§ 2.42 p.m.
§ Baroness Greengrossasked Her Majesty's Government:
§ When they expect to publish updated guidance on the National Health Service's obligations to provide continuing care following the health ombudsman's report published in February 2003.
§ The Parliamentary Under-Secretary of State, Department of Health (Lord Warner)
My Lords, the NHS is making good progress on setting agreed 758 continuing care criteria for each strategic health authority area. Over 80 per cent of strategic health authorities have done this and the rest are due to follow suit. They know that, from October, when the Community Care (Delayed Discharges etc.) Act 2003 is implemented, all older people must be assessed for continuing care before discharge from hospital. SHAs are now investigating individual cases for recompense for financial injustices back to 1996. We do not want to slow progress through the prospect of new guidance, but we will review the case for it after the summer.
§ Baroness Greengross
My Lords, I thank the Minister for that reply and look forward to the impact of the Community Care (Delayed Discharges etc.) Act so that more people should be entitled to receive help with their health needs after they leave hospital. However, since the health ombudsman's report, we have had continuing confusion rather than continuing care. In the Minister's view, what is the difference between the higher band nursing care and continuing care? Is he aware of any other authorities that, like Berkshire, are retaining client moneys in a separate account until the dispute with the strategic health authority over eligibility criteria is resolved?
§ Lord Warner
My Lords, I understand the noble Baroness's concerns. However, as I tried to imply in my Answer, we have responded to the six main recommendations of the ombudsman. As I said, the majority of SHAs now have agreed new continuing care criteria. We have agreed with the recommendation to recompense for financial injustice. We have agreed to check that legal advice has been taken by each SHA to ascertain whether their criteria were compliant with the Coughlan case judgment. and to ensure that legal advice has been taken to support the new criteria. I think that we have tried to take all the necessary steps to ensure that there is consistency in different parts of the country commensurate with allowing people to make individual assessments on individual cases.
§ Baroness Barker
My Lords, what status does the Department of Health guidance have given that it was due to be either reviewed or cancelled by 28th June this year? Does the Minister agree with the conclusion of the health ombudsman's report that the current guidance is opaque and that that is one of the main reasons why strategic health authorities have been taking decisions that have led to, in her words, financial injustice for older people?
§ Lord Warner
My Lords, the ombudsman said in her report that, in 1999, the promise of more guidance following the Coughlan judgment,may also have encouraged some authorities to wait before taking significant action".We agree with that analysis, and that is reflected in our current position. As I said, we will review the need for further guidance after the summer.
§ Earl Howe
My Lords, the health ombudsman also stated in her report that identifying patients who may have been affected by the issue would not be at all easy, and that a greater public awareness of the issue might be required. What have the Government done to ensure that there is a greater public awareness of the issue?
§ Lord Warner
My Lords, the issue has been aired fairly widely. We have put in place arrangements to pay for further compensation after individual assessments are made. It is down to strategic health authorities to work with people in the local area to ensure that cases come to light. It turns very much on looking at individual cases when people feel strongly about the issue. There is no evidence, I think, that people are not coming forward with individual cases.
§ Baroness Finlay of Llandaff
My Lords, will the Minister tell us about the current situation and how many NHS inpatient beds were blocked last month while patients waited for continuing care to be instigated?
§ Lord Warner
My Lords, I do not have that information to hand, but I shall write to the noble Baroness.