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Baroness Wharton: My Lords, I, too, support this amendment. Once again, the noble Baroness, Lady Hollis, has very clearly outlined all the awful problems that face couples should one partner need to go into long-term care.

At the weekend, I read that at least one local authority in the Midlands is charging residents in its homes interest on bills that they cannot pay until the cash is raised from the sale of their property. They are able to clock up interest immediately if the resident agrees to a charge on his or her home. I understand that if the resident refuses to agree, then of course the local authority cannot charge interest. I do not know whether that is true, but it is quite frightening. After all, we all grow old; and perhaps many of us will end up in long-term care, unable to look after ourselves.

From what I can see, residential homes in London cost upwards of £400 a week. Modest savers, even with pensions, could not possibly find that sort of money for care and have anything like enough left over for the spouse who is left in the family home. Most people have paid tax all their working lives. Under this system their modest savings could quite easily disappear, not within years but within months. Quite honestly, having talked to many people, that is hardly an incentive to save for old age. With the best will in the world, and even with an extremely good pension, I do not see how people could possibly save enough to pay that sort of money for residential care.

I read an article in one newspaper today which stated that some £15 million is given by the Government for AIDS related research and only £1.5 million for dementia and Alzheimer's. Some half-a-million people suffer from Alzheimer's. So far the disease mainly affects the elderly. It is unfashionable, is it not, but I feel that somehow there ought to be some redress in the balance: an enormous sum goes in one direction and such a pitiful amount in another. The more research that we do into the disease, the less chance there is that many of us might end up in long-term care, facing the problems that the noble Baroness has already outlined. Along with others in this House, I hope that the whole subject will be looked at again sympathetically.

Lord Mackay of Ardbrecknish: My Lords, this amendment seeks to address an issue that we discussed at length both in Committee and at Report stage. Indeed, at Report stage we decided upon the matter in a Division. The issue is how the position of the spouse left at home can be adequately safeguarded when the other spouse has an occupational pension and is admitted to residential accommodation.

The earlier amendment sought to specify how the pension should be allocated between the spouses in those circumstances. The amendment now before us tackles the issue from the other end. It seeks to specify how the local authority should meet the needs of the spouse at home in calculating the personal requirements of a spouse in residential care for the purpose of assessing his or her liability for charges.

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I appreciate that in drafting the current amendment the noble Baroness has sought to meet some of the concerns expressed in our earlier debates. Nevertheless, our view remains that amending legislation to address this particular issue is neither necessary nor desirable. Replacing the current discretionary arrangements by statutory prescription would introduce an unwelcome element of inflexibility and, in my view, would not achieve the objective of certainty which the noble Baroness indicated she wants. Moreover, by addressing in isolation one detailed aspect of the charging system for residential accommodation it could well create anomalies elsewhere.

Under the present discretionary arrangement, the guidance says that,


    "it would be reasonable for the local authority to take into account factors such as"—

I stress the following words—


    "the usual standard of living of the spouse at home, and if the spouse has higher than average outgoings, for whatever reason".

Again, those last three words "for whatever reason" are worthy of note. The guidance goes on to state that,


    "the weight to be attached to these considerations will be for the authority themselves to determine".

The noble Baroness's amendment, on the other hand, is far more prescriptive and far less flexible. It would require the local authority in calculating the resident's personal requirements to have regard to the needs of the spouse at home and to his or her usual standard of living. The phrase "have regard to" sounds on the face of it innocuous enough, although I can see the prospect of a legal argument about precisely what the authority would be required to do to discharge its responsibility in that regard. What about needs? How would they be defined for this purpose? Would they cover "higher than average outgoings", as the guidance suggests? If so, what sort of outgoings? How would the resources of the spouse at home—if they have capital, for example—be treated? What would be the relationship between the requirement to have regard to need, on the one hand, and the requirement to have regard to the usual standard of living, on the other. I can envisage cases in which applying the latter requirement could produce anomalies and patently unacceptable results.

The noble Baroness may say that these matters can safely be left undefined, given that all that the local authority has to do is have regard to these matters. I doubt whether in reality things would turn out quite like that. Once the provisions are set in statute, the scope for argument as to how precisely each of those expressions should be interpreted is potentially considerable.

There is a more specific problem with the amendment. Unlike the present discretionary arrangement, it covers only occupational pensions. I imagine it does that because the noble Baroness knew that she could only cover occupational pensions to get within the scope of the Bill. But, as the Department of Health guidance recognises, similar situations can arise—though much less often, I fully accept—where the resident is the sole recipient of a couple's income which is not an occupational pension. It is also true, as the noble Baroness, Lady Wharton, reminded the House, that there are some problems that have been raised on

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the question of capital, especially if the capital is in the form of a house. To introduce a measure confined solely to occupational pensions into the National Assistance Act, as this amendment does—the National Assistance Act is a wide-ranging Act and provides for all adults, not just pensioners—could be regarded as not only inappropriate but also unfair and discriminatory.

As I said the last time we debated this matter, I recognise that there is a real issue here. I am still waiting on specific cases where, if I may put it bluntly and quickly, the local authority has taken all the pension and told the spouse at home to go along to the benefits office and claim income support. Certainly, I should be very interested to see cases like that.

I am trying to be as reasonable as I can but the noble Baroness produced her usual sob song for local authorities. It always amazes me how the first thing a local authority cuts or threatens to cut, as local authorities do year after year when they get their support grant statement, is home helps. They never look at any of the other things. They always promise huge increases in council tax. Certainly in Scotland, it never transpires that way. By some miracle they always manage to be a long way short of their original fears. But still I am amazed—it is something I have noticed over 15 years, I think—that local authorities are always saying that they must cut home helps. It is not for them to cut out some of the glossy pamphlets and leaflets that I and other noble Lords receive in the post on subjects which are not directly the responsibility of local government but are much more politically motivated, at least in Scotland—the amazing nuclear free zone committees which take up time, expense and manpower in order to pursue an objective which has long since been abandoned, even by the Labour Party. I am always amazed at how local authorities manage to attack the home help system whenever they are asked to live within their budgets and be reasonable.

I do not want to go too far down that path, although the noble Baroness has tempted me greatly in that regard. I do want to say to her, as I have said before—I hope that she will accept that I am genuine on this matter—that I gave a clear, unequivocal commitment to the House at Report and Committee stages that I would pass on to my right honourable friend the Secretary of State for Health the points that have been made. She is indeed considering these issues; the one directly in front of us from the noble Baroness, Lady Hollis, and other issues related to that particular age group, and the question of residential care. She is considering them. I believe that that consideration should to be in the context of the overall structure of the arrangements for charging for residential care. To seek to introduce separate statutory provision to deal with that issue in isolation would, I believe, be ill considered.

On that basis—certainly once again I shall talk to my noble friend Lady Cumberlege and bring the points that have been made to the attention of my right honourable friend the Secretary of State for Health—and saying once again that I would be very interested to receive some documented evidence that local authorities have indeed behaved in the way I suggested earlier. I hope that the noble Baroness will feel able to withdraw her

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amendment, having put it to the test on the last occasion. If she does not, because she believes that some people did not quite get here in time on the last occasion, I hope that my noble friends will support me in the Lobby.


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