Clause 29

– in a Public Bill Committee at 10:00 am on 26th February 2009.

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Relevant services

Photo of Mark Harper Mark Harper Shadow Minister (Work and Pensions)

I beg to move amendment 24, in clause 29, page 37, line 14, at end insert—

‘(h) the provision of care services and community care for P.’.

Photo of Sir David Amess Sir David Amess Conservative, Southend West

With this it will be convenient to discuss the following: amendment 25, in clause 29, page 37, line 20, leave out subsections (5) and (6).

Amendment 70, in clause 29, page 37, line 20, after ‘services’, insert

‘, unless such exclusion would prevent P from achieving the matters set out in subsection (2)’.

Amendment 49, in clause 29, page 37, line 21, leave out paragraph (a).

Photo of Mark Harper Mark Harper Shadow Minister (Work and Pensions)

The clause defines the relevant services covered by this part of the Bill, and what services the regulation-making powers will cover:

“services...provided to or for the benefit of a disabled person”, who in the Bill we call “P”,

“which relate to...the following matters.”

The list starts off well, laying out rather broad matters:

“the provision of further education for” the disabled person and their

“higher employment”, and enabling them

“to live independently or more independently” at home and

“to overcome barriers to participation in society.”

That is a very broad set of definitions, which would pretty much encompass most services provided by government.

That subsection went well, but unfortunately, further down the clause, which is where the amendments come in, there are the main exclusions in England and Wales. Some of them are around services provided to children, which the Minister and I have already discussed in clause 28, but the provision also excludes community care services and therefore omits all of social care. Social care will be one of the significant areas, important in enabling the disabled person to achieve almost any of those matters. If we do not have adequate, flexible and responsive social care, someone will clearly have barriers  to their education and issues about securing training, getting to work and living independently. Excluding social care services leaves a big hole.

We discussed the matter in the evidence sessions, Mr. Amess, when your colleague was in the Chair. I probed the Minister then and challenged him about the provision. He said that he did not want to be too prescriptive and set out that there was already provision in other legislation about individual budgets and direct payments for adult social care. That is perfectly true, but there are problems in how such things will work and whether the procedures and processes are aligned. The Bill seems to look at things from the Department’s point of view, rather than that of a disabled person. We should have one common framework for accessing all the services, and potentially we should put together all the funding streams and resources, so that they can be directed in a way that suits requirements.

The positive news that we heard during the evidence-taking session, from one of the Minister’s officials, was that the Department did plan to work very closely with a steering group, and with the Department of Health and the Department for Communities and Local Government, in order to join up the pilots and subsequently when the pilots are rolled out. My concern is that, if we exclude community care services from this provision, we might regret it later. Were we to remove subsections (5) and (6) and include social care services, we could still specify in regulations the scope of pilots and how they are rolled out. We should give Ministers the ability to include those services, rather than restrict the scope of the regulations by excluding social care services.

Amendment 24, which the hon. Member for Rochdale has signed as well, would explicitly include the provision of care services and community care for disabled people, and amendment 24 would leave out subsections (5) and (6)—the exclusion provisions relating to England and Wales, and Scotland respectively. That would widen Ministers’ powers and perhaps make it more likely that the Departments running the steering groups will join up with the Department of Health, social care services and local government. If we provide for that power, and if organisations know that the pilots can be drawn more widely, it might help to concentrate minds and engage local authorities in the running of the pilots. That is the help that I seek to provide.

Other organisations support widening the measures. For example, Leonard Cheshire Disability, which is a very well known campaigning organisation, is very supportive of the proposals in general, as we are, but it would like assurances over the funding streams and how the system will work in practice. It wants to know how the programmes may differ and whether it would be possible to include social care payments in the right to control. If we exclude from the Bill the ability to include social care, we will tie Ministers’ hands later, rather than leave those options open. It would be helpful if the Minister could explain why the Government have chosen this route, in a little more detail than he was able to during the evidence session. Does he think that so splitting up the funding streams is helpful? Was there any evidence from the pilots that the Government ran to lead one to the conclusion that excluding social care funding from this right to control process, and doing it separately, is an improvement?

During our evidence session we heard from Liz Sayce, the chief executive of RADAR, which is another well known, pan-disability campaigning organisation. It, too, is very supportive of the direction of travel in the Bill, but it is also very keen to know whether, after we have run the pilots and rolled them out, disabled people can look forward to a system where they can access all the support that they need via one gateway, where everything is joined up and where they can look at their needs and access one budget to cover the whole area of responsibility.

I would like to put on the record one or two quotes from organisations that support that approach. In its Second Reading briefing, Mind, which campaigns on mental health services, stated that it was

“disappointed that community care services are to be excluded”.

The Equality and Human Rights Commission, in its briefing on the Bill, pointed out that

“the provisions in the Bill are limited in the scope...explicitly excluding services relating to health and social care. This is in stark contrast to the aspirations set out in the...Green Paper...The Commission proposes that explicit exemptions such as that relating to health and social care are removed from the face of the Bill and instead that the Bill relies on...regulation-making powers to extend (or remove) the right to control to different areas over time.”

I have not spoken specifically to the Equality and Human Rights Commission about my amendments. However, reading what it said in its brief it appears to be endorsing amendment 25, which would leave out subsections (5) and (6). It says explicitly that it wants those subsections removed from the Bill, to give Ministers wider powers in the regulation-making sphere, so that they can extend those powers at a later date.

Similarly, RADAR has looked at whether it would be sensible to take out those exclusions in the Bill. Some of the work that it has done seemed to show that legally that would be perfectly permissible. It would be helpful if the Minister could set out the Government’s latest thinking, subsequent to our evidence-taking sessions. If he wants to leave these exclusions in the Bill, it would also be helpful if he could give the Committee a little more detail about how exactly he proposes to work them through in the pilot. Moreover, what happens in the pilot if Ministers subsequently want to tie the right to control in this Bill with social care services? Will this exclusion tie Ministers’ hands in regulation-making powers, so that they subsequently have to come back to the House to amend primary legislation? If the Minister can reassure us about that issue, we may not have to trouble the Committee with a Division on this amendment.

Photo of Paul Rowen Paul Rowen Shadow Work and Pensions Minister 10:15 am, 26th February 2009

Like the hon. Gentleman, I look forward to the Minister’s explaining in more detail some of the reasoning behind this measure. We support amendments 24 and 25, but we have also tabled two other slightly different amendments, including amendment 70.

I want to explain what we are proposing to do in amendment 70. It is to ensure that services would not be excluded should they prevent some of the other aims set out early on in the subsection. Part 2 lists a range of matters such as:

“(a) provision of further education for P;

(b) facilitating the undertaking by P of further education or higher education;

(c) the provision of training by P” and so on. What is different about amendment 70 is that we are not saying that there should be an automatic exclusion of those services, but only where the ability to control those services would prevent an individual from doing what is set out in part 2.

I had an example two years ago in my constituency of a young man who was going to university. The local authority had agreed that there could be direct payment and the university had agreed to passport over some of the support that it was going to provide. However, on the final weekend before the young man was due to go to university, we were still discussing with the primary care trust whether or not its element of care was going to be passported, because it clearly made much more sense for that young man to have a package of services rather than having different streams providing that support. In fact, having a package of services is a much more efficient use of public resources. At virtually the twelfth hour and the last minute, the PCT relented and agreed to direct payment from its element of the care. The young man was then able to purchase a total package  that has enabled him, for the last two years, to go to Leeds university. That would not have happened without that provision of direct services.

In our view, that is an example of how excluding some of these services could act as a barrier. It goes back to my earlier point and my earlier amendment to clause 28, about the authority co-operating. In the case I have just referred to, the PCT was initially unwilling to co-operate and it was only after a considerable amount of pressure had been applied, let us say, that it relented. That is an example of how the exclusion of some of these services can have a detrimental effect for some of the very laudable aims that are outlined earlier in the Bill.

Amendment 49, which is the other amendment in my name, goes slightly further by not dealing with health services, but it seeks to include care services in direct payments.

The Chairman adjourned the Committee without Question put (Standing Order No. 88).

Adjourned till this day at One o’clock.