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Baroness Greengross moved Amendment No. 277:

(1) The National Assistance Act 1948 shall be amended as follows.
(2) Sections 42 (liability to maintain wife, husband or children) and 43 (recovery of cost of assistance from persons liable for maintenance) shall cease to have effect.
(3) In section 48(3) (duty of councils to provide temporary protection for property of persons admitted to hospital etc) omit the words "or from any person who for the purposes of this Act is liable to maintain him".
(4) In section 51(1) (failure to maintain) omit the words "or any person whom he is liable to maintain for the purposes of this Act".
(5) In section 56(1) (legal proceedings) omit the words "other than a sum due under an order made under section 43 of this Act".
(6) In Schedule 6 (transitional provisions) omit paragraph 19.
(7) The Public Health (Control of Diseases) Act 1984 shall be amended as follows.
(8) In section 46(5) (burial and cremation) omit the words "or from any person who for the purposes of the National Assistance Act 1948 was liable to maintain the deceased person immediately before his death".
(9) The Local Authority Social Services Act 1970 shall be amended as follows.
(10) In Schedule 1 (enactments conferring functions assigned to social services committees) for the words "Sections 43 to 45 in column 1" substitute "Section 45"."

The noble Baroness said: This amendment is designed to ensure that relatives do not have to pay, and do not have to be pursued so that they pay, for the care of their spouse who goes into residential care. I have to say that I was bitterly disappointed at having to table the amendment. Having said in the other place that the proposal had merit, I had hoped that the Government would table such an amendment. Now that all the consequential amendments have been covered, I trust that the Government will be able to accept the proposed new clause in this place.

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However, if the amendment is not acceptable, I hope that the Minister will be able to tell me exactly why the Government are no longer supporting it. It was said in the other place that any repercussions and any policy of other government departments would need to be considered. I do not know why the Department of Health has changed its mind, nor, indeed, where the problem lies. Could the Minister please explain the position to me?

Perhaps the Minister should consider the fact that all I am asking for is that local authorities should be debarred from asking spouses to contribute towards the cost of care. Research undertaken by Age Concern has shown that this applies to a very small number of people. However, it is a matter that causes them a tremendous amount of anxiety. It is true that only a few authorities pursue spouses and that only a few individuals are being penalised, but those concerned go through a terrible time of anxiety.

Moreover, it does not fit in with the Government's statements regarding not charging carers. Spouses have often performed the role of carer for years, thus saving the state huge amounts of money. Even when they reluctantly have to give up caring at home, many want to take an active part in the care of their spouse in the care home, thereby incurring much cost to themselves in terms of visiting.

I should like to make it quite clear to the Minister that I am only asking the Department of Health to change its rules, which would entail very negligible cost. Nevertheless, it would have a huge effect in relieving the anxiety of many people. I know that there are similar rules in relation to social security, but these cover all types of separation and, importantly, the maintenance of children. We have no expectation of there being any effect on those rules. I beg to move.

Lord Rix: I rise to support my noble friend Lady Greengross, and I shall do so briefly. Where charges fall to be made, it is obviously necessary to inquire into the shared resources to determine what the person who must meet the charge should pay. However, it cannot be satisfactory that the expectations of funding by relatives and partners should vary from place to place. Indeed, it cannot be right that the pressures on relatives to top up and make good service deficiencies should vary from place to place. We need greater clarity; and we need to dispel the fear that a relative's own resources will be depleted by domiciliary and residential charges, just as they are very often depleted by caring responsibilities.

I am also anxious to block, if we can, the moral pressure problem. This arises when someone who has no legal obligation to maintain is faced by an unacceptably poor quality of service for their nearest and dearest, with the offer to pull it up half-way to decency if he or she--the family member--would like

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to pay the bill. I hope that the Bill's standards provisions will help in that respect, while my noble friend's proposal addresses the legal position.

Lord Hunt of Kings Heath: As we heard, the amendment would stop councils seeking further contributions to care costs for residential care from spouses, in addition to the costs that residents are fairly assessed to pay under the means test. Again, I fully understand the intentions behind the amendment. I am aware of the difficulties caused by the operation of the liable relatives rule as far as concerns residential care and the distress that can be caused to residents and their husbands or wives at what is already a very difficult time. I am also aware of correspondence from Age Concern England which has highlighted that not all care managers are as aware of the liable relatives rule as they ought to be and that there have been some examples of such managers bringing considerable pressure to bear on spouses to make a contribution. It has been reported that fishing expeditions have been undertaken into spouses' financial affairs, causing considerable distress.

Moreover, it is clear that the liable relatives rule is applied patchily over the country. Some councils do not seem eager to apply it, while other councils, although in a minority, seem to be very enthusiastic about it. In another place my right honourable friend the Health Minister said that he would look carefully at the operation of the liable relatives rule and the link to similar rules that apply to other government departments. We have explored all the issues thoroughly and there are a number of difficulties in proceeding along the lines proposed by the amendment. In the first place, I believe that there would be significant implications for public spending as the liable relatives rule has a read-across to wider social security issues. At the end of the day I am not sure it is possible simply to put a barrier round this particular application of the liable relatives rule.

Secondly, it is appropriate that councils are enabled, where it is appropriate, to seek contributions to care costs where the resident has relatively meagre resources while the partner at home is well off. In these instances, residents should look not only to the state for support but also to their partners. To do otherwise would be inappropriate and would place an unfair burden on taxpayers. Thirdly, as I have said, many councils apply current guidance and common sense and do not seek liable relative contributions from spouses in all cases.

Having carefully considered this matter and the arguments that we have heard tonight, I believe that the best course of action would be to remind councils of current guidance rather than to repeal this fundamental rule. When cared for people enter respite care I would expect councils fully to consider all of the issues before considering what contribution to care costs, if any, to seek from spouses who are substantial and regular carers. I realise that my response will be

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disappointing to the noble Baroness but I am committed to ensuring that we reissue current guidance and remind councils of their responsibilities.

Baroness Greengross: I am rather saddened by the Minister's response. I shall return to the matter. Meanwhile, with great reluctance and given the time of night, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 60 [Disregarding of resources when determining need for residential accommodation]:

Baroness Greengross moved Amendment No. 278:

    Page 61, line 44, after "person" insert "a local authority shall only consider care and attention to be otherwise available if it is satisfied that--

(a) the person is both willing and able to make his own arrangements, or
(b) a representative acting on that person's behalf is both willing and able to make the arrangements for that person,

The noble Baroness said: This amendment is designed to ensure that all people assessed as being in need of care and attention and who want the security of social services arranging their residential or nursing home care should not be denied access to this service.

The current provisions discriminate against people who have over £16,000, as even when they are assessed as needing residential care they are left to make their own arrangements with care homes. Many would prefer to have the security of a social services contract--these people by definition are frail and often very elderly. That would also mean that they would be under the care management of social services, which would oversee their care and would review it to check that it was still appropriate. We must remember that people's care needs change; sometimes they need less care. They do not always need more care.

There is clear guidance on those who lack the mental capacity to make their own arrangements and those people will come under social services, but that leaves frail older people who find it difficult to negotiate with home owners faced with doing so, often on their own. Even if they have relatives negotiating on their behalf, it would still leave them with no one fully qualified to oversee their care. I beg to move.

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