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Community Care (Direct Payments) Bill [H.L.]

6.43 p.m.

Bill read a third time.

Clause 1 [Direct payments]:

Baroness Hollis of Heigham moved Amendment No. 1:

Page 1, line 11, at beginning insert ("subject to subsection (7)").

The noble Baroness said: My Lords, in moving this amendment I shall speak also to Amendments Nos. 4 and 5 which are grouped with it. These amendments are about eligibility. I believe that we all support the Bill. We all believe that the disabled person should be at the centre of the care system and not dependent on it, each and every day able to exercise the kind of choices that each of us as an individual takes for granted. However, I simply do not understand why that right to choose direct payment and to exercise choice should be confined, as the Government intend, to only a small proportion of disabled people; namely, those with physical disabilities under the age of 65.

It is an issue about rights, choices and local judgment. We on these Benches believe that all disabled people who want and are able to benefit from direct payment--cash rather than services in kind--whatever their ability and whatever their age, should be eligible for it. The amendment would cost the Government absolutely

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nothing. It would do what disabled people and disability organisations led by DIG and the British council for disabled people as well as local authorities all want.

So why have the Government resisted the proposal? It cannot be on grounds of cost because the amendment is probably cost neutral and would probably save money for the local authorities. It is not about cost. It cannot be because there is no demand for it. Existing third party schemes already include people with learning disabilities, some of those over 65 whom the Government would exclude. It cannot be that local authorities would be overwhelmed because only a small proportion of disabled people, probably younger ones, are likely in any case to prefer direct payments. Indeed, we shall probably need campaigns to encourage people to take up direct payments rather than use efforts to limit them. It cannot be because it is too onerous for local authorities. The entire scheme is in any case discretionary. Local authorities will not start the scheme unless they feel that there is local demand and are confident about their own competence to do so.

If local authorities are competent to have the local decision in their judgment and if local authorities are to be entrusted with the discretion as to whether they should set up the scheme, why do we refuse them the lesser discretion as to who should be eligible within it? It cannot be that all local authorities must progress in the same way, at the same time and at the same pace. That cannot happen. Already some 60 local authorities run direct payment schemes and are several years ahead in terms of experience compared with other local authorities. Are we to hold them back until others catch up? Why? Why not benefit from their experience? Why not benefit from pluralism and let both central government and local government learn from the experience and practice of those already more experienced?

What other arguments can the Government produce against the amendment? It cannot be that the Government seek to avoid a patchwork of provision. Whether or not the Government accept the amendment, there will be a patchwork of provision on the ground. Some local authorities will set up direct payment schemes as well as maintaining third party schemes. Others will stick with only third party schemes. Others may offer vouchers. Others may limit direct payments to those receiving ILF moneys. Others may do nothing at all. Any, all or a combination of those arrangements will be possible. There will be a patchwork but instead of regarding that as a source of weakness, let us see it as a source of strength.

What other final argument can the Government have? It cannot be that central government will not trust local authority discretion. Entire social work departments each and every day are trusted by the Government to make far more significant decisions--for example, about removing a child from a family. As I said, the Government allow the local authority to make the big decision as to whether to run a scheme at all. Why, then, do the Government refuse the local authority the right to make the lesser decision as to who will be eligible? There are all sorts of decisions that local government will have to make about the scheme. They will have to

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decide whether to have a scheme, decide the charging policies and decide whether to set up advice and support packages. Why should not they also decide the eligibility according to their own local experience on the ground?

The amendment is a win-win amendment. It costs the Government nothing. But the Government gain from the experience on the ground. It costs the local authorities nothing; they will save money. But it facilitates choice for disabled people and is supported by disability organisations. Even at this very late stage I hope the Government will accept that there is no good or decent ground for denying disabled people who have learning difficulties or disabled people over the age of 65 the opportunity of taking advantage of direct payments. I beg to move.

Lord Campbell of Croy: My Lords, as explained by the noble Baroness, Lady Hollis, her three amendments would have the effect of widening the range of categories of disabled people to be included in the new direct payments system in the first stage when the Bill becomes enacted. As noble Lords will be aware, I have applauded the Government for bringing in the scheme by stages. I thought that was wise. It is a matter of forecasting. The noble Baroness said today--I had not heard her say it before--that she thought comparatively few disabled people would apply and that they would be among the younger ones. My feeling is that the new community care system is now under strain in parts of the country. It is not just a question of how much money is available from central government. It is not wise to load local authorities, even though it is a discretionary scheme, with too much more immediately.

I have in the past encouraged the Government to introduce the scheme by stages so that certain client groups--certain categories of disabled people--will be dealt with under the Bill when it is first enacted. I ask my noble friend Lady Cumberlege to confirm that it is the Government's intention, once the Bill is enacted, to extend its terms to other categories in due course when it is clear that the new system of direct payments is working efficiently and effectively. If that is the case, I would certainly hope to keep the Bill in its present form.

Lord Addington: My Lords, these amendments just ask the Government to allow local authorities to do within the rules what they have been doing outside the rules in many cases. There are no real cost implications as direct payments seem to save money--that is the evidence so far--rather than create the need for extra expenditure.

The noble Lord, Lord Campbell of Croy, referred to bringing in the scheme in stages. The amendment merely says that the people who are administering the scheme should be allowed to bring it in at their own pace for themselves and those they are administering it for. Everything said by the noble Lord, Lord Campbell of Croy, is taken care of by the amendment. It merely enables the scheme to become available more quickly to those who want it and to be administered by those who are ready for it. Nothing of a radical nature is suggested here. If we all want the scheme to work surely we should let those who are to implement it decide how they implement

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it. There is nothing radical suggested here. We want merely to allow those who are to run the scheme--those who are going to drive--have the wheel.

Baroness Hamwee: My Lords, when the Minister responds to the amendment, I ask her to bear in mind one simple point. The amendment directly addresses the issue of partnership between the service providers, on which the success of community care crucially depends.

Baroness Cumberlege: My Lords, the noble Baroness, Lady Hollis, has gone to enormous lengths to find a form of words which will meet two goals; first, to allow those local authorities which can manage to do so, to have discretion over the client group; secondly, to avoid the risk of overwhelming those authorities which are less able to cope. But I am afraid that her amendment still does not meet the concern that I expressed at Report stage that where direct payments are available they should be offered to a limited group but still on a national basis.

I have spoken ad nauseam on the need to see how things go so that we can judge whether the national framework needs to be adjusted. We accept that by giving local authorities discretion, as we are, variations are introduced--a patchwork, as the noble Baroness said today and the noble Lord, Lord Carter, has said in previous debates. But this amendment will create variations not only in terms of geography but also in terms of groups which are eligible. The more that we allow the differences, the more the Government lose their capacity to judge how direct payments are working nationally and overall.

During the course of the passage of the Bill I have listened carefully to the particular concerns that have been expressed in previous debates by the noble Lord, Lord Rix, and the noble Baroness, Lady Darcy (de Knayth), over the eligibility of people with learning disabilities who are not also physically disabled. I have given them some assurances that I should like to repeat now so that the words are in Hansard. Those with learning disabilities would be included in option B, paragraph 15 of the consultation paper. We will consider carefully, before reaching a final decision on eligibility, the responses to the consultation exercise, the views expressed in your Lordships' House and the fact that this House divided so narrowly on this issue.

As we have already said, we will consider particularly carefully whether all people with learning disabilities under the age of 65 should be included in the initial eligible group and we intend to keep the eligible group under review, as suggested by my noble friend Lord Campbell of Croy. As the eligible group is to be specified in regulations, we will be able to expand it in the future, if we think that is appropriate, without amending primary legislation.

We also remain unconvinced about the way in which this amendment would work in practice. The amendment would require regular consideration and much updating of the regulations. In this respect the amendment is even more cumbersome than that tabled at Report stage. The Secretary of State would still require large amounts of information to enable him to

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form a judgment about each local authority which wished to expand its eligible group, and if necessary to defend that judgment in Parliament.

I recognise what the noble Baroness, Lady Hollis, is seeking to achieve in this amendment. But the amendment goes no further to meet our wider concerns than the amendment which your Lordships rejected at Report stage. I therefore hope the noble Baroness will not choose to divide the House.

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