Health and Care Bill

Lord Lansley Excerpts

Lords Hansard - Part 2 & Committee stage
Monday 31st January 2022 Lords Chamber

For these reasons, we wish to delete Clause 140. It should be replaced with the wording set out in Amendment 235 from the noble Baroness, Lady Greengross. I also need to say to the Minister that we do not expect him to move the government amendments tonight because a much wider discussion is needed in your Lordships’ House. I thank noble Lords for allowing me to speak at this point in the debate.

[Lord Lansley (Con)]

My Lords, we have reached the point where my noble friend on the Front Bench—who is doing his job well—should look round for support on his own Benches. I fear all he has got is me.

I can see the point he was making about the desirability of these amendments. If Clause 140 were to be proceeded with, they are improvements on the structure of Clause 140, but they rather illustrate the point that Clause 140 itself was brought forward at a late stage and was not fully thought through. I might say to my noble friend that I am a little confused as to how he can be asserting that these amendments are the result of implementation of the existing system, demonstrating a problem when—as far as I can see—Amendments 232A, 232B, 234H, 234J and 234K all relate to parts of the Care Act 2014 that were never brought into force. So they cannot, in practice, have resulted from the implementation of what he describes as the existing system.

I wanted to follow the noble Baroness, Lady Thornton, because what I have to say follows directly on from what she had to say. The noble Lords will recall that at Second Reading I made it clear that I thought it was best to take Clause 140 out—I still am of that opinion. If we were to proceed with Clause 140, the noble Baronesses, Lady Bull and Lady Campbell of Surbiton—the noble Baroness, Lady Bennett, not having a chance yet to explain—have explained very well the two central points about young adults. One is that they will not have had an opportunity to accumulate assets in their lifetime. The Dilnot report itself said:

“Anyone developing an eligible need up to the age of 40 should also face a zero cap, as we do not think that people younger than 40 can, in general, realistically be expected to have planned for having a care and support need, nor will they have accumulated significant assets.”


Of course, the point that was made very well by the noble Baronesses, Lady Campbell and Lady Bull, was that, even in so far as they have incomes derived from benefits, these may be taken into account in the means test, and so we would have a situation where, under the impact of Clause 140, they would have, potentially over many years, the erosion of whatever benefits are intended to be achieved for precisely that reason. So I very much support Amendments 233 and 234.

My point more generally is that when we get to Report I hope we will have a fuller Chamber and a fuller opportunity to explain why we should take out Clause 140. Of course, in part, in doing this—I see the noble Lord, Lord Warner, standing by ready to explain what the Dilnot commission, of which he was a member, said—I am in a sense defending the Dilnot report and its implementation. I asked Andrew Dilnot to undertake the review, and it reported to me.

I noted that, on Report in another place, Matt Hancock said:

“The reason that the Dilnot system, as previously proposed, was never put in place was that there was never a proposal to pay for it”.—[Official Report, Commons, 22/11/21; col. 111.]


I have to tell him that he was a Back-Bencher in 2010-11 and there was a proposal to pay for it. It was not a Dilnot commission proposal; it was my proposal, and it would have had significant benefit in that, because it would have removed the domiciliary care exemption on the means test, it would have rebalanced domiciliary care and residential care in the social care system. It would of course have meant that, very often, those who were benefiting from the cap and had significant housing assets would have contributed towards it.

I also proposed that the winter fuel allowance should not be made available in future to older people who were higher rate taxpayers. The net effect of these two measures was about £2 billion a year, which at the time would have been enough to pay for it. The Treasury, of course, said no, because 100,000 people a year would benefit from the cap, 200,000 people a year would have to pay into the system, and therefore it was not a good idea. Politically, the Treasury was completely wrong then, and probably it is completely wrong again in bringing forward the proposal encapsulated in Clause 140.

I will just elaborate and then I will stop. On Report in the other place, the right honourable Mel Stride said of what was then new Clause 49, now Clause 140:

“The first we heard of it was not in Committee”—


there were 12 sittings of that, until 2 November—“or in September”, when the tax measures were announced, “but on Wednesday evening”. This was Monday evening, and the first they had heard of it was the previous Wednesday evening when the amendment was tabled. So it was strictly last-minute but, even in the time available, a significant number of Members of the Conservative parliamentary party in the other place had their reservations. The clause was passed with a majority of just 26, with 19 Conservative Members of Parliament voting against it. Quite a number spoke, including Kevin Hollinrake, who said that

“there is no doubt that the way that the cap works means that it is less generous for those with more modest assets.”—[Official Report, Commons, 22/11/21; cols. 115-47.]

The objective—which, as I remember, was calculated on the back of the Dilnot report—should be that, broadly speaking, whatever your level of assets, there is a maximum level of loss of assets resulting from the implementation of the cap with a means test. If I remember correctly, it was about 45% loss of assets for those with the least assets; it would not exceed that. Of course, for people with lots of assets, the loss of their assets is significantly below that percentage. But now we have ended up with people with a large amount of assets having a potentially very low loss of assets and they are the principal gainers; people with very few assets, but some, may well lose them all. This cannot be right, and it cannot be fair. It is quite clear that Members of the other place, including a significant number of Conservatives, want to think about this again. When it comes to Report, if we take Clause 140 out, we will rightly give them the opportunity to do so.