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Health and Social Care Bill

While the Minister considers what the standard parliamentary answer to that kind of argument is, I shall make one or two relevant points. I do not wish to criticise the health ombudsman—in fact, I think she is a wonderful health ombudsman—but I think I am right in saying that the changes in Scotland to which she referred coincided with the introduction of the policy of free personal care. Therefore, in Scotland there was something that does not exist in England: a clear understanding of basic entitlements in health and social care. I point out to those who are unaware of it that we do not have a happy precedent, given that it has taken eight years for there to be some kind of resolution about what the criteria for NHS continuing care should be and consistent application of those criteria. I think we are underestimating the scale of the problem. I wish to highlight the point that a major element of the argument is costs in residential care. Regulating acute care, when one looks at what happens to a patient where there is a particular adverse incident, and looking at when a care home provider decides to up his or her fees and the person who is paying for himself takes issue with that are wholly different. That is a commercial transaction. It is worth reiterating that within this one regulator we are seeking to bring together things that are at present in separate systems, both of which are wanting. Putting them together may compound a lot of the problems. I urge the Minister not to underestimate the scale of the problems that will have to be dealt with.