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Personal Care at Home Bill

The hon. Gentleman makes an important point. There are some people for whom reablement, or intensive support, would not be appropriate. He gave as an example people who receive palliative care, and that is obviously true for them. Nobody would want anything in the Bill to place pressure on people or put them through a process that they must and should not go through. The regulations under the legislation will make that clear. Of course, the measures should not deny such people any support should they qualify under the relevant terms. We believe that by investing in reablement we can prevent emergency admissions to hospital, prevent people from ending up in crisis situations and help people live independently in their homes for longer. I have mentioned the Isle of Wight a few times. It has had a 40 per cent. reduction in residential care placements since it introduced free personal care in the home. That work is already going on in other places and showing its worth. The Wirral is also taking a lead on investment in reablement services. Let me give an example. A 77-year-old woman who had been dependent on carers for two years was admitted to hospital for aortic valve surgery. She had got used to doing very little for herself; she was sleeping downstairs and was using a bowl of water in the lounge and a commode to meet her personal care needs. On discharge, she received three visits a day from the home assessment and reablement team to help her with personal care and meal preparation. The team helped her to practise using the stairs and encouraged her to undertake daily tasks such as opening the curtains, putting on the washing and making her own lunch. Over six weeks, the number of visits that were required gradually decreased, and she is now living happily and independently without any intervention from social services. Such inspiring examples show how we can help people to regain independence and how we can spend public money more effectively. In that way, the Bill aims to enable people to retain their independence, as well as aiming to reduce costs and prevent ill health. It will help to ensure that people remain economically active by providing the support and control that families and carers need to balance work and caring. We want to build on the work that many councils have already begun on prevention and intervention to support people in living independently in the community. The Bill encourages, but does not require, councils to offer a reablement package. The offer of free personal care and better use of resources will push authorities to bring in alternative models of care and will embed prevention and reablement, all of which have been shown to be more cost effective and to offer better outcomes. That approach could help authorities to generate by 2013 the £250 million that early estimates suggest will be the additional cost of free personal care. It will reduce the cost of care for individuals, including those who continue to fund their own care, and will help people to stay independent. By extending a hand to those with lower-level needs, we can help to reduce isolation and help to keep people active. In doing so, we can prevent people from slipping to the point at which more intensive care and support is required. There has been a great deal of speculation and misinformation about how the Bill will be funded, so I shall take this opportunity to explain our approach again in the clearest terms possible. The measures we are proposing will cost £670 million in the first full year, which will be provided entirely from the Department of Health budget and by local government. Some £420 million will come from the Department, and the remainder will be met by local authorities. That funding, along with the scope for further efficiency gains, will be considered as part of the normal spending review process. It is right that councils should play their part alongside central Government in helping to deliver the commitment on free personal care. We will be consulting on the distribution mechanism for local authorities. I repeat that it is completely incorrect to say that any of the money will come from cutting disability benefits or from cutting cancer research or any other important research.