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Lord Lucas: Perhaps I may ask a couple of supplementary questions. I may have misunderstood but I do not believe the Minister addressed the questions raised on Amendments Nos. 91 and 92. Those amendments reverse the sense of the Bill as at present drafted and I do not see how that can be
Lord Hunt of Kings Heath: I am glad the noble Lord intervened. I was remiss in not responding to those specific points. In fact, I am sympathetic to those arguments and would like to take them away and give them further consideration.
Lord Lucas: My second question concerns a technical point--that may be a polite way of putting it. Clause 28(3)(b) gives the inspector power to inspect and take copies of any records. Subsection 3(c) adds,
Lord Hunt of Kings Heath: That is a very interesting point. The noble Lord will not be surprised if I say that I would rather reflect on that question. I shall either write to him or return to the issue on Report.
Earl Howe: Once again, we have had a useful short debate. I am grateful to the Minister for covering the ground so comprehensively. I am particularly grateful to him for saying that he will take away Amendment No. 90 to see whether there is merit in what I say.
I entirely understand that there will be strong arguments for inspectors making inspections of care homes and other establishments outside normal business hours. On reflection, I think that the wording of my amendment is slightly wide of the mark. Indeed, facing the combined fire power of the noble Baronesses, Lady Barker and Lady Pitkeathley, as well as facing the Minister, can only give me cause to reflect very carefully on the merits of that amendment.
Nevertheless, as the Minister said, there are sensitivities involved and I believe that there is a germ of an idea in that amendment which could perhaps be put into a different form. I should tell the Minister that there are two points of view on the matter. This was not an idea that came out of my own head; indeed, it was strongly suggested to me that there should be some kind of restriction on the rights of inspectors to march into a premises at any time of their choosing.
I am also a little disappointed that Amendment No. 97 did not find favour with the Minister. Its purpose was to ensure that inspectors would be obliged to produce identification under all circumstances. I am
Amendment No. 95 refers to conduct during interviews. This all depends on what one means by "an interview". My idea of an interview is where someone takes a person aside and says, "I would like to talk to you in private about this matter". It is not a casual conversation where you pick up information, as you may do when you go round a care home and converse with someone. That is not an interview; indeed, an interview is something much more formal. Nevertheless, the information from the Minister about the provisions of the Police and Criminal Evidence Act was very helpful. Those are the sorts of circumstances where the interview becomes, shall we say, difficult and confrontational and which could lead to criminal charges. That was my chief concern in drafting the amendment in this way. I am grateful to all Members of the Committee who contributed to this debate and beg leave to withdraw the amendment.
Lord Clement-Jones: I wish to speak to Amendments Nos. 102 and 103. My noble friend Lady Barker will speak to Amendment No. 104. I believe that Clause 30 is one of the measures in the Bill that causes great bafflement. We have been baffled on certain points but the provisions of Clause 30 in particular give rise to the
Amendments Nos. 102 and 103 are designed to include private establishments in the measure. It seems rather extraordinary, if, in a sense, they are subcontracting from a body which is not a public body, that domiciliary care establishments are not required to be registered. It seems to me that the boot should be on the other foot. If anything, there seems a greater requirement for registration in those cases than where bodies subcontract from an independent clinic or a private hospital.
I hope that the Minister will consider this issue carefully. I do not know the basis on which the clause has been formulated. I do not know whether some issue of resources has been taken into account, or what the motives are behind it. However, it seems rather peculiar and rather unnecessarily limited. I look forward to the Minister's response.
Baroness Barker: Amendment No. 104 needs to be considered in the context of Amendments Nos. 102 and 103. As my noble friend Lord Clement-Jones said, we support and would wish to see the extension of measures which will guarantee the quality of as many domiciliary care services as possible. The Committee may not need to be reminded that perhaps the greatest uncertainty among older people is experienced by those who arrange their own domiciliary care and who do not go through the route of the NHS or local authority bodies. That constitutes a huge problem.
Having said that, Amendment No. 104 may appear rather strange. The objective is to ask the Minister what will happen to existing, workable arrangements under the direct payments scheme with providers who are not, and will not be, registered. I do not want anyone to misinterpret this matter. Anyone who works with older people will realise that the quality and the safety of domiciliary care providers is perhaps one of the biggest issues of concern to older people who are becoming slightly frail and who live in their own homes. This is a probing amendment in relation to the direct payments scheme as it works at present.
Lord Hunt of Kings Heath: I am glad to have the opportunity to discuss with the Committee how the direct payments scheme fits into these arrangements. I believe that all Members of the Committee support the direct payment concept. The Committee will know that we are extending eligibility for direct payments to a greater range of people, including older people.
Let me begin by reassuring the Committee that Clause 30 applies only to local authorities and NHS bodies; it does not apply to persons purchasing their own domiciliary care, even if they are using direct payments to do so.
I should also take the opportunity to make it clear that the requirement to register will not extend to arrangements between individuals for the provision of domiciliary care. So if people in receipt of direct payments want to use them to pay another individual, for instance, to come to their house, to get them up in the morning and to wash and dress them, that would never be covered by the provisions in the Bill. Clause 4(3) defines a "domiciliary care agency" as,
With regard to the amendment relating to independent healthcare bodies, it is unlikely that independent healthcare providers will be purchasing domiciliary care services on behalf of their patients in the way that local authorities do on a routine basis. Certainly on that ground I see no necessity to extend Clause 30 to cover independent hospitals and clinics.
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