8 February 1999
Dr. Lynne Jones (Birmingham, Selly Oak): I am grateful
for the opportunity to raise the anxieties felt by residents of Goodrest elderly persons
home in my constituency, their families and residents of other homes that Birmingham
social services committee proposes to close or privatise.
I shall begin on a positive note. Birmingham city council has an
excellent scheme for the development of extra care sheltered housing for elderly people.
Under such schemes, individual residents have their own flat and their own front door, but
where extra care is needed, it can be tailored to the specific needs of the individual and
can change when the person's needs change, as he or she becomes more frail.
There is no argument in Birmingham about the development of the
schemes. There are already 11 schemes providing 426 flats. I fully support those schemes,
as the first two began when I was chair of housing in the mid-1980s, so I claim to be
responsible for the development of the schemes. They are excellent, and Birmingham has
been praised for them. There are various new developments on stream, and it is hoped that
by the millennium or soon afterwards there will be 26 schemes running, providing a total
of 1,030 flats.
By their nature, those are mixed developments. Although there are
already several hundred such flats, I understand from the social services department that
only 26 places have so far been allocated to those assessed as being in need of
residential care. The provision is thus good for the future, but it is not particularly
relevant to existing residents of elderly persons homes.
Over the years Birmingham city council has closed a number of homes,
many of them in unsuitable locations. One was at Highbury hall, the former home of the
Chamberlains. That building is now much better developed as a conference centre. It was
right for the council to close that home. Over the years non-purpose-built homes that were
not entirely satisfactory have been closed.
I had hoped that my hon. Friend the Member for Birmingham,
Northfield (Mr. Burden) would be present for the debate, but unfortunately he has been
held up in his constituency, which includes the Longbridge area. I am sure that hon.
Members and my hon. Friend the Minister understand that he would have liked to participate
and is equally concerned about the proposals.
Birmingham city council has 35 residential homes for elderly people.
Only 14 of the homes so far have been refurbished to bring them up to the standards
rightly demanded of the private sector. A further four homes already meet registration
standards, although they are in need of refurbishment. That leaves 17 homes that need
considerable upgrading. The social services department reckons that it needs to spend £19
million to bring them up to scratch. Local residents have queried that figure, but even if
it were halved, it would be a substantial sum.
The social services department is in a difficult position. Central
Government, who control the capital spending of local authorities, have not allocated to
it that level of resource. In recent years the problem has got worse. Until 1995-96 the
previous Government allocated about £2.5 million for social services capital schemes.
Since then the sum has steadily decreased. In the forthcoming year the allocation is a
mere £838,000. I know that the leader of the council has made representations to the
Secretary of State and expressed her concerns.
In the forthcoming financial year, only £100,000 will be available
for new schemes -- the rest of the money is already committed to existing schemes. The
council has had to devise means to deal with the problem, which unfortunately involves
closing several homes. It is proposed to retain and refurbish only four of the homes. The
rest are to be sold to the private sector, to be privatised, or -- as in the case of
Goodrest elderly persons home -- are to be demolished, and the site will be used for extra
care sheltered housing.
The council will be left with eight homes for elderly people. The
council says that it has a role to play in providing residential care, especially for
those suffering from dementia. As hon. Members know, there is a growing elderly
population, many of whom will unfortunately suffer from dementia.
In a report produced last year, the Royal College of Psychiatrists
and the Royal College of Physicians stated that the figure of 700,000 elderly people
currently suffering from dementia is set to rise to about 1 million in 30 years. The
report called for a national framework of provision. It pointed out that the policy of
contracting out institutional long-term care to the independent sector was imposed by the
previous Government in order to transfer costs from the health budget to the means-tested
social services budget. The report further stated that there is no evidence that the care
provided is comparable in quality, safety and cost to that which can be provided by
The report went on to deal with problems of abuse of elderly people
in residential establishments. It identified abuse as a matter of growing concern and
pointed to various risk factors -- poor working conditions for staff, inadequate numbers
of staff, inadequate supervision and training of staff, and inappropriate mixes of
residents with different care needs.
I do not want to cast doubt on much of the excellent provision in
the private sector. In Birmingham, as in other areas, the majority of residential care is
provided by the private sector, but there are considerable concerns about the quality of
provision in some homes.
In respect of these risk factors, there is grave concern about the
rates that those homes are either prepared or able to pay their staff. I emphasise the
words "able to pay", because I have been approached by proprietors of excellent
private homes in my constituency who are extremely concerned about the rate of pay for
each resident that they receive from the social services department, which has continued
to pressurise them to reduce costs. The proprietors say that -- because of the growing
dependency of many elderly people who are discharged, often from hospital, into their care
-- they are not able to provide for their needs with the weekly allocation given to them
by the social services department.
That means that many of those homes -- some because they have no
choice and others because they wish to profiteer -- are paying appalling rates and using
staff who have little training and are not committed to the work. Looking after elderly
people in residential care settings is a difficult job that requires dedication and a
great deal of skill, whether or not the elderly people are frail or suffering from
This morning I went to my local jobcentre to look at the vacancies
for care assistants in private homes. The rate of pay varied from £3.10 an hour to £4.15
an hour for those trained to national vocational qualification standards and prepared to
work shifts. One home was offering £3.60 an hour to experienced workers, including
working nights and weekends. It does not require any stretch of the imagination to
understand that those rates of pay are simply an insult to the work that is required to
look after our elderly people.
Birmingham social services department pays its staff £4.35 an hour,
which is not exactly rich pickings. It pays slightly higher rates for weekend and evening
work and double time for night shifts. I think that those workers deserve that level of
pay, and probably more. That level of pay, and more, ought to be provided for those who
look after elderly people in our residential homes.
The residents of Goodrest home are extremely concerned about the
closures. Occupancy in the homes that are run by Birmingham social services department is
slightly under 100 per cent., because a number of places are reserved for respite care.
Some elderly people, from time to time, need to go into respite care to give their carers
a break or if they are ill and need residential care. Those places will also be put at
risk by the closures, but -- because there is no longer any slack in the system following
previous closures, including the closure of one of the other elderly care homes in my
constituency a couple of years ago, again to widespread concern among the residents and
the local community -- there is no slack in the system and there are next to no places
available in other council-run homes. Even if people wanted to take up such places --
which they do not, because they want to stay in their homes and they value the care that
they receive -- that choice would not be available to them.
Residents and their relatives are extremely concerned about their
future. A meeting was organised last November by the local councillors -- in Birmingham we
have a system of ward sub-committees -- and held at the home concerned in my constituency.
Most of the residents attended, as did their relatives and members of the public. A vote
was taken and it was unanimously decided that people wanted to stay in their home. They
valued the quality of the care and feared what the alternatives might be.
It was made clear when the vote was taken that people would have to
move out if refurbishment took place, but they would be able to move back later and
maintain contact with friends and family during that process. Even though there would be
disruption, there was overwhelming desire to stay in the Goodrest home. From letters that
I have received from relatives of my constituents in other homes, I know that such desire
is felt elsewhere.
During the discussion, the assistant director of social services was
asked what provision could be made for people if the closure went ahead. The assistant
director made clear -- this is in the minutes of the ward sub-committee meeting -- that it
"was not possible to give any guarantees about the standard
of care to be provided to residents in the future".
He added that
"the Department would be doing its utmost to seek to achieve
the best possible care provision available at the time",
although that was likely to be in the private sector. There was no
guarantee about the quality of care.
It is known that those homes are likely to employ staff on the rates
of pay that I have mentioned, and there will probably be a lower ratio of staff to
residents, so it is understandable that people fear for the future. They have been given
no guarantees. Even if they had been, they would have wanted to stay in their home.
There is demand for these places in Birmingham, which is shown by
the fact that the homes are full, and we will have a growing elderly population. Over
time, provision in extra care sheltered housing will be available for the frail elderly,
but there will be growing demand for residential accommodation for elderly people
suffering from dementia and other symptoms of confusion.
The local residents and the carers have set about campaigning to
keep their homes open. I pay tribute to the dedication of those local people and the
relatives of residents living in Goodrest. The residents are not able to campaign, but
their relatives are doing an excellent job on their behalf. They are collecting petitions
and this Saturday was one of many on which they have spent hours in the cold and the wet
collecting signatures to get public support for keeping their homes open. That is
happening across the city, and they will be lobbying the social services committee when it
meets next week to take decisions.
The consultation has shown that there is demand for homes that are
run by the social services department. We know that most of those homes are already in the
private sector. It is important, not only for the care of the residents, but for the
well-being of all elderly people, to retain a proportion of such care in the public
sector. That sets standards and acts as a benchmark for other provision. It also gives
support to inspection regimes, which, I know, are having their hands tied.
Issues have been raised by my hon. Friend the Member for Newport,
West (Mr. Flynn) -- I have taken them up with the social services inspectorate in
Birmingham -- in respect of monitoring of the administration of medication to residents.
It is clear that the monitoring of these private homes is
unsatisfactory in that regard. A gun is being held to the inspectors' heads. They cannot
close these homes because there is no alternative provision. That is another reason why we
should maintain places in the public sector.
The local authority cannot raise the capital because of Government
restrictions on capital spending. That is nonsensical. We are encouraging private
provision, but to make places available the private sector is required to raise capital.
It is more expensive for the private sector to raise finance than for the local authority
to do so.
In the long run it is economic nonsense to close these homes. They
provide an excellent quality of care, and residents, their families and the people of
Birmingham want them kept open. They are looking to their local councillors, local MPs and
the Government to get together to ensure that Goodrest and other homes for the elderly in
Birmingham stay open. I hope that the Minister will have something positive to say about
meeting their needs.
Mr. Richard Burden (Birmingham, Northfield): I apologise for my
late arrival in the debate. As my hon. Friend the Member for Birmingham, Selly Oak (Dr.
Jones) said, I was unfortunately detained by what could not honestly be described as a
little local difficulty at Longbridge -- a major crisis facing the whole of the Mdlands. I
hope that the House will forgive me for my late arrival.
I congratulate my hon. Friend on securing the debate, and on her
description of the issues facing elderly persons homes in Birmingham. I should like to
make a few comments, which will be fairly parochial, as one of the homes affected is in my
constituency. I shall illustrate some of the general problems facing elderly persons homes
in Birmingham and some of the issues at stake.
The city council and the social services committee in Birmingham in
particular face formidable problems. Over the years, they have attempted to establish an
imaginative policy for the care of the elderly, in consultation with the health authority
and others, under the "new homes for old" strategy. In principle, that strategy
is valuable, because it emphasises partnership and the need for quality and choice in the
care of the elderly. It emphasises the right of people, as they reach old age, to have the
quality of care where they need it and the choice of care in all possible situations.
Frankley in Northfield became part of Birmingham in 1995: it was
formerly part of Bromsgrove. Lyttleton house is an elderly persons home in Frankley which
has provided a valuable community resource, and has been well regarded by people who live
in the area. It is one of the homes that did not meet registration standards under the
social services review. In the early part of last year, it was recommended for closure.
The issues surrounding that home are much the same as those described by my hon. Friend
for other homes, especially the Goodrest home in her constituency.
The "new homes for old" strategy adopted by Birmingham
city council is about providing diversity in choice for elderly people in the city.
However, I have been worried about the way in which the debate has gone in the past year
in Birmingham. Under the most recent review of elderly persons homes, the selection of
which homes should change their character, which should be recommended for closure, which
should be offered other options and which should be refurbished seems to be linked to the
current financial situation of the homes and the refurbishment costs estimated by the city
council, rather than to the clear estimate of needs in the community and how those needs
relate to the needs of communities elsewhere.
The city council and the social services committee have a genuine
desire to consult local people about their proposals. Unfortunately, that genuine desire
to consult has not always been matched by action on the ground. Questions have often been
asked by local residents. In my area, an action group was formed to campaign for Lyttleton
house, and the social services department has been asked about the plan for closure.
Although answers were given, sadly they led to more questions about the cost of
refurbishment, occupancy levels and so on. In Birmingham, we need a little more clarity
about the review, and about how the current provision of elderly persons homes fits into
The "new homes for old" strategy is sound. The responses
to consultations have not related to that strategy. The committee's response to the
comments on Lyttleton house, which included a 10,000-name petition of local people who
want to save it, has been to suggest that, rather than closure, perhaps it could be
considered for sale as a going concern. There may be arguments for that, but it prompted
another round of consultation. Local people did not know whether they were coming or
going. They were told that the home in which their relatives lived and which they valued
was earmarked for closure. They were consulted, they gave their views and they were then
asked whether, rather than closure, they wanted it to be sold off as a going concern.
The meetings of local people that I attended did not have confidence
that their comments would have an impact on the decision-making process. I say that not to
criticise or to have a go at the social services committee, because it is faced with a
difficult situation in a difficult financial climate, and there are various competing
pressures on it. But the difficulties faced by the social services committee are nothing
compared with the difficulties faced by the residents of those homes and their relatives.
They are told about the cost of refurbishment and that the need in their area is not
easily equatable with the need elsewhere, but they are the ones that have to make
decisions and advise their relatives for whom places such as Lyttleton house and Goodrest
are their homes.
On 17 February, the social services committee in Birmingham will
again meet to consider the future of elderly persons homes. I do not underestimate the
difficulties that it faces, but I want to use the opportunity of this debate to suggest to
the committee that it may be worth while pausing a little longer and thinking in a more
joined-up way about the future of those homes.
For the homes that are threatened with closure, the solutions may
not be limited to the straight choice of closure or sale to a purchaser as a going
concern. We should think a little more flexibly and creatively about the way in which we
provide elderly care in Birmingham. There should be more discussions with the health
authority and other partners to see how the principles of the "new homes for
old" strategy can be taken forward in practice. I want that imaginative strategy to
succeed in Birmingham, but it will work only if its principles are reflected in the
practice of the department on the ground. When the social services committee meets, I hope
that it will consider proceeding along those lines.
I echo the point made by my hon. Friend. The local authority's
ability to act is often circumscribed by the financial climate. Perhaps greater
flexibility in that financial climate would enable it to be more creative, which is what
we all want.
The Parliamentary Under-Secretary of State for Health (Mr. John
Hutton): I congratulate my hon. Friend the Member for Birmingham, Selly Oak (Dr.
Jones) on securing time for tonight's important debate; she clearly feels strongly about
the issues. I also congratulate my hon. Friend the Member for Birmingham, Northfield (Mr.
Burden) on his thoughtful comments.
My hon. Friend the Member for Selly Oak raised a number of issues
relating to the provision of residential care in Birmingham. In particular, she discussed
arrangements for the local authority's so-called part III homes, standards of care, and
roles for the public and private sectors as providers.
In Birmingham, as elsewhere, residential care is an integral part of
community care. Before I deal with the specific issues raised by both my hon. Friends, it
may be helpful if I say a word about the wider context in which the debate should be seen.
As I am sure my hon. Friends are aware, the aim of community care is to provide the
support that frail or vulnerable people need if they are to live in their own homes or in
homely settings, retaining the independence, dignity and quality of life that come from
being a part of the community. That means that local authorities must provide a balanced
range of services that are accessible and adapted to meet the needs of individual service
We take no ideological view of who the provider should be. We see no
reason why good-quality, cost-effective services cannot be given by the public sector, the
private sector and voluntary providers. We recognise the important contribution that each
must make. The important issue is not that of who provides a service, but that the service
itself is of high quality, is responsive to users' needs and wishes, and delivers the best
possible value for money. That means that local authorities must be rigorous and skilled
purchasers of services from independent providers, and equally rigorous and skilled
managers of their in-house services. In both cases, authorities must be committed to
putting users' needs first, delivering top-quality services and ensuring that resources go
as far as possible.
The local authority has the lead in planning and commissioning
important services. The role of Government is to provide a legal as well as a financial
framework within which those important services can be delivered. Let me say a little more
about that wider framework, and about what we as a Government are doing to promote quality
and value. The key elements include promoting partnership working -- effective
arrangements between agencies working locally, and the development of national standards
and objectives for social services. We are doing that now, for the first time. We also
want to encourage more effective commissioning, and we are providing the resources that
authorities need to commission and deliver services effectively.
As I am sure my hon. Friends will know, over the next three years
£3 billion of additional revenue will be devoted to social services. Let me mention some
of the important initiatives with which we are taking forward our agenda. We are
determined to improve partnership working between social services and the national health
service, because people's needs do not recognise organisational boundaries. In the case of
older people particularly, they are often complex: they change, both in the short term and
over a longer period. Following a period in hospital, people may need additional support
-- from the community health service, for instance -- if they are to return home; or they
may need residential care places if discharge is not to be delayed, and if unnecessary
readmission is not to be caused. We need to consider residential care provision within the
broader context of community care services, mapping out the key links with other agencies.
When residential care is planned, what is important is effective
joined-up thinking in the wider community care and health context. The interdependence of
health and social care makes it essential for the provider agencies to collaborate
effectively in service planning, commissioning, assessment and delivery -- and, not least,
Section 28A of the National Health Service Act 1977 has long been a
key funding mechanism enabling health authorities to support the work of social services.
Not least, that includes supporting residential and nursing home placements -- for
example, through the provision of "dowries" and similar payments in respect of
people transferring from long-stay hospitals, or through the support of innovative
I am sure that both my hon. Friends will know that, in the Health
Bill that we published recently, we outlined the way in which we intend to legislate in
order to ensure that more effective working between social services and the national
health service becomes the norm. First, we are determined to remove whatever legal
obstacles might obstruct effective working between the NHS and social services. Secondly,
in our executive letter entitled "Better Services for Vulnerable People", we set
out the medium-term agenda for people with continuing health and social care needs.
Further guidance on the better services initiative was issued in August by the NHS
executive and the Department's social care regions.
The circular asked local and health authorities to proceed in three
important areas. First, there were the joint investment plans that will provide a national
framework for multidisciplinary assessments of older people in acute and community health
settings, jointly with social services, and the development of a range of recuperation and
rehabilitation services for older people. Joint investment plans will constitute a
distillation of the health improvement plan and community care planning information. They
bring together in a single document the joint information needed for health and social
services to deliver on their respective responsibilities. The recent guidance requires
health and local authorities to have joint investment plans in place by April this year,
as a minimum, for older people, including those with mental health problems.
Multidisciplinary assessments, by health and social services, have
always been a joint responsibility within community care. More effective multidisciplinary
assessment means better co-ordination of care services. In the community, it may avoid
unnecessary hospital admission and allow older people to remain in their own homes for far
longer; in the hospital setting, good multidisciplinary assessments may avoid an
unnecessary admission subsequent to institutional care. Similarly, we hope that the
development of recuperation and rehabilitation services will enable people to return to
the community sooner, and to remain in their homes for longer.
Thirdly -- perhaps this is our most important proposal -- we intend
to modernise social services. This is a key theme in the recent social services White
Paper, which provides a context in which services such as residential care must be seen
and developed. We are talking about maximising independence rather than supporting
dependency, with the new emphasis that we intend to place on rehabilitation, recuperation
and prevention services.
The White Paper, however, does not stand alone. It is part of the
Government's overall strategy to improve health and social services. Together with the
document "The new NHS" and the Green Paper "Our Healthier Nation", the
social services White Paper provides a foundation for the future of health and social
My hon. Friend the Member for Selly Oak raised the issue of
standards of care and inspection in care homes. That is a key issue, and, indeed, a key
element of the White Paper. Local authority-provided residential care homes are not
currently required to be registered in the same way as independent homes, but local
authorities are required to inspect their homes, and to apply the same standards to
private and public provision. When local authority homes are below standard, we expect
authorities to take appropriate action to bring them up to scratch. It is only right for
vulnerable people in local authority homes to expect the standards that authorities apply
to the independent sector.
There are many problems with the current regulatory system for
social services, and we want to put those problems right. We are committed to reforming
regulatory arrangements for social services, and our proposals have been set out clearly
in the White Paper. We want to create independent regulatory bodies, which will be called
the commissions for care standards and which will be responsible for regulating all
residential care homes, including local authority homes as well as nursing homes,
children's homes and other care services such as domiciliary care agencies.
We are also committed -- my hon. Friend the Member for Selly Oak may
be interested in this -- to the development of national regulatory standards that can be
applied to all care homes. As a first step in the development of national standards, we
commissioned the Centre for Policy on Aging to advise us on standards for older people in
residential care. The CPA recently submitted its report to the Government, and we intend
to publish the standards for consultation shortly. I assure my hon. Friend that we are
determined to set standards that will consider the quality of care that is needed for
My hon. Friend spoke at length about the particular circumstances of
social services in Birmingham.
As I am sure she will be the first to acknowledge, spending
priorities vary from area to area. As I have said, of the authorities locally, local
authorities are best placed to assess those priorities. I have described several ways in
which we are supporting them in delivering quality, cost-effective services. Clearly,
though, a crucial factor in the equation is money. Commissioning services means committing
resources. Committing them wisely means planning ahead. We are aware of the strains on
social service budgets, and we have demonstrated our intention to ensure that social
services receive priority among the many services that receive Government support.
My hon. Friend the Member for Selly Oak will be aware that the
outcome of the comprehensive spending review provides significant increases in resources
for local authority social services -- as I have said, almost £3 billion extra over the
next three years and an additional £500 million in the current financial year. The
increased resources mean that social services departments will be able to plan ahead,
knowing that there will be increased funding in each of the next three years. They will
have the resources that they need to provide effective and integrated services to
vulnerable people in society.
I should like to return to the specific question of residential care
homes and, in particular, the arrangements that my hon. Friend the Member for Selly Oak
has described affecting Birmingham. As I have said, resources nationally for social
services are being increased by 6.1 per cent. next year. That is significantly above
inflation. We are targeting a large proportion of that increase at improving the services
for older people through better planning and delivery of services across the interface
between the health service and social services through improved rehabilitation services.
Older people make an enormous contribution to national life. The
Government are determined to ensure that their wishes and needs are taken seriously. We
also intend to ensure that older people are valued and can play their full part in
As I have mentioned, the recent White Paper set out what the
Government propose to do to modernise social services. People generally want to live in
their own home if they can, and the Government intend to put greater independence at the
heart of social services for adults. However, we recognise that, for some people, care in
a residential setting will be inevitable and appropriate.
A recent survey by Birmingham social services showed that some
people in residential homes were inappropriately placed and capable of managing their
lives better at home. It was believed that, given improved rehabilitation services, many
of those people would not need to go into residential homes in the first place. I am sure
that my hon. Friend the Member for Selly Oak would want to ensure, if possible, that that
Birmingham health authority is developing a proposal whereby social
services would pay a premium for short-term stays in residential homes if they offered
rehabilitation services that enabled the person to return to their home eventually.
Birmingham health authority is also running a pilot along those lines for people with
specific health needs.
Dr. Lynne Jones: All that my hon. Friend has explained on the
Government's strategy is commendable, as are the additional revenue resources, but it has
been made clear that the residents of the homes that are to be closed will not be offered
a place in their own home. Many have left their homes. They have no home. The extra care
sheltered housing is not on offer to them. The issue is not about the revenue cost -- the
day-to-day cost of running the home -- but the cost of the refurbishment and capital
expenditure. That is the important issue. I would be grateful if he would say a few words
Mr. Hutton: I do intend to say a few words about that, but I am
sure that my hon. Friend and I are at one on the general direction that we want to take,
which is to promote wherever possible independence and independent living. She was anxious
-- I think that it was her main concern -- about the quality of care that her constituents
could face in the private sector. She expressed anxiety that there would be no guarantee
that they would receive a comparable quality of service. I accept that one of the
Government's responsibilities is to take action to set standards and to ensure that they
are sufficiently high. We take that responsibility seriously.
That is why we have commissioned the work from the Centre for Policy
on Aging to help us to set a proper standard that we can apply across the spectrum, but we
intend -- the Government have made it clear; I hope that I have done so tonight -- to
ensure that, in developing those new national standards, we consult as effectively as
possible with all providers, in both the public sector and the private sector.
My hon. Friend the Member for Selly Oak referred to capital. She may
be interested to know that I had some correspondence with the leader of Birmingham city
council about the issue. Figures from the Department of the Environment, Transport and the
Regions have shown that, from 1995-96 to 1999-2000, Birmingham has had approximately £230
million made available to it from central Government for capital programmes, and between
£6 million and £10 million in usable receipts.
We have told Birmingham city council that we are anxious to
encourage local authorities to make full use of the private finance initiative. We are
keen for authorities to seek partnerships with the private or voluntary sector because, in
many cases, as my hon. Friend may be aware, such partnerships can offer very good value
for money in the provision of services and capital investment.
My Department has PFI credits available for the current financial
year. If Birmingham city council is interested in exploring that option with us, we would
be interested in hearing from it.
Dr. Jones: That is an interesting proposal, but I understand
that that has been explored. In relation to the total capital programme, obviously
Birmingham is a big city and it has a big capital programme, but the fact remains that the
allocation that the Government have earmarked for social services has declined and is very
Mr. Hutton: I would hate to have an argument with my hon. Friend
about the level of social services expenditure. I am sure that she would acknowledge that
over £500 million of additional money has been put into social services in England, Wales
and Scotland this year. That is a significant increase. The local government financial
settlement for Birmingham shows that, overall, resources increased by 4 per cent. this
year, which is above inflation.
We could go on arguing around those points. I do not think that it
would be fruitful to do so, but, as I have said to the leader of Birmingham city council,
we are interested in exploring with the council any opportunities for private finance
initiatives. We still look forward to hearing any confirmation from the council that it
wants to explore that with us.
My hon. Friend the Member for Selly Oak was right to say that the
social services department has been considering the future of all of its own residential
care homes for older people. Some homes have been sold and some have been refurbished. The
overall strategy included upgrading some of the homes to meet registration standards, and
receipts from the homes that have been sold contributed significantly to that upgrading.
The strategy also includes providing for a range of alternative care provision, to
residential care in which people can still have their own front door and receive the
degree of care and support related to their needs.
My hon. Friends the Members for Selly Oak and for Northfield both
mentioned the development of extra care sheltered housing, which now has 11 schemes in
operation, with a further three new build schemes planned for 1998-99. As 12 more schemes
are in the pipeline, there will be a total of 1,030 flats by 2001.
The strategy employed by the social services department has been in
line with that of many other local authorities that have divested themselves of in-house
residential provision for older people. The social services committee has approved the
strategy, and there has been a formal process of consultation with all stakeholders before
any decisions have been taken on the future of each home.
I understand that arrangements for all but eight of the authority's
35 homes have now been satisfactorily resolved. The social services department is
currently out to consultation on the final eight homes, and findings and any final
proposals will be reported to the social services committee for a decision, on 17
February. Any homes that are sold to the independent sector will be subject to the process
of registration and inspection that -- I should like to ensure my hon. Friend the Member
for Selly Oak -- will ensure the quality and standard of care available
Birmingham is not alone in reviewing its provision of residential
care. Local authorities across Britain have been examining ways of improving services, to
put together imaginative and innovative care packages for the benefit of care service
users and their families. Whatever decisions an individual authority makes when
considering changes to the extent of their provision of residential care, the welfare and
wishes of residents and staff of the residential care homes concerned must be taken fully
Regional offices of the Social Care Group monitor developments of
that nature and keep Ministers fully informed. However, as I am sure that both of my hon.
Friends will accept, it is essentially a matter for the local authority concerned to
decide how best to meet the need for social services, including residential care, in their
Taken together, the measures that I have outlined will help to
improve both the quality and the delivery of social services across Britain. The
Government are committed to ensuring that we have first-class social services that provide
flexible user-centred care to those who need it. I assure both my hon. Friends that that
applies as much in Birmingham as it does anywhere else in Britain. I assure them also that
I shall continue to take a close interest in the issues that both of them have raised in
Question put and agreed to.
Adjourned accordingly at half-past Eight o'clock.
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