Care Bill [Lords]

Debate between Madeleine Moon and Stephen Dorrell

Monday 16th December 2013 Commons Chamber

[Mr Stephen Dorrell (Charnwood) (Con)]

I welcome the Bill. I do not propose to follow the shadow Secretary of State into a discussion of competition policy, as there will be plenty of other occasions for that; it is not germane to this Bill. The reason I welcome the Bill is that it begins to look at health and care from a different point of view from the one with which those of us who have participated in health and care debates in this Chamber over a long period are familiar. When a Bill comes before the House, it usually starts off by describing the function of one bit of the bureaucracy—perhaps creating a strategic health authority or re-creating a different bit of the bureaucracy somewhere else on the landscape. This Bill starts in a quite different place.

Clause 1 talks about the “well-being” of individuals and suggests that if we are to build a health and care system that meets the needs of patients and users for the 21st century, we should, instead of thinking of it as a bureaucracy planned from the top down, think about the service that is delivered to individuals who rely on these services. Clause 1 talks about the needs of individuals, and later clauses place an obligation on local authorities to do needs assessments for those individuals.

Clause 2 introduces something that the health and care system has talked about since 1948, but almost never put real resource into, which is preventing the need for the delivery of health and care services, and particularly of acute health care. This Bill’s emphasis is on the needs of individuals and on the need we each feel as individuals to avoid unnecessary health costs and care. None of us wants to be a patient in an intensive care unit if it is avoidable. That is why clause 2 talks about the importance of prevention and avoiding the need for care.

[Mrs Moon]

Does the right hon. Gentleman appreciate that it is possible to carry out lots of needs assessment—goodness knows, I carried out many of them in my day—but that unless care is available to allow a patient to be discharged from hospital, it does not matter how many needs assessments have been done? In fact, the longer patients are in hospital, the greater their needs will be—they will not be able to walk, their incontinence will increase and so forth. What is important is to put the cart before the horse and make sure that the funding of community-based care is there. It is not there at the moment.

[Mr Dorrell]

I shall come on to that point, but to react directly to the hon. Lady’s point, surely it is much better to intervene before the patient arrives in hospital in the first place, preventing the avoidable episode of care. The hon. Lady talks about discharge, and she is, of course, quite right, but how much better is it to prevent the case from arising in the first place, which is what clause 2 is about?