Home Care Charges: Statutory Guidance (Hansard, 15 January 2002)

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)
My Lords, the department has received 13 responses. Most of them posed detailed questions on practical aspects of the guidance.

§ Lord Ashley of Stoke
My Lords, is my noble friend aware that the present system of care charging for disabled people is absolutely chaotic? Some councils provide the services free but others charge up to £200 for exactly the same service. Can my noble friend tell us about the national guidance? It is admirable so far as it goes, but why should councils be allowed to evade some parts of it until 2003? What are the Government's plans for monitoring the rogue councils that neglect and ignore the guidance? What sanctions are being prepared with which to hit them when they are found to be neglecting charges?

§ Lord Hunt of Kings Heath
My Lords, I agree with my noble friend that in the current situation charges are applied in a wide variety of ways throughout the country. The Audit Commission reported on the matter some time ago. It drew attention to wide discrepancies between local authorities and a lack of transparency. The statutory guidance will lead to a much clearer understanding among users and much greater consistency across the country.
On implementation, it is fair to point out to my noble friend that by this October, all users who receive income support and whose overall income equals or is less than basic defined levels plus 25 per cent should not be charged. Users who receive more than 10 hours of home care weekly should receive an assessment of their disability-related expenditure if disability benefits are taken into account. In addition, earnings should be disregarded by that date. The remainder of the statutory guidance should be implemented by April 2003.
So far as concerns monitoring the implementation of the guidance, I can assure my noble friend that it will be performance-managed. If we come across cases where local authorities do not implement the guidance satisfactorily, we can of course use the various mechanisms available to us to point that out to those local authorities.

§ Lord Roberts of Conwy
My Lords, what is the Government's view of the Scottish Parliament's proposal for free personal care for the elderly? I understand that that was recommended by the commission of the noble Lord, Lord Sutherland, for the United Kingdom as a whole. Is it true, as reported today, that the Government are refusing to allow the Scottish Parliament to implement its proposal and denying it the use of some £23 million that would be saved by the abolition or suspension of constant attendance allowances?

§ Lord Hunt of Kings Heath
My Lords, that is a matter for the Scottish Parliament. So far as concerns England, the Government considered very carefully the recommendations of the Royal Commission. At 971 the end of the day, it is a question of priorities. The Government decided that the resource that might have been spent on free personal care was better spent on such services as intermediate care. That will enable us to ensure that many thousands of people do not have to enter the care sector but can return to their own homes. We considered that, together with providing for free nursing care, the resource was much better spent on intermediate care.

§ Baroness Wilkins
My Lords, if disabled people's benefits entitlement is to be correctly calculated in the assessment of charges, will the Minister say what steps the Government are taking to ensure that councils are properly resourced in providing expert welfare benefits advice in this very complex area of benefits which social workers are not sufficiently trained to provide? Will he say what percentage of local authorities currently have trained welfare benefits advisers in post?

§ Lord Hunt of Kings Heath
My Lords, I certainly agree with my noble friend that in the development and implementation of the statutory guidance it is important that local authorities make available adequate and effective welfare advice to potential users of services for which charges are made. It is worth informing the House that the Torbay local authority, which is seen as being a good practice authority in this area, has shown that, through good welfare advice to local people, people can claim more benefits. In addition, that local authority probably raises more income through charges than many other local authorities. We very much wish all local authorities to follow that example to ensure that good quality advice is available. I am absolutely convinced that the effective implementation of the statutory guidance will lead to that.

§ Baroness Barker
My Lords, under the guidance, income from earnings is disregarded but income from pensions is not. As the Minister said, the guidance, as written, refers to income support and the minimum income guarantee, which the Government intend to replace with the pension credit. Can the Minister say how the guidance will be changed to reflect the Government's principle behind the pension credit that pensioners should not be penalised for having saved for their retirement?

§ Lord Hunt of Kings Heath
My Lords, my understanding is that we shall lay regulations before the House in due course. We are considering those matters at present.

§ Baroness Masham of Ilton
My Lords, what is the present situation in relation to severely disabled people living in their own homes who cannot now receive help with bathing and washing because some councils do not provide that service?

§ Lord Hunt of Kings Heath
My Lords, I should be very concerned if appropriate services were not 972 available from local authorities. In relation to the performance management of social service authorities we are very concerned to see that effective services are available. I am sure that this is one aspect of overall performance management that will be undertaken by the Social Services Inspectorate.

§ Baroness Pitkeathley
My Lords, given the Government's excellent record on putting users centre-stage in the new arrangements for monitoring social care, can my noble friend tell us whether any plans have been made for monitoring the effect of the new charging arrangements on disabled people and their carers?

§ Lord Hunt of Kings Heath
My Lords, as part of our performance-management arrangements generally, we shall keep a very close eye on the way in which the statutory guidance is implemented. I can also say to my noble friend that, in introducing changes to their own charging regime, if they do make charges, each local authority will also be expected to consult users locally.

Lord Campbell of Croy
My Lords, does the noble Lord recall that last week when I raised the question of the difference between Scotland and England on the matter of payment for nursing care in nursing homes—in England the policy was for payment to be made but not so in Scotland—I was given the impression that there would be no interference and that Scotland could go its own way?

§ Lord Hunt of Kings Heath
My Lords, with the greatest respect to the noble Lord, Scotland can, indeed, go its own way. It has made its own decision in relation to free personal care, as opposed to the decision in England. It seems to me that that is perfectly appropriate and follows the logic of devolution.