Personal Care at Home Bill

Amendments 11 and 15 in the names of my noble friends Lord Warner and Lord Lipsey and the noble Baroness, Lady Murphy, focus on the discretion of local authorities in providing personal care at home. Before I come to the specific amendments, some of which are, of course, against the spirit of the Bill’s principles, I say to noble Lords that we recognise that, when determining people’s care needs, local authorities are best placed to judge what is appropriate in their own situations, depending on their clients and on the availability of services. However, we want to move towards greater consistency of care provision and, as noble Lords know, we will soon have a White Paper. We believe—I know that my noble friend Lord Lipsey disagrees with this—that this is a stepping stone towards greater consistency of care provision. The Bill requires all local authorities to offer free personal care at home to those with the highest needs in order to end the postcode lottery which this House has discussed on and off for many years. It will allow councils to have elements of continuing discretion so that they can provide the most appropriate services, which will be dependent on them knowing what works well in their community. We think that it is right that the Bill proposes that functions imposed on local authorities relating to eligibility for free provision should include the exercise of that discretion, so that they can effectively manage the provision of free personal care in their area. There will be a need for some cases to be considered in light of other healthcare services being provided to an individual and we have already discussed that. There is sometimes confusion about continuing care and what it means. It is care provided over an extended period of time to a person aged 18 or over to meet physical or mental health needs that have arisen as a result of disability, accident or illness. If an individual has primary healthcare needs, NHS continuing care should meet this and the individual’s package of care would be provided by the NHS and not by the local authority. It is important to recognise that if an individual needs continuing care to meet needs which do not include a significant health component, this will be provided by the local authority—it is right that they should be able to receive their personal care free of charge, if they qualify for it. It is important that NHS continuing care and free personal care are recognised as different ways of delivering health and social care where the balance between health and care may differ. I think that the noble Lord, Lord Lipsey, is trying to seduce us by his proposals of pilot schemes, but I am afraid that he is not going to divert us from our intention in this matter. We oppose Amendment 11, which is a wrecking amendment. It refers to regulations under Section 15 of the Community Care (Delayed Discharges etc.) Act 2003 as having the power to be able to "permit", as opposed to "require", free provision of personal care. However, Section 15 enables the Secretary of State to make regulations requiring—as opposed to permitting—qualifying services to be provided free of charge. This amendment does not change the fundamental nature of the power under Section 15 and therefore the reference to regulations permitting free provision of personal care does not correctly reflect the nature of that power. Therefore, the amendment is not necessary. Local authorities have the power to charge for non-residential community care services but are not obliged to do so. They are therefore already able to provide free personal care if they wish and do not need additional powers to be able to do so. Amendment 15 seeks to limit the functions relating to eligibility for free provision of personal care which can be imposed on local authorities in regulations. However, in doing so, it would prevent a very important sub-delegation of powers by removing reference to those functions included in the exercise of discretion. We believe that local authorities are best placed to judge what is appropriate in their own situations, dependent on their specific clients’ needs and circumstances and the availability of services. It is therefore right that functions imposed on local authorities relating to eligibility for free provision should include the exercise of discretion, so that they can effectively manage the provision of free personal social care in their area. I ask the noble Lord to withdraw his amendment.