in the second session of the fifty-third parliament of the united kingdom of great britain and northern ireland commencing on the thirteenth day of june in the fiftieth year of the reign of
HER MAJESTY QUEEN ELIZABETH II
VOLUME DCXLVI SIXTH VOLUME OF SESSION 200203 House of Lords
Baroness Barker: My Lords, I thank the Minister for that Answer. Will the Department of Health also revise the NHS nursing-care guidance to ensure that both it and the guidance on continuing care are compliant with the Coughlan judgment and that older people are not subject to what the ombudsman repeatedly and unequivocally called "injustice"?
Baroness Greengross: My Lords, I take into account what the Minister has said. Does he agree that, because of the impact the Community Care (Delayed Discharges etc.) Bill and the ombudsman's findings, there could be a greater role for the NHS in arranging and funding the care of people who have left acute hospitals?
Lord Hunt of Kings Heath: My Lords, I am not sure that I follow that argument. As I have indicated, we will review the guidance, but that which has consistently been given to the health service is, in my view, clear about eligibility criteria for continuing care. The issue raised by the ombudsman is whether some NHS authorities have acted in accordance with that guidance. It is therefore far too early to say that the NHS might in future fund more continuing care cases. However, the ombudsman's report makes clear that the whole assessment and delayed discharge procedure needs to be sharpened up, and that is what the delayed discharges Bill is all about.
Earl Howe: My Lords, but does the Minister not agree that, until there is clarity on continuing NHS care and a patient's eligibility for it, it will be impossible to implement the provisions of the Community Care (Delayed Discharges etc.) Bill with the level of effectiveness for which the Government are clearly hoping?
Lord Hunt of Kings Heath: My Lords, I do not agree because I believe that the issue which arises from the ombudsman's report is not so much about the guidance that has been given to the health service, which follows from the Coughlan judgment, as about the way in which certain NHS bodies have implemented that guidance.
Annex C of the current 2001 guidance clearly sets out the considerations which NHS authorities need to take into account. Of course we shall look again at the guidance in the light of the ombudsman's report, but it does not follow that there ought to be a major problem in the way in which it operates at local level if NHS authorities follow the guidance that has been set down.
Baroness Chalker of Wallasey: My Lords, will the Minister agree to look carefully at the interface of social services, which I pointed out to him last week, when under the guidance it is not found possible to continue NHS care but when someone continues to need nursing care outside the NHS? I believe that that interface in the guidance is still wrong and I hope that the Minister will take it into account in formulating the eventual legislation.
Lord Hunt of Kings Heath: My Lords, as I said in our debate last week, it is most important to ensure that people do not fall between any gap in the responsibilities of the NHS and of local authorities. I believe that the delayed discharges Bill, by encouraging both the NHS and local government to improve their assessment and delayed discharge procedures, alongside improvements in intermediate care, will tackle the issue raised by the noble Baroness.
Lord Lloyd of Berwick: My Lords, in thanking the Minister for that Answer, I must express a certain degree of disappointment. The Minister will, I am sure, confirm that the restoration of the West Pier is a matter of some
Lord McIntosh of Haringey: My Lords, the noble Lord says there is no valid objection. Unfortunately, the Harbours Act 1964, which is a very outdated piece of legislation, says that an inquiry must be held unless the objection is trivial or frivolous. It does not use the word "vexatious", which we use nowadays. There are those who think that the objection is vexatious, but I do not think it could be said to be trivial or frivolous. So we are stuck with the Harbours Act until something can be done to replace it.
Lord Dholakia: My Lords, I spent many of my student days in Brighton, and the piers were a great attraction. When I write my autobiography, it will be called "From Pier to Peer". With the West Pier falling to pieces and Palace Pier having recently caught fire, the structures have a very nostalgic value. Can the Government do anything to assist in preserving something which is so precious to our seaside?
Lord McIntosh of Haringey: My Lords, I agree entirely with the noble and learned Lord, Lord Lloyd, and the noble Lord, Lord Dholakia. We very much want both piers to be in full working order. For that reason, the Heritage Lottery Fund has already paid out £1.7 million for emergency work on the West Pier, and £14 million or more is set aside for restoration work once all the procedures have gone through. But we are, as I said, stuck with an outdated piece of legislationthe Harbours Act 1964which says that there must be a public inquiry if there is any objection, unless that objection is trivial or frivolous, and we do not think it is. There are two other routes: first, the Bill of my noble friend Lord Berkeley would bring the Harbours Act up to date. Secondly, there is the possibility of a regulatory reform order, which would depend on a marine consents review that my noble friend Lord Rooker is undertaking. If that can be brought forward, the situation will improve. But neither would be retrospectivethey could not apply to Brighton West Pier.
Lord Lloyd of Berwick: My Lords, does the Minister realise that while all this is going on, the pier is collapsing, and that unless something is done very soon, there will be nothing to restore? It is obviously for the Minister to decide, but it can be done on the basis that the only objection was based on a planning point, which has now gone. Therefore, the remaining objection, in so far as there is one, is trivial or vexatious, or any other word you care to use.
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