Standing Committee D
Thursday 12 December 2002
[Derek Conway in the Chair]
Mrs. Cheryl Gillan (Chesham and Amersham): On a point of order, Mr. Conway, I wish to seek your advice on a matter pertinent to the further scrutiny of the Bill. As the Government know, the Conservative party always objects in principle to programming. You will appreciate that it is difficult at the start of consideration of legislation to estimate with any precision the length of time that scrutiny of that Bill will take. When we embarked on scrutiny, we were offered—and accepted—four sittings. It has become obvious over the course of the past three sittings that some five clauses have remained entirely unscrutinised, including two groups of amendments which it was not possible to discuss in full. Could you advise me on the position that you and your co-Chairman would take should I make a formal request for the re-convening of the Programming Sub-Committee in order to consider a further extension of the time to scrutinise the Bill?
The Chairman: I have chaired Committees for which the Programming Sub-Committee has re-convened, normally when the usual channels have been in agreement. Since that would appear not to be the case, I must draw the hon. Lady's attention to the resolution of the House, which requires that the Committee not only concludes today, but this afternoon by half-past five—[Hon. Members: ''Five o'clock.''] Five o'clock. That is exactly what we shall be doing. However, I am sure that the hon. Lady's point will be taken into account on Report.
Free provision of certain community care services
Mrs. Patsy Calton (Cheadle): I beg to move amendment No. 87, in
clause 12, page 7, line 18, at end insert 'and that local authorities are not to charge for social care; if that social care is
(a) personal care defined in section 121(9) of the Care Standards Act 2000 as assistance in connection with bodily functions;
(b) nursing care, whether or not from a registered nurse; or
(c) the care of a kind mentioned in Schedule (Social care not ordinarily charged for) to this Act.'.
The Chairman: With this it will be convenient to take the following:
Amendment No. 88, in
clause 13, page 8, line 7, at end insert 'and to Schedule (Social care not ordinarily charged for) of that Act'.
Amendment No. 89, in
clause 13, page 8, line 13, at end insert 'and to Schedule (Social care not ordinarily charged for) of that Act'.
Amendment No. 90, in
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clause 13, page 8, line 19, at end add 'and to Schedule (Social care not ordinarily charged for) of that Act'.
New schedule 1—Social Care Not Ordinarily Charged For—
'(1) As regards the personal hygiene of the person cared for—
(b) cleaning teeth and providing assistance in rinsing the mouth;
(c) keeping fingernails and toenails trimmed;
(d) assisting the person with going to the toilet or with using a bedpan or other receptacle;
(e) where the person is fitted with a catheter or stoma, providing such assistance as to requisite to ensure cleanliness and that the skin is kept in a favourable hygienic condition;
(f) where the person is incontinent—
(i) the consequential provision and changing of continence pads;
(ii) caring for the person's skin to ensure that it is not adversely affected.
(2) As regards the person's eating requirements, assisting with the administration of food.
(3) If the person is immobile or substantially immobile, dealing with the problems of that immobility.
(4) If the person requires medical treatment, assisting with medication, as for example by—
(a) applying creams, lotions, or administering eye drops;
(b) applying dressings in cases where this can be done without the physical involvement of a registered nurse or of a medical practitioner.
(5) With regard to the person's general well-being—
(a) assisting with getting dressed;
(b) assisting with surgical appliances, prostheses and mechanical and manual equipment;
(c) assisting with getting up and with going to bed.'.
Mrs. Calton: In tabling the amendments, the Liberal Democrats seek to improve and clarify the range of services that are available free to those in need of care.
Four years ago, we felt that the royal commission on long-term care would end the scandal of the forced sale of homes that has been necessary to pay for care, particularly on the part of elderly people. The royal commission reported that charges for personal and nursing care should be scrapped. Four years on, sadly, that situation has not been arrived at. The Liberal Democrats will continue to campaign for what was described in the 2000 NHS plan. It said:
''charges increase the proportion of funding from the unhealthy, old and poor compared with the healthy, young and wealthy.''
Further, the plan said that charges
''discourage use of necessary services.''
Given that the NHS plan, the royal commission on long-term care, and not only the Liberal Democrats but many members of the public have said that, I very much hope that the Government will listen to a further plea to resolve the difficulties that older people face when they deal with—
Mr. Simon Burns (West Chelmsford): I am interested in the hon. Lady's speech. She is making the case, which she has in part made before, for free residential care in the way that Scotland has introduced—
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Mr. Paul Burstow (Sutton and Cheam): Free personal care.
Mr. Burns: I am sorry; free personal care. In the case of home care charges under the National Assistance Act 1948, it is within the power of local authorities to decide whether and what to charge. Will the hon. Lady say which Liberal Democrat local authorities in England operate a zero rating on charges for home care?
Mrs. Calton: Clearly not—
Mr. Burns: Ah!
Mrs. Calton: If the hon. Gentleman would be happy to listen to the remainder of my answer, perhaps he would learn a little more. The remainder of my answer is that more recent legislation requires local authorities to charge for a proportion of home care services.
Mr. Burns: What is that legislation and where does it state that?
Mrs. Calton: I thank the hon. Gentleman for his questions. Although I do not have to hand the precise legislation, I am happy to provide information on the background, which made it clear to me when I was a chair of social services that a proportion had to be paid for, and was expected to be paid by those who could afford to pay. If I am proved wrong, I will say so, but that is my understanding.
Mr. Burstow: Does my hon. Friend share my concern and disappointment that Conservative Members still seem to take the view that they adopted during the passage of the Health and Social Care Act 2001 of not supporting the idea that basic personal care should be free on the basis of need, in keeping with a long-established NHS principle?
Mrs. Calton: I am grateful to my hon. Friend for that intervention. Clearly, we have hit a sensitive point for Conservative Members. It is very interesting.
Mr. Burns: Will the hon. Lady give way?
Mrs. Calton: Yes, certainly.
Mr. Burns: I am grateful to the hon. Lady and would like her to answer my original intervention because, contrary to what she says, four local authorities in England do not charge for home care, which contradicts her belief that there is a law that says that they must charge a proportion. I repeat my question: can she name a Liberal Democrat council, to join those four local authorities, which does not charge?
To answer the point made by the hon. Member for Sutton and Cheam (Mr. Burstow), I intervene not to put forward my view, but to emphasise the fact that Liberal Democrats say one thing—
The Chairman: Order. I am sorry to cut off the hon. Gentleman in mid flow, but interventions must be brief.
Mrs. Calton: Again, I am grateful for the intervention. We seem to be taking a long time to tease out whether Liberal Democrats tell the truth or whether they say one thing in one place and something else in another.
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I reiterate that, from my experience as a chair of social services, it was entirely necessary to introduce charges for home care because, unless they were introduced, grant was stopped. Some local authorities may not have charged so far, and no doubt the hon. Gentleman will tell us which ones they are.
Mr. Burstow: In giving the official Opposition spokesman an answer to that question, my hon. Friend might recall that it was a Conservative Government, in their standard spending assessment methodology, who made an assumption about how much local authorities would recoup through charges for services, which drove many local authorities to introduce charges in the first place. Although that is no longer explicit in the SSA methodology, it exists in practice.
Mrs. Calton: Once again, I thank my hon. Friend, who has such things more at his fingertips than I do.
Mr. Burns: The hon. Lady should not be too grateful to her hon. Friend because charging for home care services on a pro-rata basis was practised long before the Conservative Government made those changes to the SSA.
Mrs. Calton: I thank the hon. Gentleman for his further intervention, but I wonder whether, given the searching series of questions that has been put, we can make some progress.
I was quoting the words of the NHS plan. The Conservatives may say that we have moved on, but the point is that we should consider where we are now. Liberal Democrats are asking that assistance with such elementary tasks as washing, feeding and lavatory needs—tasks that nobody capable of doing them for himself would wish a paid helper to do—should be paid for. The royal commission said:
''We should expect to meet our housing costs all our lives.''
Liberal Democrats agree with that. However, we also believe that care costs are a risk that we should meet together as a society. The Government say that if someone has £18,000 in a bank, a pension or a home, they should not become frail or sick or old because it will be taken away. Our care system should not be a substitute for a tax system. The Government have a very narrow definition of what they will pay for. They will pay only for the costs of a registered nurse providing, delegating or supervising care—not the costs of the care assistant, who carries out the bulk of the work.
The amendments reproduce the provisions of the Scottish legislation, placing a duty on local authorities not to charge for personal care.