Health and Social Care Bill

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Mr. Hutton: It might be helpful for Committee members to consider the context of clause 47 and what it is designed to do. If the Committee accepts the principle—I accept the Conservative Opposition did not agree to this—that the Secretary should have the power to set up a care trust in the circumstances outlined in clause 46, I hope it is clear to the right hon. Gentleman that the powers in clause 47 are necessary and complementary to making sure that that policy objective can be secured.

It is clear from the way in which clause 47 has been drafted that, even in circumstances where a compulsory care trust has been set up, we want to allow for the possibility of an agreement about the resources that should be transferred. We all accept that that would be the preferable solution. At the same time, however, we cannot allow a situation to develop where, in the absence of such an agreement, the compulsory care trust could be frustrated by one or other of the parties not agreeing the resources that were necessary for the establishment of the care trust. That would clearly drive a coach and horses through the main policy objective. We need, therefore, to deal with a situation where, in the absence of agreement, the Secretary of State has to make a decision about the resources. Having looked at the matter very carefully—and I agree that more discussions are needed between the Government, the Local Government Association and other interested parties—we consider that it makes sense to use the expertise of an arbitrator to resolve any disputes about how much resource should be transferred to the care trust under clauses 46 and 47. That is essentially what we are trying to do and it makes sense to deal with it in that way.

The right hon. Member for North-West Hampshire (Sir G. Young) has asked me to specify what I think will be transferred to the care trust under clause 47. With the greatest of respect—and I am sure that he knows this as he has done my job—it is not possible for a Minister to tell the Committee precisely how much will be transferred if particular circumstances arise in the future. That is clearly not a possibility. Of course we would have to look at the standing spending assessment and at what the local authority had spent on the services involved. Of course we shall have to do that. In the absence of agreement, however, it will be the arbitrator's job to advise the Secretary of State on the appropriate level of resources that should be transferred.

Mr. Hammond: The Minister will correct me if I am wrong, but my understanding is that the standing spending assessment indicates the amount that a local authority ought to spend in order to deliver services adequately. How will the Minister tell a local authority that he requires them to deliver a sum greater than their social services SSA for the purpose of financing a care trust or a partnership arrangement? How will Minister justify that? Is he saying that the SSA does not provide an adequate formula for determining the correct amount of spending?

Mr. Hutton: I would be a very brave man if I were to enter into that discussion. I do not know how other members of the Committee feel about this, but having some responsibilities in these matters and looking at the current distribution of local government resources, I think that very few right hon. and hon. Members would say that the system was satisfactory. That is why the Government published proposals in the Green Paper on the reform of local government finance setting out a way in which we might introduce greater fairness into the system. The discussions are on-going and the Government have come made further proposals.

As a matter of principle and a matter of record, the right hon. Gentleman might be interested to know—he might have had some responsibilities for this in his previous ministerial incarnation—that under the previous Administration the Welsh Office introduced arbitration schemes for settling resource disputes between GP fundholders. The principle, therefore, of an arbitrator to resolve these disputes is not novel. It has been used on previous occasions. I must also say, with the greatest respect, that he was not right in his remarks when he talked about transferring resources to a central Government Department. That is not so. We are talking about transferring resources to the care trust, so that it can deliver appropriate, high-quality public services. That is not transferring resources to the Department of Health.

The question is whether we need the clause. In my view, the answer is yes. Resolving the issue of resource transfers is a complex matter. We have set out a proposal that will make sense of that, and allow the matter to be dealt with. It will be dealt with in the first instance by agreement, wherever that is possible. If it is not, it will be dealt with through the expert assistance of an arbitrator, who will advise the Secretary of State about the appropriate level of resource transfer.

With the greatest of respect, I probably cannot go any further than that in specifying the formula that will be used to judge the necessary amount of resource transfer, or in answering the detailed questions, which are important and must be resolved. They will be resolved, and a sensible set of conclusions will be reached, in further discussions with the LGA and others. As with clauses 45 and 46, the fundamental question is whether we need such a power. The answer is clearly yes, as we have established the case for a compulsory care trust, and the detail of the proposals offers a sensible, pragmatic, fair and even-handed way of resolving issues that are complex both in practice and in principle.

Question put and agreed to.

Clause 47 ordered to stand part of the Bill.

Clause 48

Exclusion of nursing care from community care services

Mr. Paul Burstow (Sutton and Cheam): I beg to move amendment No. 279, in page 42, line 38, after `authority', insert `in England'.

The Chairman: With this it will be convenient to take new clause 11—Exclusion of long term care from community care services in Wales—

    `.(1) The National Assembly for Wales may by order provide for the exclusion of long term care from the provision of community care services in Wales.

    (2) ``Long term care'' means any care in a residential or care home setting that is not board and lodging.'.

Mr. Burstow: The amendment seeks to avoid the House debating whether to allow another body to decide how to proceed with personal care and whether or not it should be provided. The amendment and the new clause make it clear that these are devolved matters for the Welsh Assembly. It is a matter of ensuring that the Welsh Assembly is able to take decisions on the provision of personal care in the context of its own priorities and resources and the situation in Wales. In other words, it would enable the Welsh Assembly to reach its own view, on the basis of the evidence, on whether to follow the royal commission's recommendations for free personal care. That is the purpose of the amendment and the new clause—to allow the Welsh Assembly the same freedoms as the Scottish Parliament.

In the debate in the House last night, the Minister referred to the current position of my colleagues in Wales, for the simple reason that the Liberal Democrats are committed to devolution. We accept the possibility of different solutions in different places. We do not have a problem with that. In the case of England, we believe that the Government should adopt the policy that has been adopted in Scotland, because it is right. If our colleagues in Wales, having assessed the situation there and having considered the representations that are made to them, reach a different conclusion, that is the consequence of devolution. There should be no problem with that. The amendment and the new clause were tabled in order to secure for the Assembly the same power as the Scottish Parliament and allow them to consider the matter for themselves.

Mr. Hammond: I am grateful to the hon. Member for Sutton and Cheam (Mr. Burstow) for tabling the amendment. He and the Minister had the pleasure of slugging out the debate on personal care last night in the House. Unfortunately, I was not present, so I apologise to both of them if it turns out that some of the issues that I want to raise were discussed last night. I know that some of them were, but I am sure that neither hon. Gentleman will be dismayed by having to discuss them again.

The amendments give us the opportunity to discuss the devolution-related issues, to which the hon. Member for Sutton and Cheam has already drawn our attention. There are continuing controversies surrounding the matter. Essentially, in this part of the Bill, there will be three separate debates. The first would be about balancing the desire to address the concerns of older people and their families about the iniquities of—and the perverse incentives in—the current system of means-tested support for long-term care with the fiscal concerns. The second issue relates to devolution and the third concerns the Government's definition of nursing care and how the provision will work in practice.

On the second matter, the devolution-related issue, the hon. Gentleman has set the amendment in in the context of Wales, but he referred to the situation in Scotland. Theoretically, the amendments would place Wales in the same position as Scotland. I am sure that the Liberal Democrats would like that to happen, as they are currently exploiting to the full the Government's discomfort over the Scottish fiasco—and who can blame them? Labour's problem in Scotland really concerns its approach to devolution. The controversy over personal care throws the issues into stark relief. We have said for some time—and I have said it more times than I care to remember in Standing Committees—that Labour's perception of what devolution means and how it works was always based on the assumption that the same party would be in control of both sides of the equation. The Liberal Democrats have exploited the leverage that they currently have in relation to the Scottish Parliament in order to embarrass the Government and place them in something of a dilemma.

 
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Prepared 6 February 2001