Personal Care at Home Bill

I wish to speak to my Amendment 13 in this group. The noble Lord, Lord Lipsey, talked about the criteria for social care and their tendency to lead to gaming. My response to that is: whatever criteria exist for social care or NHS continuing care, there will always be somebody who endeavours to get round them for good or for ill. The noble Baroness, Lady Murphy, set out in considerable detail quite a number of government policies surrounding community care. Every one of these policies has a direct effect on the care market in some way. My small and perhaps seemingly innocuous amendment is about the distortion that I think may happen and that is that the services which local authorities currently provide for people with moderate to high needs—which enable many thousands of people and their carers to carry on—will go in order to meet the demands of this Bill. Over the weekend noble Lords might have read about what is likely to happen in the Isle of Wight, where local authorities will simply no longer be able to provide a number of services which have been in place, including telecare and so on. At Second Reading I talked about the fact that back in the days before the NHS and social care were funded to the extent that they have been through this Government, the capacity of mangers mostly, but also frontline staff, in social care and the NHS to bat older people back and forth between them, in order to avoid having to pick up the costs of their medicines, adaptations or care, was considerable. That has not been the case for about the past 10 years, but when the NHS is looking down the back of the sofa for money and social care is ripping up the floorboards because it has already looked down the back of the sofa, it will happen again. Older people will find themselves being pushed between one and the other. At that point, what the law says is of utmost importance. I point noble Lords to the fact that the title of this clause is: "Free provision of personal care at home". It is not free provision of care to people living at home. There is a world of difference to a social services department that has no money between those two different phrases. Does care at home mean only care in a person’s home or does it mean care to a person who lives in their home? As the noble Baroness, Lady Murphy, said, how do you define a home that is eligible under this Bill? That may seem like utter pedantry but on it rests the fate of thousands of people. I want to draw to noble Lords’ attention the fact that there are thousands of older people who are unable to remain living at home because they and their carers use services in their locality but not in their homes. We need to take into account the collateral damage to services provided in the community to people who have substantial, high-care needs that keep all the older people in an area—and their carers—going. They are at risk if we are not absolutely clear about the definition. Does the Bill refer only to services in a person’s home, or services provided to them as they live at home in order to keep them living at home? It may be pedantry, but it is of the upmost importance in these matters.