Personal Care at Home Bill

My Lords, Amendment 7, tabled in my name and those of the noble Lords, Lord Lipsey and Lord Warner, and the noble Baroness, Lady Murphy, concerns what is commonly known as a sunset clause. It would impose a time limit on the effects of the Bill which is specified at two years. Why do we seek such a measure? Having listened with great interest not only to the discussions in your Lordships’ House but also to a variety of briefings from the Association of Directors of Social Services and the charities, as well as from the Government, I still think there is too much about the Bill which is unknown. What it should be is a pilot measure, and I will come on to explain why I believe that this amendment is the most effective way to turn it into a pilot. As the noble Lord, Lord Lipsey, said, the Health Select Committee report of another place is a pretty devastating critique of the Bill. I commend noble Lords to read it all, but would direct them in particular to the section that talks about unmet need. I refer to the paragraphs in which the Secretary of State and officials set out in various ways the extent to which they cannot be sure how many people there are at the moment who might be eligible for care but who pay for themselves, and the number who might be eligible with or without assistance from a carer. I have to say that of our debates in Committee, the ones I thought were the least satisfactory were those in which we discussed the process of assessment and the involvement of carers. During the passage of the Bill, I have become used to the term "carer blind assessment", but when I read the Select Committee report, I came across a term that was new even to me, and I know a lot of jargon in this field; and that is "carer centred". It is where carers are not involved in the assessment of someone’s abilities but, I believe, that carers themselves are taken into account in terms of assessing the services that will be provided. I may be wrong, but that is what I understand. Throughout our discussions I have said that I have a fear that is different from that expressed by many noble Lords. They are concerned that the Bill will lead to an opening of the floodgates and that large numbers of people who are currently paying for their own needs will now believe themselves eligible for personal care. I have said consistently that I think that there is a completely different danger to consider. The number of people who will be assessed as being FACS-critical and in need of substantial assistance with four activities of daily living may be very small. I shall quote a statement made by Mr Andrew Harrop of Age UK to the Select Committee. I should say that the same thoughts were passed on to me by Pauline Thompson, the longstanding policy officer of Age UK who is to retire tomorrow. Many noble Lords will know her and will have appreciated her work. Mr Harrop said that he found some of the policy a narrow but "welcome move forward", but went on to say about the proposed eligibility threshold that, ""you will need to be very, very disabled in order to get this free offer … the people who are going to be supported by this could be relatively few in number. There is a particular concern that people with fluctuating needs could be disadvantaged by the tightness of the eligibility criteria"." Officials in front of the Select Committee admitted that councils do not regularly hold data on unmet need, and indeed there is a school of thought, backed by In Control, which says that assessment of need by councils is unnecessary because people themselves are best equipped to know their own needs. Therefore, unmet need simply is not recorded. In her response, the noble Baroness will say, as I would if I were she, that this Bill has the support of a number of different charities. Not surprisingly, those charities are doing their job, which is exactly the job I would do if I were in their place. They are attempting to secure some help for some of the people with whom they work. But all of those charities have noted that the legislation is deeply flawed at various different points. We should go for a sunset clause for the following reason. The noble Lord, Lord Lipsey, is right to say that an incoming Government—I would include an incoming Liberal Democrat Government in this—will be faced with one of the most difficult political decisions to be made in a long time. It is so difficult that this Government ducked it 10 years ago. It will be extremely difficult to convince people not only that there must be restraint in public expenditure, but also to agree the priorities for the resources that are available. Governments of any hue find it intensely difficult to take away an entitlement that so far has been given for free. That is why, at this stage, we should add this clause to the Bill so that two years after the enactment of the legislation, whoever is right—whether it leads to an unmanageable level of demand for free personal care or whether I am right and the eligibility criteria have been drawn up in such a way that the Bill does not fulfil its intended purpose—a Government of any hue will be free to look again at the overall context of personal social care. My colleague, Norman Lamb, has done a sterling job over the past few weeks in making the point that there has to be reform of social care and that, whatever the detail of that reform, it has to reflect a universal basic entitlement to care, a partnership model between the state and individuals, and some role for private insurers, all based on common criteria. I think that any incoming Government will work towards that. Perhaps the Minister will be able to tell us, when the White Paper is published, that her Government are moving in that direction. So far all that she has been able to do is assert that this is a step towards that kind of process, but she has given us no evidence. In the absence of that, and with so many unknowns of such magnitude, I believe that putting a sunset clause into a very small Bill at this time is a prudent act and one that we should take.