Clause 11
Health Bill [Lords]
2:45 pm
Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)
I beg to move amendment 186, in clause 11, page 7, line 7, leave out
‘securing the provision to a patient of’
and insert
‘enabling a patient to secure’.
We are forging rapidly through the amendments, and we have reached clause 11. The Minister will recognise that we are likely to find ourselves engaged for a while, as we have reached the subject of direct payments. It is known across the House to be an extremely important development in health policy. However, it raises a number of concerns because it relates sensitively to some of the most vulnerable people in our society—be they the elderly in need of care, or those with long-term conditions who need the confidence of knowing that their care packages will be sustained and that they will receive them in a quality way.
The amendment addresses the heart of the principle behind direct payments. The substantive question is whether the Secretary of State is still in charge, or whether patients are truly empowered to commission their own care. We would argue that the Government have come somewhat late to the party on direct payments; we have been calling for them since 2004. The Government rejected them as recently as 2006, when we debated the White Paper entitled “Our health, our care our say”. The then Secretary of State for Health—there have been several—the right hon. Member for Leicester, West (Ms Hewitt), called them a
“revival of the patient’s passport”.—[ Official Report, 30 January 2006; Vol. 442, c. 29.]
She could think of nothing ruder. Can the Minister explain his party’s change of heart?
In fairness to the Minister, the Government are going only as far as piloting direct payments. I think that that is a way of saying that they are the right thing to have, but I also think that they have been concerned about a number of issues that have been raised with them, not least by those on the Government Benches and some people outside the House who represent groups of interests.
Given that we know where the two major parties stand on the issue, it will be useful, in the course of this process, to have equal clarity from the Liberal Democrats. I know that there are a number of amendments to the clause that the Liberal Democrat spokesman will be leading on. I have been concerned that perhaps we have not been completely as one in our approach to direct payments, which has always struck me as being absolutely in the line of Hobbes and Hume. I would be very surprised if the Liberal Democrats did not support this, but we shall see as the debate proceeds.
The point is about enabling the patient—the person who needs the care—to be empowered and, as the expert in their own care, to be in charge of the care with which they are provided. In addition, we should not forget that often the family and friends who are their carers are equally expert.
It is interesting to note that the former Health Minister, Lord Warner, said in Committee in the House of Lords:
“I have often thought that the NHS, which, as a Minister, I sometimes found a somewhat inward-looking organisation, is rather slow to learn from local government, which has often been much more innovative”.—[Official Report, House of Lords, 2 March 2009; Vol. 708, c. GC212.]
I hope that the Minister will agree with his noble Friend’s assessment of our NHS, that we can now move rapidly to much greater clarity and expansion of the principle of making direct payments, and that that will become much more central to Government policy. As we shall develop the point through succeeding amendments, I shall not take up the time now, but we need to ensure, in relation to the patient being in charge, that we have the ability to make direct payments effective and move beyond the current pilot stage to something more full-blown.