Personal Care for the Elderly
The next item of business is a Scottish National Party debate on motion S1M-1589, in the name of Mr John Swinney, on personal care for the elderly. There are two amendments to the motion. One of the amendments appears in the business bulletin. Copies of the second amendment are available at the back of the chamber, in the usual place.
In opening today's debate, I acknowledge that our motion was, to all intents and purposes, drafted by the Liberal Democrats. The SNP lodged it for debate in our Opposition time in order to give the Parliament an early opportunity to express its will on a matter of great importance to thousands of elderly people and their families throughout Scotland.
The debate has been prompted by something that the Government has not done. However, before I discuss that, I will first take a few moments to acknowledge what the Government has done. All members welcomed Susan Deacon's announcements on 5 October and yesterday that there would be more money for aids and adaptations and for better home care, a focus on bedblocking and a single needs assessment. All those commitments will make a positive difference to the lives of many elderly people in Scotland.
Let me make one thing absolutely clear. It is not the case—as the Government has implied time and again and as a certain London peer has said—that we face a choice between the initiatives that the Government has already announced and full implementation of the Sutherland commission's recommendations. This is not an either/or question. The payment of personal care costs for all elderly people in Scotland is an essential part of any package to make the system of long-term care fair and to improve the quality of life for all those who require long-term care.
The reason why we are debating the motion is that a majority of MSPs—I believe—and of the Scottish public think that the Executive has not gone as far as it should have gone, could have gone and was expected to go. I will deal with the "should" and the "could" later. Amid the claims and counter-claims about what full implementation of the Sutherland report will mean, it is important to restate clearly the simple but overwhelming case that personal care costs should be paid from general taxation.
First, I will deal with the matter of expectations. The reason why the reaction to yesterday's statement—which, given its content, or rather lack of content, was always going to lead to deep disappointment—turned to fury was that the Government, and the First Minister in particular, had over the past three months misled the people of Scotland. In the words of Maureen O'Neill of Age Concern Scotland, as reported in this morning's press,
"expectations were raised over the past eight weeks only to be dashed"
by the Minister for Health and Community Care yesterday. That is putting it mildly.
However hard Henry McLeish tries to rewrite recent history, the fact remains that he led Scotland to believe that Sutherland would be implemented in full. At the very least, that was how everyone in Scotland interpreted his remarks. The crucial point is that at no time did he or anyone acting on his behalf challenge that interpretation. He was happy to let Scotland believe that he was about to do right by Scotland's pensioners. He then allowed himself to be dictated to by his colleagues in London, letting Scotland down in the process.
I hope that, if nothing else, Henry McLeish pledges never again to play politics with an issue that is so important to so many people. It is no accident that the majority of people in Scotland—including MSPs, voluntary organisations, elderly forums, the general public, Malcolm Chisholm and, at least until last week, Henry McLeish—support Sir Stewart Sutherland's recommendations. They do so because Sir Stewart and his commission were right.
Long-term care for the elderly involves a range of complex issues—on that point, the Government is right. That is presumably why the Royal Commission on Long Term Care was established in the first place and why it was given a year to examine the issues and to come up with its recommendations.
Its conclusion was absolutely clear—it is wrong to charge people for personal care. I can put it no better than the Sutherland report did. The commission accepted that people should, where possible, make a contribution to living costs, but it stated:
"The costs of personal care as such are however quite different. These are the costs which, unpredictably and through no fault of their own, old people have to incur when unfortunately they can no longer be looked after at home or cannot be sent home after hospital treatment. They reflect the true risk and ‘catastrophic' nature of needing long-term care.
In our judgement it is right for the state to exempt personal care from means-testing altogether. This is our key recommendation."
In other words, the Sutherland commission was saying, loudly and clearly, that it is wrong to ask people to pay for help with washing, dressing and going to the toilet. That is help that nobody wants to have to ask for, but that many people are forced to rely on, simply because they are old.
We do not now need review after review to consider the principle of the issue when the principle has already been established clearly and convincingly by the Sutherland commission. What we need now is an acceptance of that principle by the Government. Incidentally, that acceptance is contained nowhere in the amendment lodged by Richard Simpson. We need a commitment to full implementation of Sutherland and a detailed timetable for implementation. That is what the people of Scotland want and deserve.
Let me deal with the arguments that have been made against full implementation, starting with the assertion that to pay personal care costs for all elderly people is to target scarce resources at wealthy pensioners. Let me make it absolutely clear that we are not, in the main, discussing wealthy pensioners; we are talking about people who belong to a thrifty generation and who have managed to save a little, or people whose only asset is the family home. We are talking not about wealthy pensioners but about ordinary pensioners, who have contributed to society for their entire lives and deserve support in their old age.
Even to advance the argument about wealthy pensioners benefiting from full implementation is to miss the whole point of the Sutherland report. The point of the Sutherland recommendation is that it is the very nature of personal care, and the fact that it is such a lottery which of us will require it, that makes payment from taxation the only equitable way of resourcing it.
Secondly, there is the argument that we cannot afford to pay for personal care. The only figures that have been presented in the debate are those of the Sutherland report and those of Sir Stewart himself. The report concluded that implementing its recommendation would, by the middle of the century, add 0.4 per cent to the amount of tax revenues spent on long-term care. To my knowledge, that figure has never been seriously challenged.
The report costs implementation of its recommendation at £110 million per annum. However, as Sir Stewart has said, that is already an historical estimate because it takes no account of other commitments that the Government has made, such as to the provision of free nursing care. According to Sir Stewart, the gap between where the Executive was on Tuesday and where people want it to go is £25 million—again, that figure has never been convincingly challenged. Presumably, that gap has narrowed further since Susan Deacon's announcement yesterday.
So, is implementation affordable? The First Minister seemed to think so on 15 January, when he asked in The Scotsman:
"Is anyone really suggesting that with the teachers and with Sutherland, that is money that cannot be made available out of our budget?"
Is anyone in the Government suggesting that we cannot afford to pay for personal care? I await the minister's answer. It is abundantly clear that until last week it was the First Minister's view that paying for the personal care costs of the most vulnerable people in our society was not only a priority for the Government but a policy that could be afforded.
This is not about affordability. It is an issue of political will, and today it is an issue about the will of the Parliament. There is majority support in Scotland for implementing the Sutherland recommendation and I believe that that majority is reflected in the Parliament. It includes, if they are honest, Malcolm Chisholm and Henry McLeish. Today is our chance to assert our authority as the elected representatives of the people of Scotland and say clearly to the Scottish Government that the Government is the creature of the Parliament, and not vice versa. I hope that MSPs of all parties will support the motion so that, together as members of the Parliament of Scotland, we resolve to do what is right for the pensioners of our country.
I move,
That the Parliament, while welcoming the further package of proposals to improve care for the elderly announced by the Minister for Health and Community Care on 24 January 2001, notes that it is the policy of the Liberal Democrats, SNP, Conservatives and others to introduce free personal care for the elderly as proposed in the Sutherland Commission Report and calls upon the Scottish Executive to make a similar clear, firm and unequivocal commitment together with a definite timetable for its implementation.
On a point of order, Presiding Officer. At the beginning of the debate, you said—the Official Report will confirm this—that there was an Executive amendment, copies of which were available at the back of the chamber. It turns out that that amendment is in the name of Richard Simpson. Will you make it clear for the Official Report that the amendments are in the names of Richard Simpson and Tommy Sheridan, neither of whom are yet in the Executive?
You are misquoting me, Mr Rumbles. I did not mention the word "Executive".
On a point of order, Presiding Officer. What amendments have you accepted?
I have accepted two amendments: one in your name, Mr Sheridan, and one in the name of Dr Richard Simpson.
I begin by declaring that I am a director of a nursing home, although it operates in England and will not benefit from any action that is taken by the Executive.
The time has come for a mature debate on the care of elder citizens. Yesterday, according to Alzheimer Scotland—Action on Dementia, there was a major breakthrough. Why did that organisation use that term against the cacophony of soundbites from the SNP and the Tories? It did so because it recognises the reality of the future.
There has been a major breakthrough because we have radically challenged the basis of the debate. No longer will any elderly person or their carer have to decide whether the type of care that they receive is nursing care or personal care. That sterile debate is over. Now we have a Scottish solution to the problem. We have a care needs assessment system that will ensure that many more people will now receive the help that they need.
The discrimination against people with dementia, mental illness or learning disability, which was inherent in the concept of free nursing care, is over. The Parliament should now concentrate on the definition of personal living expenses. Not even Sutherland has ever suggested that those expenses should be anything other than a personal responsibility that is met through personal income, pension or benefits. No matter where people live—in a nursing or residential care home, or at home—they will have to meet their personal living expenses, assessed under the benefits system.
Will the member give way?
No.
The Parliament must recognise that even people in national health service units make a contribution to their personal living expenses, through the stopping of pensions above £15 per week after they have been in NHS units for six weeks.
Yesterday, the Labour-led coalition made it clear that we have begun a journey towards the renationalisation of health care, which the Tories privatised.
Will the member give way?
No, I am sorry. The changes that have been announced represent a decisive break with the rest of the UK. Does the Opposition welcome that? No.
Yes, we do.
The SNP does not welcome the break.
The long-term care bill will offer an opportunity for the Parliament to hold a rational discussion about how we create sustainable funding for the long-term care of the growing number of elderly people who need it.
I accept most of what Dr Simpson has said. Does he accept that the responsibility of the person being cared for to meet the costs of that care, commensurate with their means, can be operated through a system of income tax and a universal benefits system?
We have to decide and define where personal responsibility ends and the state's responsibility begins. I do not object to debating that matter on the basis of Sutherland, but we have to define that boundary on a sustainable basis, as the demographic pressures on the Parliament's budget will be substantial. The Parliament has an opportunity through the implementation group and the long-term care bill to define reasonable and sustainable boundaries between personal costs and the state's costs.
Instead of acting rationally and reasonably, the Opposition and—I regret to say—some of our coalition partners want soundbites. Rationally, if I were in opposition and had heard the Executive state yesterday that the end of the journey on which we had begun was free personal care, I would immediately have asked what constituted the free personal care that had just been agreed to and where the line would now be drawn. There will always be boundaries between what is personal responsibility and the responsibility of the state.
Will the member give way?
I am sorry; I am in my last 60 seconds.
I tell our partners that, notwithstanding the efforts of the Tories and the SNP, whose sole purpose is to wreck the coalition—[Interruption.]
Order.
The SNP's profligate promises to the Parliament amount to more than £5 billion. The SNP would wreck our budget and economy.
I appeal to our Liberal colleagues to join us. We believe, as they do, that we should move towards the restoration of the state's responsibility for the care needs of older people, but we recognise that this is a coalition and that Labour has a commitment to those in greatest need. We have commitments, which we will not abandon, to central heating for the elderly, social inclusion and the extension of respite care to support our carers.
There is no dispute about what we want. Margaret Smith and Keith Raffan know the extent of my commitment to the goals that we share. I appeal to the Liberal Democrats to move beyond the rhetoric and ensure that the path that we are on leads to a common goal. I call on them to join us and not pander to the Opposition, whose sole purpose is to wreck the coalition. They should accept the responsibilities and disciplines of government and support the amendment.
I move amendment S1M-1589.2, to leave out from ", while" to end and insert:
"recognises that there are benefits in providing free personal care for the elderly; welcomes as a major step in this direction the further package of proposals announced by the Executive on 24 January 2001 which set out a process that will lead to a substantial extension of free personal care; notes that there are significant issues of cost and practicality in moving further and calls upon the Executive to broaden the terms of reference of the Development Group to require it to consider the practicalities, costs and implications of providing free personal care for all and to report by August 2001 with proposals that will inform the Executive's expenditure decisions for 2002-03 and beyond."
I should explain to the chamber that I will now call Mr Sheridan, who will formally move his amendment. He will speak during the wind-up speeches at the end of the debate.
I move amendment S1M-1589.1, to leave out "and others" and insert:
"the Scottish Socialist Party and the Scottish Green Party".
I am glad that we are having this debate, as it is right and proper that, once and for all, we decide on some of the issues that are at the core of the challenges that we face in delivering better and fairer care for older people in Scotland. I want a better and fairer care system—I think that all of us want that. We want greater equity and higher quality and we want more and better services. The challenge for Government is how to deliver that care to people.
Already, this Executive has made clear our commitment to Scotland's older people, not only in words but in deeds. Last October, we announced a massive investment package of £100 million a year. That is the biggest ever investment in older people's community care services in Scotland—real measures and real investment to deliver better and fairer services throughout our country.
Alongside that investment, we have provided concessionary fares and warmer homes for older people, again backed by investment, action, changes to the organisation and to the design of services and, where necessary, legislative change. Those actions will benefit tens of thousands of Scotland's older people.
Will the minister give way?
I thought that those of us who supported the creation of the Parliament spent so long arguing for it in order to make a difference to the lives of the Scottish people.
I will take a quick intervention from Mr Rumbles.
I respect the minister's comment that we want a fairer system for the delivery of personal care. However, we do not want people to fall through the net because their assessment is wrong. For example, on the income supplement, people fall through the net of the minimum income guarantee. That is the point.
I have only a few minutes, but I will deal with Mike Rumbles's point. I do not want people to fall through the net. I do not want to make promises to people if I am unable to say when and how those promises can be delivered. I do not want to tell someone that they will receive free personal care if I cannot have the confidence to say that the services are in place to deliver that care. I do not want to tell people that they are going to have free personal care if I cannot say when or how they will receive that care. I do not want to say to people that they will receive free personal care if the consequence of that promise is that other services may ultimately need to be cut. In the Health and Community Care Committee's report of its year-long inquiry into community care, the committee said:
"Clearly the decision to make personal care available free of charge means money is no longer there to be spent on other aspects of community care".
Yesterday, I said that we were determined to create greater fairness and greater equity in the care system. We are ensuring that everyone, universally, will get free nursing care. As I said yesterday, we are pushing out the boundaries and extending the provision of free nursing and personal care to those in greatest need, in order to ensure that some of the greatest inequities in our care system, which affect people with conditions such as dementia and Alzheimer's disease, are addressed once and for all. Those measures will create greater fairness—they are not hollow words, empty rhetoric or promises that cannot be fulfilled. They are real measures that will make a difference to the people of Scotland.
Even the SNP spokesperson said today that she welcomes everything that the Executive has done to date. No one has advocated that we are doing anything that should not be done. No one has said that we should not make progress on the community care agenda. We want to make progress on that agenda. That is why we set out clearly yesterday that care of the elderly would be a top priority for additional investment and why we said that we wanted to examine all the issues involved in extending the boundaries of free care and in improving long-term care.
We will examine the relationship between care and the benefits system. We will examine funding flows through all the other funding streams that come into community care. Malcolm Chisholm's group will advance that work over the next six months and that fixed time scale will feed into our legislative programme. We want to ask the questions and we want to come up with the answers. We want to base our policy and investment decisions on facts, not rhetoric.
If we promise change and improvements for older people in Scotland, we will deliver change and improvements for older people in Scotland. We will say when we will do it and how we can do it. We will explain the consequences of making changes and we will ensure that we deliver change. That is the Executive's commitment; the measures that I set out yesterday demonstrate how that commitment will be met. It is a pity that, on an issue on which we share so many objectives, we now dance on the head of a pin of words, when we all want to deliver change.
The Conservatives welcome both the debate and any move that would benefit the care of the elderly. We also look forward to the Health and Community Care Committee's debate in the chamber in February. Today is an opportunity for all MSPs who are committed to personal care for the elderly to vote for it.
Not only is the Executive's response to the Sutherland report disgraceful, but the Minister for Health and Community Care's response to the Health and Community Care Committee's report is overrun by references to the joint future group, which she set up. It is clear that she responded in that way in order to state the Executive's case and to overshadow the committee's report with her ideas. I find it galling that other ministers are able to work effectively with their subject committees, while the Minister for Health and Community Care continually drives a wedge into what could be an excellent working partnership.
I will examine the background to the debate. In 1997, the Royal Commission on Long Term Care was set up. The Sutherland report was published about 18 months later. We are now two years down the line from the Sutherland recommendations. We believed that Labour could not procrastinate any longer with focus groups, strategies, commissions, reviews and working groups, but what do we get? A development group.
If the minister wants to hear a soundbite, I will give her one from Alzheimer Scotland, which said:
"the Development Group is a stalling device."
The reason for the additional delay centres on the definition of personal care, which is set out clearly at chapter 6, page 68 of the Sutherland report. The report says that personal care
"falls within the internationally recognised definition of nursing, but may be delivered by many people who are not nurses"
and should be based on assessment of need, not on demand.
How can the Executive and the Minister for Health and Community Care have any respect for old age when the minister recommends that free care should be provided only to those dementia sufferers with the greatest need?
I want to finish my point.
Dementia can only get worse. The minister is setting up a system that will continually test and assess the frail and elderly until they are sufficiently ill to fit her definition. How cruel and demeaning can she be? When she considers her views on personal care, will she follow the advice of the chief nursing officer? Point 29 of the report by the chief nursing officer for Scotland's group on free nursing care states that those who refuse assessment
"need to be made aware that to do so will prevent their nursing care being paid for."
Point 26 says that
"reassessment of need should be as frequent as the person requires".
Where do respect and dignity fit into that approach? The care of someone with mild dementia is not paid for. The care of someone who is cantankerous, thrawn or downright independent is not paid for. Someone who values their self-respect, dignity and independence in old age gets no help. However, someone who submits to endless assessments until they finally fit the new Deacon definition of personal care might just get help. What does it profit a man to gain the minister's grudging, tight-fisted measure of personal care if he loses all his dignity and self-respect on the way?
As Alzheimer Scotland says, the development group is a delaying tactic. We know that the vast majority of Labour members support the funding of personal care for the elderly. Today, they have run out of excuses and run out of time. Today is their opportunity to help old people in Scotland.
Will the member give way?
No—I am on my final sentence.
There is political will in the Parliament to give our old folk care, dignity and security in their old age—can Labour members afford not to support the motion?
There are two issues at the heart of the debate. First, the principle of free personal care for all older people: an issue on which there is a genuine difference of opinion between the Liberal Democrats and Labour ministers. The second is that of the status of the Scottish Parliament and the extent to which the Executive is not just sensitive but responsive to the clear will of members of the Parliament.
The Scottish Parliament is not Westminster and Holyrood is not a rubber stamp for an all-powerful UK Government. The Scottish Executive is a partnership that has formed a coalition Government between two parties. Ministers cannot get what they want simply by driving it through using a large majority: there is no large majority. They have to persuade and convince; the Executive cannot command support, it must win it.
I will start by saying what we in the Scottish Liberal Democrats want, and why. We want the Executive to make a clear, firm and unequivocal commitment in principle to free personal care for all older people, with a definite timetable for implementation. We do not expect that to happen overnight. Indeed, our own federal pre-general election manifesto stated that the Liberal Democrats
"aim to provide free personal care for those in long-term care, by the end of the next Parliament".
That means by either 2005 or 2006. Being in government means living in the real world. The timing of implementation is a matter of resources and of when those resources become available.
We welcome the minister's announcement yesterday of a development group on long-term care. That group will build on what has already been achieved and carry forward work on implementation. Members need to know as precisely as we can how many older people would be eligible for free personal care and what the cost would be—then we will find out whose estimates are closer to reality, Stewart Sutherland's or David Lipsey's. I know whose estimates I would back.
Why do the Liberal Democrats believe in free personal care for all older people? I do not intend to rehearse the arguments in detail: they can be found in the reports of the Sutherland commission and the Health and Community Care Committee. The arguments centre, of course, on fairness. They centre on equity. They centre on delivery of service to all in need. All their lives, older people have expected to be looked after and cared for in their old age. They have paid national insurance with that expectation in mind. They should not have to face their final years in fear.
Targeting, or restricting, resources to the most needy requires means-testing. It will also result in increased bureaucracy. Worse, it will lead to a lower take-up of what is, for many, a badly needed benefit. Means-testing is stressful for those who have to go through it—and especially so for the elderly. Means-testing does not easily equate with the dignity and respect that is the right of older people.
Does Keith Raffan agree that the implementation of the Sutherland report would not result in the abolition of means-testing? Does he also agree that the single needs assessment process that I announced yesterday—which is to be piloted this year and rolled out next year—will lead to a reduction in bureaucracy in the system?
I am about to pay some tribute to the minister. I accept what she says and I accept that the Sutherland report includes means-testing, particularly of living costs, but we are talking about the element of free personal care. The minister talked about an argument on the "head of a pin". It is that small—we are dancing on the head of a pin. If it is that small, why will the Executive not move towards our position? Why is the minister being so stubborn? Why is she so reluctant to move in principle?
We are proud of what the Executive has achieved so far for the elderly. I might add that I have a high respect for the minister. I have three health boards in my constituency that are confronting major issues and facing serious problems. Hers is no easy task. Despite a £5.5 billion plus budget for the national health service in Scotland, there is no surfeit of resources. Resources are scarce and there is competition for them everywhere.
The minister was right yesterday when she said that much has been done; she was also right when she said that much remains to be done. The Liberal Democrats welcomed her October announcement as a landmark for older people in Scotland. She had every right to claim that that package of proposals, investing up to an extra £100 million a year, would deliver radical change for the elderly—far more than Westminster has so far delivered. That is entirely to the Executive's credit.
We welcome the additional measures, with resources to match, that the minister announced yesterday, to extend the provision of free care to many more older people in Scotland—and especially to dementia sufferers who are in desperate need. We welcome the decision that additional resources for long-term care will be a top priority of this Administration. All the sadder then—from our perspective and in view of the Executive's distinguished record of achievement for the elderly—that the minister cannot bring herself to take that one further step and commit the Scottish Executive in principle to free personal care for all older people.
We are with the Executive on the journey towards improved care for the elderly; it is the ultimate destination on which we differ. There is a genuine difference between us on the Liberal Democrat benches and Labour ministers. However, a difference of opinion is not a ground for divorce. It may be uncomfortable and unsettling for both parties, but working to ensure that the current tension between us is creative—and positive in outcome—can lead to the maturing and strengthening of our relationship.
What we seek today is not the defeat of the Executive but a victory for the elderly—a victory that will make a real difference to their quality of life and a victory that will accord them the respect and dignity they deserve. And yes, we seek a victory for this Parliament too—one that will mark a further step in our development and a significant stage in our growth towards the mature and powerful Parliament for which the Scottish people voted and which our country deserves.
Richard Simpson referred to beginning a journey with the development group. As Mary Scanlon said, that journey began on 4 December 1997, when the royal commission was required to report, within 12 months, on long-term care for the elderly. It did. The report has since lain around for nearly two years. Do not frown at me, Labour members, I am coming to the point.
The Health and Community Care Committee took it upon itself to follow up the work of the report and it produced its own recommendations. I commend Mary Scanlon, Margaret Smith, Kay Ullrich and many others for that. I, too, followed up on it, lodging the first motion in Parliament calling for full implementation of Sutherland on free personal care. I proposed a member's bill at the same time. Since then, I have tinkered with that bill and put it on the back burner because I thought—I foolishly thought—after hearing Mr McLeish's words in this chamber that Labour would deliver on free personal care. Mr McLeish flirted and teased, here and in the press, on this serious and crucial issue. Today, we are coming to a test for this Parliament on delivery for Scotland's elderly people.
Down south, Labour's parliamentary colleagues say that implementing Sutherland in full would help rich pensioners. Well, yes—all these years since 1997, rich pensioners have been selling their council houses to pay for their personal care. Richard Simpson knows that not all pensioners who are selling their houses are suffering from dementia; many are sentient and know that they are losing their homes and their possessions. Families sometimes lie to them and tell them that their homes remain. Of course the personal care that they seek is not free: they have paid for it for years, with their taxes and national insurance. All they ask is the same treatment and care in their old age as others expect in a civilised society.
Yesterday, the minister announced a review. There is to be a report in another six months—conveniently after a general election. The leader in The Scotsman today is headed:
"McLeish plays for time on care of the elderly".
I count the delay from 1997 to now at three and a half years—not bad at playing for time.
The one thing that Scotland's frail elderly do not have is time. The delay is the Executive's disgrace. There is a coalition in the chamber on behalf of Scotland's elderly. I hope that the Parliament will tell Scotland loudly and clearly that across this chamber we stand by Sutherland and we stand by the frail elderly. That coalition is asking with one voice on personal care—when?
I will read from the report of the Health and Community Care Committee on the delivery of community care in Scotland:
"The Committee welcomes the steps that have been taken towards implementation of several of the key recommendations within the Sutherland Report. It is persuaded however by the substantial body of evidence presented to it that there should be no charge for services assessed as being required to meet the personal care needs of an individual. It therefore recommends to the Executive that free personal care should be provided on the basis of assessed need."
That was signed by members of all the major parties in the Parliament, including Richard Simpson, despite the impression he has given today.
This morning, I just happened to open the committee report at a page with a comment by Malcolm Chisholm, from 31 May. On the Sutherland report he said:
"I do not agree with the minority report".—[Official Report, Health and Community Care Committee, 31 May 2000; c 972.]
The support in the chamber for free personal care knows no bounds: there is support for the coalition for Scotland's elderly from the Deputy Minister for Health and Community Care and other ministers from both parties and from members from every party in the chamber.
As Keith Raffan said, there are two fundamental issues. The first is about policy—what is fair, what is right and what will deliver the best possible community care services. The second is the power of this Parliament. I thank John Swinney: by withdrawing his motion on the powers of the Parliament, he has given us the opportunity to debate these issues. I hope that today we send out a very clear message about the power of the majority will of the Parliament, which is to listen to professionals, carers and users of services, as the Health and Community Care Committee did.
This is about making prudent use of finance. I have not heard anyone, today or in the earlier, long debates on the issue, call for free personal care to be delivered next week, next month or the month after that. However, we are the voice of our country: if this is the majority will of the people in this chamber, then let it be spoken and acted on. That would be the right course of action.
Yesterday, the Minister for Health and Community Care set out important steps on the journey towards achieving free personal care. As she said today, we are dancing on the head of a pin. That is why those of us who are disappointed feel that way—because we are almost there. The minister is responsible for a very great deal of the good work and progress that has been made. Yesterday, she said that people in Scotland are not interested in aspirations. If that were so, most of the Executive documents over the past year and a half would not have been printed.
Aspiration is about what we are, who we are, what we believe in and what we want to see happen for our country. We must send a message to people that we must be prudent, we must take forward work over the next six months, we must audit how the community care pound is spent and we must find the best way to put joint working into practice. There is a lot of work to do to untangle ourselves from the benefits system across the UK and the cross-border links and the possibility of people hobbling across the border into Scotland with their zimmers. What the Health and Community Care Committee wants—and what the Scottish Liberal Democrats want—is a commitment to the end of that process; a commitment that could begin today with the majority will of the Parliament being stated loud and clear.
The issue is not one of wealthy pensioners but of attacking thrift and personal responsibility. Despite the welcome announcement by the Minister for Health and Community Care yesterday on single assessments, it is about leaving in place charges for services. It does not matter whether it is called personal care or nursing care or whatever, some people will still be charged. As the Royal College of General Practitioners made clear to the Health and Community Care Committee, some people will not get the services they require and the care they should have.
The minister and the Executive have gone further than their colleagues in England and Wales. In October and yesterday, they put in place a good package of measures to improve things for the people of Scotland. However, the final step is still left. Today the Parliament has the opportunity to say that we want to take that step. It is right for Scotland's pensioners and for Scotland's Parliament.
This morning's debate has focused on one issue rather than surveyed the big picture of how we treat and look after our older people who are in need of care. The Health and Community Care Committee took more than 10 months to complete its investigation into the delivery of community care. Yesterday, the Executive published its response to the committee's recommendations. It is a disservice to this chamber to use it to ignore the committee's recommendations and the Executive's positive responses and to pursue just one issue in isolation.
It is recognised that care needs must be assessed and that they must be understood in the same way throughout Scotland. The chief nursing officer undertook the task of considering, for the first time, what nursing care comprises. That report also was published yesterday and it confirms the way forward recommended by the Health and Community Care Committee. The success of that approach depends on all in the care stream being signed up to the process. It is right that a larger pilot of the care needs assessment package for the elderly should be conducted and evaluated before it is rolled out across Scotland. The value of evidence-based best practice was recognised in the committee's report.
The complexity of current funding and services was made clear to the members of the Health and Community Care Committee by the many individuals who gave evidence. A simplified, equitable and transparent system based on assessed need was called for. The committee recognised that that could not be achieved overnight and that significant work would be needed. The commitment to undertake that work was given by the Executive yesterday.
I quote the Executive's response to the committee:
"We agree with the Royal Commission that greater equity should be achieved in charging for care and that existing anomalies should be addressed. We committed ourselves to start by ending the anomaly whereby nursing care was charged for in some settings, but not others. We made clear our determination to adopt an approach which was person centred and based on need. The report of the Chief Nursing Officer's group on free nursing care makes detailed proposals for a move to a single needs assessment for each individual requiring care. The proposed approach is person centred and recognises that different individuals have different levels of needs, often resulting in a complex mix of care needs which do not fit neatly into boxes."
As a member of the Health and Community Care Committee, I recall the collective desire of those who gave evidence to ensure equity, the individuality and dignity of our older people and that appropriate services should be provided for them. I believe that we have embarked on doing that and I commend Richard Simpson's amendment.
I will begin by doing two things I thought I never would. The first is to praise the Liberal Democrats for making a stand on principle—they deserve a degree of credit for that. I ask them to resist Richard Simpson's overtures on returning to the fold. I must tell Margaret Smith that a rough wooing might be the way to describe it. Today could be a defining moment for the Parliament; I hope it will be. After this debate and after the motion is, I hope, passed, the fight must continue within the coalition. The issue will not be resolved today and we have no assurance from the Executive.
Secondly, I will come to the defence of the Minister for Health and Community Care—for once. It is unfortunate that she has been left carrying the can for the debacle. Henry McLeish is the person who told us, in all but the detail, that he was going to go down this road. It was Henry McLeish who engaged in the cruel flirtation with Scotland's elderly yet, in an act of unparalleled cowardice, fled the field and left the minister to pick up the pieces. Surely the role of the Minister for Health and Community Care is to fight against that—she should be arguing the case within the Government.
Will the member give way?
No.
The minister did not do much to her credit when she told us why she would not give us a principled commitment to free personal care. She said that she would not give an open commitment until she had worked out the details of implementation. What has been happening in the two years since Sutherland was published? That was the time for the reviews and thoughts on implementation. That was the point at which the minister should have been taking forward not just the points that the Executive has been praised for—
Will the member give way?
No.
Two years on, the minister should know why we should progress and how it should be done. We know that the Executive displays a stubborn refusal to listen to civic Scotland. Dr Simpson told us that that is Opposition carping. I suggest that when the British Medical Association, Scottish Care, Help the Aged, the Royal College of Nursing and Age Concern Scotland come together to say that they are hugely disappointed with the package—Maureen O'Neill from Age Concern Scotland described yesterday's announcement as the worst of both worlds—it is not Opposition carping, but the genuine concern of the Scottish community.
We know about the arrogant dismissal of the conclusions of the Scottish Parliament's Health and Community Care Committee. There was unanimous agreement—including Malcolm Chisholm, who is now the Deputy Minister for Health and Community Care—that there should be universal free personal care. That position included Richard Simpson, who, today, has conveniently forgotten that. We know that the situation puts Malcolm Chisholm in a difficult position. However, if the committee or the Parliament and its structures mean anything to Susan Deacon, she must listen to the unanimous, cross-party view.
We do not know where we go from here. Last night, on "Newsnight Scotland", Malcolm Chisholm was asked several times what would happen if—or, indeed, when—the SNP motion was passed. What will be the Executive's response to the majority of the Parliament saying that we believe that personal care should be free? Will that view be resisted or accepted by the Executive? I would be happy to give way to the minister now, if she would clarify that point. I see that she intends to remain seated.
There has been much talk about a constitutional crisis and what will happen to the coalition. I do not care what happens to the coalition and whether it stays together or breaks down. I care about the will of the Parliament being ignored. If the unanimous view of the majority of members is that personal care should be free and the Executive decides to ignore the Parliament, it will set an astoundingly dangerous precedent.
The Parliament is not here for the Executive or the parties of the politicians—it is here for the people of Scotland. Yesterday's announcement let those people down. Today we have an unrivalled opportunity to put the record straight and to say, as a country and as a Parliament, that we believe in universal free personal care. When the Scottish Parliament says that, the Executive had better listen.
Let us be clear about one thing: this morning's debate goes much further than the rights and wrongs of the full implementation of the Sutherland report. Surely that argument is finished. Every member of the Parliament is personally committed to Sutherland and only the Labour component of the coalition is dragging its heels on the subject. The arguments in support of full implementation are compelling and have been articulated well by many members. Everyone has accepted those arguments. I draw the Parliament's attention to the report of the Health and Community Care Committee, which recommended full implementation and to which Malcolm Chisholm—then a member of the committee—signed up quite happily.
The issue is not now about care and compassion for the elderly—to which I know we are all committed; the issue is the personal credibility of the First Minister. In interview after interview, news feature after news feature, report after report and in replies to parliamentary questions, the First Minister implied strongly that Sutherland would be implemented in full and in the near future. Now, the hopes of many elderly people and their relatives have been dashed because Henry McLeish cannot deliver.
When such things happen, one must wonder about the relationship between the Executive and the Westminster Parliament. Like Duncan Hamilton, I have a scintilla of sympathy for Susan Deacon. Over the past few weeks, her statements have been much more circumspect than have those of Henry McLeish. Her caution was clearly well founded. If the minister feels some inhibition and embarrassment in having to explain the situation to organisations such as Age Concern Scotland, she would be entitled to feel that she has been sold the hospital pass and left without a prayer by the First Minister.
However, any sympathy for Susan Deacon is dispelled by the fact that she is part of an Administration that has spun mercilessly over recent weeks and has built up the hopes of thousands of vulnerable people in Scotland, only to dash them at the last minute. Labour, and Henry McLeish in particular, has been left without a shred of credibility in the matter. It is clear that Mr McLeish has been unable to carry Treasury ministers at Westminster with him in what he was seeking to do. That speaks volumes about his credibility at Westminster as well.
It is clear that the implementation of Sutherland has a cost. The Conservatives would not pretend that such issues have anything other than the most far-reaching consequences for the future of health spending provision. The Conservative party prides itself on a fairly hard-headed approach to financial issues. We thought long and hard about how the Sutherland proposals could be funded and supported and came to the inescapable conclusion that we could no longer be party to a system where prudence is penalised. We recognised the agony being suffered by many elderly people and their relatives. In common with the Scottish National Party, the Liberal Democrats, the Scottish Socialist Party and the Green Party, we recognised that such injustices had to be remedied and that the proposals should be implemented in full, immediately.
Is it not the ultimate irony that the first crisis that the Executive and the Scottish Parliament faces as a result of the devolution settlement should arise not out of the activities of the SNP, which is committed to independence, but because Gordon Brown refuses to put his money where Henry McLeish's mouth is?
The minister said that she is glad to have today's debate. I am not particularly glad that we are having the debate and I am not glad to speak in it. I am not glad about it because the debate should and need not have happened. It could easily have been avoided if the First Minister—unfortunately, he is not here—had had the courage of his convictions. This, as we all know, is the Scottish Parliament and the Executive is—in Mr McLeish's words—the Scottish Government. It is time that everyone, particularly the Scottish Government, acted on behalf of the Scottish people.
I am convener of a cross-party group on the elderly. In that role, I have met numerous groups across Scotland and the topic that is raised most often is the Sutherland report and its implementation in full. I see that Malcolm Chisholm has turned to speak to one of his colleagues. Perhaps he should be listening, given that he was the former joint convener of the cross-party group. Clearly he is not listening, just as he did not listen to most of the people who spoke to him at the cross-party group.
I would like to mention a couple of people who were involved in the cross-party talks with Malcolm Chisholm and me: Phyllis Herriot and John Wilson of the Scottish Pensioners Association. Those people, among others, came to our cross-party group in the faith that we would listen to them and perhaps put forward their concerns and those of the pensioners whom they represent. Those people have been let down by the Labour part of the Scottish Government. Malcolm Chisholm should think about that.
On several occasions, Henry McLeish made announcements to the newspapers about the implementation of the Sutherland report. He gave hope to such people, who took the time to visit us. He gave them hope and then snatched it away.
I will give Age Concern Scotland's comment: the world is divided into two sorts of people—those who care and those who do not; those who have had to deal with the difficulties of arranging and paying for the care of older people and those who think that old age and its attendant difficulties are nothing to do with them.
Tony Blair has indicated that the Government seems to believe that the majority of the electorate are in the latter category. Let us not allow the Scottish Government to be in the latter category.
There are still two members who wish to speak. I can accommodate them both, if they will be brief.
I join those who paid tribute to the minister for the progress that we have made so far, which is welcome.
On the basic issue, let me give the analogy that we are walking in the same direction, but the terminus of our walk is free personal care. Getting there might take some time, and we might have to wander round a few hills and glens, but we must get there. There is all the difference in the world between stating that our commitment is to get there and saying that various groups will examine the issue and something might happen.
The key point is that on a fundamental issue, the minister and some of her party—perhaps the whole of her party, although I do not believe that—believe one thing. If they do so in good conscience, there is nothing wrong with that—the majority in the Parliament believes something different. We have to have a mechanism so that the Parliament's will prevails. That means that the ministers must take account of the views of Parliament. They cannot just sail on as if nothing has happened at all.
I know that it is difficult for people who have been brought up in the Labour party tradition to accept losing votes. I have spent my whole life losing votes. I have probably lost more votes than anyone in recorded history, having been in two councils for many years. It does not mean that someone is bad or wrong if they lose a vote—I have been consistently right and lost all the votes—but in this case, the Executive has to accept that the majority of the Parliament, coming from different angles but doing so conscientiously and based on good information, such as that from all-party committees and that contained in the Sutherland report, believes that something should happen, so something must happen. It does not mean that the Minister for Health and Community Care has to run up the white flag and say, "I abjectly surrender", but the policy of the Executive must be modified significantly to meet the majority wish of the Parliament. If it is not modified, there will be serious trouble, and I will do my best to create it.
I promise to be right beside Donald Gorrie when he does his best to create trouble. I add my weight, which is shrinking fast, to that.
I shall address only two points of principle, because I do not pretend to be an expert on the matter, and I defer to many of the Labour members who have spoken, with whom I have a disagreement today, because in this area they have expertise that I do not share. However, we once did share a belief in the principle of the universality of benefits and services so that people do not fall through the cracks. I urge those Labour members who still share that belief to realise that the tremendous advances that the Minister for Health and Community Care outlined with regard to needs and care assessments, and the amalgamation of different styles of caring, can be accomplished while achieving the aim of universality.
We have a sophisticated taxation system now, which can be used in a way that previous generations could not do to achieve the dream of universality and equality. I urge the minister to accept the principle of universality of service provision. The people whom the Minister for Health and Community Care reckons can afford to pay and should not be supplied with free services—unlike those whom she wishes to target with means-testing—will still be caught in the net of income tax. There is a way to achieve the principles that are being espoused in the chamber, while achieving what the minister is trying to do in the Executive, or Government.
Briefly, I will mention the other principle, because that is the one on which I think Jenkins will want to intervene.
The second principle is that which Donald Gorrie spoke about. There is no use in having a Parliament if it does not speak for the people. We know what the people say. I urge everyone to listen to them, but I will listen first to Jenkins.
We all agree that we are approaching the debate from the correct angle, but I worry that we are in danger of sending out a message to old people that they will never, ever have to sell their house to look after themselves in their old age. If we are talking about spin and unrealistic expectations, we must ensure that that is not one of those expectations.
I call Margo MacDonald.
I do not mind if other members speak.
Please close, Ms MacDonald.
Right.
I am sorry that I cannot guess from this distance what my colleague Christine Grahame might have said. She might have wanted to say, "Ian, we're nowhere near that yet." We are nowhere near the spin on and the interpretation of the outcome of the debate. We are still trying genuinely to debate the issue.
The debate revolves round two principles: long-term care, and the status and effectiveness of the Parliament in meeting the aspirations of people in Scotland.
I thank John Swinney for making available some of the SNP's time to debate a motion from the Liberal Democrats. In view of yesterday's statement, it was important that the Parliament had a chance to make its views known.
Richard Simpson has lodged an amendment, which Duncan Hamilton rightly described as rough wooing. The level of support for Richard's amendment was shown by Margaret Jamieson's supporting speech, which she made through gritted teeth, to say the least.
Richard Simpson talked about demographics and about where the line is drawn between the state's responsibilities and those of the elderly pensioner. Sir Stewart Sutherland dealt with that in his report and described the demographic issue as a red herring. He drew the line between state support and the responsibility of the individual, by ensuring that hotel and living costs remained the individual's responsibility. The line is drawn. Richard Simpson's last point was that the Liberal Democrats were pandering to the Opposition. Richard is pandering to London, and that is the problem.
I recognise that the Minister for Health and Community Care and the Executive have gone a long way in delivering Sir Stewart Sutherland's recommendations. Yesterday's announcement took us slightly further along that road, but not the full distance. Why was the Minister for Health and Community Care unwilling to take that last step? She talks about dancing on the head of a pin. It is she who is dancing on the head of a pin. We agree with everything in the statement—it is what was not in the statement that we disagree with.
We all know the First Minister's position. After the previous debate on long-term care, when pressure from Labour and Liberal Democrat MSPs kept the door open, Henry McLeish started to walk through the door. In the media, we have been led to believe that the decision was a done deal. Why? Given the cross-party support for that deal and the unanimous backing of the cross-party Health and Community Care Committee for Sir Stewart Sutherland, why on earth did the First Minister raise expectations to such a level, only for the Minister for Health and Community Care to dash them completely yesterday? We must ask that question. I hope that the minister answers it.
The debate boils down to one simple question—are the minister and rest of the Executive willing to accept the will of Parliament and the wishes of the Scottish people, or will they ignore them? I ask the minister to recognise that—as Keith Raffan pointed out—this is not Westminster. No party here has a majority in its own right. The minister must recognise that, if the Parliament expresses the view that Sutherland should be implemented, that is precisely what must happen.
It is clear from the speeches in the debate today that a majority in the Parliament supports the implementation of the Sutherland recommendation of free personal care.
I take pleasure from the fact that, back in September, we were the first party in the Parliament to introduce a motion and a debate on the matter, and I welcome the support that we received then from the Scottish National Party and a few Liberal Democrat members. I also welcome the fact that the majority of Liberal Democrats appear to have changed their position on the matter and are supporting Nicola Sturgeon's motion on behalf of the SNP. That is a very generous sentiment.
Will the member give way?
I am sorry, but I have only a few minutes.
The only missing link in the Parliament is the Scottish Executive, although we know that there are many in the Labour group who do not support the Executive's position. Not so long ago, one of them wrote:
"It is equitable that individuals should pay for their own personal living costs wherever their place of residence, but have personal care and nursing care costs met out of taxation. It is what the current generation of older Scots had expected in paying their tax and National Insurance over a working lifetime."
That was Dr Richard Simpson in Holyrood magazine in September last year. It is not the Dr Richard Simpson whose intemperate speech—highly uncharacteristic of him—was delivered in the chamber this morning. If this is the major breakthrough that he claims—and that the minister claimed in her statement yesterday—I ask him, on the basis of his experience, how many of the 8,000 people in residential care in Scotland will benefit from it. What dent will be made in that tally by the minister's announcements yesterday?
Dr Simpson spoke about renationalisation of health care—that is absolute nonsense. As he well knows, since the inception under his party of the national health service in 1948, people have had to pay for personal, nursing and living costs in residential and nursing homes. People are living longer, so what has changed is the scale of the problem, which must have more resources devoted to it. To talk about renationalisation of health care is complete and utter nonsense.
Will the member give way?
I am sorry, but I have only a few minutes.
As Nicola Sturgeon said, we know that the issue is not one of affordability. The money is effectively there. It is a tiny fraction of the total health budget, and less than last year's underspend in the Scottish health budget, which was £135 million. It is less than lumberjack McConnell filched from the health budget last year for Scotland's trees and to pay for the landscaping of the Scottish Parliament building.
Will the member give way?
No.
Let us not pretend that lack of money is the problem. Why is the recommendation not being implemented? One explanation that has been advanced is that Mr McLeish and the rest of the Executive wanted to go ahead, but were blocked by the Prime Minister and his emissaries. It is all to do with control from London by Labour.
It may well be a matter of internal party management. There may be internal party reasons, bound up in the Westminster Government and the Labour general election campaign. However, there is another explanation. Keith Raffan asked why the minister is so stubborn. The fact is that there is a body of opinion within the Labour party in Scotland, led by Susan Deacon, which is implacably opposed to the principle of free personal care. That body of opinion is stubborn because it regards the 8,000 people in residential homes in Scotland as wealthy, and it does not intend to devote any additional resources to them.
As Christine Grahame and Bill Aitken said, I do not call someone living in a £30,000 former council house rich or wealthy; such a person does not regard themselves as rich or wealthy. It is an issue of fairness. Those people have paid into the national health service throughout their working lives. Now, in their hour of need, they feel that they have earned the right to be looked after. As Bill Aitken said, their prudence should not be penalised.
It is quite clear from the contributions to today's debate and from the way it has gone over the past six months that the Labour Scottish Executive has lost the argument. Susan Deacon has lost the argument, so why does not she quit while she is behind, accept the terms of the motion and act on it?
Nicola Sturgeon and Margaret Smith referred to my previous views. I am happy to refer the whole chamber to the speech that I made on 28 September, when I said that free personal care was a priority, but so was the expansion of home care and respite care and the ending of delayed discharges, so that everyone can get appropriate care wherever they happen to be. That is the big picture that Margaret Jamieson was referring to.
While he is reminding us of what he said in the chamber, perhaps the minister could also comment on what he said when he was a member of the Health and Community Care Committee:
"Ultimately, we should not change what we think because of what the Executive thinks".—[Official Report, Health and Community Care Committee, 6 September 2000; c 1148.]
What has changed for him since then?
I have just told members that nothing has changed. The considerable resources that we have put into services for older people must meet all those priorities. I remind members of the £100 million announced by Susan Deacon on 5 October 2000 and of her commitment yesterday to make additional resources for older people a top priority in future. We are determined to move forward on a broad front, increasing the quantity of services, improving the quality of services, dealing with the systems issues and addressing equity of charging. Mary Scanlon referred to the Health and Community Care Committee. There was substantial agreement between the Executive and committee members, particularly on systems issues.
It is not only today's issues that are relevant to charging. I remind members that, on 5 October 2000, we said that we would try to address unevenness of charging across Scotland, and we will take a reserved power to ensure that that happens. Today, however, we are focusing on Sir Stewart Sutherland's recommendation on personal care. The important point to make is that we have started a process that will push forward the boundary between what is free and what is to be paid for. We cannot define the precise end point, but I remind members of the Alzheimer Scotland—Action on Dementia press release that said that there had been a major breakthrough. I also tell George Lyon that what is proposed is certainly not a London solution, because the journey that we are going on is quite different from the journey south of the border.
When he was a member of the Health and Community Care Committee, Malcolm Chisholm supported the committee's call for free personal care. Now that he is a minister, he is against that call. Will his constituents in Edinburgh North and Leith understand his position?
I have already dealt with my views, all of which are on the record. I cannot spend any more time on that issue, although I should remind Bill Aitken that I left the Health and Community Care Committee on 1 November.
One of the tasks of the development group, as Dr Simpson's amendment states, is
"to consider the practicalities, costs and implications of providing free personal care".
I thank Keith Raffan for supporting that objective. The development group is not a review group, but a group focused on action and implementation over a short time scale.
Why is it taking two years? The Sutherland report will be two years old in March. Why has it taken the Executive two years to set up a development group?
On 5 October, we announced our response to the report and we are now pushing it forward. We have had two excellent announcements for older people, one yesterday and one on 5 October.
I appeal to the Liberal Democrats to support the process that we have started and to have confidence in the group. They may not be reassured by my chairing it, although I hope that they are, but perhaps they will be reassured by the presence on the group of Mary Marshall, who is the director of the dementia services centre at the University of Stirling and who was a member of the royal commission. Perhaps they will also be reassured by the words of Sir Stewart Sutherland, who has not taken the attitude of some Opposition members, but is willing to work with that group. It would be entirely consistent with what the Liberal Democrats said in their Scottish Parliament manifesto and in their new manifesto for the UK general election for them to support the group and to support Richard Simpson's amendment.
Will the member give way?
I think that I am out of time. Is that right, Presiding Officer?
You are indeed. You must close now.
Okay.
First, my amendment is basically a tidying-up amendment. I do not think that the SNP will disagree with it in any way, as it merely seeks to state a fact, which is that of the six political parties represented in the Parliament, five are committed to a definite time scale for the implementation of free, universal personal care.
It has been pointed out that the debate is about the elderly citizens of Scotland. I read in the Evening Times last night the comments of one Bill McVey, who may be known to some of the Glasgow members, as he is chair of the Glasgow elderly forum. He is a 77-year-old activist, if that is not a contradiction in terms—he has a lot of energy; he is a war veteran. Bill said of the whole debate:
"We are the generation who gave everything, now the politicians want to take everything."
That type of comment reflects the point of view of the likes of Bill McVey and tens of thousands of senior citizens the length and breadth of Scotland, who are asking the Parliament to make a firm commitment today to implementing universal free care. No one today has attacked what the Executive has announced. No one has undermined in any way what the Executive has brought forward; what we are attacking is what it has not brought forward.
Let us be absolutely clear about the time scale. In March 1998, the Sutherland commission was established. It had until March 1999 to give its one-year report. The minister commented on the report in October. Let us be clear: the minister gave a very honest assessment of the Executive's response to Sutherland. She ruled out at that stage the implementation of free universal care. The majority of members, certainly those from the Opposition parties, opposed the minister's position when she made her statement.
Would Tommy Sheridan care to examine the Official Report and the detailed written response that was made at that time? I said that we agree with the principle of equity upon which the recommendation is based, but that we believe that to implement it at this time, when so many wider needs exist, would not be right. Our discussion of the subject and any progress on it has been based, as Malcolm Chisholm said, on asking how we can make progress, while ensuring that we meet other priorities and do all the other things with which all members in the chamber also agree.
The minister will accept that she talked the language of priorities. As far as she was concerned, this particular recommendation of Sutherland's 24 recommendations was not a priority. We had the debate. We had the fall-out. We had the argument. There was a lot of disappointment across Scotland. The problem is that the First Minister then intervened. That is what changed the whole debate. The First Minister entered the debate and raised the prospect—the hope—of the decision being changed. Unfortunately, from November right up until now, he dillied, he dallied and he dazzled. Ultimately, he has failed to deliver. In fact, the Minister for Health and Community Care has been consistent throughout the debate. The problem is that the Parliament's expectations have been raised, only to be dashed by the First Minister.
As a socialist, I disagree with the Sutherland recommendations, because they argue for the retention of means-testing in relation to living and housing costs. As a socialist, I believe that we should tax people directly, so that when they need personal or health service care, they get it free at the point of need. I disagree with retaining an element of means-testing. However, Sutherland did argue for the removal of means-testing in relation to personal care. What the Minister for Health and Community Care is failing to do today is to announce that that is what the Executive will do and then deliver the resources to achieve it.
It is a failure of the Government to say, as the minister said this morning, that it cannot make that announcement because it does not think that it has the ability to deliver on it. Is not that what government is about? Make the announcement today, name the date when it will be implemented and then ensure that the resources are available to deliver universal free care for our elderly.
This has been a good debate, and I hope that it ends up being a defining moment for the Parliament. As many members have said, it is about the will of the majority of the Parliament prevailing on an issue that is of huge importance to tens of thousands of people throughout Scotland, and their families. If there is to be a defining moment, I want it to be about such an important issue.
The SNP welcomes the steps that have been taken to improve the delivery of community care in Scotland. Time and again, when the minister has made an announcement that will improve the lives of elderly people in Scotland, we have said that we welcome it.
This is not a choice between what the minister has announced and what is in the SNP's motion; they are not mutually exclusive. Members—including Margaret Smith—have said time and again that this is about completing the last part of the jigsaw.
If this is about dancing on the head of a pin, as Susan Deacon claimed, why all the fuss? It is an awful lot of fuss about a very small pin.
The more the minister refuses to accept the will of the Parliament, the more stubborn for its own sake she is seen to be, because her arguments against full implementation have become weaker and weaker in every debate that we have had on the issue. The case that has been made by all members cannot be opposed rationally by Susan Deacon or Malcolm Chisholm; they have lost the argument, so it is time to accept the consequences and do the right thing.
To be fair, Susan Deacon has remained consistently opposed to full implementation, unlike her leader, who has given clear signals in support of full implementation over the past few weeks. At least that has given us the opportunity today to finish the debate once and for all, by accepting the majority will of Parliament fully to implement Sutherland and to get on with the job of doing so.
Susan Deacon implied that that would be a dangerous road, as services might not be in place to cope with the consequences of free personal care. That could be solved easily, by today setting a defined and clear time scale during which the necessary services could be established and put in place. There is no problem. We do not need another review; we need an unequivocal statement from the minister that she will commit herself to full implementation within a clear time scale. Nothing less than that will do. We do not want any more of the delay that Christine Grahame mentioned—three and a half years have passed so far. We do not want to wait another six months or another year; we want the statement now.
If the SNP motion is passed today, we will expect Susan Deacon to come back with a timetable for the full implementation of Sutherland. That is what we will expect and we will settle for nothing less.
Can we do this? Yes, we can. Clear evidence has been given about affordability.
I draw Shona Robison's attention to my amendment, which requires the development—not review—group
"to consider the practicalities, costs and implications of providing free personal care for all and to report by August 2001".
That is the absolute intention behind the development group.
In that case, why has the minister time and again refused to commit herself to the full implementation of Sutherland? That refusal clearly indicates to the Parliament that she does not intend to go through with full implementation unless the Parliament's will prevails and she is forced to do so.
Will the member give way?
I want to continue.
Affordability is not an issue. The last piece of the jigsaw is estimated to cost about £25 million. Henry McLeish has said:
"We will be spending approximately £55 billion every three years. Is anyone really suggesting that, with the teachers and with the Sutherland report, that is money that cannot be made available out of our budget?"
If Henry McLeish does not seem to think so, I will take his word for it. We should be able to find the £25 million without any great difficulty.
At the beginning of the debate, Nicola Sturgeon supported the home care package that Susan Deacon announced in October. Does she understand that the £25 million for free personal care would be diverted from the funding for the home care package?
That is a rather misleading statement.
I do not believe that Sir Stewart Sutherland was misleading the Parliament when he stated that the final piece of the jigsaw would cost £25 million. Most members would accept that Sir Stewart knows what he is talking about.
I will briefly refer to the amendment in the name of Richard Simpson, who either drew—or was given—the short straw. When I became a member of the Health and Community Care Committee, I was aware that a great deal of work had been done on the Sutherland report and the issue of long-term care, and I commend the committee on that work. However, when the committee reached the view that the Sutherland recommendations should be implemented in full, Richard Simpson did not want his dissent minuted, nor did he produce a minority report. Why has he now lodged an amendment that runs counter to the conclusions of the committee's report? I find his behaviour extremely disappointing.
I hope that this will be the Parliament's finest hour. As George Lyon said, although no party has a majority in its own right in the Parliament, the majority of the Parliament wants to do the right thing for the tens of thousands of elderly people and their families throughout Scotland. Today, they are waiting to see what the Parliament will do—I do not think that they will be disappointed.
On a point of order, Presiding Officer. I am not clear whether Malcolm Chisholm was replying to the debate on behalf of the Executive or on behalf of Richard Simpson and his amendment.
Malcolm Chisholm replied on behalf of the Executive; no one replied on behalf of Richard Simpson and his amendment.