Health and Social Care Bill

moved Amendment No. 30: 30: Clause 4, page 3, line 6, at end insert— ““( ) the assessment of social care needs under the National Health Service and Community Care Act 1990 (c. 19);”” The noble Baroness said: The amendment to some extent carries on the argument that was being tested with the previous set of amendments in that it would introduce into Clause 4 the assessment of social care needs as a regulated activity. The noble Lord, Lord Warner, made the case that it is not possible to come to an informed judgment about the quality of service provision if one does not know what the commissioning process has shown up. Equally in social care, it is impossible to come to a judgment about the quality of services if one does not know the needs of the population. As I said at Second Reading, the assessment of social care needs is problematic. The right to have one’s needs assessed is one of the few rights that people who need social care have. They do not have entitlement to receive services in the way in which people who require health services do, but they have a right to an assessment. That assessment should indicate to them what their needs are and how those needs should be addressed. Increasingly, those needs are met not by local authorities but by the individuals themselves. Indeed, as individual budgets are rolled out, those needs will increasingly be met by other arrangements. What form an assessment should take is the subject of an interesting debate in the social care field. In relation to learning disabilities and adult social care, there is a growing belief that there should be only self-assessment. However, for other groups, most notably older people, there is a strong and informed body of opinion that assistance or the right to an independent assessment is an important part of the process of ensuring that people get what they require. At Second Reading, I mentioned my concerns that a number of local authorities are starting to abandon the assessment process or, more likely, are engaged in the absolute minimum of assessment, with a process that consists of an initial question, ““Do you have £21,000 or other capital?””. If the answer is yes, you are handed a list of approved suppliers. That is increasingly what is happening. I do not believe that that is an adequate way in which to determine the needs of individuals. Moreover, I believe that it is damaging in the longer term, as it means that our overall understanding of social care needs across populations is decreased. I believe, therefore, that there is a case to be made for ensuring that assessment of needs is a regulated service. Amendment No. 31 is slightly different. Noble Lords will have worked out that it is a probing amendment. Clause 4(3) states that the CQC will be responsible for addressing, "““the supply of staff who are to provide … care””." I am intrigued by the word ““supply””. The supply of staff within the NHS is a subject about which noble Lords know a great deal. We have discussed it endlessly in the past two years as the debacle of MTAS has unfolded. I do not wish to spend a great deal of time focusing on NHS staff, not least because we have had the recent proposals of the Tooke report for an NHS board for medical education in England and the changes to the Postgraduate Medical Education and Training Board and the GMC. How do the Government believe that the CQC will be in a position to address the issue of supply of social care staff if it is not responsible for the assessment of social care need at the same time? It is an incomplete proposal that would leave members of the CQC shooting in the dark. That is the thrust of these amendments. I beg to move.