Care Bill [Lords]

John McDonnell Excerpts

Monday 10th March 2014 Commons Chamber

[Dr Wollaston]

I thank my hon. Friend for those comments and I welcome the mental health crisis care concordat, and what is being done to emphasise that prevention is by far the best way forward, but even with those prevention measures in place I think we would all accept there will still be circumstances where people will reach crisis, and unfortunately a police station is absolutely the last place anyone, let alone a child, would wish to be in crisis. In Devon and Cornwall alone, 27 children last year were taken to police cells for long periods of time. On three occasions those children were as young as 12 and 13. That is simply unacceptable. One of the reasons it is likely to continue is that there is no penalty currently for the NHS in continuing to use such facilities. It does not have to pick up any of the financial tab. That is putting enormous pressure on our police forces. They do not wish this to happen, of course. If we cannot at least have this sunset clause, which I think is eminently sensible, I hope the Minister will consider making sure that the NHS has to pay to use the police cells, and that there is a significant financial penalty, because that would be a driver. That would make it financially much more sensible for the NHS to put in place measures for these vulnerable people—who often have been found by the police at the point where they are about to take their own lives. It cannot be acceptable for this situation to continue.

Moreover, the variation in such use of police cells is extraordinary. There are some areas where that is not used at all and others where it is very heavily relied on. I hope the Minister will say in his response that he is prepared to consider a sunset clause, or at least a financial penalty, so we see drivers in place and we continue to move away from such a practice. However, I absolutely recognise the point made by my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) that prevention is far better, and I know all areas are working towards that and that the Minister fully supports it.

New clause 9 is an extraordinary measure that is widely welcomed because of the principles to which the right hon. Member for Salford and Eccles (Hazel Blears) referred about well-being and prevention. These are at the heart of the Bill and everybody welcomes them. However, I think the Minister recognises that there could be unintended consequences if we were to introduce many new statutory obligations without their being funded fully. As he will know, we have two tests—a needs test and a means test—for people to pass in accessing social care, and 88% of needs tests are now set at a substantial level, which has been quite a considerable change. There is also the means test, which stands at £23,250. On many occasions as a GP, I remember coming across the absolute shock encountered by people when they realised that they would get no help whatever.

The change under the Bill will be extraordinarily welcome, although we should be under no doubt about the burdens that it will place on local authorities, in particular in my area. Devon has the third oldest demographic in the country, but funding of local authorities for health care does not have sufficient emphasis on the age structure of the population. There will be great impact on Torbay and on other areas in Devon, such as my constituency.

New clause 9 is a sensible measure about how we plan for the future and make an appraisal of whether we are fulfilling the important provisions in the Bill, ensuring that we have sufficient resources directed towards prevention and well-being. I hope that the Minister will see the new clause as helpful and as one that will assist us in planning for the future.

[John McDonnell (Hayes and Harlington) (Lab)]

I will speak to the amendments in my name. I share the view of the right hon. Member for Banbury (Sir Tony Baldry) that we should not have nodded the programme motion through blithely. Many of my constituents have contacted me about the Bill, because care in my area is on the edge of crisis, with the new threshold rolling it back for many people. That is why I support new clause 11; people need their human rights to be ensured in the Bill. New clause 2 is important, because we have a Children’s Commissioner and we need a commissioner for the elderly and other care services, so that there is someone to speak out for people. I support new clauses 7 and 9, because I agree that introducing legislation without funding is meaningless. We place local authorities in an impossible position, as they struggle to provide the services.

With regard to the work force, we need to ensure pay and adequate training, so that we fully professionalise the work force. In my area, we have a high turnover of care workers, which leads to distressing results. In one case, an elderly lady was burgled and on the next day a new carer came in, but she thought that she was being burgled all over again, because she did not recognise the person. That is the instability in the industry at the moment. That is why I support new clauses 17 and 18.

On the amendments in my name, new clause 31 is generated by one of my constituents called Jonathan Kay, who asked me to get the matter dealt with in the Bill. For many years, Jonathan has been funded by the local authority to employ a personal assistant to enable him to carry out his day-to-day tasks—he is a disabled person—but he has experienced serious problems with personal assistants in the past, even suffering abuse on more than one occasion. When employing personal assistants, Jonathan has found assessing the suitability of candidates extremely difficult, and he has not been able to obtain reliable recommendations from any public body, despite using public funds to employ them.

Part 3 of the Bill provides that the training and education —but no qualifications—of carers will be undertaken by Health Education England. The purpose of my new clause is for Health Education England to allow scope for the local education and training boards to do such work and to compile, publish and maintain a register of all persons who provide regulated social care for individuals under arrangements made by or paid for by a public authority. That would allow people such as Jonathan to access a list of trained professionals whom they can employ with confidence, we hope, in future.

With amendment 26, I am simply seeking to install into the Bill a provision on the right to live independently, as recommended by the Joint Committee on Human Rights, but dismissed by the Government. The Government might well have been concerned about the legal actions that were taking place with regard to the independent living fund, but the Committee’s report made its disappointment very clear that the Government had not taken the opportunity of the Bill to be explicit about their support for the convention on the rights of people with disabilities and article 19—“Living independently and being included in the community”—being a human right. It should therefore be included in the Bill. The Government have given assurances that the general direction of the Bill might achieve the same ends, but that is not good enough in that it does not enforce the rights in law.

My amendment 21 covers the same ground as new clause 15, so I will not dwell on it in any depth, but I will give an example. Whether with our parents or in our community, we all know about the uncertainty of charges for residential care. They cause real concern and anxiety among families. Yes, the ability of local authorities to negotiate rates influences the overall market, but that is why there is a need for some form of indicative price. A care funding calculator is used to set the care of people with learning difficulties, and that model has worked and saved public funds. We should at least be considering in the Bill that sort of process for care overall.

My proposals in amendment 20 would

“require the local authority, when carrying out the assessment, to capture an individual’s main and other disabling conditions”.

A whole group of organisations, including the Parkinson’s Disease Society, Sue Ryder, the Motor Neurone Disease Association, the Multiple Sclerosis Society, the Epilepsy Society, the Neurological Alliance and the Alzheimer’s Society, have all campaigned for this simple change in the assessment process, which merely requires local authorities to collect and record information about an individual’s main and other disabling conditions when they are conducting their social care assessments and arranging care packages. Why is that important? It is important for local authorities to be aware of the different conditions in their community, so that they can plan long-term services, but it is also important for us to be aware of the information nationally, so that care services and our investment can be planned in the long term. Taking that into account seems to be a minor amendment.

Amendment 22, which I also tabled, was proposed by the Royal National Institute of Blind People and lobbied for by a number of my constituents. In clause 76, the duty is placed on the local authority to establish

“a register of sight-impaired and severely sight-impaired adults who are ordinarily resident in its area.”

The existing provision relates only to adults and does not include children. My amendment simply ensures that the local authority is required to collect information on both adults and children. The reason for this is that, under the Children Act 1989, there is a requirement on local authorities to collect information with regard to blind and partially sighted children, but 20% of local authorities admitted failing to meet that legal requirement. Furthermore, 20% of local authorities have no register; three councils include just 1% of disabled children known to the authority on the registers; one in four authorities have whole registers with fewer than 2% of disabled children known to the council; and almost six in 10 councils include 10% or fewer of the disabled children. The RNIB therefore emphasises that in clause 76 we should place on local authorities a duty, when collecting information, to include children ordinarily resident in their area. Again it is the same mechanism; it is about the planning of services to ensure that they are properly invested in over the long term.

Overall, I welcome the Bill, but I fear that it will disappoint many as a result of the failure to address some of the considerable issues with regard to funding, rewards to the work force and professional training, and the appropriateness of the cap on costs.

[Sheila Gilmore (Edinburgh East) (Lab)]

I am pleased to have the opportunity to speak to new clause 5, which is in my name. I thank the many Members who have supported the clause.

I have been pursuing the issue since 2011, initially on behalf of a constituent, a Mr Kenny, who suffered an injury when he was serving in the Army and is paralysed from the waist down. He originally lived in the London area, but his family is from Edinburgh and he wanted to move back to his family. For four years, he got absolutely nowhere, because neither authority would take responsibility for him being able to move. They argued backwards and forwards. Eventually, his family helped him to move physically, but for a period none of his care costs was being met, until Edinburgh relented and began to meet those costs. By that time, he had incurred quite a lot of debt.

I first raised the issue in 2011. The right hon. Member for Sutton and Cheam (Paul Burstow), who was then the Minister, said that it should be covered in the White Paper, but when that came out it only related to portability of care within England and not to the devolved authorities. I kept raising the matter and I was assured that something would be in the Bill, but when it was published the measures related to the portability of residential care packages but not home care packages.