Care Bill [HL]

Debate between Baroness Oppenheim-Barnes and Earl Howe

Tuesday 29th October 2013 Lords Chamber

[Earl Howe]

My Lords, Amendment 5 returns us to the issue of deferred payments. I begin by saying that I welcome the opportunity to debate this subject again. Unfortunately, the Government’s position on it has been fraught with misunderstandings, and I would like to take this opportunity to dispel at least some of those.

First, I remind the House that a consultation on funding reform has been running over the past three months, and it closed last Friday. During these three months, officials have travelled across the country explaining our proposals and seeking people’s views. What we have put forward so far are proposals—something for people to consider. These are not set in stone. We will listen to what we have heard through our consultation, and indeed in this Chamber, as we develop our policies over the next few months.

The purpose of this amendment, as the noble Lord, Lord Lipsey, has explained, is to ensure that anyone—even people with assets of great monetary worth in addition to their main home—can have a deferred payment agreement. I have to make it clear that if one takes this amendment literally, I disagree with that principle. I do not think the public purse should be helping people who do not need financial support to pay their care fees. This would seem a long way from the Dilnot commission’s view that deferred payments should be used to support people who,

“would be unable to afford care charges without selling their home”.

For a person with a substantial sum in their bank account or substantial liquid savings, a deferred payment agreement might be a cheap loan—a convenience, one might say—but it would not be serving its core purpose.

I hope that we can therefore agree that the principle of having an upper threshold for non-housing assets is a sound and a necessary one. If we agree that this is a sound principle, all that is left to do is agree on an amount. Our consultation sought views on that amount. The noble Lord, Lord Lipsey, asked what was wrong with an asset threshold of £118,000. From April 2016, we are extending means-tested support for people with up to £118,000 when the value of a person’s home is taken into account in the financial assessment. This determines when an individual may be eligible for local authority support with their care costs. Deferred payment agreements are designed to help people to pay for their care costs; their ability to meet these costs in the short term will be dependent on their liquid non-housing assets rather than housing wealth. I can say to the noble Lord that we are happy to consider using a threshold of £118,000 as we analyse the consultation responses. We are happy to consider a range of figures.

The noble Lord, Lord Hunt, asked why we proposed the £23,250 threshold. We were seeking to identify those people most at risk of having to sell their home to pay for their care. The reason we proposed £23,250 specifically is because it provides consistency with the threshold for means-tested support when the value of someone’s home is not taken into account, and with the principle that people with non-housing assets under that amount are likely to need state support to pay for their care costs. Indeed this is the same figure and the same reasoning that the previous Government applied in their White Paper. Therefore, from that point of view if no other, it is a little surprising to hear the noble Lord, Lord Hunt, arguing against it.

There is an interesting point about people with more than £23,250 in savings. About 60% of people entering residential care are state-supported, meaning that they have only limited assets. Of the remaining 40% who enter residential care as a self-funder, less than half have liquid savings of more than £23,250. This means that the proposed threshold of £23,250 excludes only the richest 15% of people entering residential care. By increasing the liquid savings threshold to £118,000, the scheme would be available to all but the richest 5% of people entering residential care. I hope that that is a helpful contextual analysis. However, I reiterate—particularly to the noble Lord, Lord Lipsey—that we are not wedded to the figure of £23,250. We will analyse the responses to the consultation before making any further decision.

To answer the question posed by the noble Lord, Lord Hunt, about whether the scheme will actually be cost-neutral, we intend and believe that in the long run the scheme will be cost-neutral. We have committed £330 million to fund the implementation of the cap cost system, and deferred payments to cover the initial set-up costs.

I hope that in the light of what I have said the noble Lord will, on reflection, agree that his amendment would be undesirable as drafted and that he will be content to withdraw it.

[Baroness Oppenheim-Barnes (Con)]

Before the Minister sits down, will he confirm that if a house has to be sold, after the repayment of the debt, the proceeds remain the property of the person whose house was sold? Would it be possible for the potential beneficiaries to pay the debt in advance so that the house does not have to be sold?

[Earl Howe]

My understanding is that the short answer is yes. There is no reason why potential beneficiaries should not use other moneys to pay the debt, in which case the legal charge over the house would be released by the local authority.

Medicine: Experimental Drugs

Debate between Baroness Oppenheim-Barnes and Earl Howe

Monday 10th June 2013 Lords Chamber

[Earl Howe]

My Lords, there is no need to think in those terms. There are many routes by which patients can access medicines lawfully and maintain their legal rights. We want to make sure that ethics and patient protection continue to be at the forefront of drug development. It would be wrong to give an indication to drug companies that they can throw caution to the winds in that sense.

[Baroness Oppenheim-Barnes]

It often takes as long as five or six years to develop a new drug. Sometimes, even after that period, when permission has been given, something is found late in the day. Therefore, does the Minister agree that we need to know what sort of period he is thinking of in accepting drugs that have not yet been approved?

[Earl Howe]

My Lords, this will very much depend on a case-by-case analysis of the drug in question. If there is a very promising new drug that is a breakthrough medicine, where there is no alternative treatment, there may be a case for considering that more favourably than a drug for which there is a readily suitable alternative. As I mentioned earlier, the menu of options available to us, such as an early access scheme for unlicensed medicines and an adaptive licensing scheme within European Union rules for licensed medicines, can perhaps be tailor-made to suit the drug in question.

NHS: Public Information and Advice

Debate between Baroness Oppenheim-Barnes and Earl Howe

Tuesday 12th June 2012 Lords Chamber

[Earl Howe]

My Lords, there will be national focus programmes led primarily by Public Health England, but we see those as complementary to the work going on at the local level. By no means are we abandoning national campaigns. Indeed, we have seen considerable successes. In 2010-11 we invested almost £11 million to support 59 cancer awareness campaigns around the country. In 2011-12 we provided £8.5 million to support a range of cancer awareness campaigns, and this year we hope to spend even more on cancer awareness than we have in previous years.

[Baroness Oppenheim-Barnes]

My Lords, what is the reaction of the NHS to the explosive headlines appearing daily in newspapers about new cures, magic pills and other things of that nature? Surely these are being trialled for the NHS, which must be creating new demands every day as a result. Does the service have a plan to deal with this?

[Earl Howe]

The key is to make available to the public accredited sources of information because there is an awful lot of unaccredited information available. Through mechanisms such as NHS Choices and NHS Evidence, people can now see online not only what best practice looks like, but what clinical trials are available for the latest drugs and treatments. My noble friend is right; we have to direct people to the right sources of information.

EU: Food Labelling

Debate between Baroness Oppenheim-Barnes and Earl Howe

Monday 17th October 2011 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, we welcome the new regulation. The UK has led the way in Europe in improving nutritional information for consumers. Access to nutritional information supports consumers in choosing a balanced diet and can help in controlling calorie intake. The regulation meets our main negotiating objectives and will give the UK freedom to maintain and build on existing practice.

[Baroness Oppenheim-Barnes]

My Lords, I am a little astonished by that response. Is my noble friend aware that I have campaigned for many years in your Lordships’ House for clear, uniform food labelling on pre-packaged goods for easy comparison? The FSA produced such labelling, which I understand was approved by all five Select Committees but was rejected by the EU, which has now produced something futile, pathetic and unenforceable, to put it mildly. Does my noble friend agree that it is time for the proverbial worm to turn and to tell the EU that we do not want its version—we prefer our own?

[Earl Howe]

My Lords, I am not sure that I would accept the epithets that my noble friend has applied to this regulation. We have led the way in these negotiations. It is true that it has taken some time but we have come away with most, if not all, of our key objectives met. Nutritional information will now be displayed in a consistent manner on the back of all pre-packed foods, which is a major plus. A voluntary approach has been secured for front-of-pack nutrition labelling and for non-pre-packed foods, including those sold by caterers. It will also be made easier for alcohol companies to include energy information on their products on a voluntary basis. This will give people the information they need to make informed choices about what they eat and drink, which is the whole idea.

Reform of Social Care

Debate between Baroness Oppenheim-Barnes and Earl Howe

Monday 4th July 2011 Lords Chamber

[Baroness Oppenheim-Barnes]

My Lords, I was extremely pleased to hear this Statement and to hear it in the form that it has come. It must be well over 20 years since I first started writing to various Prime Ministers about the dreadful case of a constituent who had to sell his house—his life savings went into the house—to go into a care home, who said, “This cannot be fair. People who never bothered to save or to put money aside are getting the same treatment I am being charged for”.

On the other hand, and this illustrates the difficulty of the problem, the view of the taxpayers, also expressed to me, was, “Why should we have to support the inheritance of the sons and daughters of these people?”. There were two completely separate points of view that were very difficult to reconcile. As the problem becomes bigger and more urgent all the time, it is extremely brave of the Government to embark at this stage on a Statement that refers to the priority that will be given to this problem, and I welcome that very greatly.

[Earl Howe]

I thank my noble friend Lady Oppenheim-Barnes for those remarks. The House will know that her experience of these matters goes back many years. She is right; these thorny issues have been with us for a very long time and we have to get a grip on them. There is, as I made clear earlier, a clear imperative to inject certainty and predictability into the system, but there is also a need to strike a balance between the state and the individual. That principle was one that the Dilnot commission articulated—overreliance on the state would be unsustainable and arguably unfair, and overreliance on the individual presents obvious problems of a different sort. It is that balance that we need to identify.