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Lord Swinfen: That is what I understand the amendment does, which is why I was puzzled when it was moved. I agree with the amendment, as I understand it. It provides, I understand, that the recipient of community care can elect to have part of his care provided in the form of grant and then he buys that care for himself. However, if he wishes to do so he can retain that care from the local authority if the local authority is the only provider of that particular kind of care in the area or if the recipient of community care deems that the local authority is the best provider. I believe that that is right. Let the individual recipient decide how best he wants those services and control his care himself.

Baroness Hollis of Heigham: There appears to be some misunderstanding and if I have contributed to that I apologise to the Committee. I was trying to make the point that the amendment is not about the privatisation of care by putting it through the cash mechanism. It is about choice. It is about putting the disabled person at the centre of the choice mechanism.

Clearly, as the Minister made clear on Second Reading, it was always open to a disabled person in negotiation with his social worker to go for a mix of direct payments and services from the local authority. That has not been in dispute; that mixture applies. However, it may be that the client wishes to use his direct payments to purchase services from the local authority.

There is a difference between my reading of what the Bill intends and what the noble Lord, Lord Jenkin, appears to believe it intends. I believe that, if the individual client is purchasing services with direct payments, whether from the local authority or from any other private body, that individual client remains at the centre of the care system. He decides who, how, when and in what way even though he is purchasing from the local authority. That is not the case and cannot be the case when he is simply the recipient of services. If he is the recipient of services he must fit the local authority pattern of managing that care.

The question and the real issue is whether we are empowering the disabled person. Yes, we hope to do so. Do we unnecessarily limit the choice of that disabled person as regards the supplier from whom he can purchase his services? Unless we accept the amendment, I fear that we may do. That is why I hope the Minister will feel able to support it.

Lord Jenkin of Roding: Does the noble Baroness not recognise the logic of what she was saying? It is that the local authority can perfectly well provide precisely the service that the individual wants but is prepared to do so only if there is a financial nexus. That is a pretty strange proposition to put forward. Either it can or it cannot. If it can, it should, and, if it cannot, the service ought to be bought outside anyway. I do not see the

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point of having the right to buy the service from the local authority. It is a double handling of money and will add to the cost.

Baroness Hollis of Heigham: Why is the noble Lord so reluctant to allow the disabled person to make that choice?

Lord Jenkin of Roding: I am not.

6.15 p.m.

Baroness Cumberlege: Perhaps I may put the Government's view. We do not believe that the amendment is necessary because the Bill already allows people to receive a combination of direct payments and local authority arranged services, as my noble friend Lord Jenkin said.

Under subsection (1), the local authority may make payments to someone in relation to any of the services for which it has decided his needs call. That leaves open the possibility that it may provide direct payments in relation to some but not all of the services which the individual needs.

Under Clause 2, the local authority retains the responsibility to arrange services except where the individual's needs are met through the arrangements that he has made using direct payments. It follows that, where the local authority provides direct payments in lieu of some but not all of the services which it has assessed an individual as needing, it has the duty to arrange the direct provision of the remainder. I hope that that clarifies the situation.

Baroness Hollis of Heigham: I am not entirely sure that it has met all the points that we have raised. We shall wish to study the Minister's reply and perhaps return to the matter. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

The Deputy of Chairman of Committees: I should tell the Committee that, if Amendment No. 21 is agreed to, I cannot call Amendments Nos. 22 to 24 inclusive.

Lord Carter moved Amendment No. 21:


Page 1, line 24, leave out subsection (4) and insert--
("( ) A payment under subsection (1) above shall not be exercisable in relation to the provision of residential accommodation except for such temporary care for respite purposes as is determined by the local authority, and only at the request of the direct payments user.").

The noble Lord said: Amendment No. 21 deals with the question of respite care. It is intended to tease out the point of whether direct payments can be used for the respite care of either the recipient or the carer and, if so, under what circumstances. I have looked at the consultation paper quickly because I received it only today, and I do not believe that that is mentioned at all.

There is a four-week limit to residential accommodation in the consultation document. We are not entirely clear what the situation is in regard to respite care. We know that the concept and practice of direct payments came from disabled people who were looking for an alternative to either full-time residential

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or part-time respite care. We know that personal assistants enable disabled people to remain in their homes and give their partners or informal carers the opportunity to leave the home for employment or recreation. We have received comments from people who say how much they appreciate the direct relationship that this permits and that residential care obviously produces a number of problems.

The Government have said in consultation that they will limit the amount allowed to be spent to four weeks in any 12 months. How does that apply to respite care that the recipient wants to use over and above the four weeks? Can it apply to the carer? How does all of this fit in to the Government's wish to see use made of the payment? Will it be met by other aspects of the Community Care (Direct Payments) Bill, or will it have to be dealt with only through the particular avenue of direct payments? I beg to move.

Lord Swinfen: It is essential that an element of respite care should be provided under the terms of the Bill in order to allow those who are normally caring for the individual to have a holiday, for their unpaid relatives who will be helping also to have a break and possibly even to allow the disabled person to have a break from his or her relatives who are providing that care. We all need breaks every now and again. Where there is a large team of carers, it will be very much more expensive to recruit a completely new team to cover the periods when the normal carers are on holiday or when family and friends who are doing unpaid work are away. It will probably be cheaper, more effective and efficient to provide respite care than to ignore it altogether. This may well be something that is required in an emergency where full-time carers suddenly become ill or relatives have to go into hospital. These are matters that cannot be foreseen but we should be prepared to deal with them.

Baroness Cumberlege: As I understand this amendment, it seeks to write on the face of the Bill the principle that I have said will guide regulations made under subsection (4). I have explained previously that this provision is intended to exclude the use of direct payments to pay for long-term residential care but to leave open the possibility that they may be used for temporary care for respite. This is an area in which we consider it desirable to lay down national parameters because this is a new untried development. The regulations will be adjusted to keep them sensibly aligned with social security regulations. This is one of the specific questions that is asked in the consultation document in the box at the top of page 10:


    "Q. Do you agree that the maximum period for which direct payments may be used to pay for residential accommodation should be four weeks in any twelve month period? Q. If not, do you think the maximum should be shorter or longer? What would you propose instead? Why?"

We believe that this is a matter that needs national debate.

Lord Carter: I am extremely grateful to the Minister for her helpful reply. If the consultation reveals that there is overwhelming evidence to support an eight-week limit on respite care in any 12 months, for

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example, will the Government be prepared to listen? They have chosen a four-week period, but are they prepared to listen to other suggestions? I see that the Minister agrees.

This has been a short but helpful debate. It was not entirely clear from a reading of the consultation document exactly how the two points about permanent and temporary residential care marched together. I believe that I now see what the Government are driving at. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Lord Pearson of Rannoch moved Amendment No. 22:


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