Community Care (Delayed Discharges etc.) Bill—
Amendments to be debated in the House of Lordscontinued

House of Lords

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Clause 4

 

THE LORD HUNT OF KINGS HEATH

35Page 4, line 12, leave out subsection (1) and insert—
"(1)  This section applies where notice of a patient's case under section 2 and notice of the proposed discharge day under section (Duties of responsible NHS body after notice under section 2)(3) have both been given (and are in force)."
36Page 4, line 17, leave out subsections (2) and (3)
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

37Page 4, line 18, after "day" insert ", which shall not be a Saturday, Sunday or public holiday,"
38Page 4, line 20, at end insert—
"(c)  the day when a dispute is resolved over whether or not a qualifying hospital patient should be discharged from NHS care or whether the community care services to be made available to a qualifying hospital patient under subsection 3(3)(b) are appropriate."
 

THE LORD SMITH OF LEIGH

38A*Page 4, line 20, at end insert—
"(   )  the day when—
(i)  any issues arising from any disputed application by the NHS body of continuing care and nursing care criteria have been resolved, and
(ii)  any reimbursement due to any party following the resolution of the disputed issues in paragraph (i) has been made."
 

THE EARL HOWE
THE BARONESS NOAKES

39Page 4, line 24, at end insert "excluding Saturdays, Sundays and public holidays"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

40Page 4, line 25, at beginning insert "Subject to subsection (4A),"
41Page 4, line 32, at end insert—
"(4A)  The payment due under subsection (4) may be reduced (as prescribed in regulations) by up to 100 per cent where it has not been possible to discharge the patient because the responsible NHS body has been unable to make available a relevant health and community care service as agreed in the aftercare plan."
 

THE LORD HUNT OF KINGS HEATH

42Page 5, line 8, at end insert—
"(   )  The references in subsections (5) and (7) to services "decided under" section 3(3)(b) or (4)(b) are, in a case where the decision in question has been altered under section 3(6C), to any services specified in the altered decision."
43Page 5, line 14, leave out paragraph (c)
44Page 5, line 24, leave out subsections (9) and (10)
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

45Page 5, line 24, leave out subsection (9) and insert—
"(   )  Any payment which a relevant NHS body or relevant social services authority is required to make under this section shall be made to a fund, which shall be held and jointly administered by the Primary Care Trusts and relevant social services authority in each area.
(   )  Expenditure from this fund shall be agreed jointly by the Primary Care Trusts and social services authority in each area to provide any of the services made available under Schedule (Assessment by responsible authority)."
 

THE EARL HOWE
THE BARONESS NOAKES

46Page 5, line 28, at end insert—
"(   )  This section shall not come into force until 30 days after the Secretary of State has determined that the system of incentives within relevant NHS bodies operates to discourage NHS bodies from discharging patients prematurely."
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

47Page 5, line 28, at end insert—
"(   )  A dispute shall be deemed to be resolved under subsection 4(2)(c) when an independent panel has completed a review of the case in question and made recommendations."
 

After Clause 4

 

THE LORD HUNT OF KINGS HEATH

48Insert the following new Clause—
  "Delayed discharge payments: supplementary
(1)  In prescribing an amount under section 4(4) the appropriate Minister must have regard (among other things) to either or both of the following matters—
(a)  costs to NHS bodies of providing accommodation and personal care to patients who are ready to be discharged; and
(b)  costs to social services authorities of providing community care services to, and services to carers in relation to, persons who have been discharged.
(2)  Any payment which the responsible authority is required to make under section 4 in relation to a qualifying hospital patient shall, subject to subsection (2), be made to the responsible NHS body.
(3)  In case of any description prescribed in regulations the payment shall be made to the person prescribed in relation to cases of that description."
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

49Insert the following new Clause—
  "Pilot schemes
  The Secretary of State or the Assembly may by order establish pilot schemes for the operation of this Part in selected areas."
 

Clause 6

 

THE LORD HUNT OF KINGS HEATH

50Page 5, line 41, leave out subsections (1) and (2) and insert—
"(1)  Regulations may make provision for panels appointed by Strategic Health Authorities in England and by Local Health Boards in Wales to assist in the resolution of disputes between two or more public authorities about matters arising under or in relation to this Part.
(2)  The persons forming a panel for the purpose of a particular dispute must be appointed by a Strategic Health Authority or Local Health Board from lists of persons required by the regulations to be kept by the Authority or Board.
(2A)  The regulations must contain such provision as the appropriate Minister considers appropriate for ensuring that each social services authority situated (or any part of whose area is situated) in the area of a Strategic Health Authority or a Local Health Board is consulted about the persons whose names appear on any list kept by the Authority or Board for the purposes of subsection (2).
(2B)  The regulations may make provision about the panels, including in particular—
(a)  provision for determining who is to appoint a panel in the case of a dispute between public authorities which are not all situated in the area of a single Strategic Health Authority or Local Health Board;
(b)  provision specifying the descriptions of disputes which may be referred to a panel;
(c)  provision about the recommendations (including recommendations relating to the payment of any amount by one party to another) which may be made by a panel in relation to any dispute referred to it."
 

THE EARL HOWE
THE BARONESS NOAKES

51Page 5, line 41, after "Authority" insert "and local authority"
52Page 5, line 42, after "Board" insert "and local authority"
53Page 6, line 3, after "panel" insert "(which, if so established, shall be independent of the parties in dispute and comprised equally of representatives from a Strategic Health Authority and local authority, with a wholly independent chairman)"
54Page 6, line 7, at end insert—
"(   )  Any regulations made covering the matters referred to in subsection (2) shall include provisions requiring the panel in the case of any dispute to take into account the views of the patient and his carer, if any, or to satisfy itself that the views of the patient or his carer would have no bearing on the panel's findings."
 

THE LORD HUNT OF KINGS HEATH

55Page 6, line 10, leave out "established" and insert "appointed"
 

Clause 8

 

THE LORD HUNT OF KINGS HEATH

56Page 6, line 36, at end insert "and different provision for different areas"
 

THE EARL HOWE
THE BARONESS NOAKES

57Page 6, line 42, at end insert—
"(   )  Any regulations made under this Part shall be drawn up in consultation with local government."
 

Clause 9

 

THE LORD HUNT OF KINGS HEATH

58*Page 7, line 2, at end insert—
 ""carer", in relation to a qualifying hospital patient, means a person who—
(a)  provides or intends to provide a substantial amount of care on a regular basis for the patient; and
(b)  is entitled to ask for an assessment under section 1 of the Carers and Disabled Children Act 2000 (c. 16);"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

59Page 7, line 8, at end insert—
 ""pilot scheme" shall mean a pilot scheme conducted under Clause (Pilot schemes) above"
 

THE LORD HUNT OF KINGS HEATH

60Page 7, line 10, at end insert—
 ""the relevant day" has the meaning given in section (Duties of responsible NHS body following notice under section 2)(6)"
 

Clause 12

 

THE EARL HOWE
THE BARONESS NOAKES

61Page 8, line 41, at end insert—
"(   )  Any regulations made under this section shall be drawn up in consultation with local government."
 

Clause 13

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

62Leave out Clause 13 and insert the following new Clause—
  "Free provision of services in Wales (No. 2)
  The Assembly may by regulations made by statutory instrument require that any community care services provided by local authorities in Wales, in discharging any statutory function, may be provided free of charge to the person to whom they are provided."
 

Clause 14

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

63Page 9, line 25, at end insert—
"(   )  In section 7 of the Health and Social Care Act 2001 (c. 15) (function of overview and scrutiny committees), after subsection (2) there is inserted—
    "(2A)  The overview and scrutiny committee shall agree and adopt with local NHS bodies in their area, joint local protocols as regards the discharge of hospital patients, to include—
    (a)  action plans to prevent and reduce delayed discharges,
    (b)  administrative and practical arrangements for the implementation of the Community Care (Delayed Discharges etc.) Act 2003, defining the roles and responsibilities of all parties,
    (c)  local targets for reducing delayed discharges,
    (d)  joint administrative arrangements for the local implementation of the duties in sections 2 to 5 of the Community Care (Delayed Discharges etc.) Act,
    (e)  named persons responsible for co-ordinating all stages of the patient journey up to and beyond discharge, and ensuring that all necessary arrangements are put in place at the right time,
    (f)  joint agreement on how payments made under section 4 of the Community Care (Delayed Discharges etc.) Act are used to encourage an inter-disciplinary approach to services for older people, and to ensure that all stakeholders are involved in deciding how the payments are spent.
(2)  An action plan under this section is a document drawn up by the relevant bodies specifying the action intended to reduce delayed discharges, and to change procedures and arrangements which may cause or contribute to the failure to comply with duties under section 3 of the Community Care (Delayed Discharges etc.) Act.""
 

Clause 17

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

64Page 10, line 4, after "shall" insert "not"
65Page 10, line 4, after "force" insert "until pilot schemes have been carried out for at least a six month period.
(   )  After the end of the period mentioned in subsection (2), Part 1 shall come into force"
66Page 10, line 6, at end insert—
"(2A)  Part 1 shall only come into effect following publication of an evaluation by the Audit Commission of a pilot scheme conducted under section (Pilot schemes) above.
(2B)  The publication of the evaluation under subsection (2A) above shall not take place earlier than 1st April 2004."
 

After Clause 17

 

THE EARL HOWE
THE BARONESS NOAKES

67Insert the following new Clause—
  "Duration
(1)  Subject to subsection (2), Part 1 of this Act shall cease to have effect at the end of five years beginning with the date on which it comes into force.
(2)  If the Secretary of State is satisfied that it is necessary for social services authorities to continue making payments in cases where the discharge of patients is delayed for reasons relating to the provision of community care services or services for carers, he may make an order providing that Part 1 of this Act shall continue in force for a further five years.
(3)  An order may not be made under subsection (2) unless a draft of that order has been laid before, and approved by resolution of, both Houses of Parliament."

 
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©Parliamentary copyright 2003
10 March 2003