Care Bill [HL]

Lord Hamilton of Epsom Excerpts

Tuesday 29th October 2013 Lords Chamber

Moved by

[Lord Hamilton of Epsom]

1: Clause 1, page 1, line 10, after “emotional” insert “and spiritual”

[Lord Hamilton of Epsom (Con)]

My Lords, I am a great supporter of the Care Bill, and my disagreement with my noble friend the Minister is on an extremely small point. When I went to see my noble friend the Chief Whip and stated my intention to press this amendment to a Division if it was not accepted by the Government, she said that she was very unhappy about people pressing Divisions at Third Reading. I have a lot of sympathy with her on that issue, but the problem is that when my noble friend Lady Barker tabled her amendment, it had a fantastic amount of support from all over the House—although not unanimous support, as the noble Lord, Lord Warner, had reservations. If he does not mind, I shall come back to those in a minute. My noble friend the Minister said that he would look at this matter again and come back at Third Reading—and that is where we are now.

I am a little naive and overoptimistic, and as the amendment tabled by my noble friend Lady Barker referred to spiritual well-being, I assumed that any amendment tabled by my noble friend the Minister would also include references to spiritual well-being. Instead, the government amendment would merely add the words “and beliefs”, so that local authorities would have to take into account,

“the individual’s views, wishes, feelings and beliefs”.

I do not regard that government amendment as meeting the legitimate desires of the noble Baroness, Lady Barker—with my support and that of many others—even half way. If anything, it takes us about a third of the way. It is a compromise, but it does not go very far towards meeting our original desire.

The problem is that the provision as amended would continue to deny the role of spirituality for carers and those facing chronic illness. The South West Yorkshire Partnership Foundation Trust says:

“Spiritual care can help you make the best use of all your personal and spiritual resources in facing and coping with the doubts, anxieties and questions which can arise in a health setting or when you are ill.”

That illustrates the problem that faces the Minister. The whole concept of spiritual well-being has not just been dreamt up recently by people who want to influence the Care Bill; it is a concept that has been adopted by the National Health Service since 2002, and it is already incorporated in NHS guidance for professionals and patients.

At the risk of boring the House, I shall read out some NHS advice:

“Provider units, including NHS trusts should make adequate provision for the spiritual needs of their patients and staff”.

That comes from NHS Management Executive, HSG(92)2. Here is another quotation from the NHS:

“NHS staff will … be sensitive to and respect your religious, spiritual and cultural needs at all times”.

That comes from Your Guide to the NHS, dated 2002.

“All NHS Trusts should ‘Make provision for the spiritual needs of all patients and staff from all faith communities’”.

That is from New Guidance DOH on NHS Chaplaincy, also dating from 2002. Indeed, my noble friend the Minister paid tribute on Report to the hospital chaplains, who perform an important role in the spiritual context. We have to ask why, if spiritual well-being is a commitment by the National Health Service, it cannot also be a commitment for local authorities.

I now turn to the concerns of the noble Lord, Lord Warner, who is chairman of the All-Party Humanist Group. He was concerned on Report that the clause might be discriminating against humanists. There is no question of that at all. The clause is focused on individual well-being. If an individual desired to have their spiritual well-being promoted, the local authority would be required to do that. On the other hand, if the individual expressed no desire to have their spiritual needs attended to then they would not get any form of spiritual counselling. That works well in the NHS, where you do not hear of an atheist’s interests being overridden. There is no reason why it should not work equally well with local authorities. Indeed, the Home Care Association, the London Borough of Hillingdon and the Social Care Institute for Excellence have all made reference to the importance of people’s religion and spiritual needs.

My amendment would not wreck the Care Bill. It is a tiny amendment that would make no difference whatever to the main purpose of the Bill. I am not asking the Minister to go the extra mile—merely the extra yard. Surely it is right to bring the local authorities into line on the question of spiritual well-being with the NHS. Surely it must be right to give solace to those many people who believe that there is a spiritual dimension to their lives. It would be particularly important for those in their declining years.

The Minister has rightfully won himself a reputation for dealing with your Lordships’ House with courtesy, politeness and understanding. I ask him now to show courtesy and understanding and to support my amendment.

[Lord Cormack (Con)]

My Lords, I support my noble friend, which is why I put my name to this amendment. I spoke briefly when it was first debated a couple of weeks ago and I am delighted to add my voice now.

I hope that the House will feel that what we are discussing is an important matter, but one that does not in any sense reflect on the Bill and would not impede the Bill’s limitation. All that it would do is give a degree of solace to many people for whom the spiritual dimension of life is crucially important. That is very simple but very profound. It behoves this House, of all places, to put this in the Bill.

I accept, without any reservation whatever, the good intentions of the Minister, for whom we all, in all parts of the House, have very high regard. He is a man of diligence and sensitivity, and he always tries to meet the legitimate concerns of his colleagues in all parts of the Chamber. I say to him today, with the greatest possible respect, that while he has tried to meet us, he has not quite succeeded on this occasion. The phrase “feelings and beliefs” is not a substitute for the word “spiritual”.

As my noble friend Lord Hamilton said, this would in no sense damage the concerns or interests of humanists and others. If someone did not wish to have spiritual care or to have their spiritual needs taken into account, then so be it. However, there are many people, especially, as my noble friend said, those in the evening of their lives, for whom this is an exceptionally important dimension of those lives. I urge colleagues in all parts of the House to recognise the profound importance of this simple amendment and, if my noble friend feels inclined to test the opinion of the House, to react sympathetically. I hope that that will not be necessary, however; my noble friend has referred to the misgivings of the Chief Whip over Divisions on Third Reading. Like him, I understand those reservations, but the fact is that the Minister said that this was a matter to which we would return at Third Reading, and that he would try to table something. He has been as good as his word in tabling it, but I do not believe that he has quite met the points that concerned my noble friend Lord Hamilton and I, and many others. Therefore, the best possible solution to our dilemma this afternoon would be for the Minister to accept this modest amendment. I hope that he will do that and avoid the Division which the Chief Whip would so regret.

--- Later in debate ---

[Earl Howe]

I agree with my noble friend, which is precisely why I am resisting the word “spiritual”. I do not think that that is a concept that is well defined in law and I think that it could give rise to enormous confusion. It is for that very reason that I am resisting the suggestion of my noble friend.

I hope that noble Lords will agree that my amendment achieves the aim of ensuring that a person’s beliefs, including those of a spiritual nature, are taken into account where that is important to the individual concerned. I propose that local authorities may promote an individual’s spiritual well-being by taking their beliefs into account, while avoiding any negative consequences. I hope that the House will agree not to follow my noble friend in this instance.

[Lord Hamilton of Epsom]

My Lords, I must say that my noble friend has put before us a rather fine argument. It strikes me that if we are saying that spiritual needs cannot be named, but that on the other hand they are covered under the expression of taking into account “beliefs”, that does not hold a lot of water. I very much take my noble friend’s point—we must make this absolutely clear. People must understand the legislation. I do not think that just putting in “beliefs” will necessarily mean much to people. I am sure that “spiritual well-being” would mean something to people. As I said in my opening remarks, I think that it would give great reassurance. In the circumstances, I must test the opinion of the House.