I did not say it was irrelevant; I said it was not germane to this Bill—and in the seven minutes remaining to me, I am not going to cover that. All I will say to the right hon. Gentleman is that the difficulty with competition policy that the NHS chief executive talked about is a difficulty that health care systems around the world—in north America and in continental Europe—are finding as well. I agree with the right hon. Gentleman, however, that we need to look at how competition policy can be aligned with the policy prescriptions I am describing.
I now want to list the fourth key premise upon which this Bill is based; in what must be a short speech, I can only list four. It is around the well-being of individuals; it is around early intervention and prevention; it is around integration; it is also, critically, for the first time in statutory form, around doing needs assessments that take account of the needs not just of the individual person, but of their carer and social context as well. In that way, the support that is provided to individuals takes account of the context in which they live, rather than treats them as individuals divorced from the carers and people who care for them when the statutory social worker is not there.
The Opposition spokesman said this is an enormously ambitious set of objectives, and I entirely agree that the objective of redefining the delivery of health and social care in a way that matches the aims set out in the first three clauses and clause 10 around carers is ambitious. The objective is to re-imagine care so that we think of the health and care system not as being primarily around acute hospitals, but as a system designed to meet the needs of that majority of people who are the main focus of those who work in the service—people who primarily have a care need with an occasional medical or clinical requirement. In other words, this is about thinking about the system from the front end rather than viewing it from the top of the bureaucracy. I commend this Bill because I believe it sets that framework in statute.
I also commend the Government because they are not just setting out these aspirations as commitments in law. It is one thing to change the law. It is another thing to change the way the service is actually delivered on the ground. The most effective step the Government have taken to achieve this re-imagination of care is the £3.8 billion that my right hon. Friend the Secretary of State talked about. That is £3.8 billion voted into the NHS but available only if the service at local level delivers the joined-up, person-centred care that is set out in the first three clauses of the Bill. So this is not just a set of wordy aspirations; it is a set of aspirations
supported by the resources necessary to deliver the change in the care model that the Bill describes. The £3.8 billion is the catalyst that will allow us to deliver the objectives.
With respect to those on the Opposition Front Bench, it is wrong to say that it is only £3.8 billion out of £125 billion. The £3.8 billion is the minimum that the law will require to deliver integrated care within a locality, through the health and wellbeing boards that are much beloved of the right hon. Member for Leigh and which were legislated for by the Government. This is an important step forward. If the health and wellbeing board in a locality can see a way to use health resources to deliver a changed model of care that puts more focus on prevention and on individuals through the delivery of more joined-up services, there is no constraint in the legislation, as I understand it, to prevent more than £3.8 billion from being used for the delivery of that objective.
Resources are important in this regard. This is partly about the £3.8 billion from the taxpayer, but it is also about individual resources. It is about individual users having their right set out in the Bill to engage with their personal budgets and with direct payments, enabling them to make real choices about how joined-up, person-centred care will work best for them. It is the curse of these health debates to imagine that we can gather 650 people together in this Chamber and work out how we are going to deliver £125 billion-worth of care in a way that will work for an individual old lady in her own home. That is nonsense; we need to engage the people themselves in the decisions on how the resources are used. We also need to assure them that they will not be exposed to catastrophic personal losses by making their own contributions to their care. That is why I welcome the fact that, despite what the right hon. Member for Leigh (Andy Burnham) says, the Bill gives effect to the basic propositions set out in the Dilnot report.
The Bill sets out the vision of person-centred, joined-up, integrated care, and the Government have set out plans to commit resources to turn those fine words into deeds. Also, through the establishment of an independent Care Quality Commission, the Bill will provide independent assurance about the quality of care that is provided right across the health and care system. The right hon. Gentleman claims credit, as he is entitled to do, for the fact that the previous Government took the first faltering steps down the road to introducing proper regulation of health and care provision, but he cannot possibly believe that the Care Quality Commission that he bequeathed was fit for purpose. If he does, he is the only man in the kingdom to do so. I welcome the fact that this Government are putting in place new management and, importantly, a new statutory framework so that the aspirations that might have motivated the Labour Government to set up the CQC will now be delivered in reality.
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