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Personal Care at Home Bill

I understand that it is important for us not to have a perverse incentive that means that people who should be in long-term residential care are not, and that they are instead being looked after at home in ways that are not necessarily in their best interests. There are clearly worries about that. Many families and individuals make the decision for their older relative, partner or spouse to be in long-term residential care most reluctantly and when it is in their best interests to be there. We should not create an ideological fixation on people not being in long-term residential care. We should operate on the basis of what is in the best interests of older people themselves. Equally, I agree with the hon. Gentleman that we should not seek to create a perverse incentive for people to be in long-term residential care because there is not adequate support in the domiciliary context. That is why, as I have just said, we should consider the opportunity of extending the voluntary insurance concept to critical care needs in domiciliary care. In the circumstances that we have described, with an affordable insurance market to meet the costs of long-term residential care, insurance providers will have an incentive to help people stay at home rather than go into long-term residential care, so we can begin to create the broader insurance system that I understood underlay one of the Government's options in the Green Paper. To that extent, although we clearly have problems with the Government's Green Paper, we have not said that we are not prepared to use it as a basis on which we can develop our own proposals. We have already done so, and we helpfully added to the proposals at our party conference, as I described. The Bill is very short. It contains only one substantive clause, containing a number of amendments of previous community care legislation. As I shall explain, I fear that it has significant flaws and that there are significant unanswered questions. Of course, it is undercosted and as yet unfunded. Essentially, the local government component is simply to say to local authorities, "Here is this additional statutory obligation. By the way, you'll find the money for it won't you?" Local government has been through such a process many times before. The Government seem to be engaging in double counting. On Wednesday of last week, they were telling local authorities to achieve those efficiency savings and scoring them as part of the reduction of the deficit; this week they are presenting legislation that scores the same efficiency savings but then tells local authorities they have to spend them. They cannot have both. We need clarity on the future of social care. The Secretary of State keeps asking whether our intention is to reform social care after the election, but why is he so fussed about that if he is confident of being in office then? He clearly is not. There is something deeply ironic in saying, after 13 years of a Labour Government who have not achieved the reform of social care, "It's about time a Conservative Government who are committed to the reform of social care came in." We have had 13 years in which hundreds of thousands of older people have had to sell their homes to pay for care, contrary to Labour's promises; 13 years of rising costs and, as the Office for National Statistics has demonstrated, falling productivity in social care; and 13 years of decreasing council-arranged care, when the proportion of people with moderate and lower care needs has been falling. Now, months before a general election, having said for 13 years that providing people with free personal care was unaffordable and unattainable, the Labour Government say it is their priority; and now, lo and behold, they suddenly say that they can find the money, starting in October 2010. It all fits into the same pattern that we heard so much of from the Chancellor in his pre-Budget report—make the Government virtuous, oh Lord, but not yet.