Personal Care at Home Bill

My Lords, I speak very briefly to support the noble Lord, Lord Low, in all that he has said about service user involvement. He has cited various good, technical reasons why his amendment should receive sympathetic treatment from the Minister, but what troubles me about the Government’s policy for rolling out free personal care to the elderly is the prescriptive feel of the policy. It has a kind of "take what you’re given" feel. As such, I cannot help feeling that it cuts across the trend towards greater personalisation in social care, on which—to be fair to the Government—there has been a lot of encouraging progress in recent years. Before you can get free care, you have to tick a whole series of boxes, at the end of which you are either entitled to the service on offer or you are not. By contrast, the premise of the personal budget is the exact opposite: it starts from the position of saying that service users should have choice and control over what they buy to meet their care needs. The policy will also, I think, serve to disincentivise people from engaging in prevention programmes before serious health problems set in. If people are led to believe that they do not have to worry much about looking after themselves should their physical condition deteriorate, they may well be less motivated and less fully engaged in trying to stay healthy. Involving service users and their carers in decisions about the type of care that is appropriate and necessary is absolutely essential. I hope the Minister will find a way of ensuring that, at the very least, the guidance to local authorities on the issue makes this point clear.