Skip to main content

Caring for the Elderly

Volume 496: debated on Wednesday 15 July 2009

I beg to move,

That this House believes all old people should be treated with dignity and respect; regrets that 2.5 million pensioners are living in poverty; notes the Government’s failure to state when it intends to restore the link between the uprating of the state pension and the growth in average earnings; regrets the sharp decline of defined benefit schemes during this Government’s stewardship; further regrets that the Government failed to adopt proposals for fully-funded measures to help savers in this year’s Budget; notes that some 45,000 people are forced to sell their homes each year to pay for long-term care; regrets the lack of costed options and proposals in the Government’s Green Paper for the future funding of long-term care; recognises the pressures on the health and social care systems due to demographic factors and the debt crisis; notes that, despite claims to the contrary, no party has plans to cut support for pensioners such as free bus passes, free TV licences for over 75s or winter fuel allowance; supports active and independent ageing; pays tribute to all those with caring responsibilities across the public, third and private sectors, in particular the 6 million voluntary carers in the UK; and calls on the Government to introduce more effective policies to encourage respect for older citizens and to promote security and dignity in old age.

Prior to their election in 1997, the Government made three hugely important promises to our older citizens. First, the current Prime Minister said:

“I want the next Labour government to achieve what in 50 years of the welfare state has never been achieved—the end of the means test for our elderly people.”

Labour also promised in its 1997 manifesto that

“all pensioners should share fairly in the increasing prosperity of the nation.”

At the 1997 Labour party conference, Tony Blair said:

“I don’t want them”—


“brought up in a country where the only way pensioners can get long-term care is by selling their home.”

On all those promises, Labour has comprehensively failed to deliver for older people. Means-testing now affects nearly half of all pensioners. Some £5 billion a year in benefits goes unclaimed by pensioners. As for increased prosperity, there are now some 2.5 million pensioners living in poverty. Even before the economic downturn began to bite, research for Age Concern and Help the Aged showed that 60 per cent. of low-income pensioners were struggling to get by and were finding it hard to manage, two thirds were cutting back on gas and electricity, more than half were buying less or poorer quality food, and one in 12 pensioners said that they had built up debt as a result of increases in the cost of living. As for long-term care, some 45,000 people a year are still being forced to sell their homes to pay for care costs. Not much of a record, is it?

What are Ministers doing, as this Government head for the buffers? They publish more discussion documents. In the last few days alone, they have produced two such documents. What do they have in common? Is it the fact that they serve only to underline this Government’s record of inaction and failure when it comes to the needs and concerns of older people?

First we had “Building a Society for All Ages”. After 12 years, it appears that Ministers have finally woken up to the challenges of an ageing society. Of course, we can agree that increased longevity is phenomenal. If my speech were to last an hour, Madam Deputy Speaker—I promise you that it will not, although it may seem like it—your life expectancy on average would increase by about 12 minutes during that hour. Indeed, in the foreword to that document, the Prime Minister is good enough to refer to my erstwhile constituent Henry Allingham, who at 113 is now the oldest man—but not the oldest person—in the world.

The best Labour can offer us is a “grandparents summit” in the autumn and an earlier review of the default retirement age, plus a ragbag of existing initiatives, empty self-congratulation and some vague aspirations for the future. There are to be refresher courses for older drivers. It is all jam tomorrow while hard-pressed pensioners bear the brunt of the recession.

The document promises to bring forward to next year the review of the default retirement age. It rightly points out that more than 1 million people are already working beyond state pension age—mainly, I suspect, through harsh economic necessity. It sets out the financial and social benefits of working longer, but for many people, continuing to work may be the only way of repairing their finances for retirement. Indeed we have already legislated to raise the state pension age to 68. But the Opposition have been saying for several years that retirement should be less an event and more a process. Flexibility is what older workers need. However, the document is bizarrely free of any opinion from Ministers as to whether they support a default retirement age. This is the very point to be decided by a High Court judge very soon. Perhaps in her response the Minister for Pensions and the Ageing Society could give us some clue about the Government’s thinking on the subject, or even just tell us what she thinks. The Government also make much of the Equality Bill as a vehicle to tackle age discrimination, yet although that Bill includes wide powers to bring in exemptions relating to older people, the detail of the exemptions is not yet available.

The document is also guilty of spin when it deals with pensioner poverty. It asserts:

“For the first time pensioners are now less likely than others to be in poverty.”

That is also a favourite mantra for Ministers, but it is based on statistics after housing costs. If we take the figures before housing costs, the story is very different.

Is my hon. Friend aware that in their latest proposals the Government talk about a £20,000 tax on prudent pensioners—if they still have a pension left. That will be a £10 billion-plus a year tax on the very people who have saved to look after their future. Is that not a disgrace, and does it not sum up the Labour approach to poverty in old age? They want more people to be poor, because they want to tax them more.

I am grateful to my right hon. Friend, who makes a powerful point. The people who should always beware of the Government’s Green Papers and White Papers are, of course, those who have taken the precaution of saving for their old age.

I was talking about Government spin on pensioner poverty. The truth is that 2.5 million pensioners are living in official poverty. A recent OECD report put the UK at the bottom—Ministers should listen to this—of a league table of 17 industrialised countries for its state pension provision. Another example of spin is the oft-repeated mantra by Ministers—indeed, it makes another appearance today in the amendment—that they are spending £x billion more than if pre-1997 policies had been maintained. That is, of course, grossly misleading because it assumes that if there had been a Conservative Government in the intervening years not a penny extra would have been spent on our pensioners.

I am sure that my hon. Friend will appreciate that the desperate plight of the elderly is being raised on the doorsteps in the Norwich, North by-election. People have had enough of the inaction of this Government. Does he agree that that will be shown in the voting pattern at the election next week?

I am grateful to my hon. Friend, who makes an excellent point. As someone who has also encountered older people’s tangible anger with this Government on the doorsteps of Norwich, I am sure that his prediction is absolutely right.

I am not sure where the hon. Gentleman was in the very early 1980s when, in one of the meanest acts of the Thatcher Government, pensions were detached from average pay in the economy. If he was in this place at that time, did he vote for that? If he was not in this place, did he support it? That was one of the accelerators of pensioner poverty in the 1980s and 1990s.

I am grateful to the hon. Gentleman for his intervention. In fairness, he assiduously attends these debates on pensions issues. I might have a slightly lived-in look, but I certainly was not a Member of this House in the early 1980s. We could go into the prehistory of 1980 and the decision to break the link at that point—again, curiously, as history repeats itself, the then Government had inherited a disastrous financial situation from a previous Labour Government, but we will not go down that route—but this Government have had 12 long years to restore the link and they have done nothing about it.

Perhaps the most unfairly treated of all are those pensioners to whom I referred a moment ago, who did the right thing all their lives. They saved while they were working so that they could supplement their pension when they retired. About three quarters of pensioner households receive income from savings and investment, and in recent times they have seen those savings rendered almost worthless. The interest that they receive, thanks to the economic mess that this Government have caused, is pitiful or even non-existent. To make matters worse, the Treasury assumes that they are getting 10 per cent. on those savings when it comes to calculating entitlement to benefits. Will the Minister now undertake to review the tariff income rule that causes such blatant unfairness?

In this year’s Budget, we called on the Government to increase age-related personal allowances for those aged 65 or above by £2,000, which would have benefited them by up to £400 a year. We pressed Ministers to scrap income tax on savings for basic rate taxpayers. Instead, the Government increased taxes on pensions. Ministers have even refused our proposal that the compulsory annuitisation rules be temporarily suspended during the financial turmoil. As a result, many people who prudently saved for their retirement have been forced to fix their income for the rest of their lives at the worst possible moment. We Conservatives believe that Governments should encourage saving, not penalise it. We would introduce measures that would help everyone, but particularly older people, such as the two-year council tax freeze, which is worth more than £200 to the typical family, and energy-efficiency improvements for every household, saving energy and reducing bills.

The hon. Gentleman proposes fixing council tax for two years, which will result in councils having less money to spend. Does he not appreciate that councils are responsible for the adult social care budget, which is the only part of their budget that is not ring-fenced, and that they will therefore look to that budget for savings?

The hon. Gentleman assumes that all councils will go down the route taken by some Labour and Liberal Democrat councils of cutting front-line services, instead of achieving efficiencies and savings in back-room operations, but I can tell him from my experience not only in my constituency but on the doorsteps in Norwich that the two-year council tax freeze is extremely popular, not least with pensioners, who bear the brunt of council tax rises.

Does the hon. Gentleman agree with me that even better than a council tax freeze would be a local income tax, which would link people’s ability to pay with what they actually pay for local services?

I do not agree with the hon. Gentleman. I would be happy to have a completely separate debate on that topic, because when the Liberal Democrats were pushing that policy in my constituency, it turned out that most people would end up paying more.

Does my hon. Friend agree with me that now is the perfect time for the Government to do the right thing by the Equitable Life pensioners, who are demanding justice? The parliamentary ombudsman has ruled on their behalf, but the Government have flagrantly ignored that ruling and refused to give justice to so many pensioners.

I can only agree with my hon. Friend. The blatant way in which the Government are attempting to put off the evil day, while more and more Equitable Life victims sadly pass away, is outrageous. There seems to have been a campaign of delay and dithering, as on so many other things.

The Government’s record on pensions is no better. A report produced by the Department for Work and Pensions concluded that 51 per cent. of people would not trust the Government to act in their best interests on pensions. Although we passed the necessary legislation some time ago, Ministers will still not say exactly when they will restore the link between the uprating of the state pension and the growth in average earnings. May I please press the Minister on that again today?

The Government have tested to destruction the notion that mass means-testing can deliver help to those most in need. As I said, each year more than £5 billion of benefits goes unclaimed by needy pensioners and some 1.7 million people never claim the pension credit to which they are entitled. Other benefits have even worse take-up, the best example being council tax benefit. Why will Ministers not support the British Legion and Age Concern campaign to change the name of the benefit to council tax rebate, so that people can see that it is theirs as of right?

The Government have also presided over a huge retreat from private and occupational pensions. More than 70,000 occupational schemes have wound up or begun winding up since Labour took office in 1997—no wonder, when one of the Government’s first acts was their tax raid on pensions, which is estimated to have cost pension funds up to £150 billion since 1997. They have continued to heap extra costs and red tape on those employers who, for all the right reasons, continue to sponsor defined-benefit schemes for their work force. The latest estimate puts the funding shortfall for UK defined-benefit schemes at more than £200 billion—a staggering 88 per cent. of the country’s DB schemes face a shortfall. The pensions regulator has warned of “severe pressures” on employers and pension fund trustees and members, and pensions expert Dr. Ros Altmann has said that we are

“on the way to being a nation of pensioner poverty.”

In contrast, we will simplify pensions rules and do everything possible to encourage responsible employers to make generous workplace provision. The new system of personal accounts may auto-enrol many thousands, or even hundreds of thousands, of workers, who may be no better off or even worse off because of the effect of the means-tested benefits system. Even worse, personal accounts could actually hasten the demise of more generous existing schemes—a phenomenon called levelling down.

Yesterday, the long-awaited Green Paper on care and support was published—another one with a chatty foreword by the Prime Minister. He seems to think that we need “a major debate” on the issues. We do not need another debate; we need a decision. Is that really the best that Labour can do after 12 years in government, and 10 years since the Sutherland report—more dithering, more options to debate, and a menu without prices?

Given that the serious question of how we care for a growing number of frail, elderly people did not suddenly arise in 1997, and given that for 25 years or more, Governments have dodged that serious social question, left over from the Beveridge reforms, will the hon. Gentleman engage, as I think he says he will, in the serious debate on the subject that was kicked off by the Secretary of State? As part of that serious debate, will the hon. Gentleman tell us now what the answer is, according to Conservative Members?

I was happy to give way to a distinguished former Pensions Minister. He is right about the dodging point; I do not know whether he was in the Chamber when I quoted Tony Blair saying that he did not want children brought up in a country where the only way that people could pay for long-term care was by selling their homes. I am sorry, but it was absolutely no good the Secretary of State’s saying yesterday that he was kicking off a debate. Where has the right hon. Member for Croydon, North (Malcolm Wicks) been? We have certainly been debating the subject for more than 12 years.

If the hon. Gentleman has been debating the issue, what are his party’s proposals? We have not seen them. When will his party tell the British people of its policies, or does it not have any?

I am sorry to disabuse the hon. Lady, but we have to have the small formality of a general election before we can start doing something.

The Secretary of State said yesterday:

“it would be wrong to force the pace of that debate.”—[Official Report, 14 July 2009; Vol. 496, c. 162.]

Does my hon. Friend the Member for Eastbourne (Mr. Waterson) accept that, for people who are dying in poverty because of the inaction of this Government, 12 years is far too long to wait?

Well, 45,000 homes a year for 12 years—hon. Members can do the maths. People have had to sell their main asset, which was built up painfully over a working life, because the Government have dithered and delayed. To go back to the intervention of the hon. Member for Morecambe and Lunesdale (Geraldine Smith), let me point out that of the main parties ours was the only one that had a specific policy on long-term care in their election manifesto. I can assure my hon. Friend the Member for South-West Norfolk (Christopher Fraser) and the hon. Member for Morecambe and Lunesdale that we will have one in our next manifesto.

That is an extraordinary statement. The hon. Gentleman knows full well that we had a policy on social care at the last election, so will he correct his false statement?

I think that I said “the main parties”. I believe that the hon. Member for Romsey (Sandra Gidley) described the policy to which the hon. Member for Leeds, North-West (Greg Mulholland) refers as dishonest in a debate in Westminster Hall, on the record. Perhaps they would like to sort that out between themselves.

I am grateful to my hon. Friend for giving way. Does he agree that there may well be some merit in the Government’s argument that the subject cannot be rushed? It involves the need for cross-party consensus. However, does he also agree that the real question is what has happened in Government between the publication of the Wanless review in 2006 and the publication this week of a series of options for further discussion? What have the Government done between those two dates?

My hon. Friend is right; it is a bit of a mystery.

Age Concern and Help the Aged have commented on the Green Paper, saying:

“With time now short the Government must set out a clear timetable to move from debating options to agreeing and implementing specific proposals.”

I entirely agree.

I want to raise a specific issue to do with benefits for people with disabilities. The Green Paper makes various suggestions about using non-means-tested disability benefits—such as disability living allowance and attendance allowance—to help fund the means-tested social care system. That would represent a huge shift in the principles that underlie the system of disability benefits, and would be of great concern to many disability organisations and disabled people. If media reports are to be believed, the Secretaries of State for Work and Pensions and for Health were arguing about the point right up to the last moment before the Green Paper was published. It seems that the Secretary of State for Work and Pensions lost that battle in Government, but that will not be good news for disabled people.

The Green Paper could not be clearer: there is no guarantee of extra Government funding to meet the yawning gap in provision. People may well end up being forced into a compulsory insurance scheme and, at the end of it, a nationalised system of care. Yet still the relentless destruction of hard-won family assets goes on, the lottery of care continues, and older people and their families remain fearful about what will happen to them when they are frail and needy. What older people need in these difficult times is more help from the Government, not less. Dot Gibson, the general secretary of the National Pensioners Convention, said:

“The fact that it has taken 12 years for the Government to come up with any proposals—with the prospect of up to another five years before any legislation—is a terrible betrayal of Britain’s pensioners and their families.”

I shall take this opportunity to explode some of the myths that Labour have been peddling about Conservative policies, especially in connection with the Norwich by-election. Labour is saying that we would cut pension credit, but that is dishonest as we have never said that we would cut either pensions or pension credit. Labour is saying that we would scrap free TV licences, but that is dishonest as we have no plans to do so.

Labour is also claiming that we would scrap free bus passes for the elderly, but we have no such plans and it is dishonest—

Order. Comments are being made from a sedentary position. May I remind Members about the conduct of parliamentary debates?

We have no such plans, and it is dishonest to claim otherwise. Labour claims that we would scrap the winter fuel allowance. We have no such plans, and it is dishonest to claim otherwise. I hope that that is clear.

I think that my hon. Friend has just exposed how this dying Government are behaving. They are using elderly people and the services that they rely on as a political football, and they are doing so in a dishonest fashion. [Interruption.] Labour Members may laugh, but dishonest and untruthful allegations about another party’s policies, when so many people rely on the benefits involved, is absolutely wrong.

I agree. It is beneath contempt to raise fears, especially among the elderly, but that is a sign of the Government’s desperation.

I was in the House when the Conservatives were in government for 18 years. Will the hon. Gentleman bear it in mind that his party strenuously opposed the winter fuel allowance and the free TV licence at every stage? They also opposed my private Member’s Bill, and they said no whenever we said that the elderly should be helped with heating.

Unlike the hon. Gentleman, I am talking about the here and now—the pensioners who are suffering and being told blatant untruths, here and now.

I shall draw my remarks to a conclusion. Thanks to huge advances in health care, nutrition and living conditions, old age need no longer be a time of anxiety and frailty. Most of us are living longer and healthier lives. As someone said recently, 70 is the new 50 and 50 is the new 30 but, thanks to this Government, many older people have little to celebrate.

Our older citizens are the innocent victims of this recession made in Downing Street. They deserve help in these difficult times. They need a Government who are on their side, not a Government who have destroyed the value of their savings, laid waste their pensions and failed to provide a proper safety net for when they can no longer cope. They need a new Government who are prepared to tackle those issues with fresh energy and fresh ideas. They need change. I commend the motion to the House. [Interruption.]

Order. The Question is as on the Order Paper—[Interruption.] Order. Can those on both Front Benches come to order? Can we please have this debate conducted in the proper manner?

I call the Minister to move the amendment in the name of the Government.

I beg to move an amendment, to leave out from “House” to the end of the Question and add:

“welcomes the steps taken since 1997 to tackle increasing pensioner poverty; notes that policies delivering real help to pensioners include free bus passes, free TV licences, winter fuel payments and Pension Credit which ensures no pensioner lives on less than £130 a week; notes that the Government is targeting around £100 billion more on pensioners than if pre-1997 policies had been maintained; further notes the Government’s commitment to reversing the policy of separating uprating of the state pension and growth in average earnings; notes the introduction of the Financial Assistance Scheme, the Pension Protection Fund and the Turner consensus as building a sustainable pensions system going forward; welcomes raising of Individual Savings Accounts limits at Budget 2009; warmly welcomes the Government’s Ageing Strategy; further welcomes the publication of the Green Paper, Shaping the future of care together, which proposes a National Care Service to create the first national, universal, entitlement-based system for care and support ever in England; notes that the Government’s proposals will shape a new care and support system fit for the 21st century that will be fairer, simpler and more affordable for everyone; further notes the published indicative costs an individual may face during their lifetime and the comprehensive impact assessment for the Green Paper; recognises that carers make a huge contribution to society; and acknowledges that the new Care Quality Commission has made dignity and respect one of its six key areas of inspection.”

We have heard quite a peroration today, but to say that it was policy-light would be the understatement of what is admittedly a young century. There was quite an extraordinary lack of content: a lot of bluster and noise, but absolutely no clue to, or content on, the Opposition’s approach to these difficult and complex issues.

The Prime Minister laid out the Government’s agenda for the future in “Building Britain’s Future”, and on Monday we published our strategy, “Building a Society for All Ages”, which explained how the Government will provide flexible retirement opportunities for older people and enable those who wish to remain in work to do so. We will ban unjustifiable age discrimination as part of the Equality Bill, and on that point I might ask Opposition Front Benchers why they voted against the Bill’s Second Reading.

We also announced that we are bringing forward the review of the default retirement age, and if the review shows that the policy is no longer justified we will take steps to remove it. We have laid the foundations for a better future for older people, focusing on planning and saving for later life, and we are committed to doing more.

On the default retirement age, does the Minister agree that, in the coming years, with longer life expectancy, the idea that one retirement age should apply to all is bound to be thrown into the dustbin of British social history? Would it not be sensible if the Government came forward now and said that that was their position? It is a sensible position, and it will soon happen.

It is quite clear that the approaches to social policy that Beveridge developed, essentially, when our life expectancy was much shorter and a man could look forward to barely one year of life in retirement, involved a different society from the one in which we will routinely enjoy 20 to 25 years of retirement. It is quite clear also that we have to evolve our structures, our system and the meaning of retirement, so that there is a flexible approach, rather than a cliff edge off which one falls. That is the clear way forward, but we are committed to looking at the review and the evidence. It is important that we take evidence from employers who are worried about the situation, and those who do not wish to see their chances of employment disappear the day after their 65th birthday.

As part of the review, could we reflect what is one of my frustrations and, perhaps, one of the Minister’s? In such debates, we always refer to older people as a drain on the nation’s resources, not as contributors to them. May we please reflect the fact that older people make a huge contribution to the child care needs of a variety of families and to the charitable sector, and recognise at all times that they are net contributors as well as drawers on the nation’s resources?

I am more than happy to agree wholeheartedly with the hon. Gentleman. I do not think that we, certainly on the Government Benches, refer to older people as a burden. It is quite clear that they offer a great opportunity for economic development and for handing on many of their life experiences to the younger generation, and that there is a great deal of opportunity in developing older businesses. Opposition Front Benchers rather sneered at the idea that grandparents fit in as a sandwich generation, often caring for younger people as well as for older relatives, but it is a key social policy issue that needs to be developed, not sneered at.

I was disappointed with the sneering approach of the hon. Member for Eastbourne (Mr. Waterson) to that issue. The Budget announcement about crediting in national insurance contributions for grandparents with caring responsibilities is a breakthrough policy. I expect that we will see more such measures, so that we can establish that grandparents have an important and central role in our social policy.

Does the hon. Lady accept that, as I mentioned earlier, there is cynicism among elderly people on the doorsteps of Norwich, North? They are saying on a daily basis that there is too little, too late; the Government have ignored them for too long, and there is suddenly a bit of action when a by-election comes up. Does she accept that they have had enough and that that will be reflected in next week’s result?

My experience of meeting older people in many areas around the country is not that they reflect the approach that the hon. Gentleman wishes for in respect of next week’s by-election. Time will tell.

Can the Minister tell us whether the Prime Minister plans to visit Norwich, just as he did Glenrothes? Perhaps he will explain the Government’s policies to older people there.

When Conservative Members see a woman, they often think that she is a secretary. I have to tell the House that I am not the Prime Minister’s secretary, so I do not know about his intentions in respect of visiting the constituency.

We have laid the foundations for a better future for older people, focusing on planning and saving for later life. We are committed to doing more. We are not just taking action to deliver help now for Britain’s pensioners, but planning for generations to come and encouraging others to do the same.

Yesterday, we published “Shaping the future of care together”, a Green Paper that considers how care and support services can be personalised, placing choice and control at the heart of the system. Under a new national care system, everybody with a care need will have at least some of their care costs paid for by the state. There will be a national entitlement and an end to the postcode lottery.

The hon. Lady mentioned personalising care. A problem that has been around for a long time—and one, I have to say, that I picked up on while on the streets of Norwich, North only this week—relates to when people have a package of care. Elderly people do not want to find that they have to be put to bed at half-past 6 or 7 o’clock. Their care is not personalised; they are often in the hands of agencies, funded through social services, that do not personalise care packages, but treat elderly people as numbers.

That is why we are working with the process set out in our document “Putting people first”, which is about personalising care. It is absolutely clear that we should be transforming services for older people by having them at the centre, making choices about how their care is delivered, rather than having one-size-fits-all care policies under which there is a compulsory bed time in a person’s own home according to what suits whoever comes to give the care. That is why yesterday’s Green Paper put such choice and personalisation right at the centre of the transformation that we want to see. We have already spent £500 million on developing the first examples of that kind of personalisation. That approach is transforming how local authorities are planning to deliver their care packages to their clients in future.

I am sure that my hon. Friend has not forgotten—perhaps the hon. Member for Tiverton and Honiton (Angela Browning) has—that this Government made it compulsory for councils to offer a direct payment instead of providing care directly; every one of those people in Norwich could ask for the cash instead of the care service, and organise their care themselves. Equally, the Government gave councils the money to put a charge on people’s homes so that they did not have to sell their homes during their lifetimes, and their care could be paid for after their deaths.

It is important that the approaches that are being developed now become the norm in time. We are in the middle of an approach that moves away from the old mass care packages that are delivered for the convenience of the organisation that is delivering them rather than for the convenience and comfort of the people receiving them. That is a major theme that this Government have begun to develop and to fund.

I would be grateful if the hon. Lady corrected the hon. Member for South Thanet (Dr. Ladyman) on the timing of the introduction of direct payments. I refer her to page 33 of the document that she published yesterday, which features an entirely accurate time line saying:

“Direct payments introduced offering disabled people more control to buy directly the services they want”,

with an arrow pointing at the year 1996. I invite her to remember who were the Government at that time.

I think there might be some sort of approach on which we can agree in terms of philosophical change in this regard. What I am trying to do instead of having this rather juvenile exchange—[Interruption.] Well, there is a lot of consensus in pensions policy. Conservative Front Benchers seem to think that “consensus” is a dirty word. That is interesting, and I will bear it mind when I hear them talk about it in future.

Can the Minister assure the House that elderly people who are making a very valued contribution to care in their families will be rewarded instead of taken for granted?

A carers strategy is being developed. It is important that we begin to move further along the road of valuing and rewarding the work that millions of carers do, which keeps our society going but is often unrewarded. The changes that we are making to crediting into the basic state pension in 2010 are a reward for that, as are the changes announced in the Budget about crediting grandparenting. There is much more for us to do, but I am happy to agree with the sentiments that the hon. Gentleman expressed.

I have given way to the hon. Gentleman, and I want to get on with my speech as this is a short debate.

I want to compare Labour’s record with that of the Conservatives. The hon. Member for Eastbourne talked about pensioner poverty, but after 18 years of the previous Tory Government, pensioners in Norwich and elsewhere had got poorer. The poorest had to survive on a basic state pension of just £69 a week.

The major factor in that was the breaking of the link with earnings made almost as soon as Mrs. Thatcher came into power.

It was certainly one of the many factors.

Twelve years of a Labour Government committed to helping the poorest and most vulnerable has seen 900,000 older people lifted out of relative poverty, each one with enhanced life chances that should be celebrated rather than dismissed by the Conservatives. Thanks to increases in the basic pension and pension credit this year, no pensioner need live on less than £130 a week. Since 1997, this Government have spent about £100 billion more than if we had maintained the policies that we inherited from the Conservatives, and £13 billion of that extra spending is happening in this financial year, despite the economic challenges that we face. As a recent European Union report underlines, there has been a significant change in the income of the over-65s in the UK. In 1997, it was 15 per cent. below the EU average: that is the Conservative record. After 12 years of Labour government, it has risen to 9 per cent. above the average.

We continue our efforts to increase the take-up of pension credit, a benefit that did not even exist when the Conservative party was last in power. Since October 2008, it has been easier to claim, with claims for housing benefit and council tax benefit being made over the phone and pension credit being directly forwarded to the local authority without the need for a signed claim form. We continue to press ahead with targeted take-up campaigns, working with groups such as the Royal British Legion and the Market Traders Association to drive up pensioner claiming.

On that point, does the Minister accept that although there may have been an improvement in the number of claims, there is still a bit of a gap?

Of course, and we continue to try to drive up the percentage of people claiming. In the Welfare Reform Bill, we are taking powers to share information, so that we can try to make claims more automatic, and we now have a partnership agreement with all 209 primary local authorities to share housing and council tax benefit claims as well as pension credit claims. I am optimistic that we can continue to make good progress, but I am not going to say that I am completely satisfied with take-up. We still have to do more, and we are.

Pension credit can open the door to many other benefits, such as housing and council tax benefits. Jointly, they can lead to an equivalent income of about £200 a week, which is why we recently wrote to 230,000 people about their council tax benefit to encourage them to take up the benefits to which they are entitled. We make 13,000 home visits every week to conduct benefit checks, and that work is ongoing week in, week out.

May I commend the village agent scheme set up by the Department for Work and Pensions, which is run in pilot in Gloucestershire? A group of people are employed to go into rural areas and follow up on benefit opportunities. That has made a dramatic difference to people who are never contacted in any other way. That is a real example of Labour working in rural areas.

I thank my hon. Friend for his observations. When we conduct take-up campaigns, we must understand how important peer endorsement is. One of the most effective ways of getting pensioners to claim their entitlements is to enable them to have contact with pensioners who have been through the process and can reassure them that it is not difficult and that a successful claim makes a real difference to their living standards.

I do not know about Norwich, but I was recently talking to a pensioner in Morecambe who told me that he would be voting Labour because of the winter fuel allowance, the free TV licence, the free bus pass and pension credit. He did not trust the Conservative party, because he was old enough to remember the 1980s and the last Conservative Government.

I was speaking to a pensioner in Norfolk just a few days ago who knew that the take-up rate for the winter fuel allowance is very high indeed. What she will not have known is that just 58 weeks ago today, my hon. Friend the Member for Walsall, North (Mr. Winnick) asked the hon. Member for Eastbourne (Mr. Waterson),

“are the Tories now making a commitment to keep the winter fuel allowance if they win the election?”

The hon. Gentleman said:

“I will not make any commitments two years from an election”.—[Official Report, 4 June 2008; Vol. 476, c. 841.]

We are now 58 weeks on, and 42 weeks and one day from the likely date of the election. When will the Opposition be clear about whether they support the winter fuel allowance? An assertion that they have no plans to cut it is not equivalent to an endorsement that they are going to continue—

Order. I think I have had to say to the hon. Gentleman on more than one occasion that in his role as a member of the Chairmen’s Panel, he would never allow that length of intervention.

My hon. Friend the Member for North-West Leicestershire (David Taylor) has drawn attention to a point at issue. The country has to judge the Opposition by their actions. If they are so concerned about pensioner poverty, why did they oppose the extra money allocated in the pre-Budget report to cold weather payments? Why did they vote against Budget measures to finance the increase in winter fuel payments, paid last year and due to be repeated this year?

I do not know whether the Minister has had a chance to read the report of the Select Committee, on which her party’s representatives predominate. One of its criticisms of the winter fuel allowance is that it is extremely poorly targeted and goes to those who pay higher rates of tax. The Select Committee has made a recommendation that money could be saved by withdrawing the allowance from the rich. Does the Minister support such a policy?

The Government have no plans to do that, but I wonder whether the hon. and learned Gentleman’s intervention gives a little glimpse into what the future might be were there to be such a tragic occurrence as a Conservative victory at the next election.

Should not my hon. Friend congratulate the hon. and learned Member for Torridge and West Devon (Mr. Cox) on saying frankly what Opposition Front Benchers refuse to say? The Opposition would either abolish the winter fuel allowance, or, if they kept it, it would be means-tested. Let us tell the people, including pensioners throughout the country, what a Tory Government would mean.

I pay tribute to my hon. Friend’s tenacity in attempting to get some sort of sense out of Opposition Front Benchers. My hon. Friend the Member for North-West Leicestershire quoted one of his attempts, which was rebuffed, to get the hon. Member for Eastbourne to come clean about his party’s intentions last year.

Recently, the right hon. Member for Haltemprice and Howden (David Davis) referred to winter fuel payments as “a gimmick”. The Tory think-tank Reform suggested scrapping the payments altogether, along with free TV licences. That attitude goes to the very top. In May, the right hon. Member for Witney (Mr. Cameron) refused to rule out scrapping winter fuel payments. As my hon. Friends have just pointed out, the hon. Member for Eastbourne has refused to commit the Conservative party to retaining them. I note that he is not leaping to the Dispatch Box to put us right about that.

With respect, the Minister is struggling. Let me make it clear: we have no plans to scrap those payments, and it is dishonest to suggest otherwise.

Order. I sense that the debate is deteriorating. Far too much extra chatter is going on. Eight Back-Bench Members wish to speak in the debate and we have not yet got through Front Benchers’ speeches, so some people will be disappointed. I give notice now that the time limit will be reduced.

I have been generous in giving way. To get through the rest of my remarks, I will not be so generous. I merely observe that in May, when the right hon. Member for Witney was asked whether he would rule out abolishing the winter fuel payment, he refused to do so.

The Government have legislated for the most radical pension reforms since the basic state pension was introduced. Those changes will sharply narrow the gender gap in pensions, delivering fairer outcomes for women and carers. In 2010, more women will be able to claim a full basic state pension than ever before. The number of qualifying years will be reduced from 39 to 30, which means that around three quarters of women reaching state pension age in 2010 will be entitled to a full basic state pension in their own right, compared with around only 30 per cent. now.

Our reforms will enable more women to build up a state pension based on their own contributions. For the first time, paid and credited contributions for caring will be recognised equally for basic state pension and state second pension purposes. It is a great step forward that the invaluable caring work done by millions of women up and down the country is finally to be recognised, valued and rewarded in that historic reform.

The Pensions Act 2008 also introduced a vital measure to allow eligible people, mainly women and carers again, to buy an additional six years of voluntary national insurance contributions. We estimate that as many as 500,000 women will benefit from that change alone.

The Opposition have claimed that we have not been clear about the restoration of the link with earnings, but that change is already enshrined in law. We have been clear that we will restore the link between state pensions and earnings in 2012 or by the end of the next Parliament at the latest. From 2012, radical changes to private pension saving will start to come into effect. Those changes will be the most significant changes to pension provision since the state pension was introduced 100 years ago. We will see between 6 million and 9 million workers either newly saving or saving more in workplace pension schemes. That will be supported by the introduction of the personal accounts scheme, which will fill the gap in the pensions market for workers on moderate or low incomes. Annual pension contributions are estimated to grow to around £10 billion a year by 2015 as a result of those changes. Around £6 billion of that is estimated to be new saving. That represents significant steps toward tackling under-saving for later life, as well as a boost to the industry.

Through the Budget this year, we introduced two important changes for pensioners with savings. From November, the capital disregard for pension credit will be increased from £6,000 to £10,000. That will benefit 500,000 people, with an average weekly gain of £4, and it means that 88 per cent. of pension credit recipients will be unaffected by having benefit deducted because of their savings. From October, we will increase the amount that the over-50s can save in an individual savings account to £10,200. Those measures, when taken with the planned changes to personal allowances announced in the Budget last year, will mean that around 600,000 more pensioners will pay no tax at all. Overall, that means that 60 per cent. of pensioners will pay no tax.

Maintaining confidence in pensions is undermined by scaremongering about the state of the industry. Unlike in previous downturns, this Government have put in place arrangements to ensure that people are not left without a pension, even when their employer goes bust. This Government set up the Pension Protection Fund to ensure a strong and clear protection regime for people whose pension scheme fails. The Pension Protection Fund provides a safety net for 12 million members of defined-benefit schemes. It has £3 billion in assets and is currently paying out around £4.2 million a month in compensation to those whose employers have ceased to trade. Given those numbers, there is no question but that the Pension Protection Fund is sustainable and that people can have confidence that pensions savings can be maintained.

After inheriting a situation in 1997 where pensioner poverty had been growing, this party has made genuine progress in helping the most vulnerable. For the first time in history, we in Britain have broken the link between age and poverty. Thanks to the policies of this Government, people are now no more likely to be poor because they are old. That is an achievement of which we on the Government Benches are rightly proud. We have also laid strong and lasting foundations for the future. We are not only taking action to deliver real help now to Britain’s pensioners, but planning for generations to come. Our pension reforms mean that generations will benefit from a fairer and more generous state pension and that millions more will be saving in workplace pensions. Being old need no longer mean being poor, thanks to the action that we are already taking.

That is the agenda of a Government who are on the side of the people, not markets—a Government of action who will not sit idly by and do nothing. We have published our strategy to build a society for all ages, and we will take action to bring forward the review of the default retirement age. Yesterday, we published a Green Paper looking at the care and support system, which encompasses many of the important issues that have struck such a chord outside this House, such as personalisation and the national carers system. I commend the Prime Minister’s amendment to the House.

Order. Before I call the hon. Member for Leeds, North-West (Greg Mulholland), let me say that I rather hope that his speech is no longer than that of his Front-Bench colleague earlier, on which basis the time limit on Back-Bench speeches had better be reduced to 10 minutes.

I shall endeavour not to speak for longer than that, Mr. Deputy Speaker.

I think that we can all agree that the Government are extremely good at warm words. The Prime Minister stated in his foreword to yesterday’s Green Paper on social care:

“The way in which our society provides care and support for those who need it, whether in later life of because of disability, should reflect our values of compassion and fairness. In Britain we rightly aspire to a care and support system in which everyone’s needs are met and people can live their lives to the full.”

But how many older people in this country would recognise the reality of their lives over the past twelve and a half years in those words? Only last year, we had another consultation paper from the Government: “The case for change: why England needs a new care and support system”. Its opening paragraph stated:

“In a civilised society, we have a moral obligation to ensure that people in need are not left without any care or support.”

Yet here we are, a year on, talking about the start of a consultation process.

The sad reality for pensioners in Britain in the 21st century is that 2.5 million of them live in poverty. That is about one in five of the pensioners in this country. No Government—especially a Labour Government—should be anything other than deeply ashamed about that. The Commission for Social Care Inspection has estimated that older people are forced to spend £6 billion a year of their own money—often through selling their homes or raiding inheritance funds—in order to pay for their care in retirement. More than 2 million pensioners do not claim money from the benefits and credits system even though they qualify for it. So, whatever the Minister says, I am afraid that the system is not working to address the problem of pensioner poverty.

The hon. Gentleman is making powerful points about the position of the many pensioners who live in poverty in Britain today. Is he aware that the Institute for Fiscal Studies predicted—in 2007, before the current downturn—that there would be no change in the proportion of pensioners living in poverty in the next 10 years? I believe that the figure was one in five.

I thank the hon. Gentleman for that interesting figure. The reality is that the number of pensioners living in poverty in this country was increasing even before we got into the recession, so as the recession bites, there is real concern about what will happen to the most vulnerable people in our society.

Over the next 20 years, the number of people in England over 85 will double, and the number of people over 100 will quadruple, yet we continue to have discussion after discussion on what we should do about the situation. The Government themselves estimate that over 1.7 million more people will need care and support in 20 years’ time, yet we are seeing inadequate funding at local authority level from central Government, and a tightening of criteria. We have all heard stories in our own areas about people not getting the basic services that they need in order to lead a dignified and independent life.

Does my hon. Friend accept that one reason for pensioner poverty is that pensioner inflation is far in excess of the ordinary inflation that we feel? For instance, the increases in utility bills, water rates and council tax have far exceeded the rate at which pensions have increased. This has led to more pensioners being in debt and more being worse off than they were before. We need to address not only the level of the pension but the increase in costs that many pensioners have to bear. For instance, we could get rid of the council tax and replace it with—

My hon. Friend raises an important point. Indeed, the issues relevant to this debate are covered by many Departments.

Social care in this country has been a Cinderella service for many years, and we have had very little apart from warm words to suggest that that is going to change. Recently we saw the publication of the NHS constitution, which once again entrenched the division between health and social care. Many of us find that division artificial, yet there it was again in black and white. I ask the Minister again, as I have asked before: when will that be addressed? Are we going to have a social care constitution, and why is social care not incorporated in the NHS contribution?

The hon. Gentleman seems to have missed the legislation that allowed the local NHS to create care trusts, in which social care and NHS funds are indeed pulled together and spent exactly as he suggests.

There are some interesting pilots taking place in parts of the country, but that simply will not deal with the institutional divide in Whitehall, which I am afraid will take a lot longer to shift.

I now turn to the Green Paper, and I shall again quote the Prime Minister. Let us bear in mind that we are now nine months away from a general election, yet the Prime Minister says:

“What is now needed is a major debate about the challenge we face and the options for addressing it…This is the start of a process for discussion rather than the end”.

That is extraordinary. The Green Paper should have been published many years ago. If the warm words said before the 1997 general election meant anything, we would have had such a Green Paper published during the first years of the Labour Government.

The Secretary of State made a big plea for consensus yesterday, saying that we must all work together. Frankly, I am afraid that nine months before a general election, in the dying days of a Government, is absolutely not the time to be talking about needing consensus.

I assume that during the election campaign the hon. Gentleman will be explaining in his own words how his party is going to offer free social care to the elderly—and how that will be costed.

I will, of course, tell the House what my party policy is—and, unlike the hon. Gentleman’s party, we have one!

The reality is that the Government have no timetable. We are told in the Green Paper that there will be a White Paper in 2010. Will it be in January, February or March? If it is any later than January, are we not talking about a Labour party manifesto commitment rather than a White Paper? The Government know full well that they will be able to do absolutely nothing to implement the proposals.

Let me cite what Age Concern and Help the Aged have said:

“While agreeing that a public debate is needed”—

let us face it, most of us have been engaged in that debate for many years—

“the charity called on politicians…to set out definitive proposals for reform and a clear timetable for action as soon as possible.”

Yet even in yesterday’s statement, we did not manage to get that. What we now have is yet more warm words and more commitments to achieve things that the Government know they cannot deliver.

At least we achieved a U-turn on Monday on the mandatory retirement age. I welcome that, and the fact that the review will be brought forward. It is important, particularly in a recession, to allow older people who so wish the dignity of continuing with their working lives. At least that is now on the agenda, whereas when I questioned the Minister some months ago, the idea was directly rebutted. Let us hope that in this Government’s remaining months, we will see further U-turns to bring about changes that will help older people.

The hon. Member for South-West Norfolk (Christopher Fraser) asked about my party’s policy. I am very pleased to tell him; we announced our policy last year. As a party, we think it important to engage in the debate and say what our policy is. Our policy involves a universal care guarantee—a partnership model based on the excellent King’s Fund Wanless report, which the Government ignored. [Interruption.] It is costed, absolutely. I would be delighted to send hon. Members a copy. We remain committed to ensuring that those who are least able to pay get all their care paid for, but that everyone receives a minimum entitlement to care. That is set out in the Wanless report and is now in the Green Paper, which is welcome, but it should have been in a Green Paper and up for discussion back in 2006.

I think that the hon. Gentleman may have made an inadvertent error in suggesting that the Wanless proposal for a guaranteed minimum financed by the taxpayer was in the Green Paper. It absolutely was not. The Wanless version of the partnership model is not one of the Government’s canvassed options.

I thank the right hon. Gentleman for clarifying that technicality. I was talking about the partnership ideal, but I accept that our policy is a version, based on the Wanless model, of what we believe to be genuine partnership.

Let me quote the Prime Minister again. Back in 1993, at the Labour party conference, he said:

“I want the next Labour Government to achieve what in 50 years of the welfare state has never yet been achieved—the end of the means test for our elderly people”.

I am afraid that, twelve and a half years into the present Government, that is very much not the case.

Let me now turn to the Conservatives—

I thank the hon. Gentleman for his generosity. An argument that I have not heard advanced so far is that care should be about quality. I think that one thing that the Government have tried to do is drive up quality, although what they have done may not be perfect. It may, for instance, have resulted in the closure of facilities that, with the benefit of hindsight, the Government realised could have remained open. Nevertheless, we should be trying to ensure that our older people experience quality, rather than just thinking about numbers. Does the hon. Gentleman agree with that?

I agree entirely with the hon. Gentleman’s sentiments, but I am afraid that if he spoke to all the elderly people in the country he would find that they were not receiving quality services. What they are receiving is patchy services that are very different in different areas, along with different entitlements. All the surveys conducted by older people’s organisations make it clear that the quality of care is as important as its funding, but the two must be seen together. It is simply not realistic to suggest that we can secure better quality services without facing up to the difficult issues of funding.

I will try to be brief.

The truth is that under this Labour Government, the local authority bar for access to care has risen repeatedly because of the funding position. Care has been removed from those with moderate or even quite serious needs. It is necessary for people to be at the top end of the care need scale before they have access to local authority care, thanks to the actions of this Government.

Indeed. I do not think that the burden placed on local authorities is taken seriously enough in this place. We need mutual minimum entitlements for people throughout the country, to prevent a different quality of care from being provided in different areas.

One would think that the Conservatives—especially as they called for the debate—would want to lead it by revealing their proposals for care in this country. I must say that I find their attitude rather barefaced. Although I do not agree with the Government on many aspects of this policy area, the Conservatives’ criticism of the Government for not having a policy is amazing, given that they have no policy whatever themselves.

The shadow Secretary of State for Health, the hon. Member for South Cambridgeshire (Mr. Lansley), said on the “Today” programme how late the Green Paper was, and of course that is true. He also said:

“We will come forward with a clear proposal by the next election if the Government don’t.”

That, I think, exposes the reality of the Conservative position, which I am afraid is typical “substanceless” new Tory. It is very much like the Labour party’s position in 1995-96. It is strong on warm words and spin, but very empty on policy. Of course, this is the party that abolished the link between pensions and earnings, and led us into the care system that we have now. The crisis with an ageing population was perfectly visible then, but the Conservatives did nothing to prepare for it.

We have approximately nine months left before the general election, and we are being asked to start a discussion about care. We are being asked to wait possibly six years for fundamental change to the pension system, such as a restoration of the link with earnings. This is not a time for discussions, let alone the start of discussions; this is a time for firm policy commitment.

The Secretary of State for Health tripped himself up yesterday. Having said that we want consensus—the title of the Green Paper is “Shaping the future of care together”—he said that at the next election all the parties would put their proposals to the electorate. Frankly, is that not what a Green Paper at this stage is all about, because it can deliver no change for people in our country before this Government leave office some time next spring?

We need real decisions that will affect older people’s lives to be made now. We need to bring forward the decision to restore the link between pensions and earnings. We need clear policies for how we will deal with the care crisis that is ruining older people’s lives now. We have heard quite enough warm words, but older people know that this country currently does not adequately value them.

I have been a Member in this House for a little while now, and during that time I have discussed demographic change on many occasions. The hon. Member for Eastbourne (Mr. Waterson) has been in the Chamber for some of those debates, and we have had several exchanges about the need to look ahead at what we must do for people in the future. It is therefore a little remiss to have forgotten those occasions and instead to spend all our time talking about what we must do on pensions and pensioners as if that is all that needs to be addressed on the subject of elderly care—because the subject of today’s debate is elderly care, not pensions.

I thought for a while that I had wandered by mistake into a session on leaflet-writing for the forthcoming Norwich by-election. That distressed me a little, because I had made a promise to people very important to me that on this rare occasion when I am able to speak in the House I would talk about elderly care, as that matters a great deal to me, partly because of members of my family, but also because of constituents of mine, some of whom have had good experiences and some of whom have not.

Having seen the Green Paper and some of the statements made in the House, I particularly wanted to take advantage of the opportunity given to me by the Opposition—I am grateful to them for that—to say what I think needs to be done on elderly care in the round. I want to pay tribute to the Government for what has happened already, because we would think from listening to today’s debate that nothing had happened in the past 12 and a half years—but actually a great deal has happened.

I can remember—Members have to acknowledge this—a time when in homes we would think, “My goodness, I hope I never end up here.” I still think that about some homes, and we have to do something about that. Having said that, however, there are homes in my constituency that have changed beyond recognition, and I pay tribute to those people in my constituency and the officers on the council who have worked closely together on that. The local authority and the staff of those homes have worked hard to change the system entirely. As a result, we now have assessment centres so that when people leave hospital they can be properly assessed and we can ensure that they get the proper care that they then need.

Sadly, that is not the case throughout the country. I have been very saddened when I have seen people who are not my constituents not receiving that level of care; some of them have been relatives of constituents of mine, who have asked me to intervene on their behalf. We have seen some high-profile cases on editions of the “Panorama” programme and elsewhere, so we cannot say with hand on heart that all our older people have had a life of dignity and care—the sort of life we would want for members of our own families. Some people have starved or have suffered elder abuse, and we must say that in this day and age that sort of thing must stop. It has saddened me a bit that this House has not taken just a little while to talk about that and what we need to do.

I have not had enough time to digest all of this Green Paper, but from what I have read I have seen the beginning of what could tackle some of the issues. This country has some fantastic people whose brains we ought to be using in order to bring together what we could be doing, but I still wish to make suggestions in order to take things further. The idea of having personalised care has been talked about for some time, but it has not been properly delivered. Such care has been delivered in some places, but it has not been delivered everywhere and it has not been delivered to the standard that all of us have wanted. We would all want the best for our mother if she was in care, yet we would have to say that we have encountered cases in our constituency mailbags where the care provided has not been good enough.

What in the Green Paper would make the situation better? Having one standard of care for everybody below which we cannot drop must be a good thing, but how are we going to make it work? Where the only other member of an elderly person’s family is themselves old and frail, how could that person ensure that the care provided is top-notch? How could that person stand up to everybody in the system, given that the system sometimes feels overwhelmingly large? I think that the relevant body is now called the Care Quality Commission, but because there are so many names in the system these days people going into homes may not know the right name to give and may feel quite belittled by the system. Can the family member be sure that they are asking the right question? Do they know who to ask for? Are we really empowering people in the right way? Do we perhaps need something akin to what we have in the health service? Do we perhaps need a patient advice and liaison service in the social care system? Could we be considering that in this Green Paper, so that there can be advocacy for people in the care system and so that in future we do not have people who feel that they have not been fed properly?

My mailbag, like those of other hon. Members, has contained cases where someone has felt that their relative had not been properly fed, had not received enough drink and had not received the proper care. Those people may have felt that their relative died inappropriately and too soon because of the care that they did or did not receive. If such people feel that and then cannot obtain answers, they will never believe that their loved one died in the way that anybody would want their loved one to die, and we cannot have that in our system today.

I thank the hon. Lady for giving way. Does the situation not grow worse, and is insult not added to injury, when some elderly people have sold or have had to sell their house to get that care, yet still find themselves in a situation where they are not getting nourishment, proper food and nutrition?

I understand exactly what the hon. Gentleman is saying, but I have read the Green Paper and I feel that the Government are making three interesting proposals. It is right for us to debate the new proposals and see what we can do to change the situation that he describes. The people in the cases in my postbag have been receiving NHS care, so that situation has not arisen because such care is paid for. I know that some people have not been in that position, but usually where someone is having to be fed, an NHS paid-for place is involved. I can see that he looks quizzical and does not agree with me, but the places in the cases I am discussing have involved NHS care. I understand the point that he is making, however. If he has experience of different cases that have not been funded by the NHS, I take his point.

The Green Paper contains three options that we have all been asked to consider and debate. I have my own preference, but we will have to have the debate. I hope that people will not have to choose between their homes and care in the future, but that has been the choice for many years for many people, usually those in social care places. I would not want to make that choice. Personally, I have never wanted to inherit anything from my parents: I have wanted them to have the best care. However, I have heard from relatives of Alzheimer’s sufferers that it is very distressing to know that they are unaware that the home that they have always treasured has had to be sold. So I understand the point that the hon. Gentleman was making.

In a roundabout way, that has brought me to the point that I was going to make about funding in general. When people are feeling vulnerable—and it is that vulnerability that I wanted the House to consider—they do not know where to go or to whom to turn. That is where the notion of advocacy comes in. In cases that I have looked at, the system has not always worked out as people expect. They have gone to people and asked for help, but they have been a little let down—

Order. The House has been listening to the hon. Lady with great respect, but in fairness to other hon. Members we have to move on.

I wish to follow the hon. Member for Colne Valley (Kali Mountford) in adopting a relatively non-adversarial tone, but nevertheless addressing some of the core issues that are at the heart of the debate that the Government seek on this sensitive issue.

The truest words spoken in the House this afternoon have been by the former Minister for Pensions, the right hon. Member for Croydon, North (Malcolm Wicks), who acknowledged that this subject has been avoided by Governments for the previous 25 years. It is therefore true, as my hon. Friend the Member for Eastbourne (Mr. Waterson) said from the Front Bench, that it is disappointing that a Government who came in pledged to action on the subject, which was certainly unfinished business when I left office as Secretary of State 12 years ago, are only now introducing a Green Paper and seeking a national debate. I am happy to enter into that debate, because it is a hugely important issue.

The central problem, of course, and the reason why Governments have consistently failed to address the issue, is not that it is difficult to express the aspiration—the Green Paper expressed many of the aspirations accurately, and I could have used much of the same language myself. The key issue is how we produce the resources necessary to deliver the services that we all aspire to provide for our elderly citizens.

I agree with the Green Paper’s emphasis on the importance of carers. As one of my hon. Friends said earlier, elderly people can be carers not only for their elderly relatives—often their spouses or partners—but important sources of care for other members of the wider family community. Engaging in a proper discussion about how to use the voluntary support available from a wider understanding of family connections is an important part of this discussion. That is my first point.

My second point relates to my intervention on the Minister on the subject of direct payments and to the rather larger subject of personalised care, about which the hon. Member for Colne Valley was talking. We must all have experience from our personal lives and in constituency surgeries of money being wasted because it has not been accurately used in a way that reflects the individual preferences—I use that phrase as distinct from a need calculated from a dispassionate point of view—of the service user. The importance of personalised care and, in particular, of the direct payment principle is that it focuses resources on the delivery of service chosen and fashioned by the service user. In my view, that is the best way of securing care that meets the service user’s needs.

The third issue that I want to touch on briefly before I come on to what I have described as the core issue of resources is what has been called “a National Care Service”. The Government are extremely unclear in the Green Paper about what that phrase means. What, for example, is the role of the local authority in delivering a national care service? Is it to be a service provider? Is it to have local discretion on commissioning? The Green Paper refers to the oft-used “postcode lottery”, which is exactly the same concept as local discretion. Do the Government think that all exercise of local discretion is merely a manifestation of the postcode lottery? If so, do they aspire to a single, uniform national service or are they willing to defend local differences of service and not dismiss every local difference as merely a manifestation of the postcode lottery?

I would suggest to Ministers that the phrase “national entitlement” is extremely dangerous, as we have seen not just from court cases in the social care field but from the broader debate about what the national health service should be providing as a national minimum entitlement. The moment we get into a discussion about the concept of a national entitlement, it becomes extremely difficult to produce services in a local area that reflect accurately the needs of people in that area and represent an efficient use of the resources available. Those resources will be different in different parts of the country for a variety of difficult historical reasons and the needs that arise will be different because of the nature of different local communities.

The concept of a “National Care Service”—the balance between the national definition and local delivery and between national priorities and local priorities—is not made any easier by the introduction of initial capital letters. With respect to Ministers, all the difficult questions attached to that phrase are left unanswered by this Green Paper.

I now come to the fundamental issue of resources. In 2006, Wanless analysed the resource implications of moving from social care provision, which we acknowledge does not deliver what we would want it to deliver to elderly people, to either what he called scenario 1, which was the current basic level projected forward for another 15 years, or scenario 2, which met the current aspiration projected forward for another 15 years. One can follow the arithmetic with decimal points, but in back-of-the-envelope numbers Wanless identified a funding gap of £20 billion emerging over 15 years. That funding gap of £20 billion is the elephant in the drawing room. It is the reason why, 12 years on, we have a call from Ministers for a national debate. It is the reason why we have not had the action promised by Tony Blair at the Labour party conference of 1997.

The Government say that it is impossible for tax funding to fill that gap—in their phrase, that is “ruled out”—and I agree with them. I suspect that the Liberal Democrats still believe that it is possible—through a penny on income tax, no doubt.

I am following the right hon. Gentleman’s argument with care. He is absolutely right: that is the elephant in the room. That gap can be funded only from public spending or from people’s savings—largely, the money they have locked away in their property. Although he may be justified in criticising the Government for not facing the elephant in the room, are not his hon. Friends, who started this debate by implying that, somehow, people would never have to tap into their savings, equally open to that criticism?

I agree with the hon. Gentleman to the extent that the funding gap has to involve more private resources—I totally agree with that. However, although it may be the policy prescription that he espouses, I do not think that it is necessarily true that those resources have to come out of the savings of retired people in retirement. It is, to my mind, one of the unattractive policy options canvassed by the Government that we should have a compulsory system that pays for provision exclusively through what is, in effect, a tax on elderly people. I think that we should be encouraging people to look forward to their likely evolving need during their working lives, and the secret to doing that lies in the insurance system.

The Government identify what they describe as partnership funding. As I said in an intervention on the Liberal Democrat spokesman, the hon. Member for Leeds, North-West (Greg Mulholland), the Government’s definition of partnership funding is different in an important respect from Wanless’s definition of partnership funding. As it happens, I am more on the side of the Government than I am of Wanless in that debate. However, the Government identify partnership funding as one option and then imply that insurance is a different option. I think that they are wrong to imply that they are different; in fact, they are one and the same option.

In my view, the Government’s refashioning of the resource that is currently provided from the Exchequer—using Government money more effectively—in partnership with private resources will, if the Government develop a proper policy, automatically lead to an insurance market that allows resources to be mobilised in a way that is significantly fairer than trying to pay for the provision from a tax on pensioners, which is what I understand the Government’s so-called comprehensive option to be. The core challenge, which the Government acknowledge but do not face head-on, is to use existing public resources more effectively and in a way that enlists private resources in order to fill the Wanless funding gap.

I am loth to intervene, but the right hon. Gentleman seems to be arguing for option 2, which is the insurance model—partnership with a voluntary option. What does he see as the strengths and weaknesses of that option in the longer term?

The key strength of a link between partnership and insurance is that more private resources are unlocked for an area where I see no alternative source of funding available to meet the requirement, and those resources are levied in a way that is fairer than the other options offered by the Government, because the insurance system allows people to contribute during their working lives. That is why my hon. Friends and I have repeatedly tabled different versions of insurance-based schemes that work in partnership with the public sector. That is where the answer to the conundrum lies. What is disappointing is that, 12 years on, we are still taking about the concepts, rather than the detail of the legislation. As the Minister knows, a version of that legislation was left in the desk of the incoming Secretary of State in 1997. I no longer sign up to every detail of that legislation, but it was a long way on then from where we are now.

I sometimes think that I am a little bit too naive for this job. When I saw on the Order Paper the subject that the Opposition had chosen for debate, I thought, “Ah, they realise that the Green Paper is coming out, and they want to make a contribution on it in a debate.” It was only when I got to the Chamber that I realised that the debate was intended to be a statement to the people of the by-election constituency, Norwich, North.

Before I try to follow the right hon. Member for Charnwood (Mr. Dorrell), and comment on his constructive comments and on the very thoughtful and impressive comments of my hon. Friend the Member for Colne Valley (Kali Mountford), let me say a little bit in response to the way in which the debate opened.

If people in Norwich, North are listening to this debate to help make up their mind how to vote, let me remind them that it was the Conservatives who broke the link with pensions. They then attacked the Government’s tax changes, and the impact that those changes had on definable benefit pension schemes, but they never point out that it was their Government who gave employers payment holidays, which accounted for a large part of the black hole in pension pots. Of course, the Conservatives never explicitly say that they will change those tax arrangements to refill the pot, because they are not going to do that. They do not mention that it was they who opposed the introduction of pension credits.

The Conservatives raise issues such as Equitable Life and try to give the impression that if they were in power, they would find £5 billion with which to compensate all Equitable Life pensioners. I have some Equitable Life pensioners in my constituency, and I hope that we will treat them generously, but the Conservative party really should not try to give the impression that it will give a blank cheque to those pension holders when clearly it will not. The Conservatives keep telling us that they want honesty about public spending in the debate, yet today they have tried to imply that every pensioner will be better off. They have even tried to fudge the difference between means-tested benefits and universal benefits. They tried to give the impression to people who currently do not get means-tested benefits that the Conservatives will move to universal benefits, and that everybody will get something, without being honest to the people on means-tested benefits about the fact that if one does that, the pot of money has to be distributed more thinly, and the poorest in society will get less. The people of Norwich, North would be well advised to take what has been said today by Conservative Members with a substantial pinch of salt. That also applies to the Liberal Democrats—

In one moment. I was just about to be rude to the Liberal Democrats; let me do that first, and then I will certainly give way. The Liberal Democrats have at least changed their position now, but for a number of years they gave the worst of misdirections to the people of this country by implying that social care could be made free sustainably; they did so in the past couple of general elections, when clearly that was never an option. We should have been honest with people about that, and so should the Liberal Democrats.

I was going to agree with the hon. Gentleman absolutely until he made his last point. Everything that he says about Conservative policy, about the fact that the origins of the problems lie in what the Conservatives did in the 1980s, and about their lack of an answer now is true. However, is the hon. Gentleman—a former Minister—happy that after 12 years of a Labour Government we have the worst pensions in western Europe, 20 per cent. of pensioners in poverty, and still no answer on the question of care for the elderly? All we get, after 12 years, is another discussion paper that will come to nothing until after the next election.

I am not happy if one single pensioner is in poverty, but I know that, thanks to this Government, far fewer are living on low incomes than in 1997, because there is pension credit and winter fuel payments. I have not been to Norwich in the run-up to the by-election, but I have knocked on an awful lot of doors in the past few months, and poorer pensioners, to a man and woman, say to me that they are better off than they were. They recognise that the Government have targeted resources on them. Means-testing may be inefficient, and we might wish that we could do otherwise, but it has meant that we have been able to help the poorer people in society.

I turn now to the issues thrown up by yesterday’s social care Green Paper.

The hon. Gentleman has said that pensioners are better off, but we have had 12 years of economic growth so of course they are—although still far too many are in poverty. Does he agree that social care received only a 1 per cent. increase in the Treasury’s spending provisions, which in real terms was a cut? It was separated from NHS spending, but should not the two be joined together in future?

I certainly think that we need to bring funding for the NHS and for social care together in various ways. I was going to make the following point later anyway, but will make it now instead: we already have a model that could help us to do that. We do not need to reinvent the wheel, because we have done the same thing for children.

Children’s trusts have been created to bring together all the resources—for education, social care and so on—that are focused on children. That is the responsibility of the directors of the children’s trusts. We have also introduced the idea of care trusts. Local areas can voluntarily create care trusts, in which NHS resources and social care resources from the local council are pooled together. What we have not yet done, but ought to, is say that that approach should no longer be voluntary. We should say that adult care trusts must be created everywhere, with each one having a director of adult care services responsible for pulling together funding from the NHS and local councils and making sure that it is spent most effectively. That is a way in which we can reduce the cost of social care.

One thing was missing from yesterday’s Green Paper. We have identified the options for funding social care and how we might move forward on them, and I applaud the Government for grasping that nettle and being prepared to open the debate, but the Green Paper did not really put forward ideas for minimising the growth in the costs of social care.

By the middle of the century, four times as many people will be needing care than now. The fastest growing demographic consists of people over the age of 100: if we are spending £12 billion to £15 billion a year now on social care, we will be spending £60 billion in today’s terms by the middle of the century. That cannot be afforded, so as well as identifying ways to fill the social care spending gap identified by the right hon. Member for Charnwood, we have to look at how we can minimise that spending.

Basically, the models in yesterday’s Green Paper suggest that people should put a certain amount of money into the pot and that the Government will meet the rest of the costs, but that does not include any incentive for people to organise their lives in a way that minimises their care costs. They can continue to live in the biggest houses in the remotest parts of our constituencies and expect care workers to travel out to deliver care. Effectively, that will be at great expense to the Government: the liability falling on individuals will be capped, with the result that the public sector will have to step in and meet the costs.

How are we to incentivise people to organise their lives more sensibly? One option that I am very keen to promote is extra care housing. First of all, it means that people remain independent, because they stay in their own homes and do not have to live in residential care homes. They can access care as and when they need it, but the system means that care-providing organisations can model the care around the fact that people who need it are all in a relatively small place.

The extra care housing environment is a very efficient way to deliver care, yet councils around the country are still allowing developers to build ordinary, warden-assisted housing everywhere. Ninety per cent. of all the accommodation for older people that is being built is still simple assisted-living accommodation, with no element of care service provision. Therefore, we should change the planning laws, so that local councils can say, “No, you can’t build this accommodation as just warden-assisted accommodation. You have to have care services delivered there as a way to help with that aspect of reducing costs.”

When can we expect councils, as part of their planning duties, to design their town centres around what I like to call “liveability” for older people, and design older-people-friendly town centres, so that older people have an incentive to move from remote accommodation into their own accommodation but in the town centre, where it is far easier to provide them with the care services that they want?

Will the former Minister answer the question about how we deal with rural areas where people want to live in their community? He seems to suggest that such people should move to the towns.

I am absolutely not suggesting that, but many people live in suburbs and around towns and are happy to be urban dwellers. Some people may be happy to move from rural to urban communities, and if they want to do so that is fine, but we can still organise services differently around rural communities to minimise cost. Telecare is one option. Where are our proposals to ensure that every older person is entitled to a package of telecare? If one lives in a remote rural cottage, one could make feasible the provision of care in one’s home environment through telecare. Perhaps that should be the universal option that we put forward.

I mentioned earlier direct payments, of which I am a great fan. The right hon. Member for Charnwood rightly mentioned that the Conservatives introduced them, but they made it only optional for councils to offer them; we made it compulsory for councils to do so, and compulsory for councils to give such payments to individuals who requested them. We should continue to do that, but the ultimate direct payment is attendance allowance: it is not means-tested; it is a universal benefit with a national eligibility criteria. It is the ultimate direct payment; it is simply not called a direct payment at the moment.

One worrying proposal in the Government’s Green Paper is the option that we take the money from attendance allowance and put it into a pot to pay for the social care service. If we are serious about direct payments, all we will do if we adopt that proposal is take attendance allowance off people with our left hand and, calling it something else, give it back to them with our right hand,. It would be far better just to call it attendance allowance, leave it as it is and recognise that it is in place to pay for that first element of somebody’s care.

Finally, the Supporting People budget needs to be brought into the debate, too. The way in which we provide help through that budget is another element of the package which we have not addressed. I commend to Members the debate that my hon. Friend the Minister wants, and I commend the Government’s amendment.

I shall try to confine my remarks, to make them relatively short and, in the spirit of my right hon. Friend the Member for Charnwood (Mr. Dorrell), to avoid the partisan rhetoric in which it is too tempting to engage on the eve of a by-election. I was, if I may say so, struck by the sincerity and dignity with which the hon. Member for Colne Valley (Kali Mountford) addressed the House, and if I were tempted to engage in the debate in a partisan spirit, her presence here, listening to me, would shame me into not doing so.

This is a profoundly serious debate. As somebody with a 97-year-old grandmother, who lives near me, whom I am responsible for, who is in residential care, who has gone through the often bruising experience of losing a great many assets and who is now, I am afraid, afflicted by dementia, I must say that the problem is all too present and real to my family and to me. This debate is therefore not one in which I can engage with any light or bantering tone. Plainly, the situation that afflicts my grandmother as she descends into dementia afflicts tens of thousands of people throughout the country, and they look to this House not for party point-scoring, although hon. Members in all parts of the House have engaged in such activity in good humour today, but for solutions.

I have been struck by something in this debate: we seem to have made a breakthrough. In recent years, it has been particularly depressing to note that there has been an element of deception in how we have approached the foundation of public policy on this issue. Indeed, the more I have come to play a part in the system under which we now operate—on behalf of constituents and personally—the more apparent it has become that the system has become cruelly deceptive of those who operate in it. For example, carers are said to be entitled to an assessment and a carer’s package. How often do we Members experience that as a reality as we carry out our constituency functions? In the rural part of the south-west that I have the honour to represent, it is more of a declaration than a reality.

In Devon, part of which I represent, it is not true to say that when a person has exhausted their assets they can choose a home or remain in the home in which they have been resident. If the county council will not pay the fee associated with such homes, more and more families end up digging into their own pockets to top up the amounts that the county council will pay. Alternatively, a benevolent fund or charity—whomever one can find—becomes involved.

The alternative with which the resident is presented is that of moving from a home in which he or she has become happy, or at least contented and used to. That is cruel. Having paid all they can and descended beneath the relevant threshold of assets, the resident comes to the system. In many parts of the country—particularly in Devon, which has the sixth worst social care grant in the country—they find that the reality is not what they were led to expect, which was that the state would provide for them in their straitened circumstances.

Far too many in residential care are affected by serious conditions such as dementia; the hon. Member for Colne Valley spoke a little about that, but did not go into detail. My grandmother is in a home, clearly suffering from moderate, and increasingly severe, dementia. That is not, we are told, a matter for the health service and it is extremely difficult for her to access the mental health services that might assist her. I suspect that thousands of elderly people in residential care are affected by dementia. I fear that the curious assessment system that decides who falls under the health category and who falls under the social care category is also, to a large extent, a deception. The system is variously interpreted in different parts of the country and one senses that the lower the Government social care grant for a local authority, the more people who should be paid for from the health budget are in the homes of that authority.

I make criticisms of that, but I understand its springs and origins; it comes down to a shortage of money. I said that we had made a breakthrough in this debate and the run-up to it: it is that I have yet to detect anybody who seriously contests the notion that all parties must make a frank and candid admission to the country. It is that we cannot conceivably fund these measures through taxation, and if both sides of the House start from that point, we will at least have the beginning of a consensus—the start of a foundation on which we can build a policy.

I have yet to detect that; indeed, the Liberal Democrats went to the country at the last general election with a policy based on precisely that position. That reminds me of Harold Macmillan—I am going to indulge in a little badinage, but I hope it is good-humoured—saying that the Liberals are full of original and practical ideas, but the problem is that the original ones are not practical and the practical ones are not original. One has to say that the policy with which the Liberal Democrats went to the country three or four years ago was not practical. I am delighted to hear that they are no longer wedded to it, given that even their own party members considered it to be based on a deception.

We cannot go on suggesting to the people of this country that we can sustain elderly and social care on the basis of taxation. I agree with my right hon. Friend the Member for Charnwood that there must be a balance. I am going to risk provoking the concern of my Front-Bench colleagues by saying that we need to use public funds more effectively. I say to the Minister that I am not speaking for my party, so let him not make too much of this. I participated in a Select Committee that looked into fuel poverty and asked, “Are we making enough of the public funds?” and “Are we directing them and making them more effective?” That Labour-dominated Committee decided in its report, which I commend to the Minister, that we were not making effective use of the public means at our disposal. In my judgment, winter fuel payments should not be paid to those on higher-rate tax bands. It makes no sense to do that, and we could save about £250 million by not doing so—a small amount, but it would be a start. We are not making effective use of the many different allowances that are—I fully accept this—designed and targeted to relieve the poverty of the aged, including fuel poverty. On top of that, we should, as my right hon. Friend the Member for Charnwood suggested, adopt an insurance system over and above a particular threshold.

If the insurance had to be paid while one was working, which seemed to be the suggestion of the right hon. Member for Charnwood (Mr. Dorrell), and if it were made compulsory, how would it differ from national insurance, which is effectively just another tax?

Plainly, the detail needs to be examined. I can think of solutions through the insurance system that would not necessarily mean that the money was lost if one did not subsequently have to call on the insurance fund, and other techniques could be used. The danger is that there would be no incentive to engage in it. However, it would be retrograde and unfortunate simply to have a tax on those who were elderly or a tax on their estates; we must look for alternatives to that.

The silver lining that I perceive in this debate, starting from a position of far less expertise than those who have participated in examining the problem in government, is that we have all been able candidly to accept—nobody has sought to argue otherwise—that we will need a system that is based at least partly on the private financing of those affected. If we can build on that as a starting point for this policy, we then have a responsibility to develop it. Twelve years ago, the former Prime Minister came into government promising that he would solve this problem. It is a bit late for the Labour Government to produce a policy now, but I am glad that they have, because at least we can all begin to talk about this in an adult and sensible way and to say to the public that it can no longer be done on the basis of public means and direct taxation.

At the beginning of the debate, I was quite depressed by the partisan nature of the contributions, so I am delighted to speak towards the end and follow three or four excellent contributions that show the willingness of Members on both sides of the House to take this matter seriously. I welcome the debate as an attempt to look at the problems of long-term care realistically, sensibly and openly, and, I hope, to achieve consensus.

I absolutely agree that the proposals have been rather slow in coming. I have spent quite a bit of time looking back at the Select Committee on Health’s report on continuing care, published in April 2005. I had to examine the membership of the Committee to ensure that the Secretary of State himself was not a member at that time, because, as far as I can see, most of the recommendations in that report are covered in the Government’s proposals and the Green Paper.

I shall go through one or two of those recommendations and what we discovered. The frequently identified problems were listed at the time:

“Inconsistency of criteria between PCTs/SHAs”—

primary care trusts and strategic health authorities—

“leading to inequity.

Gap between eligibility criteria on paper and application and interpretation in practice.

Inconsistent approaches to assessment and a lack of fit with the Single Assessment Process.

Inaccessible or incomprehensible criteria (both for professionals and patients).

Concerns over exclusion of many chronic needs (especially dementia) because of focus on physical care”,


“Confusion over relationship between high band RNCC—

registered nursing care contribution—

“and fully funded continuing care.”

The whole thing was an absolute nightmare, and I hope that the Green Paper will set about solving some of the problems.

I shall quickly go through one or two of the recommendations that the Committee made. Early in the report, we stated:

“We therefore recommend that the Government’s review of continuing care funding arrangements take the form of a full, formal public consultation, in line with Cabinet Office recommendations.”

It appears that, thank goodness, we have got there now. We asked the question

“what is health and what is social care”,

and we got no meaningful answer, so we moved on to the absolutely obvious, stating:

“We strongly recommend that the Government remove once and for all the wholly artificial distinction between a universal and free health care service operating alongside a means-tested and charged for system of social care.”

We got the answer that we expected from the Government, as the right hon. Member for Charnwood (Mr. Dorrell) might think:

“If by recommending that the Government remove the distinction between health and social care, the Committee is really recommending the removal of means testing for care services, then this would have significant cost implications.”

The cost implications that we identified then were a mere £1.5 billion, estimated to rise to more than £3 billion by 2020, not taking into account the costs of looking after patients, such as food and residence costs. The figure of £20 billion is possibly more nearly correct, and that is obviously quite unaffordable from taxation. There appears to be a general consensus about that.

The Government are to be congratulated on the fact that at a time of recession, they have introduced a Green Paper inviting consultation on how we can find the money. I cannot help hoping that that spills over into the national health service as a whole, because we have to ration money for the NHS as well.

I welcome the hon. Gentleman’s desire not to be partisan in spirit. I put it to him that one reason for some of the venom on the Conservative Benches is that this important debate has been launched nine months before an election, when it will be impossible to get consensus. Even if it were possible, it would not be possible to get legislation arising from it. The frustration is about the Government’s failure in previous years to bring the consultation forward, although it is welcome whenever it comes.

I thank the hon. Gentleman. I agree that the consultation is too late and has been a long time coming, but I still hope that it may lead to some movement forward.

The Health Committee’s recommendations in 2005 went on to urge

“a single, universal set of national eligibility criteria for continuing care to end the inequities and inconsistencies that have developed as a result of the current system.”

The situation was ridiculous. There were two separate systems for assessing eligibility for fully funded NHS care and for assessing the need for the registered nursing care contribution. I hope that the Green Paper will address all those matters and, most importantly, genuinely tackle the problem of resources.

With your indulgence, Mr. Deputy Speaker, at the last moment, I will consider a rather different aspect of care of the elderly, which is incredibly important. The reason for allowing myself perhaps to digress is that the motion uses the words, “encourage respect” and

“promote security and dignity in old age”,

and the Green Paper has the important subtitle, “Independence”.

What do independent elderly people living alone need, as well as peace of mind about long-term care? They need the security of knowing how to access appropriate acute care and that they will be cared for expertly and appropriately in the right setting. One of the disadvantages of the rapid changeover of Ministers in the Department of Health is that, just when one has got a particular Minister to recognise something important, he moves on. I am referring to the right hon. Member for Exeter (Mr. Bradshaw), with whom I have had more than one debate about access to emergency care. That is particularly important for the elderly.

I want to put it on the record, so that current Ministers do not forget, that they are working towards a single, three-digit telephone number, which will allow the elderly to know that they do not have to traipse round the minor injuries unit or an accident and emergency department or to look for out-of-hours care. They can ring the number, which will point them to the correct pathway. That is the first thing that I do not want to be forgotten.

The second thing is also crucial for elderly people. Let us imagine an elderly person found unconscious in the street and taken to an A and E department. The first thing casualty officers do is measure blood sugar because, time and again, that puts matters straight. They whop in the sugar and, if it does not work, they take further tests and discover that the person has terribly low blood pressure and terribly low sodium. That raises all sorts of possibilities. If that patient were accompanied by an electronic summary care record, the doctors would be told the reason for the particular problems immediately. The electronic summary care record is crucial to quality of care for the elderly, and I cannot understand why it has been so delayed when we have an absolute model for it in Canada, where there is, on a single computer screen under eight headings, all that an emergency doctor needs to know. I hope that Health Ministers will recognise the importance of that.

I hope that, in the excitement of publishing the elderly care Green Paper, those other matters will be remembered and that everybody will engage, especially, as the right hon. Member for Charnwood has said, in working out how we can find the resources.

I want to contribute briefly to the debate in two particulars. Many useful contributions have been made about the proposals for paying for long-term care, and there is a genuine sense of déjà vu about them. Not least, yesterday’s statement contained echoes of the statement made by a former Secretary of State in May 1996. I want to use the debate to ask the Minister two questions, which need to be asked with only three sitting days left before we break for the summer recess.

The first relates to a commitment that was made last June by the Minister’s predecessor immediately to produce a paper on prescribing anti-psychotic medication to people who suffer from dementia. That scandalous practice affects more than 100,000 people a year in care homes, and it probably accounts for the premature deaths of around 23,000 elderly people up and down the country. It is clear from the evidence that has been compiled over many years that such drugs cut lives short, that they result in strokes and that they cause many of the symptoms that are then used to justify yet more prescribing. Government action on this issue is long overdue, so will the Minister tell us when the now overdue report on prescribing will be published and the necessary action that will be taken?

My second point is about the Government’s commitment to do something about elder abuse more generally and put in place new measures to tackle that scandal. Some 342,000 people a year are the victims of elder abuse in this country. That is a scandalous tally, and it does not even include those in care homes or those with dementia. I would therefore like the Minister to tell us when he expects the “No Secrets” review to release a publication. The codes of practice for consultation—codes to which the Government say they adhere—suggest that a publication should have come out in April. However, we have seen no analysis of the responses to the consultation, nor have we seen any indication of the Government’s proposals.

I have heard that the intention is to smuggle out an analysis in electronic form—a rather flawed and partial analysis—of the consultation on “No Secrets” on the Department of Health’s website tomorrow and that that will be done with no fanfare, no scrutiny and no indication of what actions will flow from it. It would therefore be useful if the Minister were to confirm today that it is not the Government’s intention to do that, that there will be full accountability to this House and that there will be a genuine effort to keep minds open to the case that has been made by the police, the Commission for Social Care Inspection and almost every statutory body that responded to the Government’s consultation. Legislation should be introduced to put the protection of vulnerable adults on a similar footing to the protection of children. Surely that should happen, because it is long overdue.

Those are the two issues that I wished to bring to the House’s attention. I hope that the Minister will do me the honour of responding to those two points with some reassurances this evening.

Like others, I pay tribute to those colleagues who have spoken in this debate, because many of us feel passionately about this issue.

In particular, I want to refer to something that the hon. Member for South Thanet (Dr. Ladyman), a former Minister, said about the Opposition motion. The issue has been on the Opposition agenda for some time. From where I am standing, I assure him that it is not in our motion, because of the Green Paper that was published yesterday. Partisan comments have passed across the Chamber, but I am a Norfolk MP and make no bones about it. The issues that affect people in Norwich equally affect people in my constituency, so I make no apology for bringing up that matter.

The fact is that elderly people feel vulnerable, but at the same time people in Norfolk are proud people: they want dignity and respect in retirement; and they want the state there as a hand-up, not as a handout. The fact is—this comes up on the doorsteps—that there is much social and economic deprivation across the county of Norfolk. I have spoken to people in Norwich and in my own constituency, which is highly rural—Norfolk is a disparate county that covers eight constituencies of various sizes—and they are concerned that what is being proposed today is too little, too late.

Tony Blair talked about the issue 12 years ago. I have a quote here from a constituent who came to see me at my surgery: “It’s 12 years of hardship and misery—not just for me, but for my family and all those people whom I am now reliant on to give me the support I cannot get from the state.” That is the fact of the matter, and that is what we face every day. I encourage hon. Members to listen more to constituents who say such things. That is not partisan; it is our job as Members of Parliament to stand up in this House and represent those points of view, however people may see it from the Government Benches. I am doing this, because it is right for the people of my constituency and the people of Norwich.

At the end of the day, we have a growing elderly population, who realise that their pensions will not cover the cost of care that they have to provide. They feel penalised as they go about their daily lives. They have made a contribution to the community and to society, and they have paid their taxes, yet in their hour of need, they often feel that the rug has been pulled from beneath them.

The families of many elderly people have moved away, because they can no longer afford to live next door, so they can no longer invite their grandmothers, grandfathers, uncles or aunts to live with them. Families have had to move because of work. My constituency covers 1,200 sq miles, and people can live very far away from each other while remaining in the same constituency. Villages and rural areas often do not have a proper infrastructure or a proper transport system. It is all very well to say that elderly people can get help from their families, but that is just not practical and it does not work.

Does my hon. Friend agree that the black hole in finances and resources is such that the honest message must inevitably go out from this place that families need to do more to support their loved ones in their old age? There is unlikely to be a solution that will provide the security that older people need without greater personal commitment from families.

I agree 100 per cent. with my hon. Friend. There is no doubt that families try. No matter what their political persuasion or where they live, they try to help each other as best they can. At the end of the day, however, selling one’s own home to pay for care is not the solution. Over the past 12 years, many people waiting for help from the Government have done their best to sort, but selling one’s home in an economically and financially difficulty environment is not the easiest option.

Some of the proposals in the Green Paper will not suit people, because they will not be around to see the benefit of them. There is no mention of people who are coming to the end of their lives having struggled to manage. What are they to do? What is the Government’s commitment to them? The Green Paper talks about the next generation, but we are talking about the here and now. The Green Paper goes some way towards dealing with the problems, but it is too little, too late.

Norfolk is a good example of a local county council in a diverse county doing its best. It serves local farming communities, rural villages, larger towns and, of course, the city of Norwich. Long distances mean that costs go up. People in my constituency, and in Norwich, will need to decide in a couple of months’ time whether they can afford to fuel their homes or put food on the table. That is as bare as it gets, and it is a very difficult thing to decide.

People feel very isolated, and they do not have to live in a rural community to do so. People who live in terraced houses in streets with 150 other residents can feel just as isolated if their neighbours have no respect for them and do not feel the need to knock on their front door, and if local services do not have enough money to offer services such as meals on wheels. Other charitably based organisations sometimes cannot offer services to the community. People are making great sacrifices in difficult times, and the Government must address that problem. The people of Norfolk and the rest of the county—and, of course, the people of Norwich—deserve better.

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.

We have had a vigorous debate. Some of it has been driven by political motivations—we know where they are coming from—but some has been driven by the experiences of constituents and by Members’ personal experiences. I welcomed the contribution of my hon. Friend the Member for Colne Valley (Kali Mountford)—who spoke from huge experience—and that of the hon. and learned Member for Torridge and West Devon (Mr. Cox). Both expressed sincere concern, analysing their experiences and seeking solutions for the future.

Care for older people is an issue that arouses strong feelings, and rightly so. Given that a country is measured, ultimately, by how well it looks after its elderly, it is right for this question to be at the heart of our political discourse, whether here in Westminster, in Norwich or in any other part of the country.

I recently met an elderly couple in Croydon who were receiving excellent care through a unique partnership between the national health service, the local authority and a voluntary organisation, which were working together to give them high-quality support. They made it clear to me that they wanted us in Parliament, and in Government, to ensure that they would be looked after financially, and wanted to be reassured that their health and social care needs would be met so that they could play an active part in their community. They wanted it to be recognised that although they were elderly and frail they still had something to offer society, and they wanted the opportunity to prove it. It is up to us to rise above the party political division that will inevitably accompany debates of this kind, and try to reach a consensus on a better future for older people.

Let me deal first with welfare reform and financial well-being. Many Members have reminded us of our starting point. In 1997—10 years ago—pensioner poverty was a national disgrace: 3 million older people were living below the breadline, and the poorest had to scrape by on £69 a week. Today, no one under 60 need live on less than £130 a week. We have made huge strides in providing help for older people. Every pensioner benefits from free off-peak bus travel, free television licences and help with fuel bills.

The hon. Member for Eddisbury (Mr. O'Brien) and other Conservative Members have tried to deny it, but we have seen glimpses of a future Tory Government, with threats to those free services, and to the winter fuel payment in particular. He may wish to deny it, but we know differently, and so does the rest of the country.

On care and services for older people, two themes of the Opposition contributions have been that the Green Paper was too little too late, and that nothing has been done over the past 12 years. Let me put the record straight. Through putting people first, more than £0.5 billion of extra investment is today allowing local authorities to transform the way services are delivered, including through piloting new personal care budgets. I thought there was support throughout the House for that new direction in the delivery of social care. My hon. Friends the Members for Colne Valley and for South Thanet (Dr. Ladyman) both emphasised that it represented the right approach.

The national dementia strategy was published as recently as February this year. It is the first strategy of its kind, and it is a genuine milestone in developing new services for people with dementia and their carers.

The hon. Member for Sutton and Cheam (Mr. Burstow) asked two questions. We will publish our response to the review of anti-psychotic drugs shortly. On the review of abuse of adults and older people, let me put it on record that such abuse is never acceptable; we must make that very clear in this House. We will publish the response to the major consultation, which involved more than 12,000 submissions from professional organisations and older people themselves, this Friday.

Let me be clear about what we have done in spending terms over the past 12 years. In 1997, adult social care spending was less than £10 billion. Ten years later, that figure has risen to £15.3 billion—a 50 per cent. real-terms increase. Local authorities have received record increases in funding for the care that they provide. Spending on care for older people has gone up from £6 billion to almost £9 billion—a 41 per cent. real-terms increase. All that investment over the past 12 years, and all the reform that I do not have the time to describe in detail, has made a real difference to older people in our communities, but we now need to build on those successes to reshape the entire system.

Given the unfairnesses that others have described in the system, and given the demographic challenge of an ageing society, it is clear that we need radical proposals to maintain a viable and affordable care service for the future. Yesterday, my right hon. Friend the Secretary of State for Health laid before Parliament the vision of a new national care service to deliver a fairer and simpler approach to funding and accessing care services for all adults. With the exception of the hon. Member for South Cambridgeshire (Mr. Lansley) and his Front-Bench colleagues yesterday, I thought that on the basis of some of the contributions from both sides of the House, we were beginning to see a bit of a consensus emerging. It is true to say—

I am not going to give way, as I only have a minute or so left.

When the Tories were in power, pensioner poverty increased and social care was ignored. In opposition, they are refusing to say what their policies would be and, very cynically, they have now said they will not support a national care service despite the comments of certain Conservative Back Benchers. Perhaps the Conservative Front-Bench team should look to them for sensible contributions about the right way forward, as I thought I heard support for option two in our Green Paper from at least two Conservative Back Benchers.

We want a system in which people can rely on a care service for the future, and we want to build a consensus around new national care services. For the sake of the people in Croydon whom I met recently, and the millions of people we represent as constituency MPs, I hope that the House will grasp this once-in-a-generation opportunity to support the creation of a national care service that is fairer, simpler and more affordable for all, and that provides good quality care for everyone, wherever they live and whatever their needs.

Question put (Standing Order No. 31(2)), That the original words stand part of the Question.

Question put forthwith (Standing Order No. 31(2)), That the proposed words be there added.

Question agreed to.

The Deputy Speaker declared the main Question, as amended, to be agreed to (Standing Order No. 31(2)).


That this House welcomes the steps taken since 1997 to tackle increasing pensioner poverty; notes that policies delivering real help to pensioners include free bus passes, free TV licences, winter fuel payments and Pension Credit which ensures no pensioner lives on less than £130 a week; notes that the Government is targeting around £100 billion more on pensioners than if pre-1997 policies had been maintained; further notes the Government’s commitment to reversing the policy of separating uprating of the state pension and growth in average earnings; notes the introduction of the Financial Assistance Scheme, the Pension Protection Fund and the Turner consensus as building a sustainable pensions system going forward; welcomes raising of Individual Savings Accounts limits at Budget 2009; warmly welcomes the Government’s Ageing Strategy; further welcomes the publication of the Green Paper, Shaping the future of care together, which proposes a National Care Service to create the first national, universal, entitlement-based system for care and support ever in England; notes that the Government’s proposals will shape a new care and support system fit for the 21st century that will be fairer, simpler and more affordable for everyone; further notes the published indicative costs an individual may face during their lifetime and the comprehensive impact assessment for the Green Paper; recognises that carers make a huge contribution to society; and acknowledges that the new Care Quality Commission has made dignity and respect one of its six key areas of inspection.