Clause 12 - Free provision of certain community care services
Community Care (Delayed Discharges etc.) Bill
3:00 pm
Mr John Baron (Billericay, Conservative)
I beg to move amendment No. 50, in
clause 12, page 7, line 22, after 'provided', insert 'following the patient being informed of the costs of services following this free
period and an assessment made for continuing NHS health care and for community care services of that patient'.
I also welcome you back to the chair, Mr. Conway.
The amendment aims to ensure that patients are not discharged to free intermediate services without some knowledge of what the costs will be once that has ended and it has also been established that they do not qualify for fully funded NHS care. We on the Conservative Benches are concerned that older people, perhaps not in the best state of mind because of a recent operation, will accept intermediate care without realising either that, according to the Department of Health's circular HSC 2001/001, that is normally limited to six weeks or that they might qualify for fully funded NHS care on a longer-term basis.
Although it has caused confusion in some quarters, most patients will not be aware of the ruling in the Coughlan case, which found that if a person's need for care home accommodation was primarily driven by health requirements, and that it was beyond what a social care package could provide, then that person was entitled to free, fully funded NHS care. We are concerned that the system might inadvertently funnel patients down the intermediate care route, after which they might be left to their own devices. Alternatively, those same patients could be entitled to fully funded NHS care which—although more expensive for the NHS—would be better for the patient, and possibly more cost-effective for the NHS, in the long term.
At that point in their treatment, perhaps because they have just had operations, patients could feel particularly isolated and vulnerable. There is no guarantee that they will have relatives or carers close to hand. Meanwhile, there is no guarantee that home care staff will be fully aware of the rights of the patients, particularly their NHS entitlements. The amendment aims to ensure that patients are fully aware of the implications of the options available to them and of whether, if a full assessment had been made, they were entitled in the first place to fully funded NHS care. The amendment is important, not just because of the state of health of the patients but because they might be feeling vulnerable and isolated. We should do all that we can to ensure that they are fully aware of their options.