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Baroness Carnegy of Lour: Perhaps I may suggest that noble Lords cut short the discussion on the amendment. It proposes a purpose clause. Such clauses have their uses, but they should at least amplify the Long Title of a Bill. I do not believe that this purpose clause does so, for starters. Subsection (c), which refers to extending prescribing rights, says less than the Long Title, as does subsection (f). Subsection (e), which the noble Lord, Lord Morris, seeks to amend, talks about something that does not even feature in the Bill.
The noble Lord, Lord Clement-Jones, has made all this in order by grouping it with Amendment No. 260, which proposes that there should be free nursing care. I suggest that it is quite wrong to discuss this in isolation from all the other amendments, many of which are most important and very much to the point; and, indeed, to which I believe the Government will listen. I do not know how recently he discussed the matter of free personal care with his Scottish colleagues in the Scots Parliament. However, I met a few of them last night and I gather that the whole matter is up in the air because no one knows who will pay for it. I do not honestly believe that we should spend much time on the matter. I personally could not support the amendment. I do not know what my noble friend, or the Government, will do in this respect. I think that we should move on.
Lord Lipsey: I am tempted to follow the noble Baroness because we have many more detailed amendments to the Government's proposals on which we could more profitably spend the bulk of our time. I shall not detain the Committee for long. The noble Lord, Lord Clement-Jones, made his case, and I believe that we should consider briefly one or two arguments on the other side.
The noble Lord gave the game away to quite a considerable extent right at the beginning of his remarks. He began by saying that you get your bathing free in a hospital, but that if you are in a home you may have to pay for it if you are better off. That is quite true. It is also true that you get your food free in a hospital, while you do not get it free in a residential home: you have to pay for it, if you are well off enough to be able to afford to do so.
However, the noble Lord, is not proposing that food should be free in residential homes; just personal care. Whatever solution you come to, wherever you draw the line when you look at the difference between what is paid for and what is free, you will find that there are anomalies. There simply is not a clear-cut guillotine which makes clear what should be one side of it and what should be the other. We shall pursue a chimera if we try to find such a dividing line. We should judge these matters on their merits.
New Members of this Chamber may be astonished to discover that they often hear the same speeches four times: on Second Reading, in Committee, on Report and on Third Reading. One can hear the same speeches six times on this issue because we had a pre-run round the course on the debate initiated by the noble Lord, Lord Ashley, on 17th January. We shall have two "goes" at discussing issues surrounding the provision of free personal care.
I do not want to repeat my Second Reading Speech when I argued--I did not hear the noble Lord, Lord Clement-Jones, refute this--that the cost of free personal care (which is already very high at more than £1.2 billion even on the wholly inadequate calculation of the Royal Commission) will go up not by five times, as estimated by the majority of members of the Royal Commission, but by between 12 and 20 times by the middle of the next century. Free personal care would be the cuckoo in the nest and if we provided it, we would have to sacrifice services to older people--care assistants, care homes, clothes and the care provided to keep people in their own homes. Those items would be sacrificed to pay for services for the most well-off 25 per cent of the population. I do not want to go over that argument again.
I wish to address three points to those on the crowded Benches opposite who have clearly decided to adopt this issue as the kernel of their election appeal. My first point is a kind of constitutional point. Really big spending is a matter for the other place according to the rules of privilege. We are talking about a huge expenditure commitment. I would find it strange if this Chamber felt that it could override the judgment of elected Members. The other place was in favour of free nursing care but not in favour of free personal care.
Secondly, it is terribly important that we do not delay the Bill. There is a large number of amendments. We had a debate on Second Reading when points were made about the broad question we are discussing. However, there is much detail to be discussed on the issue of free nursing care. If the Bill is lost because we examine it for too long, the consequences will be serious as the provision of free nursing care is
Thirdly, I hope that the noble Lord, Lord Clement-Jones, the noble Baroness, Lady Barker, and my many friends on the Liberal Democrat Benches who know that I am close to them on many issues will accept my next point. I spend much of my life campaigning for electoral reform. It is a great cause but not much loved by many on this side of the Chamber. Why is it that it is always so difficult to persuade the Prime Minister to go the full hog on that? He thinks that the Liberal Democrats are decent people. If they would have me, I sometimes think that I should like to join them; they are so decent.
However, at the end of the day, the Liberal Democrat Party is not serious as it will not face up to the kind of decisions that have to be taken in government regarding how scarce resources are best deployed for the maximum good. That is the fundamental issue here. If money grew on trees--as the majority of the members of the Royal Commission seemed to think that it did--of course it would be acceptable to provide free personal care. However, money does not grow on trees but has to be raised painfully from taxpayers. One has to take painful decisions as regards allocating it between competing priorities such as education, health, transport and the rest. To make a snap judgment to provide free personal care and let everything else go hang is to my mind not a serious approach to policy making and makes it difficult to achieve the truly plural politics that I should like to see.
Lord Beaumont of Whitley: On behalf of my party, I support the amendment and the amendment to the amendment, which I imagine is accepted by the noble Lord, Lord Clement-Jones. They should both be supported. The arguments which have been deployed against them are not effective. We are told that we should not override the Commons. There is a perfectly good procedure between the two Houses whereby we try to reach agreement. We have not yet reached the stage of trying to override the Commons. However, we are entitled to ask the Commons to think again. We have a perfectly worthwhile reason for asking the Commons to think again.
The argument which the noble Lord deployed as regards delaying the Bill does not hold water either. I have never considered that a good argument. It is used time and time again at various points of the parliamentary year or the parliamentary Session. As the noble Lord has just said, in the end what is wanted and what is necessary and what is right usually can be
Nor do I think the argument valid that the Liberal Democrat Party is not serious about these matters because it does not have to face up to allocating scarce resources. The Liberal Democrat Party, of which I used to be a member, has thought the matter through. It has established its priorities. I speak from experience of preparing for general elections on behalf of that party. If it is to include the measure in its election manifesto--as the other side of the Chamber seems to think that it will--no doubt it has already been costed extremely carefully. The party has faced up to priorities and has made a judgment. In my view, it is the right judgment and my party certainly will support it.
Lord Rix: My head having been chopped off by the guillotine of the noble Lord, Lord Lipsey, I hope that the Committee will forgive me if I take my head out of the basket, tuck it under my arm and support Amendments Nos. 1, 262 and 260.
I must confess that I have been outflanked. When I tabled my own amendment, I seemed likely to have the honour of firing the first shots over Clause 56. But the ingenuity of Amendments Nos. 1 and 260 let the noble Lord, Lord Clement-Jones, and the noble Baroness, Lady Barker, in first, followed closely by the noble Lord, Lord Morris of Manchester, with Amendment No. 2. But no doubt my time will come in due course!
The argument against a broad definition of personal care and exemption from charges, and matching that broad definition, is essentially one of cost and priorities. Less income from charges means greater cost for providing services, and costs incurred in one direction cannot, unless resources are increased accordingly, be incurred on other things. But we are not discussing whether the state rather than the individual should pay for very rich people, or even rich people, to have their flowers arranged or their nails manicured; we are talking about basic disability needs. I doubt whether anyone reading this draft clause (Amendment No. 260) would regard the services listed there as anything other than basic. As a civilised society, we ought to ensure that these basic services are free wherever they are provided and by whoever they are provided, including the care proposed by the noble Lord, Lord Morris of Manchester, in regard to supplementary medical practitioners.
I have no objection to people who are financially well off or reasonably well off being required to pay for board and lodging and the frills of care--all the grapes they wish to consume. But no one should be asked to pay for the disability care basics. On behalf of Mencap
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