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Lord Clement-Jones: I thank the Minister for his reply. We shall obviously consider very carefully what he said. In a sense, it is a matter of judgment as to whether there is a need to tighten up the clause. I fully accept the commitment he made that eventually all domiciliary care agencies will be registered, but I am worried about the mechanism by which sub-contracting will be carried out in all cases if it was thought to be important at some stage in the future--for instance, if a mixed economy became rather more prevalent in the healthcare sector. It seems to me that there is not the necessary mechanism in the clause--and, under the Bill, I doubt whether it could be done by regulation--to ensure that the relationship with an independent body is made utterly clear in the way that the relationship between the domiciliary care agency and the local authority and the NHS body is made clear.
If it was thought desirable, for instance, to ensure that a domiciliary agency is registered if it sub-contracts from an independent hospital, it is not clear how that will come about and how, under the Bill, it can be enforced. I am not sure whether there is a legal entitlement to do so. That is why consumer bodies which have spoken to me about this matter are keen that the clause should be widened in the way we have suggested. I am not yet convinced by the Minister. Perhaps he can give some further clarification.
Lord Hunt of Kings Heath: I am not sure that I understand the noble Lord. Perhaps he can explain a little more what he means by "sub-contracting".
Lord Clement-Jones: We are talking about the discharge of responsibility for a relevant function.
That is what I mean by "sub-contracting". It reflects the terms of the clause, which are wide in respect of an NHS body. But it seems to me that there is a gap; why are there not circumstances in which an independent hospital should not be treated in an identical way? It may be a part of their insurance policy that they are entitled to that form of home care and the domiciliary care agency is undertaking it as a result of that insurance policy. In those circumstances it seems that they need safeguards. While I fully accept that the Minister said that it is intended that domiciliary care agencies should be registered in the future, I am not sure how that will bite if there is a form of sub-contracting along the lines I have described.
Lord Hunt of Kings Heath: It may be that I am being dense here. As regards Clause 30, my understanding is that we are looking at a situation that concerns with whom a local authority or an NHS body may arrange for a relevant function to be discharged. I am afraid that the noble Lord has lost me in relation to where another body to which such a relevant function can be sub-contracted comes into this.
Lord Clement-Jones: The Minister was doubtful about whether there were many circumstances in which independent hospitals could arrange for the discharge of a relevant function. However, assuming that he was prepared to accept that there are circumstances in which they do so and they could do so, why does this clause not also apply to them? I do not believe that the Minister has fully answered that question.
Lord Hunt of Kings Heath: As I explained, in relation to domiciliary care agencies, we have decided to take a gradualist approach to their regulation. The gradualist approach requires those agencies under contract with a local authority or health authority to be regulated. We then stated that, over time, we will gradually extend that regulation to all domiciliary care agencies.
Lord Clement-Jones: How would that happen?
Lord Hunt of Kings Heath: It will happen through the provisions contained in the Bill which allow us to do that.
Lord Clement-Jones: We could spend many happy hours playing tennis on this one. I shall reflect on what the Minister said and no doubt he will do the same on my comments. I shall now leave it to the noble Earl, Lord Howe, to finish his amendment.
Earl Howe: No doubt I shall finish with some relief to all noble Lords. As regards my own amendments, I am most grateful to the Minister for his clarification on the issue of direct payments. He has satisfied a great many people who were uncertain and doubtful about the effects of the Bill on the direct payment scheme. I am delighted to discover that there will be no effects whatsoever. I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
[Amendments Nos. 102 to 105 not moved.]
Clause 34 [Provision of copies of registers]:
Lord Laming moved Amendment No. 106:
- Page 16, line 34, at end insert (", including circumstances in which the interested party is in receipt of or has had an application for a direct payment").
- "(", including circumstances in which the interested party is in receipt of or has made an application for a direct payment")".
These amendments are designed to ensure that users of direct payments are in a position to furnish themselves with high quality information as regards the registration and inspection history of services without financial cost. It is crucial that people who have been awarded public money to support their community care needs are able to make informed decisions on how best to use those resources. Can the Minister confirm that the power to charge for receipt of information will not apply to individual service users? I beg to move.
9.45 p.m.
Lord Addington: My name is attached to Amendment No. 127. It is very straightforward and a comparatively uncomplicated probing amendment. All it suggests is that in talking about registration we are speaking about information. It suggests that the most up-to-date technology should be used. I shall not use the word "modern" because what is modern today is old-fashioned and out of date tomorrow. That will be quicker and probably cheaper. I suggest that that should be allowed by the Bill. I hope that the Minister will confirm that.
Lord Hunt of Kings Heath: I have great sympathy with all the amendments concerned with ensuring that service users can access information free of charge and in the appropriate form. I shall deal first with Amendment Nos. 106, 126 and 128 concerning recipients of direct payments. Under the current regulatory regime, local and health authorities which carry out regulatory functions are already required to provide copies of entries in their registers on payment of such reasonable fee as they may determine.
With the implementation of this Bill, the national care standards commission, or, in Wales, the National Assembly, will similarly be able to require the payment of a reasonable fee for copies of, or extracts from, its registers. Parallel provision is made for the councils to determine the fee for copies of their codes or registers.
However, the commission, the Assembly and the councils will all provide information free of charge if they consider that appropriate. I can assure Members of the Committee that it would not be normal practice for a fee to be charged for the provision of such information.
Indeed, it is intended that the commission and the councils should supply information from their registers and about any codes freely to all members of the public and not just to recipients of direct payments. In fact, it is only on rare occasions that the commission, or indeed the councils, would want to make a charge for information. If a business asked for a complete copy of the directory giving details of every care home in the country because it wanted to carry out business mailings to them, I believe that it would be reasonable for the commission to make a charge in order to cover the costs. But if the request for information was from an individual who simply wanted to know about care homes in an area, that information should be made available free of charge. Regulations made under Clause 34 will make that clear. Similarly, we intend to give the councils appropriate directions about when charges for their documents may be levied.
Turning to Amendment No. 127, I am rather glad that the noble Lord, Lord Lucas, is not here to ask me more challenging questions about modern information systems. Of course, we want the councils to be able to give as much information as possible. We certainly intend that the registers will be available on the Internet as well as in the form of hard copy. However, the noble Lord's amendment has prompted us to consider whether such a provision is allowed for in the Bill as it stands. I should like to give that matter further consideration.
Lord Laming: I am grateful to the Minister for that very helpful reply. In the light of what he has said, I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Clause 35 [Service of documents]:
Clause 41 [Inspection by registration authority of adoption and fostering services]:
[Amendments Nos. 109 and 110 not moved.]
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