§ Baroness BarkerMy Lords, I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I declare an interest as an employee of Age Concern England.
The Question was as follows:
To ask Her Majesty's Government whether they intend to accept the recommendation of the Health Service Ombudsman in the report NHS Funding for Long Term Care that national guidance on eligibility for continuing National Health Service healthcare should be reviewed.
§ The Parliamentary Under-Secretary of State, 'Department of Health (Lord Hunt of Kings Heath)My Lords, the Government will carefully consider the recommendation of the ombudsman regarding departmental guidance. I said in the House last week that we will carefully review the guidance. Once the process is complete, we will consider whether any further action is indicated.
§ Baroness BarkerMy Lords, I thank the Minister for that Answer. Will the Department of Health also revise the NHS nursing-care guidance to ensure that both it and the guidance on continuing care are compliant with the Coughlan judgment and that older people are not subject to what the ombudsman repeatedly and unequivocally called "injustice"?
§ Lord Hunt of Kings HeathMy Lords, guidance on NHS-funded nursing care has consistently maintained 2 a distinction between NHS-funded nursing care and continuing NHS care. We will be issuing guidance on NHS-funded nursing care in which we will make the same point as I have intimated to the House.
§ Baroness GreengrossMy Lords, I take into account what the Minister has said. Does he agree that, because of the impact the Community Care (Delayed Discharges etc.) Bill and the ombudsman's findings, there could be a greater role for the NHS in arranging and funding the care of people who have left acute hospitals?
§ Lord Hunt of Kings HeathMy Lords, I am not sure that I follow that argument. As I have indicated, we will review the guidance, but that which has consistently been given to the health service is, in ray view, clear about eligibility criteria for continuing care. The issue raised by the ombudsman is whether some NHS authorities have acted in accordance with that guidance. It is therefore far too early to say that the NHS might in future fund more continuing care cases. However, the ombudsman's report makes clear that the whole assessment and delayed discharge procedure needs to be sharpened up, and that is what the delayed discharges Bill is all about.
§ Earl HoweMy Lords, but does the Minister not agree that, until there is clarity on continuing NHS care and a patient's eligibility for it, it will be impossible to implement the provisions of the Community Care (Delayed Discharges etc.) Bill with the level of effectiveness for which the Government are clearly hoping?
§ Lord Hunt of Kings HeathMy Lords, I do not agree because I believe that the issue which arises from the ombudsman's report is not so much about the guidance that has been given to the health service, which follows from the Coughlan judgment, as about the way in which certain NHS bodies have implemented that guidance.
3 Annex C of the current 2001 guidance clearly sets out the considerations which NHS authorities need to take into account. Of course we shall look again at the guidance in the light of the ombudsman's report, but it does not follow that there ought to be a major problem in the way in which it operates at local level if NHS authorities follow the guidance that has been set down.
§ Baroness Chalker of WallaseyMy Lords, will the Minister agree to look carefully at the interface of social services, which I pointed out to him last week, when under the guidance it is not found possible to continue NHS care but when someone continues to need nursing care outside the NHS? I believe that that interface in the guidance is still wrong and I hope that the Minister will take it into account in formulating the eventual legislation.
§ Lord Hunt of Kings HeathMy Lords, as I said in our debate last week, it is most important to ensure that people do not fall between any gap in the responsibilities of the NHS and of local authorities. I believe that the delayed discharges Bill, by encouraging both the NHS and local government to improve their assessment and delayed discharge procedures, alongside improvements in intermediate care, will tackle the issue raised by the noble Baroness.