Community Care (Delayed Discharges etc.) Bill
Lord Hunt of Kings Heath (Parliamentary Under-Secretary, Department of Health; Labour)
The noble Baroness has returned to a matter that she anticipated in some of our debates yesterday. I understand the point she has raised. In what are often difficult circumstances, decisions must be reached and of course it is important to ensure truly effective dialogue between the health service and social services. I do not deny that at all. Furthermore, we know from areas where good practice is working well that there is a seamless and integrated care approach which ensures that the issues raised by the noble Baroness, along with the downsides, are reduced to a minimum.
I apologise because I must go over ground that I covered yesterday. In the understandable concern of the noble Baroness to emphasise the need for a joint approach, there is a risk that, were we to accept the amendment, we would risk making fudgy an area where there is at present a good deal of clarity; that is, on who ultimately must take responsibility.
There is a problem with the wording of the amendment. In a legal sense, the word "agree" would mean that both the NHS and social services have a power of veto over the services provided by the other agency. My fear about that situation is that while many NHS and social services bodies would operate well and would not seek to use their ability to veto any action, it would leave far too much to chance.
I return to what I said yesterday. It is important to remember that the Bill does not change any statutory responsibility of either the health service or local government. It is best to keep it that way and to accept that in the discharge procedure both the NHS and social services have decisions to make. In a legal sense, it is best that they are responsible and accountable for such decisions. But it is part of our job to ensure good practice and the right incentives, and we encourage them to work closely together. That, in essence, is what the single assessment process is all about. That is why, ultimately, while sympathising with what the noble Baroness seeks to achieve, I cannot support her amendment.