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Division No. 1

CONTENTS

Aberdare, L.
Addington, L.
Ailsa, M.
Alexander of Tunis, E.
Anelay of St. Johns, B.
Annaly, L.
Archer of Weston-Super-Mare, L.
Ashbourne, L.
Astor of Hever, L.
Attlee, E.
Beaumont of Whitley, L.
Berners, B.
Blackburn, Bp.
Blaker, L.
Blatch, B.
Blyth, L.
Boardman, L.
Brabazon of Tara, L.
Bridgeman, V. [Teller.]
Broadbridge, L.
Brougham and Vaux, L.
Buckinghamshire, E.
Cadman, L.
Campbell of Alloway, L.
Carlisle, E.
Carnegy of Lour, B.
Charteris of Amisfield, L.
Chesham, L.
Chilver, L.
Chorley, L.
Clement-Jones, L.
Colwyn, L.
Cranborne, V.
Cullen of Ashbourne, L.
Dacre of Glanton, L.
Davidson, V.
Dholakia, L.
Dixon-Smith, L.
Downshire, M.
Eames, L.
Ellenborough, L.
Elles, B.
Elliott of Morpeth, L.
Elton, L.
Ezra, L.
Falkland, V.
Ferrers, E.
Foley, L.
Fookes, B.
Forbes, L.
Gisborough, L.
Glanusk, L.
Glasgow, E.
Glentoran, L.
Goodhart, L.
Haig, E.
Halsbury, E.
Hamwee, B.
Hanningfield, L.
Harding of Petherton, L.
Harlech, L.
Harris of Greenwich, L.
Henley, L. [Teller.]
Higgins, L.
Holderness, L.
HolmPatrick, L.
Hooper, B.
Howe, E.
Hunt of Wirral, L.
Hylton-Foster, B.
Ilchester, E.
Inglewood, L.
Jacobs, L.
Kitchener, E.
Knollys, V.
Lamont of Lerwick, L.
Lane of Horsell, L.
Lauderdale, E.
Lindsey and Abingdon, E.
Long, V.
Lucas of Chilworth, L.
Ludford, B.
Luke, L.
McConnell, L.
Macleod of Borve, B.
McNair, L.
Maddock, B.
Malmesbury, E.
Mar and Kellie, E.
Marlesford, L.
Masham of Ilton, B.
Mersey, V.
Methuen, L.
Miller of Hendon, B.
Milverton, L.
Montgomery of Alamein, V.
Mountevans, L.
Moyne, L.
Munster, E.
Murton of Lindisfarne, L.
Napier and Ettrick, L.
Naseby, L.
Newall, L.
Newby, L.
Northesk, E.
Norton, L.
Onslow, E.
Oppenheim-Barnes, B.
Oxfuird, V.
Palmer, L.
Park of Monmouth, B.
Pender, L.
Pike, B.
Plummer of St. Marylebone, L.
Poole, L.
Rankeillour, L.
Rawlings, B.
Razzall, L.
Reay, L.
Redesdale, L.
Renton, L.
Renton of Mount Harry, L.
Renwick, L.
Rodgers of Quarry Bank, L.
Rowallan, L.
Russell, E.
Ryder of Warsaw, B.
St. Davids, V.
St. John of Fawsley, L.
Saltoun of Abernethy, Ly.
Sandberg, L.
Sharp of Guildford, B.
Shaw of Northstead, L.
Skelmersdale, L.
Skidelsky, L.
Smith of Clifton, L.
Soulsby of Swaffham Prior, L.
Steel of Aikwood, L.
Stockton, E.
Strathcarron, L.
Strathclyde, L.
Sudeley, L.
Swinfen, L.
Taverne, L.
Teviot, L.
Thomas of Gwydir, L.
Thomas of Walliswood, B.
Thurso, V.
Tope, L.
Trefgarne, L.
Trenchard, V.
Trumpington, B.
Vivian, L.
Wade of Chorlton, L.
Westbury, L.
Wharton, B.
Wilcox, B.
Winchilsea and Nottingham, E.
Wise, L.
Wynford, L.
Young, B.

NOT-CONTENTS

Acton, L.
Ahmed, L.
Allenby of Megiddo, V.
Alli, L.
Amos, B.
Archer of Sandwell, L.
Ashley of Stoke, L.
Bach, L.
Bassam of Brighton, L.
Berkeley, L.
Blackstone, B.
Borrie, L.
Bragg, L.
Brooke of Alverthorpe, L.
Brookman, L.
Bruce of Donington, L.
Burlison, L.
Carew, L.
Carter, L. [Teller.]
Christopher, L.
Clarke of Hampstead, L.
Cocks of Hartcliffe, L.
Crawley, B.
David, B.
Davies of Oldham, L.
Desai, L.
Diamond, L.
Donoughue, L.
Dubs, L.
Eatwell, L.
Emerton, B.
Evans of Watford, L.
Falconer of Thoroton, L.
Farrington of Ribbleton, B.
Fitt, L.
Gainsborough, E.
Gladwin of Clee, L.
Gordon of Strathblane, L.
Goudie, B.
Gould of Potternewton, B.
Graham of Edmonton, L.
Grenfell, L.
Hacking, L.
Hanworth, V.
Hardie, L.
Hardy of Wath, L.
Harris of Haringey, L.
Haskel, L.
Hayman, B.
Hilton of Eggardon, B.
Hollis of Heigham, B.
Howie of Troon, L.
Hoyle, L.
Hughes, L.
Hughes of Woodside, L.
Hunt of Kings Heath, L.
Irvine of Lairg, L. [Lord Chancellor.]
Janner of Braunstone, L.
Jay of Paddington, B. [Lord Privy Seal.]
Jeger, B.
Jenkins of Putney, L.
Judd, L.
Kennet, L.
Kintore, E.
Laming, L.
Lawrence, L.
Levy, L.
Lockwood, B.
Longford, E.
Lovell-Davis, L.
Macdonald of Tradeston, L.
McFarlane of Llandaff, B.
McIntosh of Haringey, L. [Teller.]
Mackenzie of Framwellgate, L.
Milner of Leeds, L.
Molloy, L.
Monkswell, L.
Montague of Oxford, L.
Morris of Castle Morris, L.
Morris of Manchester, L.
Nicol, B.
O'Neill of Bengarve, B.
Patel, L.
Pitkeathley, B.
Plant of Highfield, L.
Ponsonby of Shulbrede, L.
Prys-Davies, L.
Puttnam, L.
Ramsay of Cartvale, B.
Randall of St. Budeaux, L.
Rea, L.
Richard, L.
Rogers of Riverside, L.
Sainsbury of Turville, L.
Shannon, E.
Shore of Stepney, L.
Simon, V.
Simon of Highbury, L.
Stallard, L.
Strabolgi, L.
Symons of Vernham Dean, B.
Tenby, V.
Thornton, B.
Tomlinson, L.
Turner of Camden, B.
Uddin, B.
Walton of Detchant, L.
Warner, L.
Weatherill, L.
Wedderburn of Charlton, L.
Whitty, L.
Williams of Elvel, L.
Winston, L.

Resolved in the affirmative, and amendment agreed to accordingly.

18 Mar 1999 : Column 848

4.44 p.m.

Clause 19 [Co-operation between NHS bodies]:

[Amendments Nos. 48 and 49 not moved.]

Baroness Pitkeathley moved Amendment No. 50:


After Clause 20, insert the following new clause--

Health Authorities to assist with community care assessments

(" .--(1) Section 47 of the National Health Service and Community Care Act 1990 (assessment of needs for community care services) is amended as follows.
(2) In subsection (3), for the words "invite them to assist, to such extent as is reasonable in the circumstances," there shall be inserted the words "request them to assist".
(3) After subsection (3) there is inserted--
"(3A) A Health Authority whose help is so requested shall comply with the request if it is compatible with its own statutory duties and obligations and does not unduly prejudice the discharge of any of its functions."").

The noble Baroness said: My Lords, this amendment is a modified version of one that I put forward in Committee. It seeks to place a duty on a health authority to assist a local authority in carrying out a community care assessment if--that is an important if--the local authority requires such assistance, and if complying with such a request is compatible with the health authority's duties and does not unduly prejudice the health authority's functions. There is a similar provision for co-operation between agencies in the Children Act 1989.

Section 47 of the National Health Service and Community Care Act 1990 requires local authorities to invite health authorities to assist in the assessment of an individual's needs where it appears to a local authority that an individual has health needs. This amendment would require a health authority which has been asked to do this by a local authority, to assist in the assessment if providing such assistance would be in accordance with the health authority's functions. Thus the

18 Mar 1999 : Column 849

amendment does not place a duty--I must emphasise this--on health authorities to be involved in every community care assessment. However, there will be cases where the assessment of a person's health needs will be an essential part of a local authority's community care assessment. For example, a person with learning disabilities and mental health problems may have complex needs and the assessment of such needs will require input from health professionals working with their colleagues in social services. I believe this measure would give government another mechanism by which they can ensure closer working between these two bodies. I know the Government are committed to that.

The amendment is necessary in my view because while Section 47 of the National Health Service and Community Care Act places a duty on local authorities to invite health authorities to assist in a community care assessment where they believe that a person has health needs, there is no corresponding duty on health authorities to assist, as they have been requested. Thus, if health authorities fail to assist in such assessments, there is no mechanism requiring them to do so. The section states that the local authority--that is usually social services--will, when making the assessment, take into account any services that are likely to be made available by the health authority. If the health authority refuses to co-operate--I accept that those occasions would be few--the local authority's ability to carry out an effective assessment will be undermined and as a result the user, and possibly the carer, will suffer.

Failure to provide a comprehensive, multi- disciplinary assessment can lead to a deterioration in the health of the individual. This amendment would therefore support the Government's aims in providing a more public health oriented agenda. This amendment has the support of the Local Government Association, the Association of Directors of Social Services, the Law Society, the Carers National Association, the Alzheimer's Disease Society and many others. Its aim is to underpin existing policy and guidance on community care. The expectation that health authorities will be involved in community care assessments where necessary has been made clear in a number of government documents relating to community care. I beg to move.


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