Health Bill [HL]

I start by putting firmly on the record that the Government are committed to the NHS as a service based on clinical need and not the ability to pay—and the new NHS Constitution, as we debated last Monday, enshrines that principle. Our position is clear on the general question of patients wishing to pay for additional private care. As noble Lords are aware, we debated the Richards review and the Government's response to it. Similarly, we have made it clear that personal budgets and the direct payments that we will be piloting may not be used as part payment for privately funded healthcare. I know that noble Lords will wholeheartedly agree that there must be no question of creating a two-tier system where those who can afford it can buy a better standard of NHS care. However, we know that there have been concerns about a specific question relating to NHS continuing healthcare patients who want to make a contribution towards the "hotel" costs of their accommodation. From the perspective of the patient, those costs may not appear to be part of the core clinical package of NHS care, so I agree with the noble Baroness that there can be confusion among patients about whether they are allowed to pay for them. The issue was raised during the consultation on our draft guidance on secondary care and we are currently considering consultation responses. I understand that it can be a particular concern for people who transfer into NHS continuing healthcare from the social care system, where a third party or, in some circumstances, the social care user may previously have been able to pay additional amounts towards their accommodation. Our principles are clear; no one has the right to pay for a different level of NHS care. However, I recognise that there may be a need to clarify the position on the very narrow question of "hotel" costs.