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Personal Care at Home Bill

Yes, the hon. Gentleman is absolutely right—there is no reference to that. Indeed, this is one purpose of the proposals that we have been discussing for some years: creating a public health service that operates with dedicated funding for public health from within the NHS, and, indeed, local authorities working together. More recently, the hon. Gentleman's party has joined in with the concept. Of course, this is precisely where we can begin to consider some of these programmes: the benefits accrue not only in the community at large and to those families, but to local authorities and the NHS, which makes a good case for investment on the part of the public health service as it is not simply confined to the question whether it offsets hospital admissions. That is often the narrow basis on which the NHS judges these things. We have seen programmes such as a telecare programme in Scotland that achieved savings of £11 million from 7,900 older people and an improvement in their reported quality of life; a community alarm service in Birmingham that showed a substantial return on investment and reduced residential care need; and telecare schemes for frail older people in north-west Surrey, which showed that telecare focused on safety and security reduced the number of people entering residential care by 11 per cent. in the fifth year after implementation. Those are not necessarily reablement examples. It is important for us to consider these preventive opportunities on their merits, through evaluation, and to implement them as part of a proactive public health service. I am surprised at the narrowness of the Government's approach to reablement alone. I am also uncertain as to why they see it as necessary to link access to free personal care to an obligation previously to have agreed to a reablement process. As I mentioned, partnership is clearly a necessary part of the consensus that we now need to pursue. From my point of view, that includes local government. Frankly, central Government should treat local government as a partner, which means consulting on such approaches and saying to local government, "On average, across the country, you are paying 40 per cent. of the cost of adult social care. We will treat you as a partner and discuss how we will reform this for the longer term, recognising that council tax payers and their elected representatives provide a substantial proportion of the funding, and in many local authorities more than 50 per cent. of the funding, for social care." In those circumstances, it is outrageous that the Government published a Green Paper in July and then said something completely different in September, the implication of which was that local government would simply have to pay up or be taken to court.