§ 3.56 p.m.
§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, with the leave of the House I shall now repeat a Statement made in another place by my right honourable friend the Secretary of State for Health on the Government's policies for improving care in the community for elderly, disabled, mentally ill and mentally handicapped people. A similar approach is being taken by my right honourable friends the Secretaries of State for Scotland and for Wales. Their plans will be announced in Written Answers in another place today.
The Statement is as follows:
"Our policies are aimed at improving social care services by ensuring that they are properly tailored to the needs of individual people. This requires a clear, locally determined, set of priorities, and effective collaboration between public, private and voluntary agencies. Our proposals are linked to changes in the financial arrangements for people needing public support in residential care and nursing homes. Local authorities will take over a new responsibility to assess the individual needs of people and meet the costs of residential or domiciliary care for the particular person in need.
"As we have already said, the Government recognises that the local authorities would need adequate resources to enable them to discharge their new responsibilities. The Government will transfer to the local authorities the resources which it would otherwise have provided to finance care through social security payments to people in residential and nursing homes.
"I reaffirm the Government's commitment to the totality of those policies, which have received a very wide measure of support.
"It has always been clear that the new policies represent a substantial new responsibility for local authorities. Before we implement the new proposals in full the Government must be satisfied that local authorities can sensibly take on the new duties in a way that is both fair to the people who require services and fair to their local taxpayers.
"Since I announced the Government's proposals last July it has become overwhelmingly clear that many local authorities are not managing their services and their spending so that they deliver good quality services effectively within reasonable spending limits. In many cases, local authorities have imposed excessive levels of community charge on their residents.
"In these circumstances, it is only sensible for any additional new burdens on local government in 875 1991–92 to be kept to an absolute minimum. Local authorities have made it clear that the changes we propose in community care would lead to many authorities increasing their expenditure and their levels of community charge. This would place a further unacceptable burden on charge payers.
"The Government has therefore decided that it would not be right to implement all the new proposals for care in the community simultaneously on 1st April next year. Implementation will instead go ahead on a phased timetable so that local authorities have longer to come to terms with the need to discharge their duties efficiently and at a cost which their community charge payers can afford.
"I intend that, as far as possible, the momentum of preparation for the new policy which has already been achieved should be maintained.
"In phase 1, from 1st April next year, I propose to introduce the new inspection units within local authorities and new complaints procedures. Next year development work will continue on the new planning arrangements, assessment and case management procedures, and the realignment of commissioning and providing responsibilities within social services departments.
"In phase 2, from 1st April 1992, I intend to implement the new planning arrangements for local authorities and health authorities and to continue with the remaining development work.
"The new system, including the new benefit arrangements, will be fully implemented from 1st April 1993.
"The cost of phase 1 of these proposals in 1991–92 has been taken into account in the figures for the local authority settlement which my right honourable friend the Secretary of State for the Environment expects to announce shortly.
"Help through special income support payments will continue to be available to people in private or voluntary residential and nursing homes until phase 3 of the revised programme is implemented. The White Paper proposals on preservation of benefit rights for people already in homes will also be implemented from April 1993.
"There are also three other important developments which will be implemented straight away from 1st April 1991. First, the new specific grant in support of services for mentally ill people will start from next April. I am confident that this grant will encourage closer co-operation between health and local authorities. It will ensure that local authorities will in future give higher priority to services for this group. The grant next year will be paid at the rate of 70 per cent. and will support total expenditure of £30 million.
"Secondly, the new specific grant for local authority funding of voluntary bodies providing services for drug and alcohol misusers which the House voted to include in the National Health Service and Community Care Act three weeks ago will commence in 1991. It will be paid at the same 876 rate as the mental illness specific grant and support expenditure of £2 million. Like the grant for mental illness services, this will promote the development of more services for a group which has often been afforded low priority.
"Thirdly, the specific grant for training of social services staff will be increased to support expenditure of £35.5 million in 1991–92. That is £7.5 million more than in the current financial year. This will enable us to extend the support at present available to those working with the elderly and children to new groups of staff working with mentally ill, mentally handicapped and physically disabled people. It will also enable us to increase our support for post-qualification training.
"Together, the expenditure supported by these three grants amounts to about £70 million. This has been taken into account in the 1991 settlement for local authority spending details of which my right honourable friend expects to announce shortly.
"The new policies for care in the community have been almost universally welcomed and they will undoubtedly be put into effect. We are proceeding on a phased basis because of the problems posed by excessive levels of community charge. I hope that everyone will take advantage of the extra time to ensure that they will be even better prepared for successful implementation over the next three years."
My Lords, that concludes the Statement.
§ 4.3 p.m.
§ Lord Ennals
My Lords, perhaps I may first thank the noble Baroness for reading the Statement made by her right honourable friend in another place. But I am afraid that this is the extent of the thanks that I can give her.
What we have heard is a deplorable Statement. I believe that it is a betrayal of commitments made time and again in this House and in another place. I do not blame the noble Baroness; it is the people for whom she works who are responsible.
It is the first cut in the public expenditure round which is now concentrating the minds of Ministers. We understand that the economic situation is far worse than they had anticipated. It always is. The inflation rate has not yet peaked. There is no pot of gold. I was not present at the Prime Minister's end of term meeting here last night but somehow or other I seem to have got the message.
Just a short time before that meeting the Tory-dominated Social Services Select Committee said that it was disappointed but not surprised by the Government's decision to go slow in implementing the Act, which completed its passage through this House only on 28th June. It was disappointed because those who will suffer are the elderly and the disabled, and, as I said on Monday last, their 6 million carers—the most vulnerable in our society. They have no priority from this uncaring Government.
It was not surprised because even the Conservative members of that committee knew what the 877 Government's priorities were. The voting powers of the victims of this betrayal are not very powerful or well organised, but they are easily identified because they are all likely to be poor. They are the first victims of the Star Chamber approach. They are not the higher paid workers, the top executives and managers, who have done very well, thank you, out of this Government. It is not even the costly, controversial and extremely unpopular health service reforms which the Secretary of State is determined to rush through before the next election, so determined are the Government to start the process of undermining the National Health Service before the next election.
My first question is this. Is the situation that the Government are prepared to put an extra £2 billion into a poll tax rescue operation for electoral reasons but are not prepared to provide the £0.5 billion needed to fund the community care programme? Why can they not postpone the £¼ million needed, plus the 4,000 extra administrators, for the NHS reorganisation, which virtually no one wants? Is the Minister prepared for the onslaught from her noble friends behind her?
I sought with some success, as it seemed to me, to smoke those Members out in an amendment that I tabled on 25th June. Having proposed that some of those measures should be postponed for a year, there was great anger from the other side of the Chamber. The noble Baroness Lady Gardner of Parkes, said:There should be no delay now that the Bill has reached this point and people are geared up".The noble Lord, Lord Carr of Hadley, said,We want to start the implementation as soon as we can so long as we do not rush it unduly".The noble Lord, Lord Jenkin of Roding, said,There is in these matters a momentum … expectations are now going ahead sharply".There were some very strong feelings; but we were all satisfied when the Minister said:As my right honourable friend the Prime Minister said only last week in another place:'It remains the Government's intention that the changes will get underway this coming year, as from April 1991'.My right honourable friend the Secretary of State has also taken every opportunity to make that clear. Therefore, I am happy to be in the position of being able to support both of them".—[Official Report, 25/6/90; cols. 1345–9.]She is not in that position now because both of them have changed their views. She continued in col. 1350:We believe that April 1991 remains practicable as a major milestone in taking our plans forward".No one could say that the little that they will do in April is anything like a milestone forward.
I give some credit to my noble friend Lord Carter. When moving an amendment as far back as 8th May, he said:The purpose of this clause is to make it a duty for local authorities to draw up their community care plans for 1991, when the Bill has received Royal Assent, laying a requirement on the Secretary of State to assure himself that sufficient funding is available to meet the needs detailed in the plans".—[Official Report, 8/5/90; col. 1264.]878 What has happened to that aim? As a result of that amendment the Government were defeated, admittedly by only one vote. But it was a decision of your Lordships' House.
We won that amendment, and as soon as it was overturned in another place, it was clear that full implementation of the Government's plans were doomed. The writing was on the wall. We have seen what happened. We put down a Question on Monday and there was no Statement from the Minister.
Perhaps I may put a few points on behalf of the local authorities, which are deeply concerned. First, the Government's reassurances have been taken at face value by local authorities, which have not only begun internal restructuring and investment in training, information systems and new staff but have also engaged in detailed discussions with users of services and voluntary organisations, as I know from personal experience. Delays such as those announced in another place this afternoon cause major disappointments and scepticism, if not cynicism, about the Government's intentions.
Secondly, failure to implement on 1st April 1991 poses severe problems for the social security system. Under the Social Security Act the Secretary of State has the power to vary the rates in respect of people who are in residential care homes before 1st April 1991. In doing so he will take into account information provided by local authorities with respect to the amount which they have agreed to pay for the provision of accommodation in relevant premises.
Thirdly, if the reforms in both sections are not carried out in parallel there will be real problems for local authorities in working with the National Health Service. Fourthly, the implementation of the community care reforms in 1991 would have given social service departments a measure of protection. Deferment to 1993 may weaken the defences of the personal social services. If the reforms are delayed it is likely that we shall see a significant reduction of activity in 1991. That would be a poor and demoralising run-in for 1993.
Why is it that the Government have suddenly decided that the local authorities are not ready for the changes when on every occasion that the subject has been raised from this side of the House they have assured us that they are ready? What has changed during the last two weeks since I raised the matter from these Benches with the Minister? It appears to me absurd that the Government can suddenly, and as it appears without consultation, announce that local authorities are not ready.
What consultation was there with the local authorities? They are the bodies required to carry out the Act which took three laborious months to go through your Lordships' House? Am I right that there was no consultation with the local authority associations? Am I right that, having heard suggestions that the proposals should be delayed, the Association of Metropolitan Authorities wrote to the Prime Minister asking for a meeting but she rejected that? I recognise the fact that the Prime Minister has 879 had what dear Harold Macmillan called "some little local difficulties". However, what priority do the Government give to the people affected by this part of the Act?
It is known that Members on all sides of the House gave their broad support to this part of the Act but not the NHS part. We should have been delighted if the Secretary of State in another place and the Minister in this House had said that the Government were postponing the implementation of the NHS part of the Bill. But no—they have decided that they will postpone the bulk of the Act relating to the most vulnerable in our society. We have heard an utterly deplorable Statement read by the Minister on behalf of her right honourable friend.
§ Baroness Seear
My Lords, courtesy and convention require that I should thank the Minister for repeating the Statement. If courtesy and convention did not require that it would be impossible so to do. Like the noble Lord, Lord Ennals, I find the Statement totally deplorable. The Carers' National Association represents people who are deeply affected by the changes. It has been overwhelmed with telephone calls from anxious and angry people who no longer know what will happen. They feel totally betrayed because they were led to believe that at last, after the delays following the publication of the Griffiths Report and the endless lobbying, there would be an effective community care programme.
Despite the soft-soaping at the beginning of the Statement it is plain that the Government are short of money and that they have decided to cut the amount available for people requiring community care. A great deal of money will be required for the changes to the National Health Service. However, surely if there had to be an economy and a delay they should have been in relation to the National Health Service changes because we know that in many parts of the country people are not ready for them.
We understand that many local authorities, however, are well advanced with their plans for community care. A great deal of work, thought, money and time has been invested. What are they now to do during the two years in which they must hold back from the implementation of the plans which they had begun to formulate? The people who must bear the burden are the old, the ill and the infirm. We are glad that to some extent the provisions relating to the mentally handicapped are being covered. However, they are only a small proportion of the total number of people affected by the changes. What will happen to them? Are they to stay on in the institutions? Are the people looking after them to manage as best they can? What do the Government propose that they should do now that the changes, which have been planned and embarked upon, are to be delayed?
If there must be a delay can it be used to some good effect? Can the measures for assessment begin because that will be of the greatest importance? Can proper consultations be carried out with the carers and their representatives? If that is done the issues will be well understood as will the problems that they must face. In the additional time that is now, unfortunately, 880 available plans can be introduced which will be better than those discussed during the Bill's passage through this House.
The delay will cause great hardship. I should like a clear explanation from the Minister on the paragraph which states:Help through special income support payments will continue to be available to people in private or voluntary residential and nursing homes until phase 3 of the revised programme is implemented".Does that mean that all the money will now be available? People had to leave the institutions because neither they nor their families could provide the additional money. If the money is not available it will mean that people will leave residential accommodation and be forced back into their families although the services that were supposed to support those families in looking after the patient will no longer be available. As a result of the cut in finances the additional services will not be provided and the burden placed on the families will be extremely acute. Can the Minister assure the House that no one will be forced out of residential accommodation because their families cannot pay the additional charges made by the institutions? That would bring some relief.
Although little can be done about community care, can we have an assurance that during the interval at least respite care will be introduced? That more than anything else is needed by carers looking after the old, the infirm and the ill. It is no exaggeration to say that they need a respite if they are not to be driven out of their minds and endanger their physical health by looking after people without a break and without the additional services. Since the publication of the Griffiths Report two or three years ago they believed that those services would be provided. I hope that the Government can provide reassurance on those issues.
§ Baroness Hooper
My Lords, I am grateful that courtesy and convention have prevailed on this occasion. I wish to say immediately that without doubt the changes will get under way next April, as my right honourable friend the Prime Minister said and as I said on Monday. The policy has not changed, only the timetable. Without doubt, there is a recognised need to reduce the burden on local and health authorities, both of which have a substantial programme for 1991–92, as the Statement maintained.
I fully agree with what has been said by the noble Lord, Lord Ennals, and the noble Baroness, Lady Seear, that it is very important to maintain the momentum and to use the extra time in a positive way to prepare for the full implementation in 1993. Therefore, we expect that collaboration between health and local authorities on planning community care services should begin now if it has not already done so.
I notice that the noble Lord, Lord Ennals, was rather selective in his quotations from the report of the Social Services Select Committee in another place. He mentioned that one comment of the committee was that it was disappointed but not surprised. I remind the noble Lord that the committee also said: 881We are concerned that the attempt to introduce at the same time as the National Health Service reforms a whole new structure for services provided by local authorities and health authorities and very different sets of relationships between the many different units involved may not have been sufficiently thought through. The Government may simply be demanding more of managers in the health and social services than they can deliver within the tight timetable set for implementation of the two policies".A number of questions were raised but I should like to emphasise the burden on local authorities when many policies are implemented next year. After all, we have always maintained that we must look at the details of our community care policy in the light of general public expenditure and, indeed, in the light of the burden on local authorities. They have to consider the new financial arrangements which are still settling down. For example, they have to implement the requirements of the Children Act and the Food Safety Act. It is very important to bear that in mind.
The noble Lord, Lord Ennals, asked what had changed. The reason for change was explained very clearly in the Statement made by my right honourable friend which I repeated.
As to the adequacy of income support, the structure of the present system of income support is a matter for my right honourable friend the Secretary of State for Social Security. However, I remind your Lordships that the Government are already making an enormous contribution to the independent care sector estimated at over £1,000 million in 1989–90. The limits were increased in April at a cost of £100 million and are being further increased next month at an extra cost of £45 million for this year. My right honourable friend the Secretary of State is considering how he should carry out future upratings of the income support limits and has undertaken to make a thorough assessment of the position and to look carefully at both the levels and the structure of the income support limits. He has commissioned a special survey of the costs in homes to help him to do that. That fact was announced by my noble friend Lord Henley to your Lordships a few days ago.
As to carers—a point which was raised by the noble Baroness, Lady Seear—again our policy has not changed. The key objective of the Government's proposals for community care remains, as we have already said, to ensure that service providers make practical support for carers a high priority. We expect that local authorities will continue to do that.
The noble Baroness referred specifically to assessments. They are now intended to be phased in on 1st April 1992 and must take account of the wishes of the individual and his or her carer and of the carer's ability to continue to provide care.
Expenditure as a whole on carers and the disabled has risen from £1.7 million in 1979 to £7.2 million, an increase of 89 per cent. in real terms. Spending on attendance allowance and invalid care allowance alone has risen from £205 million in 1979–80 to £1,081 million in 1987–88. We continue to work with the main 882 carers' groups in that respect and we anticipate fully that in the intervening period before full implementation considerable work will be carried out.
I believe that the best way to avoid hardships and exacerbation of any inadequacies is to have the new policy taken forward in a measured way with which all authorities can cope. It still represents a most challenging timetable and we hope that those authorities which are advanced will continue to be pioneers in the field. I must emphasise that this timetable does not prevent any local authority from continuing to pursue policies. In the past we have been able to say that the rate of increase in spending on personal social services—it was one of the arguments used against the ring-fencing amendment—has increased in real terms by 47 per cent. in recent years. We believe that those local authorities which are well advanced will continue to make progress. We are deferring the imposition of duties in that respect on all local authorities and I believe that those local authorities which are not as well advanced will be most grateful for the additional time given to them to introduce the reforms in an effective way.
§ 4.27 p.m.
§ Lord Boyd-Carpenter
My Lords, is my noble friend aware that anyone of a cynical disposition might be somewhat amused to hear the noble Lord, Lord Ennals, waxing with such apparent indignation against the partial deferment of proposals of which when they were before this House he was such a bitter critic?
§ Lord Ennals
My Lords, I have not been critical of the community care proposals. From these Benches we have merely tried to give some strength to them, to give some consultation to them and to ensure that they took place.
§ Lord Boyd-Carpenter
My Lords, the noble Lord has helped me because he has now admitted that he was extremely critical on those three headings which he has just enunciated. Despite those criticisms which he has just confirmed on at least three grounds, he now seeks to make a degree of party capital out of the partial deferment of some of them. Any of us who had the misfortune to listen to the noble Lord's intervention a few moments ago will realise that that is a perfectly fair comment on his observations.
As my noble friend is aware, the noble Lord did not attempt to criticise the substance of the Statement, which was that, as these measures are so very important—and particularly important to the people who will benefit from them—it is essential that they should start off right, and nothing could be worse for all concerned, particularly for the beneficiaries, than for the measures to start in an administrative muddle in the case of certain local authorities which are simply not prepared for them.
§ Lord Boyd-Carpenter
My Lords, the noble Lord, from a sedentary position, interjects another irrelevancy. There would be a muddle if the local authorities concerned were not prepared for them.
§ Lord Ennals
My Lords, I am most grateful to the noble Lord for giving way again. I understand that there has been no request from the local authority associations and no indication that they are not ready. They are all anxious to proceed and there has been no consultation with them—so I understand, although the Minister did not reply—before an announcement is suddenly made to the House that the whole plans have been suspended over a three-year period.
§ Lord Boyd-Carpenter
My Lords, the noble Lord is wrong again. The whole plans have not been suspended; only some parts have been suspended. That shows the noble Lord's capacity for exaggeration.
No one said that the local authorities had asked for deferment. It is the Government's responsibility to be sure, before launching an important scheme, that the bodies to which the administration will be entrusted are capable of undertaking it and are ready to undertake it. Nothing could be more irresponsible than, in pursuit perhaps of short-term popularity, introducing an important scheme and then seeing it go wrong because those responsible for undertaking it were not ready so to do. That, I understand, is the essence of the Government's policy on the matter, a policy to which most people who are deeply concerned that these wise and sensible measures shall come into effect properly, must attach great importance.
As I understand my noble friend's Statement, those parts of the policy that can be implemented on 1st April 1991 will be so implemented, but, in order to make sure that the rest of the policy is effectively implemented, it is necessary to defer full implementation for a further year. I am surprised that anyone, particularly someone with experience of administration in social security, should seriously contest that point of view. Is my noble friend aware that most people will think that the Government have acted sensibly—
§ Lord Boyd-Carpenter
No, my Lords. Most people will think that the Government have acted sensibly and responsibly. I hope that they will not allow themselves to be pushed off their policy by a synthetic outcry.
My Lords, what question is the noble Lord asking the noble Baroness about the Statement?
§ Baroness Hooper
My Lords, I am happy to answer my noble friend's question and to confirm that the Government are behaving sensibly and responsibly in making this phased and measured implementation. I am not surprised that my noble friend thought that the noble Lord, Lord Ennals, was against some of the amendments as the noble Lord introduced an 884 amendment to delay the implementation of the community care proposals which, he argued at the time, was simply to smoke out some kind of answer.
In relation to the question of consultation over delay, I confirm that the reason for the phasing is local authorities' inability to control expenditure, not their unwillingness to go ahead. We consulted the local authority associations over resources and their estimates would have been insupportable by many charge payers. Resources are not being cut or reduced. The support systems remain as now with increased available resources. Local authority expenditure is rising rapidly, even after allowing for new responsibilities. There is a need for a period of stability to enable improved local accountability to take effect, so it is not an opportune time for an additional major burden to be placed on local authorities.
The Minister of State, Home Office (Earl Ferrers)
My Lords, if we are all fairly short with our questions, there may be time for everyone. It would be well if the noble Lord, Lord Allen of Abbeydale, put his question now.
§ Lord Allen of Abbeydale
My Lords, I shall be brief. The jibe of the noble Lord, Lord Boyd-Carpenter, did not apply to Cross-Benchers' attitude to this piece of legislation.
§ Lord Allen of Abbeydale
My Lords, I rise simply to ask one question and to say that millions of the most vulnerable members of society will learn of the main decisions with sadness and incredulity. They will simply not understand the Government's explanation. They certainly will not understand the explanation of the noble Lord, Lord Boyd-Carpenter, which was rather different from that of the Government.
In particular, those people will not understand that the Government can evidently have failed to carry out the not very sophisticated arithmetical calculations that would be involved before they drove the legislation through. Noble Lords will recall that the pressure was on us until the very last day of the legislative process. Nor will they understand that the Government are now ready—for what they evidently assume to be their electoral advantage, although that is by no means certain—to abandon commitments and promises given during the passage of the legislation, in order to avoid an increase in the poll tax. It is another sad commentary on that miserable tax and another sad day for this country.
The only question that I want to ask is very short. The noble Baroness said that it was still open to local authorities that wished to proceed with the provisions in the legislation to do so, but where will the money come from? One of the main ingredients was that the local authorities were to be given the funds from the social security budget. Does she mean that those who want are in some way to be given that financial help?
§ Baroness Hooper
My Lords, as I said previously, there is nothing to stop those authorities that are well advanced from going ahead with plans, assessment and any other developments to improve community 885 care. Even at present, certain local authorities are well advanced in those systems. Although the money will not be channelled through the local authorities until 1993, as is proposed in the Act, it will nevertheless still be in the system under the current arrangements for payment for those needs and services.
§ Lord Mottistone
My Lords, one of the encouraging aspects of the Statement was that the special grant for the mentally ill will be payable from 1st April next. Will my noble friend expand on what that covers, particularly whether it will be restricted to what might be called pump priming of projects, or whether it can be spent on community care and aid for carers?
§ Baroness Hooper
My Lords, I am happy to hear my noble friend taking a constructive and positive attitude to the Statement and rightly focusing on the specific grant for mental illness.
The move towards community care that is already under way in that area has raised a number of concerns, which have been expressed in several quarters, that mentally ill people are at risk of ending up destitute, homeless or in prison. For example, it has been estimated that between 30 and 50 per cent. of the people sleeping out on the streets of central London each night are mentally ill. My honourable friend the Parliamentary Under-Secretary of State in another place announced last Thursday specific plans to help those people. There is little doubt that many of them have been in contact with psychiatric services at some time in the past, but have lost touch. Progress is therefore being made in that field.
In recognising the urgent need for improvement in the present arrangements, we are making the specific grant from 1st April 1991. The cornerstone of the policy is for systematic arrangements to be in place for assessing the health care and social support needs of each patient before he or she leaves hospital, and for ensuring that his or her needs are properly met when living in the community. Allied to the care programme approach is the important question of local authority resources available for social care for mentally ill people being treated in the community.
In contrast to other areas of social service expenditure, to which I have referred, that has tended to be the poor relation with perhaps only some 3 per cent. of social service department expenditure going on the mentally ill; yet it is critical in making substantial progress towards developing effective community services which will include an improvement of and an increase in social care facilities for seriously mentally ill people.
For that reason we propose to introduce the specific grant referred to in the Statement to stimulate new activities to provide services for people whose mental illness is so severe that they are being treated by the specialist psychiatric services or would clearly benefit from those services. The new grant will be a powerful incentive to effective joint planning as it will be payable directly to local authorities from the Department of Health on the receipt of jointly agreed 886 plans for the development of social care between social service authorities and district health authorities.
That is an example of the way that the Government are addressing the need for consultation between authorities and encouraging co-operation. Furthermore, we intend shortly to issue final guidance on the specific grant which obviously follows from the draft guidance which has already been issued.
§ Lord Kilmarnock
My Lords, I do not intend to make a statement but to ask a question. The noble Baroness will remember that during the passage of the Bill a great deal was made of guidance and what would appear in that guidance. A letter then went out asking for contributions to this consultation process by 10th August 1990 and the noble Baroness, Lady Blatch, will remember that she asked me whether I would like to contribute to that consultation process. Is that consultation process going ahead or will anything that we have sent in simply gather dust on the shelves of the department, meaning that we can spare our breath until later in the year?
§ Baroness Hooper
My Lords, I am happy to confirm that the draft guidance is out and it is planned that, on schedule, the consultation process will take place so that final guidance will be issued in the autumn. Those local authorities which are prepared, or intend, to carry on in advance of the timetable, which is quite permissible, will be able to do so in accordance with the guidance.
§ Baroness Hollis of Heigham
My Lords, as a member of a local authority, may I say how much the Minister's Statement will cause very great distress to local authorities who have invested thousands of hours and thousands of pounds in planning community care? There will also be very great distress to Members of this House some of whom, like myself, have recently arrived but who nonetheless have spent many hours taking part in and listening to debates on this subject. Above all, there will be real distress to the patients and carers who were expecting to see some relief in the immediate future.
Your Lordships and the local authorities can wait, but the people who cannot wait are the patients and carers themselves. For many of them a year may be too late. Is it not the case that what we are hearing from the Minister today is not a problem about local authorities and their inability to implement community care, but instead a statement about the problem that the Government face when local authorities pick up the consequences of the Government-imposed poll tax?
Does not the Minister agree that the consequences of the poll tax and the unacceptably high figures that exist—and they are unacceptably high figures, particularly to the poorer members of the community—are largely attributable to three factors? First, in the RSG statement in this House and in another place inflation was provided for at only 4 per cent. instead of 8 per cent. Secondly, is it not a fact that adequate funding was not made available for the new duties imposed on local authorities? Thirdly, is it not also the 887 case that adequate funding was not made available for the cost of implementing the poll tax which has cost four times as much to administrate as did the rates? Does not the Minister agree that those three factors alone largely and, indeed, substantially account for the difference between the target figures of local government and the out-turn figure of local authorities' poll tax? As a result, I suggest to the Minister that local authorities are being "fingered" for the foreseeable problems and consequences of the poll tax for which the Government should have made adequate provision.
Does not the Minister further agree that it is not too late to remedy the situation if she were to accept the following? First, if the RSG were to be properly funded, as Ministers agreed, to provide for community care and if the other place had accepted an amendment (which had support from all sides of this House) for ring-fencing there would have been little or no effect on the level of poll tax. If Ministers were worried about the implications of ring-fencing for local authorities that could have been met by introducing a sunset clause so that after three years that money could have come into the general RSG fund. In other words, had the Government taken on board full funding of community care on the one hand and ring-fencing on the other, this problem would not have a risen.
§ Baroness Hooper
My Lords, I can answer the three questions that the noble Baroness specifically directed at me by saying no, no and no. In regard to her questions on the rate support grant, I regret that she will have to wait for the Statement expected shortly from my right honourable friend the Secretary of State for the Environment.
The reason for our decision, I emphasise again, is not in any way to change our policy on the new community care approach, only the timetable. We do not believe that all local authorities could or would keep their community charge at a reasonable level. We have noted that local authority spending is rising rapidly. Therefore, I again emphasise that the best way to avoid hardship or any inadequacies in the implementation of these proposals is to introduce them in the measured way now proposed.
§ Baroness Faithfull
My Lords, I am in some difficulty because throughout the discussions on the Bill I made two points. First, I said that community care would be expensive and that money would be required for community care. Secondly, I said that the whole project should be monitored so that we would know how much money was required. From the point of view of directors of social services I feel that without the money the new proposals cannot be implemented properly. It would appear that the only answer is to choose certain projects for implementation with the money that is available.
I ask my noble friend two questions. First, can the local authorities go forward with parts of the Bill that do not have resource implications? Secondly, there are parts of the Bill which, if implemented, would be cost effective and therefore cut expenditure for local authorities. I refer particularly to respite care.
888 Without respite care people will have to go into hospital or homes. I refer to private homes, which my noble friend mentioned. Would it be possible, therefore, to consider which areas, if implemented, would in the long run be cost-saving for the local authorities and for the Government?
§ Baroness Hooper
My Lords, as the Statement said, the Government recognize that local authorities will need adequate resources. I confirm to my noble friend that local authorities can go forward with all parts of the Bill if they are able to, including respite care. Indeed, in some areas such care is already available.
§ 4.49 p.m.
My Lords, I hesitate to intervene because I realise that your Lordships are concerned about this subject. However, the Companion to Standing Orders states that discussion on a Statement should not exceed 20 minutes. That was a recommendation by the Procedure Committee which was accepted by your Lordships and is now part of Standing Orders. We have now had 20 minutes.
For clarification perhaps I may add that the Companion to Standing Orders points out that,although brief comments and questions for clarification from all quarters of the House are allowed, such statements should not be made the occasion for an immediate debate".Possibly we have slipped a little in that respect and have denied other noble Lords the opportunity to ask questions.
§ Lord Carter
My Lords, the Deputy Leader of the House will know that the noble Lord, Lord Boyd-Carpenter, took almost five minutes of the time available and did not ask a single question. In one of her answers the Minister took over two minutes. It was another statement. I believe that we should have a few more minutes.
My Lords, I realise the problem. The House is master of its own affairs. The regulations say that 20 minutes is the limit and that has been agreed. It is not for me specifically to allow that time to be extended when the House agreed that that is the limit. I made an intervention earlier and suggested that Members make their questions as short as possible. However, your Lordships are in charge of your own affairs.
My Lords, I do not wish to seem oppressive to the noble Lord, Lord Winstanley. We have taken 20 minutes with this matter and Standing Orders state that 20 minutes is available. I fear that if we start exceeding that time it will occur on other occasions.