Health and Social Care Bill

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Mr. Hutton: I am grateful to the hon. Member for New Forest, West for the way in which he moved his amendment. That will allow me to reassure both him and the Committee not only about the reasons for making the changes, but also about the manner in which we will implement them.

It has been widely recognised, by the royal commission and many others, including our own constituents, that the preserved rights scheme is a source of serious difficulties for many people in our country. First and foremost, it restricts a person's choice of accommodation to part III accommodation. For younger disabled people in particular, that is an unnecessary restriction. There are other ways, and other care settings, in which care can reasonably be provided. The preserved rights scheme does not allow that choice to be made.

There are also serious problems about the shortfall between the residential care that the preserved rights income support provides and the rate at which those care services are being challenged. That is causing serious difficulties for many thousands of people, particularly the elderly, who are experiencing real distress as a result.

The changes are being made for the right reasons. We are making the system better for people in long-term care, and we will not introduce those changes in a way that will disrupt the continuity and pattern of the provision of care for the elderly or for younger disabled people who currently receive the preserved rights income support. I understand why the hon. Gentleman has tabled the amendment, and I share his concern to ensure that people who are affected by the ending of the preserved rights scheme should be given as much information as possible about the impact of the change.

The hon. Gentleman courteously acknowledged that we have consulted extensively about the proposal and have tried all along to make sure that people understand what we are doing. We try to respond to the concerns that many people naturally feel if the pattern of funding for their residential care is altered. We have worked closely with the Department of Social Security to ensure a smooth transition to the new system. The DSS plans to notify people with preserved rights to benefits of the reasons for the change to their benefit payments, and to explain the local authority's involvement in, and future responsibility for, their care needs. The DSS plans to do that well in advance of the changes taking place.

Clause 49 allows for an approach to be made by local authorities to the people affected before the change takes place. That means that we shall expect local authorities to undertake care and financial assessments in many cases before the appointed date. As a result, a considerable number of people affected by the change will have had some personal contact with the local authority before the change takes place, and should be fully informed about how it will affect them.

In addition, we intend to issue guidance to local authorities to address the issue of how to prepare for the changes. The guidance will make clear to the local authorities their responsibility for ensuring that they provide an explanation about the impact of the change to those affected by it. I share the hon. Gentleman's concern, but hope that he will recognise that there is no need to regulate and that the point of concern, and issue of principle, that he has raised, are fully accepted by us. We intend to make sure that the changes operate smoothly and fairly.

Mr. Swayne: In view of the Minister's reassurance, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Amendments made:

No. 267, in page 44, leave out lines 28 and 29.

No. 268, in page 44, line 34, at end insert

    ` ``the responsible authority'' shall be construed in accordance with subsection (2).'.—[Mr. Hutton.]

Clause 49, as amended, ordered to stand part of the Bill.

Clause 50

Preserved rights: disclosure of information

Amendments made:

No. 269, in page 44, line 35, leave out

    `This section applies to any person in relevant premises who'

and insert

    `For the purposes of this section a ``claimant'' is—

    (a) (in relation to any time before the appointed day) a person who is ordinarily resident in relevant premises and'.

No. 270, in page 44, line 37, at end insert

    `, or

    (b) (in relation to any later time) a person who fell within paragraph (a) immediately before that day.'.

No. 271, in page 44, line 40, leave out

    `person to whom this section applies' and insert `claimant'.

No. 272, in page 44, line 42, leave out

    `purposes connected with the performance of functions under section 49'

and insert `qualifying purposes'.

No. 273, in page 44, line 45, at end insert—

    `(2A) Where information relating to a claimant is supplied to any authority or person (``the recipient'') in accordance with subsection (2), the information may be supplied by the recipient, for qualifying purposes—

    (a) to any local authority appearing to the recipient to be providing the claimant with community care services with respect to his accommodation; or

    (b) to any person providing services to, or authorised to exercise functions of, any such local authority.

    (2B) In subsections (2) and (2A) ``qualifying purposes'', in relation to information relating to a claimant, means—

    (a) purposes connected with the performance of functions under section 49 in relation to the claimant, or

    (b) other purposes connected with the termination of his preserved right in consequence of section 51(1), or

    (c) (in subsection (2)) any further supply of the information under subsection (2A).'.

No. 274, in page 45, line 2, after `(2)', insert `or (2A)'.

No. 275, in page 45, line 11, at beginning insert ```the appointed day'','.—[Mr. Hutton.]

Clause 50, as amended, ordered to stand part of the Bill.

Clause 51 ordered to stand part of the Bill.

Clause 52

Disregarding of resources when determining need for residential accommodation

Mr. Burstow: I beg to move amendment No. 293, in page 45, line 34, after `person', insert—

    ( ) a local authority shall not consider care and attention to be otherwise available if the person is not willing or not able to make their own arrangements and there is no one else both willing and able to do so on their behalf; and

    ( )'.

The amendment aims to ensure that everyone who needs residential or nursing care in a residential setting has access to an assessment of his or her needs and can, if desired, avail himself or herself of the services of the local authority in negotiating a contract with the care home provider. The evidence that has been gathered in studies such as the Nuffield Foundation's report on capital offences and the Office of Fair Trading's 1998 report, ``Older People as Consumers in Care Homes'', shows that those with assets of more than £16,000, or in future probably £18,000 are being denied an assessment of their care needs, an appropriate package and an appropriate placement with the support of the local authority.

That has nothing to do with who pays, but everything to do with ensuring that the appropriate standard of care is provided and that everyone has access to a social services assessment of their needs. The amendment is reasonable, and I hope that if the Minister cannot accept its precise words, he can accept its spirit. I hope that he can give us some assurances that everyone is entitled to an assessment, regardless means, and that everyone is entitled to ask for support from a local authority to secure a contract for a placement in an appropriate care setting to meet those needs.

Mr. Hutton: As the hon. Gentleman will be aware, councils are under a legal duty under the National Health Service and Community Care Act 1990 to assess the care needs of anyone who, in their view, may be in need of community care services. The law currently provides that where a person needs residential accommodation and care and attention are not otherwise available the local authority shall provide it. A person's ability to provide for himself is a relevant factor in determining whether to provide residential accommodation. Moreover, everyone should be advised about the type of care that he or she requires and informed about what services are available.

I hope the hon. Gentleman will be reassured by the fact that councils may not refuse to undertake an assessment of care needs on the grounds that people have financial resources sufficient to meet the costs of their care or have care and attention otherwise available to them. The hon. Gentleman has raised an important point. The Department is seized of the issue. I do not know whether he was or still is a member of his local authority.

Mr. Burstow indicated assent.

Mr. Hutton: He is still a member of his authority. He may recall that in 1998 the Department issued circular 98/19 to all local authorities reminding them of their existing legal duty to make arrangements for residential accommodation for people who cannot make care arrangements themselves and who have no one to make them on their behalf. The law is quite clear on that and provides that where a person needs residential accommodation, and care and attention is not otherwise available, the local authority shall provide it. The ability of a person to provide for himself is a relevant factor to take into account in determining whether to provide residential accommodation.

The Department has also reiterated that councils may not refuse to undertake an assessment of care needs for anyone on the grounds of the person's own financial resources. That is the position under section 47 of the National Health Service and Community Care Act 1990, which imposes an obligation to assess needs for services that a local authority is empowered to provide, where people should be advised about the type of care they require and informed about what services are available. With the greatest respect, I sympathise with the point the hon. Gentleman is making but ask him to withdraw his amendment.

9.15 pm

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