My Lords, I very much agree with noble Lords that housing, along with health, and care and support, should be considered as the three legs of the stool. In relation to housing we are clear about two things: first, many types of housing can be provided as a means of meeting or preventing care and support needs—for example, extra care housing. That is why accommodation is listed as a way of meeting needs in Clause 8.
Secondly, housing is a wider determinant of health; simply having a roof over your head can have an enormous impact on your health and well-being. To reflect this, the “suitability of living accommodation” is listed as part of well-being in Clause 1(2). I hope that those two points in particular will serve to reassure the noble Baroness, Lady Masham.
Amendment 12 clarifies that housing is a “health-related” service, and that both local authorities and the NHS are required to promote integration between care and support, health and housing. This makes the
importance of housing explicit not only in the integration duty in this Bill but in the comparable duties on the NHS in the 2006 Act. I hope noble Lords will welcome that.
In Committee, noble Lords also expressed the view that we needed to clarify that local authorities are required to co-operate with providers of services, including providers of housing services. Amendment 28, again in my name, does just this. The non-exhaustive list of the types of “other persons” we expect local authorities to co-operate with would now include certain providers of health, care and support, and housing services. However, we cannot add these bodies as “relevant partners”, as public law is limited in the extent to which it can place duties on such private bodies.
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I hope I can reassure the noble Lord, Lord Best, and my noble friends Lord Shipley and Lady Eaton that it is a key principle of the Bill that where any type of housing is provided in relation to a person’s care and support needs, that must be considered part of “care and support”. It follows that where housing or accommodation is provided to meet—or indeed prevent, delay or reduce—needs for care and support, local authority duties to provide information and advice, and shape the market, must include such types of accommodation. I undertake that these matters will be made clear in statutory guidance.
However, we must be clear where the boundaries lie between responsibilities for care and support, which will include many types of housing, and for general housing that is not related to care needs. Amendments 15 and 23, tabled by the noble Lord, Lord Best, risk blurring this divide and creating overlap and confusion between housing and care and support. In that respect, there is, I am afraid, a fundamental problem with these amendments. Providing information and advice about general housing options and ensuring that there is sufficient suitable housing available is clearly the responsibility of the local housing authority, which is not always the local authority responsible for care and support in that area. It simply is not reasonable to ask local authorities, in their care and support functions, to carry out those other functions.
Turning to the amendments tabled by the noble Lord, Lord Hunt, it is incontrovertible that local authorities and relevant partners must co-operate in order to ensure both integration and safe and timely transfers of care; indeed, the Bill already requires this. Clause 6 requires that local authorities and relevant partners co-operate with one another where relevant to care and support. Subsection (5) of this clause sets out some key examples of when this duty should be used. There can be no question that this duty would also apply to promoting integration.
With respect to integration, Clause 3 requires local authorities to promote integration while carrying out their care and support functions. Consequently, this applies to Clause 6. Further, the co-operation duty requires the relevant partners, including NHS bodies and local authorities, to co-operate with one another in the exercise of their respective functions. Such co-operation is inexorably linked to the integration duty.
I am in complete agreement with the noble Lord, Lord Hunt, in his Amendment 11 that it is imperative that NHS bodies are also under a duty to promote integration. That very thing is achieved by Sections 13N and 14Z1 of the NHS Act 2006, as amended by the 2012 Act, which Clause 3 is intended to reflect. Far from the legislation driving fragmentation, it is actually shot through with duties around integration of services. Although I appreciate the noble Lord’s intention to add further symbolic focus on integration, I do not consider it necessary to make further provisions in this regard, and I am sure he will appreciate that we should not be populating Acts of Parliament with provisions that are legally unnecessary.
That is not to say that integration of services is not important. As part of the spending review in June, we announced the £3.8 billion integration transformation fund, which will provide the biggest ever financial incentive to integrate services. The disabled facilities grant, which funds housing adaptations, is part of that fund. This will make housing a central part of local plans to integrate services.
The current discharge guidance, Ready to Go?, is clear that discharge planning should begin at or before admission, that patients should be assessed by a multi-disciplinary and multi-agency team and that certain matters should be taken into account when performing such an assessment. Further, the assessment required by Schedule 3 is the same as the one specified by Clause 9. As a result, Amendment 39 would give the power to specify in regulations that such an assessment should be carried out jointly, and Clause 12(1)(b) allows regulations to specify what the local authority must have regard to in carrying out that assessment.
Amendment 31 adds the relevant Minister for Jobcentre Plus to the list of relevant partners who are under a duty of reciprocal co-operation with local authorities. This is so that jobcentres and local authorities work together to help adults and carers access employment or training where this is one of their desired outcomes of day-to-day life. Co-operation between local authorities and jobcentres in aligning personal budgets and welfare payments was considered a positive aspect of the right to control pilots.
My noble friend Lord Shipley referred to the spare room subsidy. To recognise that some people need additional space in their home due to their needs for care and support, the Government have trebled the discretionary housing payment scheme. This includes an additional £25 million to support those affected by the removal of the spare room subsidy. That is in addition to £20 million for which disabled adults who do not live in specially adapted accommodation may apply.
I hope that I have convinced the House of the strength of the provisions for integration and co-operation between health, housing, care and support and that the co-operation duties support discharge planning and assessment, and where appropriate support people into employment and training. I hope that I have also convinced the House—and the noble Lord, Lord Best, in particular—of the need for a clear boundary between care and support and housing generally in relation to information and market shaping. I hope that he will be sufficiently satisfied with my explanations.