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That will be achieved through a combination of the regulations enabled by the Bill and the issuing of separate directions made under Section 7A of the Local Authority Social Services Act 1970. Just saying that shows that not just I but the noble Baroness, her advisers and our officials have been closeted together for the past few weeks to reach this solution.
The directions will impose a duty on both the authority providing the free personal care and the authority to which the person moves to co-operate to
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The regulations will provide that where a person in receipt of free personal care moves from one authority to another, and the new authority is providing them with personal care before an assessment of their eligibility for free provision is carried out, the new authority must provide the personal care free of charge until an assessment of eligibility for free care has been carried out.
I am very grateful to the noble Baroness and to her advisers at RADAR for all their hard work with us on the draft regulations and directions, and for giving us a further opportunity to demonstrate the move towards a future national care service. Subject to her satisfaction with our proposals, I would ask that the amendment be withdrawn.
Baroness Campbell of Surbiton: I thank the noble Baroness, Lady Thornton, for setting out so clearly the positive impact that this will have on the life chances of those with critical-plus needs. It has been a very interesting, long and challenging journey. The right of portability and clear directions on how it should be executed seamlessly must not be underestimated. Disabled and older people will be absolutely delighted with what has been achieved in this House today. It will give them more hope for the tricky times ahead. This is indeed the first step towards the fairer national care and support system that we are looking for. I believe that it has been taken very seriously. Therefore, I am delighted and beg leave to withdraw the amendment.
Lord Best: My Lords, the amendment would postpone the start date for free care at home for those with high levels of care needs. I declare my interest as president of the Local Government Association. The amendment reflects the concerns of local authorities about the timetable for this measure.
The anxieties of the local authorities which are being asked to deliver the new arrangements are of two kinds. First, there is the worry that they cannot get arrangements to help 400,000 people in a new way up and running in the next few months. These months will include local as well as national elections, with possible changes of local leadership and local policies, and will also cover the weeks of the summer holidays. Secondly, local authorities are concerned that their budgets have already been set for 2010-11 and cannot, at this stage, take the hit of an extra £125 million which they are expected to find by way of cuts in other
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This is in no way a wrecking amendment. If it finds favour with your Lordships, the measures in the Bill would simply be implemented at a later date. At earlier stages, I have praised the positive aspects of this Bill, and I know it is supported by a number of charities with which I have connections. However, it is not sensible to proceed at a pace that local authorities believe is unfair and unreasonable. After all, central government depends on the hard work and good will of local authorities for the delivery of the Bill's provisions; alienating those who will have to make it work would be a bad start. Nobody wants this new initiative to be a shambles on 1 October, discrediting its principles and antagonising those it should help.
The Minister has been unfailingly courteous and willing to listen throughout the progress of this legislation, as demonstrated in her support for the excellent portability clause pressed so successfully by the noble Baroness, Lady Campbell. She has written to all Peers with an interest in the Bill to offer a concession on the timing of the programme for delivering free care. She has said that if there are delays in local authorities processing all the thousands of assessments for eligibility for free care, then those individuals whose claims are eventually agreed will have the costs of care backdated to the date on which they applied, even though they were not assessed for some time thereafter. This is indeed a helpful concession, and would alleviate some of the pressure when people start to apply for eligibility assessments.
I have asked the Local Government Association whether this concession would make a significant difference to the administrative burden it faces. The LGA has responded that despite the very welcome efforts of the Minister, this help would not do the trick. The concession does not negate the need for councils to have completed a vast range of preparatory activity by 1 October. This activity includes: taking action on such matters as impact assessments of free personal care on other related policies; undertaking financial modelling and making changes to current charging systems; conducting equality impact assessments and implementation planning; carrying out an awful lot of training in the new assessments; introducing, testing and ironing out the bugs in new IT systems and reporting procedures; setting up and market-testing contracting arrangements with providers; communicating with the general public through an information and communication drive with new publicity leaflets; and all the rest. It would be wrong to assume there will be any less pressure on councils to complete all these tasks by 1 October simply because they can backdate an individual's entitlements.
This brings me to the question of whether, irrespective of the problems of getting the administrative arrangements up and running by 1 October, local authorities can be expected to find the money for this scheme during the financial year that is just about to start. Councils have already set their budgets and council tax for 2010-11, and are already having to make hefty efficiency savings.
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Some way down the line, there may be savings from the Bill's provisions. For example, fewer people may pay their way and go into residential care, but their money may run out and the council will be required to pick up the bills. If these people are helped to stay at home for longer, public spending at a later date could be avoided in some cases. However, local government expects no such offsetting savings for a couple of years, and everyone agrees that extra money must be found as soon as the new system kicks in. Indeed, Sir Jeremy Beecham at the LGA believes that imposing these new duties on local authorities without fully funding them or lifting other obligations from them violates the new burdens doctrine that was agreed between central and local government. How are local authorities to shoulder this extra financial burden when they are already making significant economies and their social care budgets are under huge pressure?
Even if staff are made redundant, costs in the first year are likely to be higher, not lower, because of redundancy arrangements and the rest, and I am sure that the charities, which want to see help going to those who currently pay for care as soon as possible, would not be happy if this help were at the expense of others who also need social care. As the Equality and Human Rights Commission says:
It is not justifiable to require local authorities to rob Peter to pay Paul, to redo budgets or to revisit council tax levels after the financial year has begun. Surely it is better to take this at a sensible pace and look at a start date of next April. I am therefore grateful to the Minister for her letter and her endeavours to help to ease the burden on councils which the current timetable certainly imposes, but surely the local government sector has right on its side when it says that it is unreasonable and unfair to require councils to implement and to pay a substantial share of the costs of the new arrangements from 1 October this year. Let us agree to postpone implementation, as set out in Amendment 2. I beg to move.
I agree entirely with everything that the noble Lord, Lord Best, has said. As noble Lords know, I am no great fan of this Bill, which I regard more as a cul-de-sac than a stepping stone or bridge to a reformed system. However, even if I supported this Bill, I would still press this amendment on the Government to save them from spoiling their own creation through poor implementation.
This is not a wrecking amendment; it is simply a recognition of the realities of implementing a complex new scheme of assessment alongside other existing
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This lack of preparedness has led the Association of Directors of Adult Social Services to make it crystal clear to the Government for a long time that the new system cannot be implemented in October. In replying to the Government's consultation, on page 3 of its response, it said:
It reiterated that position in a letter to me of 15 March, which it has copied to Ministers and which we have tried to make available to all Peers. The Government are simply ignoring clear advice from the people who will be held accountable for implementing the new system. This, in my judgment, is irresponsible. I hope the Government will accept this amendment.
Baroness Pitkeathley: My Lords, I, too, have a great deal of sympathy with what the noble Lord, Lord Best, has said. He is absolutely right that we should not willingly antagonise those who are the providers of care, because the best care has always been the result of good partnerships between the local authorities, the health providers and-most importantly-the users and carers. It is because of their needs that I cannot support the amendment. I am thinking of the 140,000 families-a number estimated by Carers UK-who would be denied free personal care if we delayed, of the 65,000 people who would not benefit from the reablement which they might have been able to access, and of the older and disabled people going into residential care, when that could have been prevented. As we are often reminded, most people want to stay in their own home.
Therefore, although we have duties to the local authorities and to the workforce, we also have duties and responsibilities to the biggest providers of care-the carers-and the users. For that reason, we should try to reach a compromise of the kind the Minister has very helpfully suggested. I remind the House that, in response to what the noble Lord, Lord Warner, said, we are not actually starting afresh with the workforce. Let us acknowledge that many of the social care workforce are already extremely experienced in assessment and all the other areas of need that are required to implement such legislation. I hope we will be able to find a compromise on this very important point.
Baroness Barker: My Lords, I share exactly the same concerns as the noble Baroness, Lady Pitkeathley, but I am afraid that I have come to exactly the opposite conclusion for the very same reasons. My reasoning is based, to a large extent, on the work I have done over the past year with a number of local authorities and, more importantly, a number of voluntary organisations.
I always think it is worth pointing out what is going on right now in the world of social care. Local authorities and voluntary organisations-the key providers of information and support to the recipients of this care-are currently dealing with large-scale tendering of services, in many cases for the first time, and, at the same time, implementing the personalisation agenda. That is having a huge and immediate impact on the process of assessment and resource allocation.
A number of councils-some of the most enthusiastic for the personalisation agenda-have been moving towards implementation of care brokerage. Even the most advanced councils that I know of, such as Kensington and Chelsea or Richmond in west London, are in the early stages of pilot schemes which are funded for one year and have not yet been evaluated. At the same time, local authorities are achieving the very same efficiencies that we are supposed to believe they will be using to fund the implementation of this Bill in ways that will also have a direct impact on it. They are tendering information and advice services on a generic basis. I am sorry because this is a very "anoraky" argument, but previously, information and advice services were largely provided on a client-group by client-group basis. But they are not now: they are being generically tendered for all adults over the age of 16. People with mental health, drug and alcohol problems, physical disabilities and carers will all be in the one contract. That will be a huge change, particularly for providers of information and advice. The information, advice and support services, which are always needed to make any change of this sort work-and they will be needed to make this work-are in turmoil. For that reason the noble Lord, Lord Best, is right.
I am not always particularly enamoured of provider arguments about their being overloaded, but these people in local authorities have a strong argument. A huge amount of change is going on. For example, seven local authorities in west London are coming together to tender all their information and advice services as one in order to achieve the economies that they are having to make. I hope noble Lords will understand that on the ground that is a monumental change. There will be a change of personnel and a change of practice. If this change goes ahead, there is a risk that a large number of people will not get this service to which they are entitled and will get no service at all because there is such confusion.
Notwithstanding the will of people to make services work better, more efficiently and in a more personalised way, I say to the Minister that whatever the intent of the Government the timing could not be worse. For that reason I support the argument put forward by the noble Lord, Lord Best.
Earl Howe: My Lords, I warmly support all that has been said in support of this amendment by its other movers. No one who has spoken to local government
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They also argue, as I do and as the noble Lord, Lord Best, does, that this scheme is a new burden and therefore constitutes a blatant breach of the Government's own undertaking to local government not to impose such burdens. In Committee, the Minister made light of these concerns. She seemed to be saying that there was plenty of money around and that it could be found from efficiency savings if people would only put their minds to it. She also dismissed the idea that the policy represented a new burden.
It is important to expose those arguments for the nonsense they are. New burdens are new tasks imposed on local government which are not fully funded. Free personal care at home is a new task imposed on local government and will be only partly funded. It is not any use the Minister saying, as she did in Committee, that the 4 per cent efficiency savings which councils have to make next year leave plenty of room to meet the costs of the scheme.
The term "efficiency savings" means that you take money away from a local authority's spending total without damaging the services that are provided. Local authorities are therefore being asked by the Minister to spend money which, by definition, they do not have. It seems to me that that is a curious sort of sophistry. It may be that the line the Minister meant to give was that given by her colleague, John Denham, in another place, who indicated that the efficiency savings required were to be over and above the already budgeted 4 per cent savings.
We need to be clear how unrealistic that is. In many local authorities, it is impossible as of today to identify where such additional savings might come from. It is true that some local authorities will need to find comparatively small sums, but others will be landed with an instant and very large bill-I refer to those local authorities where a high proportion of those who are currently receiving personal care are funding that care themselves. It is irresponsible for Ministers to dismiss the acute funding problems that those councils are facing at a time when they have already finalised their budgets and the council tax for next year. I believe that it is the Government's responsibility and ours in this Chamber to recognise practical reality and to back this amendment.
Lord Sutherland of Houndwood: My Lords, I wish to support this amendment for all the good reasons given by my noble friend Lord Best and others, but I do not wish to see this Bill sunk. I wish to see some handcuffs on the Bill and of the options among the amendments, this seems to me the most elegant set of handcuffs. It has the advantage that it will have, at least, a way of dealing with the initial-and real-concerns of local authorities, and the problems not just of cash but of the provision of services in such a short time.
However, the best thing about the Bill is the direction of travel and I would not wish to see that lost. The advantage of this amendment is that if the Bill were to go through, it would give every incentive to an incoming Administration of whatever political hue-even if it were a coat of many colours-to seek the consensus which everyone in this House hopes will be the basis for real future planning in this very important area. For this reason I hope this amendment will be passed.
Baroness Finlay of Llandaff: My Lords, listening to this discussion I find myself slightly confused because it strikes me that we are moving from a situation where there would be a sudden implementation date. However, the Minister's reassurances suggest that local authorities will have somewhat of an ease-in, ease-out option. I certainly do not deny the stress on local authorities-the fact that they are suddenly facing a great deal of work-but I am also well aware that there are desperately worried users and their carers who are faced with the question of whether they must move from their own homes or whether they are able to sit it out. It is a desperately important issue for them.
I am aware also that it is human nature to start knuckling down to implementing change only when the deadline is looming-whenever that deadline is. I cannot help feeling that with some of the work that must be done, there is a point where one just has to say that you need to get on and do it. The assessment processes are, by and large, already worked through. The professionals are already assessing patients; certainly, the systems have to be worked through and must be streamlined so that they are fair.
It would help me greatly if the Minister could confirm my understanding from her reassurance-that there is now somewhat of an ease-in, ease-out process so that instead of there being a sudden transition, as this amendment would create, there is a period of grace. Can she also confirm that where there is undue pressure, every effort is made neither to jeopardise the users and carers nor to allow the whole system to come crashing down because of the local authorities?
Lord Turnbull: My Lords, when I spoke on Second Reading I was critical of this Bill on grounds of both process and substance, and despite the assurances offered by the Minister nothing I have seen or heard subsequently causes me to revise that assessment.
On process, it exemplifies how not to go about developing a policy on a long-term issue. It introduces an option previously rejected in the Green Paper, even before the consultation period was finished, and, to judge by the outcry from local authorities and care professionals, insufficient work has been done to nail down the costs or establish clearly who should fund them.
On substance, the Bill remains flawed. Rather than progressively increasing the support elderly people are eligible for, as their needs rise over time, it introduces a discontinuity whereby people with moderately high needs in their own homes are helped much more generously than those with even greater needs who have to move into a residential home. This is an injustice and we should not introduce that injustice without a plan being in place quickly to resolve it.
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