Clause 1 - Meaning of ''NHS body'' and ''qualifying hospital patient''
Community Care (Delayed Discharges etc.) Bill
10:32 am
Mr Paul Burstow (Sutton and Cheam, Liberal Democrat)
I beg to move amendment No. 58, in
clause 1, page 1, line 9, leave out 'and' and insert 'or
(c) a Care Trust within the meaning of section 45 of the Health and Social Care Act 2001; and'.
I too welcome you to the Chair, Mr. McWilliam, and look forward to serving under your chairmanship during the four sittings on the Bill.
This is intended as a probing amendment. It is designed to explore the Government's thinking about the relationship between the penalty system proposed by the Bill and by the health flexibilities set out in the Health Act 1999, and the joint management arrangements such as care trusts that were set out in the Health and Social Care Act 2001. According to a written answer that I received a couple of weeks ago, 16 pooled budgets in operation around the country have been explicitly set up to deal with delayed discharge issues.
I hope that in response to the amendment the Minister will tell us how she sees those arrangements working in a system in which penalties apply. During the inquiry into delayed discharges by the Select Committee on Health, she said that four care trusts were in place to deal with services for older people, as well as those 16 budgets. Will she make it clear which bodies will be liable for the penalty? Will responsibility lie with social services departments, with the pooled budgets or, when service responsibilities have been merged into them, with the care trusts? The Bill does not make that clear. It is not obvious that the regulation-making powers elsewhere in it are sufficient to enable the fine to be directed to the agency that, within the terms of the Bill, is responsible.
For example, how will an area that operates a pooled budget or care trust share in the £100 million announced by the Secretary of State for Health on Second Reading? How will that be paid? Will it be paid to the social services department and then passported to the pooled budget? Will that be dealt with in regulations?
Will the Minister also spell out how the Department of Health arrived at the figure of £100 million? In recent written answers, she did not say clearly how it was worked out. She implied that it was in some way a capped or maximum figure, and that local authorities could not be subject to penalties that exceeded £100 million. She should give some answers on that subject, not least because it is the time of year when local authorities struggle to balance their books and make their budgets add up in time to set new budgets for the early part of the next year. It would help local authorities if they knew earlier rather than later the basis on which the money would be distributed. If they have pooled arrangements or are thinking about having them, will the money be passed to those pooled budgets? If so, on what basis?
What role will care trusts have in the system? The Bill does not deal with them at all.