Clause 45 - Care Trusts where voluntarypartnership arrangements
Health and Social Care Bill
12:00 pm
Mr Desmond Swayne (New Forest West, Conservative)
In discussing the previous group of amendments we tried to probe the question of who would be on the boards of care trusts, and how those boards would differ from those of existing trusts, such as primary care trusts. I should like to use this brief debate on clause stand part to probe the Minister further. He has assured us that the partnership will be genuine. If we take that assurance at face value, it begs several questions. For example, how will the partnership affect the local authority scrutiny function? If the partnership is genuine, the local authority will have acquired an interest in the trust. How, therefore, can its own independent scrutiny function continue to work effectively? How are the trusts linked to patients forums?
What about performance indicators? Will we develop new ones, tailor-made for care trusts, or will we apply the performance indicators that we have traditionally applied to local authorities or to NHS bodies? What happens when things go wrong? What will the complaints procedure be? Will complaints against the care trust ultimately be dealt with by the local government ombudsman, or by the NHS ombudsman?
The hon. Member for Sutton and Cheam asked some pertinent questions about financing and local authority boundaries. We require an answer on that. The question of how such things will work is not just constitutional and academic, although the discussion is interesting. The issues will have a real impact on the patients at the end of the line.
If a local authority enters into a care trust arrangement, will its social services committee continue to take policy decisions in the same way that it does currently? The hon. Member for Sutton and Cheam raised the question of charging in that respect. There is a fear that in future, existing NHS services will be repackaged as social care services, so that they can be charged for. We will be seeking some reassurance on the issue of respite care, which is currently provided by the NHS. If in future respite care is provided under social care provisions by a care trust, will the existing dispensation continue? Will there continue to be no charge for that care? It would be quite wrong if, in the new world of care trusts, people ended up being charged for a service that they currently get free of charge.
There is a series of pressing questions on the nature of the organisations, the way in which they are to be set up and the way in which they will work. The Minister says, ``We still have to think some of those problems through.'' However, all the questions have profound practical implications, which are bread and butter issues for the people who will receive the services at the end of the line.