It has been agreed that, should any of the Questions for Short Debate not run for their allotted hour this afternoon, the Committee will adjourn during pleasure until the end of the hour. Therefore, each of the Questions for Short Debate will start on the hour.

I thank noble Lords for attending today's debate—we are, I fear, the usual suspects—to discuss how the needs of those with a learning disability will be addressed in the Government's forthcoming paper on future funding for adult social care. You will appreciate that, as president of the Royal Mencap Society, this subject is close to my heart. Mencap is a leading member of the Learning Disability Coalition, which is at the forefront of the campaign to ensure that this Green Paper fully addresses the demographic changes which will necessitate, and already are necessitating, greater social care support for those with a learning disability.

Currently, only 120,000 people out of the 1.5 million people with a learning disability receive support from social services. Many of those who receive support have had it reduced because of pressures on social care budgets. That means fewer hours at a day centre and fewer hours of help with washing, shopping and attending social activities. Others have been totally excluded from care as cash-strapped councils tighten their eligibility criteria. For all the people affected, that means that their quality of life has deteriorated. Many languish at home instead of being able, like their non-learning disabled peers, to reach their potential.

The Commission for Social Care Inspection has referred to these people as becoming “lost in the system” and has confirmed that the tightening of eligibility criteria is set to get worse with 73 per cent of councils stating that next year they will be able to support only learning disabled people with severe or critical needs—means testing by another name. That means that three-quarters of councils' learning disability budgets are under-resourced.

Individual stories of hardship, as a result of this tightening of eligibility criteria, are beginning to emerge. The other day I heard from a 70 year-old mother and an 80 year-old stepfather who support their 41 year-old son, Philip, in the family home. Previously, Philip enjoyed a total of nine weeks' residential respite at a local unit three miles away from home. He also had six tea-time visits a year. The family described this respite as a “life saver”, giving them a chance to relax and carry out their household tasks. They also had access to a 24-hour emergency support service.

I believe you will be as shocked as I was to hear that most of this system of support has been withdrawn. In their own words, the family says:

“Philip's respite was reduced to just four weeks, eleven miles away at a unit which we consider unsuitable and which necessitates a difficult journey for us, his elderly parents. There are no tea time visits, no emergency services in place. In reality we had only fifteen nights respite in the last year”.

The care services Minister has announced a review of eligibility criteria, and for this we are grateful. However, stories such as Philip's show how urgently action is needed and that these alarming reductions in the availability of social care need to be addressed in the forthcoming Green Paper.

Another worrying story concerns a 43 year-old man, Andrew, whose father contacted the Learning Disability Coalition. Andrew suffers a range of physical and mental disabilities. His father says that,

“whilst his condition has been deteriorating over the past eight years, this mainly affected his mobility”.

The underfunding of adult social care in his area has meant that the vital one-to-one support that Andrew's daycare centre provided has ceased. Andrew used to have the capability to communicate vocally with a few words and short sentences, through which he could indicate his needs. However, Andrew's father says,

“Since the one-to-one facility was abandoned by the centre, he has lost all power of speech. Whilst one cannot be absolutely sure his loss of vocal communication is the result of the lack of stimulation, being shuttered up daily with 50 or so others in a ‘warehousing’ situation, leads our own doctor to strongly believe this is the major cause of his problem”.

That widening reduction in services, caused by a lack of adequate resources, will make it near impossible for the Government to deliver the admirable policy promises they have made to people with learning disabilities. Those promises have been set out in Valuing People Now, Improving the Life Chances of Disabled People, Putting People First, the Independent Living Strategy, and others. Those government plans have raised the hopes and expectations of people with a learning disability and their families. However, as the excellent report from the Joint Committee on Human Rights said earlier this month,

“limited resources are undermining attempts to implement the aims of that policy [Valuing People] effectively”.

The Commission for Social Care Inspection has also commented that,

“the quality of life for many could be significantly enhanced with relatively minor social care interventions ... support to take part in leisure activities, support to go to a skills class at the local further education college or support to sustain a job”.

Indeed, removing day-time activities for people with Down’s syndrome and other forms of learning disability can lead to early onset of dementia and mental health problems. Withdrawing support from people to take exercise endangers their health and encourages obesity. Apart from the impact on people's quality of life, that will cost more in the long run than the cost savings made. This shortfall in funding is making a mockery of the Government's prevention agenda.

The Green Paper provides the Government with the perfect opportunity to get to grips with the current failure to resource properly the services they have promised people with learning disabilities. The Government have talked a great deal previously about this Green Paper's agenda to tackle the problems of an ageing population, but they have not talked nearly enough about how they plan to address the social care needs of adults with a learning disability. There are significant differences between the social care needs of people with learning disabilities and older people. Many people with learning disabilities need care packages for life and those packages will need flexibility so that they change as their needs and aspirations change.

Co-payment, which is such a pertinent issue in funding the care of older people, is unlikely to be relevant for people with learning disabilities as many of them remain, regrettably, some of the poorest and most socially excluded in the country. I am delighted to say that more people with a learning disability are surviving infancy and are living much longer than ever before. However, improvements in neo-natal care mean that the number of babies surviving with profound and multiple learning disabilities is increasing. Such babies may need costly care packages. This is adding yet further to the pressure on social care services which, as we have seen, are already struggling to meet demand.

Another issue is that 60 per cent of people with a learning disability live with their parents. As these sons and daughters live for longer, many elderly and frail parents and families will no longer be around to care for them in the family home. Unfortunately, there is not enough up-to-date information about the trends in demand for services for people with learning disabilities to make accurate projections of how those numbers are increasing and what the likely future costs will be. We need a great deal more evidence if we are to ensure that we allocate sufficient resources to provide the accommodation and support that people with a learning disability need to live independently of their parents. I would be grateful if the Minister could tell me whether the department has, or is considering, carrying out that vital research.

My conclusion is very simple. I invite the Government to use the months before the publication of the Green Paper to commission the necessary research so that when they publish they can ensure that services for people with learning disabilities will be adequately resourced in future. The Government have set themselves the aim of achieving equality for disabled people by 2025; if they are truly committed to tackling the complex and sensitive issues that I have outlined today in the forthcoming Green Paper, it has the potential to be a vital tool in the achievement of the 2025 aim. I look forward to hearing the thoughts and comments on these issues from other noble Lords and, in addition to these speeches, eagerly anticipate the Minister’s reply to this discussion.

First, I congratulate the noble Lord, Lord Rix, on initiating this timely debate, focusing attention on the needs of one of the most significant groups in adult social care. I fear that I shall repeat many of the points that he has made but, such is the importance of this debate, I have no doubt that many of us will do so. To date, as he said, the debate surrounding the forthcoming Green Paper has been focused almost solely on the funding of long-term care for elderly people. The value of this debate is in pointing out how some of the potential solutions voiced in that area will not meet the needs of adults with learning disabilities.

As the noble Lord pointed out, social care packages for people with learning difficulties are for life, not just old age. While elderly people may be able to contribute to the cost of their social care, it is unlikely that people with learning difficulties will be able to gain the resources to do so. Moreover, the social care packages for people with learning difficulties accommodate much more than just personal care. They need to involve multi-disciplinary teams covering most aspects of that person's life, including housing, domiciliary support, employment, further education, health and leisure activities.

First, I congratulate the Government on their decision to publish a Green Paper on adult social care, which has been warmly welcomed. It is extremely heartening that adult social care is at last gaining prominence on the political agenda. The Government strategy unit's report Improving the Life Chances of Disabled People was widely applauded, with its target date to achieve equality for disabled people by 2025. However, if that is to be realised, this Green Paper must address the sensitive and complex needs of people with learning disabilities. It needs to grapple with two stark facts: first, the extent of need which is not currently met and, secondly, the future growth in demand that will result from social trends and demographic changes.

Mencap's report, Breaking Point, put in sharp relief the significant amount of unmet need that currently exists, especially relating to respite care. It found that seven of out of 10 families have never been offered a choice of short-break services and six out of 10 do not get a short break that fully meets their needs. One in three families had experienced a cut in their short-break services last year and six out of 10 family carers who are in poor physical health say that it is because of the amount of care they provide.

As this shows, local authorities are struggling to meet even current need. The Local Government Association has found that in 2005-06 three-quarters of councils experienced significant cost pressures for their learning disability services. As a result, local authorities have tightened their eligibility criteria for care services to a shocking degree. According to the state of the nation report from the Commission for Social Care Inspection, by the end of the current financial year 73 per cent of local councils will support people with learning disabilities only when they have substantial or critical needs.

What does this mean for all those people with learning disabilities who have very real needs that are not so severe? It means that they will live poverty-stricken lives of isolation and restriction, in which they are given no chance to fulfil their potential in employment, training or any meaningful social activity. They have no hope of getting even a small amount of support to live the fulfilling lives which admirable government policies have spelled out for them.

The gap between the vision of government policy and reality is stark. While central government may be committed to establishing a support organisation of disabled people in every social service authority, those organisations are the first to be cut when council funding is short. Currently, Liverpool People First, in common with many other such organisations, is in danger of losing all its core funding. Core funding is the essential element that enables these organisations to survive, yet trusts and funding organisations are loath to fund them. As People First points out, local councils’ duty to consult disabled people is severely impaired if local organisations of disabled people do not exist. As a result, local councils’ commissioning of services to meet need is bound to be faulty and inadequate. People First calls on the Government to set a baseline for funding those local disabled people’s organisations that councils are unable to fall below without financial penalty.

As the Learning Disability Coalition points out, the current lack of funding for adult services lies at the heart of the widespread human rights abuse that was detailed in the Joint Committee on Human Rights report A Life Like Any Other, which was published earlier this month. The report found that the human rights of people with learning disabilities were being violated by public authorities, local councils and NHS trusts in an alarming number of areas and concluded that:

“For many adults with learning disabilities, the violation of their human rights is seen as a normal part of their everyday lives”.

If that is the current picture, what is the prospect for the future? There are a number of demographic changes and social trends that mean that the pressure on services will only get worse unless they are properly addressed by the Green Paper. For one thing, improvements in neo-natal care have resulted in an increasing number of babies surviving with profound and multiple learning disabilities. There is the rise in single-parent households and the consequent pressure, mostly on mothers, which can lead them to breaking point. The tightening of local authority eligibility criteria means that many more people with learning disabilities are forced to stay at home as day activities are cut, which increases the pressure on families. Moreover medical improvements mean that people with learning disabilities are living longer, but that means that they are outliving the ability of their families to help care for them. It is estimated that 60 per cent of those with a severe or profound learning disability in England live with a family carer, so provision needs to be made for the time when that family carer is too old or frail to continue. Yet Mencap’s report The Housing Time Bomb found that only two in four local authorities was even aware of the number of people this affected and only one in four had planned alternative housing for people with learning disabilities who were living with parents aged over 70. The Learning Disability Coalition is keen to hear from the Government how they will use the Green Paper to ensure that there will be sufficient funding to provide adequate support for people with learning disabilities when they leave their family home.

It is this lack of awareness of the extent of need and the conflicting predictions by social care statisticians of future demand that the Learning Disability Coalition calls on the Government to address urgently. Can the Minister assure me that an up-to-date assessment of the future demand for social care for people with learning disabilities will be carried out before the Green Paper is published? Unless the provisions proposed in the forthcoming Green Paper are based on an accurate forecast, it has no hope of closing the yawning gap between the Government's admirable policies for people with learning disabilities and the reality of their needs.

I am grateful to my noble friend Lord Rix for raising this important subject in a Question for Short Debate, even though he has skilfully and clinically dispatched some of my birds. On quoting his phrase, “the usual suspects being here”, I can honestly claim to be not guilty on that score, strangely enough.

However, I must declare an interest in these matters, as chairman of a small residential home for women with physical and learning disabilities in Hampshire and as the honourable vice-president of MCCH, an organisation which provides services for those with mental illness, learning disability and autism in London and the south-east.

The debate is timely because earlier I had the honour of hosting a launch in this House for the Mental Health Helplines Partnership, a much-needed and exciting initiative by the Department of Health, NHS Direct and a media company.

It is entirely right that, ahead of publication of the Green Paper, we should be singling out one critical aspect of adult social care—the needs of those with a learning disability. These needs are inevitably more complex and diverse than those in other categories of social care, acute though they may be; that includes issues such as housing, employment, further education, home support, health, life enhancement—I could go on with such a list.

I believe that the strain on funding, and therefore on services, has never been greater, at least in my time, which is quite long. Whether it is the threat to day services and what they are able to offer clients, or to respite care facilities, the danger of cuts is evident on every side.

The critical factor is surely the evident dysfunction which exists between the entirely understandable and laudable aims of the various agencies in this field and the financial resources which are likely to be available for these purposes. You could argue that this is—indeed it is—an age-old problem, but I believe that it has never been so acute and as apparent as it is now.

Speaking in general terms and non-technically, I have become increasingly puzzled by the rationale which allows two systems to run in parallel—care provided by the NHS and care provided through the social services departments of local authorities. Perhaps a short personal example will illustrate the point. The home with which I am associated is in a serviceable building, is quite modern and is capable of accommodating 20 clients. On national criteria, however, that is 10 too many. So, until we rebuild, we will get no further referrals. Without these our income drops until ultimately we implode. Contrast that with the recent case—admittedly exceptional—of Orchard Hill in Sutton, run by the NHS with, so far as I can recall, over 100 residents and the subject of a damning report 18 months ago. Are they down to 10 yet—I wonder? The phrase “level playing fields” comes to mind.

There has been much speculation about the transfer of learning disability from the NHS to local authorities. When is that going to take place? Will wholly adequate resources be made available to fund the transfer so that those affected will not be disadvantaged in any way? Furthermore, there is a general move away from the commissioning of block contracts to spot purchasing. Will provider organisations be allowed the time to make new arrangements? Will there be guidance in the Green Paper on how commissioners can move from one system to the other without serious disruption? We know how common a disease serious disruption has been in this country in recent years.

When local authority budgets are under severe strain—18 months ago it was estimated that three-quarters were in the red—and in view of the parlous financial situation for the foreseeable future, it will be essential that the Green Paper deals with today’s realities, among which are, as we have heard, carers getting older and being unable to cope. I do not apologise for repeating that 60 per cent of those with learning disabilities live at home. People with learning disabilities are living longer. Last but not least are the alarming findings of the report from the Joint Committee on Human Rights, which states that, for many adults with a learning difficulty,

“the violation of their human rights is seen as a normal part of their everyday lives”.

I echo calls for the Government to undertake a thorough evaluation before the appearance of the Green Paper of the likely demands on special care from those with learning difficulties—that is essential. The heart of this and previous Governments has been in the right place in valuing people policies. No one doubts that for a moment—certainly not this speaker. But, since the demand for resources to back these policies up has never been greater, we are rapidly approaching a last-chance saloon in providing a satisfactory framework for the needs of our most disadvantaged citizens. If the forthcoming Green Paper does not meet these concerns head on and offer practical—I stress that—solutions, a great opportunity will have been lost. I am confident that the Minister will have regard to those anxieties when she replies.

When the noble Lord, Lord Rix, talked about the usual suspects, I could not but help feeling guilty as charged. This is an interesting debate not because anything new has come up, but because the Question has been asked as the policy paper is being commissioned. We are starting to co-ordinate a response to government, because, as has been said, they seem to be making the right noises and commitments. But the question is how parts of government tie together.

That we should get bits of government to co-ordinate is one of my usual cries. We should take it as read that Chinese walls exist in Whitehall, but how do many of the problems that have been spoken about today—for instance, the fact that social care needs are not being met—impinge on other government policies? The noble Baroness, Lady Pitkeathley, should be here to talk about carers, as they probably underpin the whole approach. If carers are let down and they ultimately fail and say, “We cannot cope any more”, one’s entire strategy is torn apart. Those with mild and moderate learning disabilities will suddenly have acute problems, because local provision for those acute problems will suddenly disintegrate as a result of the maths not balancing out. The problems will get worse without the carers and the support workers at home who are part of the demographic process which the Green Paper addresses. To make the thrust of the Green Paper work, one must have a strategy that addresses what happens to those groups; otherwise, everything will break down.

How does one tie in adult social care with other groups? When discussing the previous welfare reform package of legislation, we spoke about welfare to work and getting people involved. How do social care budgets tie in with that? The question does not apply if one is talking about those who require care predominantly for reasons of age; it does apply if one is to try to get those with mild and moderate learning difficulties into work to provide themselves with some social support and outside stimuli. That the Government have said that they will enable people to gain qualifications will mean that the day courses in colleges which have already been referred to face acute problems as well, because one is accentuating problems arising from people being at home for too long.

How this is co-ordinated is the big question for government. As the noble Viscount, Lord Tenby, said, it is not that the Government—indeed, all who are involved with government: we all must take some responsibility here; it is anybody who deals with Whitehall, either as direct lobbyer or organiser of the system—lack good intentions. But how will they make the parts come together? There are two ways of doing it: either one tries for joined-up government, or one says, “We can’t do it” and goes for a silo defence of one’s budget. We must hear from the Minister which one of these is favoured. Will she simply say that a criterion will look after this problem within these strategies, which is often the way we go forward and have to deal with it?

How do mild and moderate learning disabilities fit into the thinking? Another of my clichés is that we have reverse battlefield medicine here. In battlefield medicine, you patch up very quickly those you can get back out to be shot at again, but the state tends to deal first with those with the most severe problems. This means that those who are the least easy to spot, or who are muddling through and achieving at the moment, are ignored. Then, when they are pushed over the edge, they suddenly become a new problem. How the Government intend to deal with that and work such people into the system is an interesting question.

Although the Minister has taken on her responsibilities only comparatively recently, I am sure she has already noticed the similarities across many of these debates. She nods her head. The fact is that if you have a middle group that is undiagnosed, unhelped and unsupported, it can become a much bigger cost later on. Can we please have some indication of how the Government are starting to work this group into the system? Will the Government continue to try to get government and parts of Whitehall working together, or are they going to make sure that there is an understanding and commitment, with something written up front, that all new policies will include this group? I am sadly coming to the conclusion that that may be the only practical way forward.

I, too, thank the noble Lord, Lord Rix, for raising this matter. By doing so, he has put a challenge to the Minister and to the Government which I am sure the Minister will be able to rise to today.

The whole question of support for vulnerable adults is mired in controversy, and it should not be. It is to be hoped that the Green Paper will bring common-sense solutions to the fraught question of who pays for what. There is a crying need, too, for coherence in relation to the question of how responsibility can be borne or shared for those who need care, either because they cannot provide it for themselves, or because they have no one to provide it for them, or because their requirements, either practical or financial, are beyond committed families to provide.

It is well recognised that for our older population, irrespective of their financial means, there is a need for sensitive, practical care, either to help keep people in their own homes or in supported housing. Those who are most at risk of not finding such care are those who fall outside the criteria for the limited social care support, about which we have heard a great deal today, but where paying for their own care is beyond their means. Currently local authorities—I declare an interest as an elected member of one in London—which either give support themselves or commission it from private providers, are able to do so only for the most needy, a point raised by the noble Baroness, Lady Wilcox, very specifically. For the rest, what can be given is either extremely limited or non-existent. In many cases, local authorities are not even providing advice or practical assistance to anyone who does not meet their criteria. That seems to be as true for those with learning difficulties as for elderly people who need help.

No one who has listened to the noble Lord, Lord Rix, today, or has read the briefing provided by the Learning Disability Coalition, can have failed to be moved by what both have said. Of course, as with other people who are vulnerable, there are gradations of need. Many of those with learning disabilities can, given a modicum of help and the support and drive of their families and teachers, achieve virtually normal lives, a point made by the noble Lord, Lord Addington, and the noble Viscount, Lord Tenby. They can maintain jobs applicable to their own capacity and an independent existence. However, others are almost totally reliant for the whole of their lives on social or healthcare support.

We have already noted that medical improvements ensure that those with learning disabilities live longer than in the past and, in many cases, may outlive their parents. They either then become the responsibility of their siblings—if they have any—who may find assuming responsibility for them too onerous or too intrusive on their own lives, or they may require help from the social or health services. Regrettably—again, as we have heard—a recent audit by the Healthcare Commission found that, where health services are provided, insufficient attention is paid to safeguarding those who are most vulnerable, they are poorly planned, and residential care provided by health services is largely in institutionalised settings. I recognise, as the noble Viscount, Lord Tenby, said, that there are private organisations which provide this care, but the report related specifically to services provided by the state. As I said, they were found to be institutionalised, but is that still the case? Institutionalised settings should have gone out years ago.

The commission concluded that it had concerns about the quality of care overall in most establishments. The noble Viscount, Lord Tenby, raised a very important point in referring to one particular home. Many homes for the elderly—and, now, for those who are vulnerable in other senses—are being driven out of existence by care standards. In my own borough, I know of two large private homes for the elderly that gave up simply because they could not meet the very exacting physical standards demanded of them. I just hope that that will not happen across the board. No one wants establishments that do not have proper facilities or are unable to provide nice surroundings but, equally, do we want some of these excellent places forced out of existence simply because they cannot practically provide a room with an en suite bathroom?

As other noble Lords have pointed out, help from social services is not necessarily an option either. As the social care inspectorate found, by the end of 2008, 73 per cent of local councils’ finances will support only those who have substantial or critical needs. Local authorities will tell you that there is enormous pressure on their social care budgets, but being able to provide only a proportion of what is required, and then only for the most seriously affected, will leave many questions still to be answered.

As with the whole question of adult social care, for years solutions have been sought to the unequal conundrum of who pays, who receives and who loses out. The report, Valuing People, which was published in 2001 and has been referred to already, set out the Government’s commitment to improving life chances for people with a learning disability. Valuing People Now went further into how the principles outlined in the former report could be extended. However, fine words cannot deliver the goods if there is insufficient money in the system to enable that to happen.

There is a not unreasonable expectation that, where they can, people should self-fund at least a proportion of their care, and it is anticipated that this will be promulgated again in the Green Paper. However, this concept—I think it was the noble Viscount, Lord Tenby, who raised it—does not readily lend itself to those with learning difficulties, who are unlikely to earn sufficient to make any contribution to their present or future needs and who, in many instances, have been maintained by their parents, often at enormous personal cost.

The aim of the Green Paper is to ensure that care funding is,

“a sustainable system that targets resources effectively”.

That seems to be as relevant to the concerns about those with learning difficulties, who in adulthood become increasingly vulnerable, as it is to those who are elderly. The problems relating to both are not going to go away. Demography tells us that, if nothing else does. The distribution or sharing of resources, standards of care and responsible authorities are germane to both. I look forward to the Minister’s response to the case which I believe has been made out by noble Lords that this widely anticipated Green Paper should not address itself to adult social care alone but should include those with learning difficulties.

My Lords, I start by paying tribute to the noble Lord, Lord Rix, and by saying how much I admire his dedication and work in support of people with learning disabilities. As I am learning in my job, in which now I am not so new, many noble Lords have huge expertise in these areas, some of whom are represented here today.

Social care is a vital part of the lives of many disabled people, including people with learning disabilities. In 2005-06, a total of £5 billion was spent on social care for 18 to 64 year-olds, of which 56 per cent was spent on people with learning disabilities. That indicates the scale of the issue that needs to be addressed when we consider the future. While we have become better at identifying and supporting people with learning disabilities, there are now many more people with learning disabilities that survive into adulthood and older age and require continuing care. We have a responsibility to ensure that people can access that support. We recognise that the voices of people with learning disabilities and their carers have not always been heard in the debate on social care. Now, as we face fundamental reform of social care, it is of great importance to the Government to consider the needs of people with learning disabilities in the whole debate around social care.

Demand for social care has increased in recent years and is set to rise even further in future. The main reasons for this is down to the major changes happening in our society, which have serious implications for the care system: an ageing population; people with learning disabilities living longer and fuller lives; higher expectations about what services should deliver; and technological changes. All this is excellent news, and a tribute to the advances in medicine and in care over recent decades, as well as the effectiveness of organisations such as Mencap under the leadership of the noble Lord, Lord Rix. But we cannot underestimate the challenge that this represents to social care services.

A recent report produced by the King’s Fund estimated that the cost of providing the current levels of social care for those over 65 will increase from £10 billion per year in 2002, to £24 billion per year in 2026. We also know that by 2021, there will be over 1 million people aged 15 and above with learning disabilities in England, and the number of adults with learning disabilities aged over 60 is predicted to increase by 36 per cent between 2001 and 2021.

Although it is clear that continuing research will be needed to underpin the developing policy, we already know that there is a huge challenge before us. It is the shared ambition across government to put people first, including people with learning disabilities, through a radical reform of public services, enabling people to live their own lives as they wish, confident that services are of high quality, are safe and promote their own individual needs for independence, well-being and dignity. That is why in December last year we published a cross-sector concordat, Putting People First, which establishes collaborative framework between central and local government, the sector’s professional leadership, care providers and the social care regulator. It sets out the shared aims and values, which will work across agendas with users and carers to transform people’s experience of care and support services.

The challenges to delivering the ambitions set out in Putting People First are significant. In recognition of this, we are providing councils with £520 million over the next three years to support them to make the system changes and, more importantly, the cultural changes required to empower citizens to shape their own lives through the support that they need.

However, the noble Lord is right to seek clarity about how we will meet the needs of those with learning disabilities through these reforms. For far too long the needs of people with learning disabilities have not had the prominence they have deserved and needed in the debate on social care. We are committed to listening to the views of people with learning disabilities and their carers, and that is why we are currently consulting on Valuing People Now: From Progress to Transformation. This sets out the priorities for the provision of services for people with learning disabilities for the next three years. Valuing People Now sets out how we are working towards transforming people’s lives—for example, through prioritising jobs and housing for people with learning disabilities—through the public service agreements on socially excluded adults.

Through Valuing People Now we are setting out the Government’s strategy to tackle a number of serious concerns raised around how health services are meeting the needs of people with learning disabilities. In May 2007, the Secretary of State established an independent inquiry into the healthcare of people with learning disabilities. This was in response, of course, to Mencap’s report Death by Indifference, which highlighted the tragic deaths of six people with learning disabilities who were under the care of the NHS. Sir Jonathan Michael is chairing the inquiry and we await his report to the Secretary of State early this summer.

We are committed to considering the feedback from people with learning disabilities and their carers. We shall look with interest at the views of groups such as the National Forum, the Task Force and the Learning Disability Coalition and will look to publish the final document in the summer. Valuing people now, which was referred to by the noble Baroness, Lady Hanham, and others, and Putting People First are vital to achieving our aspirations for supporting people to live independently through choice and control. However, the challenges of an ageing population and the facts that disabled people are living longer and that higher expectations remain mean that a radical rethink is required of the care and support system to meet these long-term pressures.

The Green Paper mentioned by noble Lords will push forward the commitments made in Putting People First and address the long-term outstanding issues around funding, a point mentioned by my noble friend Lady Wilkins, the noble Baroness, Lady Hanham, and others. Over the next 10 years the Government want to create a new care and support system suitable for those with learning disabilities and their families. This is why the Government announced in the Pre-Budget Report last year that they would be producing a Green Paper on the reform of the care and support system. The Green Paper will look at options for developing a sustainable care and support system and whether it will be possible to develop a new system for all adults, not only for people over the age of 65. This is important for those with learning difficulties as a large proportion of them are of working age rather than pension age. The issue of ageing parents, a point raised by several noble Lords, is clearly part of the consideration of the Green Paper.

At this stage, the Government remain open-minded about the solutions and are keen to work closely with a number of learning disability interest groups throughout this process. These groups will play a vital role in shaping the success of the reform and the support system. My honourable friend Ivan Lewis announced on 6 February that the Department of Health will commence a public engagement process in the spring which will engage with people of all ages about the problems facing the care and support system. In order to capture the views of people with learning disabilities, the Government will ensure that the public engagement process and associated literature are accessible, available in a wide range of formats and appropriately publicised.

Turning now to specific questions raised by the Committee, the noble Lords, Lord Rix and Lord Addington, and the noble Baronesses, Lady Wilkins and Lady Hanham, particularly mentioned the issue of the eligibility criteria—one of the themes with which the noble Lord, Lord Addington, said I would become familiar. The Government have asked CSCI to carry out a review of the criteria for fair access to care services, their application by councils with social services responsibilities and their impact on people, and to address the issues, particularly for those with mild or moderate disabilities.

We will receive a full report from CSCI in the autumn. This will assist in providing evidence to inform the Green Paper—which addresses one of the points raised by noble Lords—and we will use its findings to look at the right models to promote best practice in prevention and enablement, alongside good access and information about social care services where they are required.

The noble Baroness, Lady Wilkins, raised the issue of people with low and medium-term needs. The range of ways in which local authorities support people with low and moderate disabilities has to be addressed, including support for housing and leisure programmes.

The noble Lords, Lord Rix and Lord Addington, asked about carers. From our outset in 1997, the Government have recognised the value of carers, and since 1999 we have had a policy for carers, which is now being reviewed. We are increasing the amount of money that councils can use to support carers to £185 million this year, and we have made £25 million available to councils to help them support carers who are in a crisis situation. The noble Baroness, Lady Wilkins, and the noble Lord, Lord Rix, also raised the issues of research and how to look at unmet need when planning the Green Paper. Research underpins the reason why the Green Paper is being written. It is, by definition, difficult to identify how much unmet need there is out there. The research that has taken place looked at the overall level of demand and modelled the forward trends. The Green Paper has not been planned on specific research but has been planned and led by the Treasury.

The noble Lord, Lord Rix, asked what the Government are doing about modernising day services. We want people with learning disabilities to be more independent. Valuing People Now has been published, and one of its priorities is what people do during the day, at weekends and in the evening. The deadline for responses is tomorrow.

The noble Baroness, Lady Wilkins, asked what the Government are doing to ensure that people with learning disabilities are not socially marginalised and have access to housing. We have committed to a public service agreement to prioritise support into employment and to enable people with learning disabilities to have security in housing.

I shall turn briefly to the issue raised by the noble Viscount, Lord Tenby, about when the Government are transferring funding from learning disability into the NHS and local government. In response to the investigation of learning disabilities in Cornwall, the Government’s commitment was to strengthen the commissioning of learning disability services, including giving consideration to a stronger role for local authorities. The current Valuing People Now consultation is seeking views on a proposal to transfer funding of commissioning responsibility for the social care elements of learning disabilities from PCTs to local authorities. I am not answering the question of “when” because my brief does not tell me, but I will find out and write to the noble Viscount.

I think that I have nearly run out of time, but I want to address all the other issues raised by noble Lords. I shall make two more points. The noble Lord, Lord Addington, quite rightly raises the issue of joining up on every occasion. The concordat Putting People First was signed by six departments. The review for the Green Paper is similarly cross-governmental and is being led by Her Majesty’s Treasury. I hope that we are making progress. The noble Lord always recognises when we are.

The Green Paper needs to have practical solutions. The options put forward by the Joseph Rowntree Foundation and Sir Derek Wanless are being considered. They will provide a menu of options that will need to be considered when the Green Paper is published.

The needs of those with learning disabilities are a central policy issue that is being considered in a number of high-profile government agendas. The Green Paper on the reform of care and support systems is a unique opportunity for the Government to consider the needs of large numbers of people with learning disabilities who are living fuller and longer lives. It offers those with learning disabilities an opportunity to create a new system aimed at fulfilling the roles and responsibilities of citizenship by enabling them to have choice of and control over the support they need to live their everyday lives.

I thank the noble Lord, Lord Rix, and other noble Lords. I will answer in writing those questions I have not directly addressed.

[The Sitting was suspended from 2.53 to 3 pm.]