Clause 34 - Appointment of independent consultees
Mental Capacity Bill
10:30 am
Mr Paul Burstow (Shadow Secretary of State for Health, Health; Sutton and Cheam, Liberal Democrat)
That is a fair comment. The aspirations set out in the White Paper rightly secured cross-party support; the idea of advocacy networks is certainly supported. Undoubtedly, one of the Government's concerns about putting advocacy rights in any legislation is the cost. I want to address that point in a moment. As I understand it, the resourcing that went into the implementation of the policy intentions behind the White Paper ''Valuing People'' added up to about £8,000 per local authority. It is hard to see how a meaningful advocacy service could be put in place with such a budget.
It is interesting that the Joint Committee was given quite a bit of evidence pointing towards the experience in Scotland, where there has been a move to develop local advocacy strategies, and where quite a bit of work has been driven, at least in part, by statutory requirements much more broadly drawn than those in English and Welsh legislation.
I will come back to the Scottish legislation, but it is worth drawing attention to the issue of resources, which was considered by the Joint Committee and leads to some questions that I would like to put to the Minister. The Joint Committee report said:
''In answer to a question about the costs involved if a right to independent advocacy was included in the Bill, Health Minister Ms Rosie Winterton said ' . . . quite frankly, it would be extremely difficult to envisage that there would be the scale of resources available . . . To say that we could look at the whole range of people who would be covered by the Bill and imagine that in every case there may be an advocate would be unrealistic for us'''.
The questions arising from that have been put by the Making Decisions Alliance to Ministers and officials for some time. Will the Minister tell us the estimated number of people who will qualify for an independent consultee now? Some estimates must have been made, as the figure of £6.5 million has been given as the cost. It would be useful to know what they are.
What would be the estimated cost of providing an independent consultee for each individual? What has been assumed to be the average cost of providing an independent consultee service? Given the regulation-making power to extend the independent consultee service, does the Minister have a view on whether the £6.5 million mentioned in the explanatory notes would be sufficient first and foremost to cover the proposal that it should deal with those who are ''unbefriended'', but also to allow for that to be extended? How much
money would be left to support other groups who would benefit from having an independent consultee? Some illumination of such issues, and an idea of how many others the Minister thinks might come under the remit of the amendments would be useful when we try to understand how the Government feel that the cost would be unsustainable to them and the taxpayer.
The recommendation of the Joint Committee was clear on the question of independent advocacy. It said:
''We are convinced that independent advocacy services play a essential role in assisting people with capacity problems to make and communicate decisions; helping them to enforce their rights and guard against unwarranted intrusion into their lives; providing a focus on the views and wishes of an incapacitated person in the determination of their best interests; providing additional safeguards against abuse and exploitation; and assisting in the resolution of disputes.''
The issue of disputes has not been adequately factored into the debate about cost. Unless we build low-level dispute resolution into the decision-making processes, the danger, in an increasingly litigious society, is that more cases than necessary would go to court. A more widely drawn advocacy service provided by statute as of right appears an expensive option. However, given what the Bill will, rightly, release and unleash, I suspect that such an option could mean that costs would be better controlled, and outcomes better from the point of view of the person about whom decisions are made.