind on this issue, so will the Minister explain what assumptions the models make about the disability living allowance? I shall now talk briefly about people with disabilities who are under 65. Mike Smith, chair of the National Centre for Independent Living, said yesterday:""Disabled and older people were hoping for leadership from the government in care reform."" It is clear that there are few ringing endorsements for the Government from the care sector. Indeed, it has been pointed out that reform was urgent for 12 years and remains so today, and that those under 65 with lifetime care needs have been completely overlooked. We need to ask the Government a question that they have sought to skate over, not least yesterday. They call this a national care service. The national health service was extended throughout the United Kingdom from the outset. Can the Minister explain what the Government's plans are as regards cross-border portability in social care in a national care service, when it is impossible for Members, or indeed Government policy, to impose what the Government claim will be part of a national service on three parts of the United Kingdom? That question has yet to be answered. I hope that the Minister will also be able to tell us what provision the Green Paper makes for meeting the costs of accommodation and food—the so-called hotel costs. It is interesting that, having said that he would set out his own party's policy, the hon. Member for Leeds, North-West (Greg Mulholland) failed to do so, because—not least at the last general election—the Liberal Democrats said that they would meet care costs, including "hotel costs", because that had worked in Scotland. It did not work in Scotland. Indeed, in answer to a question from me in Westminster Hall, the hon. Member for Romsey (Sandra Gidley) put it on record—it is in the Official Report—that the Liberal Democrats' policy had been dishonest, and that the writers of her party manifesto had used that approach. Lest anyone become carried away with the word "consensus", let me say that politics is about choices. Let me take this opportunity to explode the myth that Labour has been peddling about Conservative policies, not least in Norwich, which I have visited twice. How many times has the Minister been there? Labour is saying that we would cut pension credit, but that claim is dishonest. We have never said that we would cut pensions or pension credit. Labour is saying that we would scrap free television licences, but that claim too is dishonest. We have no plans to scrap free television licences. Labour is claiming that we would scrap free bus passes for the elderly, but we have no such plans, and it is dishonest to claim otherwise. Let us rise above Labour's mischief, however. The debate has given us all a chance to rededicate ourselves to delivering, above all, independence, dignity, security and good-quality care to our elderly population. We must all work towards that, and nothing less. It is the job of our political generation to find the way forward, and we shall.