Iain Duncan Smith – 2001 Speech on Care Homes

The speech made by Iain Duncan Smith, the then Leader of the Opposition, on 12 December 2001.

Thank you all for coming here today. Improving our public services is at the heart of my policy agenda, and improving the way in which we treat the sick and elderly is my personal priority.

It is becoming clearer with every day that Labour’s mismanagement of the NHS has plunged both the care of the elderly, and care homes in particular, into crisis.

It is clear to anyone with any common sense that a thriving care home sector is pivotal to the overall well-being of the health service. There are patients lying in hospital who are fit enough to be discharged, but remain in hospital solely because there is nowhere to discharge them to.

And why is this the case? Because under Labour, a combination of ineptitude and mismanagement has seen the closure of almost 50,000 care home beds since 1997. At any one time, over 6,000 hospital beds are occupied by patients whose discharge has been delayed. The Department of Health state that 680,000 patients have their discharges delayed every year.

That patients remain in hospital when they could – and should – be elsewhere means that they occupy, through no fault of their own, precious beds that would otherwise be given to patients requiring operations. No wonder the waiting lists remain stubbornly high: Not only is there a queue to get into hospital, but Labour have now brought us the queue to get out of the hospital.

It speaks volumes about their approach to health more generally. They will never deliver necessary reform because they have a deep-rooted antipathy towards private providers.

The Government seems unable to understand that the system of healthcare in this country needs reform.

They talk about working with the private sector, but here is an area in which there is a longstanding relationship between the public and private sectors, and the Government is making a mess of it.

Massive over-regulation, and a cavalier disregard for the basic economics of operating care homes, have seen care homes close at an alarming rate. Homes have faced financial ruin because of the extra costs imposed as a result of the Care Standards Act. Homes that cannot comply with the new regulations have had to close, and the number of available places will continue to diminish at an alarming rate. It is widely known that the costs of a place in a local authority home can be significantly higher than those in privately-run homes.

No wonder we have a situation where in some health trusts, such as Brent and Harrow or North & Mid Hampshire, over 18% of their beds are blocked.

Labour seem to have forgotten that ‘care’ is about treating people with the dignity to which they are naturally entitled, and not about quibbling over square inches and room sizes. The nature of a person’s care and treatment must be determined by their need, not by the administrative convenience of the Labour Party.

Labour’s only solution is to spend more money. But they will do so without reforming the system: indeed they will make it worse through constant interference from the centre. We will all pay more, but get less.

Health care in Britain, and long term care in particular, needs fresh thinking, and it is that fresh thinking that the Conservative Party is going to provide. The crisis in the care homes sector, and its implications for the care of the elderly generally, is one of our top priorities.

Unlike Labour, we are not bound by dogma, nor will we handcuff ourselves to a status quo which becomes daily more indefensible. We are free to find solutions which address the real problems people face, not the fantasy view of the NHS which ministers seem to have. We need solutions which deliver better care, not more problems.

I sincerely hope that by working with the experts gathered here today, we will be able to work together for the benefit of everyone who relies on the NHS and social services.