Clause 136

Health and Social Care Bill – in a Public Bill Committee at 2:45 pm on 24th January 2008.

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Ordinary residence for certain purposes of National Assistance Act 1948 etc.

Photo of Anne Milton Anne Milton Shadow Minister (Health)

I beg to move amendment No. 73, in clause 136, page 92, line 30, leave out ‘or by the Welsh Ministers’.

Photo of Derek Conway Derek Conway Conservative, Old Bexley and Sidcup

With this it will be convenient to discuss amendment No. 74, in clause 136, page 92, line31, leave out ‘and the Welsh Ministers’.

Photo of Anne Milton Anne Milton Shadow Minister (Health)

We rehearsed the Welsh issue earlier in our proceedings and I will be happy to withdraw this probing amendment. As a Surrey MP, I am not as familiar with the problems of cross-border and devolved issues as many hon. Members, including my hon. Friend the Member for Eddisbury. I do, however, think that we need absolute clarity about who is responsible for what and whom. We have had a heated exchange at times, but I hope that the Minister will take on board the comments that have been made by my Welsh colleague, my hon. Friend the Member for Preseli Pembrokeshire. Sometimes the lack of clarity in legislation and from Government—and the lack of clarity from Ministers and Welsh Ministers—leaves Members of Parliament and, more importantly, their constituents, in an awful vacuum between the two.

Photo of Ben Bradshaw Ben Bradshaw Minister of State (Regional Affairs) (South West), The Minister of State, Department of Health

At present there is no one person with legal responsibility for determining cross-border disputes on ordinary residence between English and Welsh local authorities. Clause 136(2) remedies that defect and allows for a proper mechanism to be put in place for resolving such disputes. The amendment would remove entirely the Welsh Minister’s power to resolve disputes, thus creating a situation in which the Secretary of State for Health would be solely responsible for making ordinary residence determinations between English authorities, Welsh authorities and English-Welsh authorities. I hope that the hon. Lady will accept that that is not a workable option.

Photo of Stephen O'Brien Stephen O'Brien Shadow Minister (Health)

I want to record how welcome that is to someone who contends almost weekly with contentious cross-border disputes in which people do not feel that they are getting a fair entitlement when they cannot get the same provision in England that is available 200 yards across the River Dee in Wales. People often cross the river to try to play the system. We need to avoid effectively gaming with our public services as a result of constitutional arrangements. Therefore, I welcome the amendment, which I think is important.

I make a general plea that perhaps could be transmitted up through the Government into policy making. If the system is to really work, my constituents, just as much as those of my next door neighbour, the hon. Member for Wrexham (Ian Lucas), for example, need to know that their Member has access to a Minister in this place who can be held to account through questioning, rather than simply having a mechanism to go through. Ultimately, my constituents’ power to make something happen lies in them coming to me so that I can rattle the cage and open the door, as we do for all our constituents.

Photo of Anne Milton Anne Milton Shadow Minister (Health)

I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Question proposed, That the clause stand part of the Bill.

Photo of Derek Conway Derek Conway Conservative, Old Bexley and Sidcup

With this it will be convenient to discuss the following new clause 18—Continuity of social care support

‘(1) This section applies where—

(a) an English or Welsh local authority (the original authority) has made a determination of need for care services in respect of a person ordinarily resident in its area under any of the social care enactments and—

(i) has arranged or is providing such services or

(ii) is making payments to such a person in lieu of care services under section 57 of the Health and Social Care Act 2001 (c. 15) or section 17A of the Children Act 1989 (c. 41); and

(b) the person concerned becomes or intends to become ordinarily resident in a different local authority (the new authority).

(2) It shall be the duty of the original authority to—

(a) give notice to the new authority if it becomes aware that a person to whom it provides care services or direct payments intends to become ordinarily resident in the new authority’s area; and

(b) co-operate with the new authority in making appropriate arrangements for such a person.

(3) It shall be the duty of the new authority to provide the person concerned with—

(a) services of an equivalent type and quantity to those provided by the original authority or

(b) direct payments enabling an equivalent type and quantity of support to that provided by the original authority, for such transitional period as may be prescribed.

(4) All arrangements made under subsections (2) and (3) are to be made with the involvement and consent of the person concerned and must include effective arrangements to meet any new or different needs of the person concerned.

(5) For the purposes of this section “social care enactments” includes—

(i) Section 2 of the Chronically Sick and Disabled Persons Act 1970 (c. 44).

(ii) Section 4 of the Disabled Persons (Services, Consultation and Representation) Act 1986 (c. 33).

(iii) Section 17 of the Children Act 1989 (c. 41).

(iv) Section 47 of the National Health Service and Community Care Act 1990 (c. 19).

Photo of Greg Mulholland Greg Mulholland Shadow Minister (Health)

I do not want to delay the Committee, particularly for selfish reasons, as I wish to get back to put my two-year-old little girl, Isabel, to bed.

I would like to give a brief explanation of the new clause. It would address concern relating to people moving house or care home between local authority areas, and designate the responsibilities of both the original authority and the new one. The aim is to resolve any problems that might arise from the patient moving so that care may continue uninterrupted. The practical reasons are that local authorities might have different standards and practices of care. People are concerned that they might have to start the assessment process again, which could have cost implications. They are also, crucially, concerned that there could be a delay in receiving care in their new local authority, and, fundamentally, that the level and quality of care may fall. I hope that the Minister can assure the Committee that that is not the case and that the new clause is not necessary, and that he appreciates that this is a sensible, practical point.

Photo of Anne Milton Anne Milton Shadow Minister (Health)

The hon. Gentleman raises an important point.

I will go back to the subject of over-zealous social services departments and problems relating to where people reside. I will give as an example an adult, perhaps with learning difficulties, who has been looked after by his parents, but who moves to another area because it is thought that he is able to manage on his own. For argument’s sake, let us say that he builds up social networks and lives there happily for ten years, but his situation then deteriorates and he needs care. He could find himself wrenched away from the area that he knows, has social contacts in, and has become used to, and having to return to where his parents live, but where he has not lived for ten years. I do not know whether the new clause is necessary, but I would like  the Minister to take on board the fact that the problem often arises because people get caught up in the crossfire of no one wanting to pay. That is what this comes down to.

Social services departments under pressure spend a huge amount of time and energy avoiding paying for things, but if they directed that attention and energy into just looking after people, they might save more than they are being required to spend on people’s care. It can be trying to watch, and extraordinarily stressful for the people involved.

Photo of Ben Bradshaw Ben Bradshaw Minister of State (Regional Affairs) (South West), The Minister of State, Department of Health 3:00 pm, 24th January 2008

The hon. Lady and the hon. Member for Leeds, North-West make some important points, but I hope to reassure them that the new clause is not necessary. Local authorities already have a duty to work together to make appropriate services available to people who move from one local authority to another and to co-operate with each other in the process. The statutory guidance that we issue also requires co-operation when people are placed by one authority into accommodation in another authority area.

New clause 18 seeks to impose a duty on the new local authority to provide

“services of an equivalent type and quantity to those provided by the original authority”.

Given the example that the hon. Lady just gave, it would remove any flexibility from the relevant authorities and would assume that the needs of the individual have not changed since the original authority’s assessment. In order to allocate funds appropriately, it is essential that local authorities have responsibility to decide their eligibility criteria and to carry out an assessment of individual needs, circumstances and preferences. In the light of those comments, I hope that the hon. Gentleman will not press the new clause, and will get home in time to put his two-year-old to bed.

Question put and agreed to.

Clause 136 ordered to stand part of the Bill.

Clauses 137 to 144 ordered to stand part of the Bill.

Photo of Derek Conway Derek Conway Conservative, Old Bexley and Sidcup

To enable me to get my breath, Mrs. Milton will move amendment No. 75.