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Lord Clement-Jones: My Lords, I support the amendment. We have had a powerful speech from the noble Earl, Lord Howe, in favour of it. It is no secret that we on these Benches believe the Bill to be completely misguided. In the best of all possible worlds, we would prefer it not to leave the House, as the Minister is clearly aware.
The Government have a rather different view. What is in contention is the evidence they have that the Bill will be effective. There appears to be no evidence at all, apart from a spurious health tourism visit that Ministers appear to have made to Sweden, as the noble Earl, Lord Howe, pointed out.
The amendment gives the Government the opportunity to put the matter to the test. In five years' time it would give both Houses the opportunity to debate whether the Bill has benefited the patient. Even
if we cannot bury the Bill in this House, I hope that at least we can provide for it to be put to the test in five years' time. For that reason, I hope that the amendment will be supported.
Lord Hunt of Kings Heath: My Lords, I am overwhelmed by the enthusiasm shown by the noble Earl, Lord Howe, and the noble Lord, Lord Clement-Jones, for the Bill. I regret that. I will not repeat what I have already stated today—this is probably our fourth Second Reading-type debate on the principles contained in the Bill—but I would like to respond to two points raised by the noble Earl, Lord Howe, and endorsed by the noble Lord, Lord Clement-Jones.
Let me clearly state that local authorities are not the whipping boys, as described by the noble Earl, Lord Howe. The Bill's architecture and the practice that will follow is so constructed that the success of its implementation will depend on both the local authority and the NHS improving their practice. If the NHS fails on its side of the bargain, incentives will be in place to ensure that it, too, suffers.
The noble Earl, Lord Howe, referred to money moving around the system. I believe that financial incentives, in the right circumstances, can encourage good performance. That is why it is appropriate that we are transferring £100 million in a full year, which is what we reckon will be the local authority costs of dealing with the current level of delayed discharges and why it is right that that money should come from NHS budgets. Where local authorities ensure that they deal with discharge cases effectively, that resource will be spent not on paying penalties to the NHS but on providing effective community support services. That is surely the point.
I very much hope and, indeed, expect that very few penalties will be issued, because that is, in a sense, the last resort under the Bill. One wants good practice to be adopted everywhere. We know that good practice exists in many parts of the country. Despite the spectacle that we have been treated to in our debates of problems facing these poor statutory agencies, there are many examples of such agencies getting their act together, ensuring that discharge procedures are put into place effectively and that there is an effective package of care in the community for older people who have been so discharged.
This is not a confrontational Bill. It is not bureaucratic, but it does demand rigour and proper processes. It demands that matters should be written down. It demands that deadlines are met. But the whole problem with so much practice in health and social care up to now is that rigour has been lacking. I make no apologies whatever for ensuring through the Bill that rigour is put into place as that is the essential safeguard for the individual patient who at the moment is delayed far too long in an acute hospital bed.
As regards the sunset clause, I repeat what I said at Report stage. Such clauses are generally used only in Acts that are passed because of national emergencies such as the Import, Export and Customs Powers (Defence) Act 1939, or Acts which impinge upon
individual civil liberties. Proposing a sunset clause for this Bill is going over the top. We shall, of course, monitor the introduction of the Bill. We have monitoring systems in place. We shall look at the data. We shall work with local authorities and with the health service to ensure that the Bill is implemented successfully. I am confident that that will be the case. I believe that older people in particular will very much benefit from its provisions. However, I do not believe that this is the kind of Bill to which a sunset clause should apply.5 p.m.
Earl Howe: My Lords, I listened carefully to the Minister and I thank him for his remarks. Once again, he asserted his confidence in the Bill before us. It would be surprising if he had not. What has been notable ever since Second Reading is that, apart from the Minister, hardly anyone at all, not even on his own Benches, has expressed any confidence in the Bill or any enthusiasm for it. I suggest that that fact alone puts the Minister's confidence into perspective. I should tell him that even at this late stage of the Bill I have received impassioned pleas from local government quarters to kill the Bill off entirely. No doubt other noble Lords have also received such pleas. It is only right to take such approaches seriously but for our part, as the noble Lord, Lord Clement-Jones, indicated, we have decided on balance that, particularly improved and amended as it has been by your Lordships, the Bill should be allowed to pass.
As I have said, this is a Bill that is not only shot through with undesirable features but is also fraught with risk and uncertainty. That is the main reason for my amendment. There is another reason which is that it should be second nature to us to look for ways of ridding the statute book of unnecessary or unsuccessful regulation whenever we can. Sunset clauses enable us to address those objectives in a very neat fashion. Frankly, it is irrelevant where and when sunset clauses have been used before. They should be seen as being useful in appropriate circumstances. I believe that this amendment is worthy of approval and I should like to seek the opinion of the House on it.
5.4 p.m.
On Question, Whether the said amendment (No. 16) shall be agreed to?
Their Lordships divided: Contents, 145; Not-Contents, 115.
Aberdare, L.
Addington, L.
Alton of Liverpool, L.
Ampthill, L.
Anelay of St Johns, B.
Astor, V.
Astor of Hever, L. [Teller]
Avebury, L.
Baker of Dorking, L.
Barker, B.
Beaumont of Whitley, L.
Biffen, L.
Blaker, L.
Blatch, B.
Bowness, L.
Bradshaw, L.
Bridges, L.
Brooke of Sutton Mandeville, L.
Brougham and Vaux, L.
Burnham, L.
Buscombe, B.
Byford, B.
Campbell of Alloway, L.
Carnegy of Lour, B.
Cavendish of Furness, L.
Chadlington, L.
Chalfont, L.
Clement-Jones, L. [Teller]
Coe, L.
Colwyn, L.
Cox, B.
Dean of Harptree, L.
Denham, L.
Dholakia, L.
Dixon-Smith, L.
Eden of Winton, L.
Elis-Thomas, L.
Elles, B.
Elliott of Morpeth, L.
Elton, L.
Ezra, L.
Falkland, V.
Fearn, L.
Finlay of Llandaff, B.
Fookes, B.
Fowler, L.
Gardner of Parkes, B.
Gilmour of Craigmillar, L.
Glentoran, L.
Goodhart, L.
Gray of Contin, L.
Hamwee, B.
Hanham, B.
Hanningfield, L.
Henley, L.
Hodgson of Astley Abbotts, L.
Hogg, B.
Holme of Cheltenham, L.
Howe, E.
Howe of Aberavon, L.
Howell of Guildford, L.
Hunt of Wirral, L.
Inge, L.
James of Holland Park, B.
Jenkin of Roding, L.
Jopling, L.
Laing of Dunphail, L.
Lawson of Blaby, L.
Lester of Herne Hill, L.
Livsey of Talgarth, L.
Lucas, L.
Lyell, L.
McColl of Dulwich, L.
MacGregor of Pulham Market, L.
Mackie of Benshie, L.
McNally, L.
Maddock, B.
Marlesford, L.
Masham of Ilton, B.
Mayhew of Twysden, L.
Miller of Chilthorne Domer, B.
Miller of Hendon, B.
Monro of Langholm, L.
Moran, L.
Mowbray and Stourton, L.
Moynihan, L.
Murton of Lindisfarne, L.
Newby, L.
Newton of Braintree, L.
Noakes, B.
Northesk, E.
Northover, B.
Oakeshott of Seagrove Bay, L.
O'Cathain, B.
Onslow, E.
Park of Monmouth, B.
Parkinson, L.
Patten, L.
Perry of Southwark, B.
Perry of Walton, L.
Plumb, L.
Rawlings, B.
Reay, L.
Redesdale, L.
Renfrew of Kaimsthorn, L.
Rennard, L.
Renton, L.
Roberts of Conwy, L.
Rodgers of Quarry Bank, L.
Rogan, L.
Roper, L.
Ryder of Wensum, L.
St. John of Bletso, L.
Sandberg, L.
Sanderson of Bowden, L.
Sandwich, E.
Scott of Needham Market, B.
Sharp of Guildford, B.
Sharples, B.
Shaw of Northstead, L.
Shutt of Greetland, L.
Simon of Glaisdale, L.
Skelmersdale, L.
Smith of Clifton, L.
Steel of Aikwood, L.
Stevens of Ludgate, L.
Swinfen, L.
Taverne, L.
Thatcher, B.
Thomas of Gresford, L.
Thomas of Walliswood, B.
Thomson of Monifieth, L.
Tordoff, L.
Tugendhat, L.
Vivian, L.
Waddington, L.
Wallace of Saltaire, L.
Walmsley, B.
Warnock, B.
Weatherill, L.
Wigoder, L.
Wilcox, B.
Williams of Crosby, B.
Windlesham, L.
Wolfson, L.
Acton, L.
Ahmed, L.
Amos, B.
Andrews, B.
Archer of Sandwell, L.
Ashton of Upholland, B.
Bach, L.
Barnett, L.
Bassam of Brighton, L.
Bernstein of Craigweil, L.
Blackstone, B.
Borrie, L.
Bragg, L.
Brett, L.
Brooke of Alverthorpe, L.
Brookman, L.
Bruce of Donington, L.
Campbell-Savours, L.
Carter, L.
Chorley, L.
Christopher, L.
Clark of Windermere, L.
Clarke of Hampstead, L.
Clinton-Davis, L.
Cohen of Pimlico, B.
Corbett of Castle Vale, L.
Crawley, B.
David, B.
Davies of Coity, L.
Davies of Oldham, L.
Dean of Thornton-le-Fylde, B.
Desai, L.
Dixon, L.
Donoughue, L.
Dormand of Easington, L.
Dubs, L.
Elder, L.
Evans of Parkside, L.
Evans of Temple Guiting, L.
Farrington of Ribbleton, B. [Teller]
Faulkner of Worcester, L.
Filkin, L.
Fitt, L.
Fyfe of Fairfield, L.
Gale, B.
Gibson of Market Rasen, B.
Gladwin of Clee, L.
Golding, B.
Goudie, B.
Gould of Potternewton, B.
Grabiner, L.
Graham of Edmonton, L.
Greengross, B.
Gregson, L.
Hardy of Wath, L.
Harrison, L.
Haskel, L.
Hayman, B.
Hilton of Eggardon, B.
Hogg of Cumbernauld, L.
Hollis of Heigham, B.
Howells of St. Davids, B.
Howie of Troon, L.
Hoyle, L.
Hughes of Woodside, L.
Hunt of Chesterton, L.
Hunt of Kings Heath, L.
Janner of Braunstone, L.
Jones, L.
Jordan, L.
King of West Bromwich, L.
Kirkhill, L.
Lea of Crondall, L.
Lipsey, L.
Lofthouse of Pontefract, L.
Macdonald of Tradeston, L.
McIntosh of Haringey, L. [Teller]
MacKenzie of Culkein, L.
Mallalieu, B.
Mason of Barnsley, L.
Merlyn-Rees, L.
Milner of Leeds, L.
Mishcon, L.
Mitchell, L.
Morgan, L.
Morris of Aberavon, L.
Morris of Manchester, L.
Orme, L.
Parekh, L.
Patel of Blackburn, L.
Pendry, L.
Peston, L.
Pitkeathley, B.
Plant of Highfield, L.
Puttnam, L.
Ramsay of Cartvale, B.
Randall of St. Budeaux, L.
Rendell of Babergh, B.
Richard, L.
Sainsbury of Turville, L.
Sawyer, L.
Sheldon, L.
Simon, V.
Strabolgi, L.
Symons of Vernham Dean, B.
Taylor of Blackburn, L.
Temple-Morris, L.
Thornton, B.
Turner of Camden, B.
Walker of Doncaster, L.
Warwick of Undercliffe, B.
Whitaker, B.
Wilkins, B.
Williams of Elvel, L.
Woolmer of Leeds, L.
Resolved in the affirmative, and amendment agreed to accordingly.
5.14 p.m.
Lord Hunt of Kings Heath: My Lords, I beg to move that this Bill do now pass.
Moved, That the Bill do now pass.—(Lord Hunt of Kings Heath.)
On Question, Bill passed, and returned to the Commons with amendments.
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