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Health and Social Care Bill

My Lords, I wish to make a point in relation to Amendment No. 73. The National Health Service and local authorities are often described as monolithic, lumbering entities, but they can move with the swiftness of a gazelle when they see a financial liability looming. It is important that whatever legislation we put in place is grounded in reality. For eight years the National Health Service and local authorities argued with all the power and might of Philadelphia lawyers to get out of the possible liability of NHS continuing care, and it is important that we recognise now that no local authority in its right mind would go near a self-funder and advise them if it thought there was the remotest possibility that in doing so it would somehow attract a liability for that person’s care. It is incredibly important that self-funders have easy and swift access to some kind of support and I agree that it is preferable that that should be local to them. It is even more desirable that it is not a reactive service but a proactive one provided by people who come along and see someone, perhaps in a care home, whose capacity has perhaps declined since they first went in. If we want local authorities to do this, therefore, it is of the utmost importance that it is spelt out that they will not assume a liability for care by default; otherwise it will not happen. As the noble Earl, Lord Howe, said, at the moment local authorities have a statutory duty to assess, which they do not do in many cases. So they are not going to do this unless they are shielded from liability. That is my first point. My second point is that my former colleagues at Age Concern have noted during the progress of the Bill that the Government have talked about self-funders having access to an independent adjudicator if they have a complaint, but there is no detail about what the process will be, how people will access it and so on. We should have some detail about that. Notwithstanding the problems of the Human Rights Act and its inapplicability, it is important that we have some idea of how that will work and the timeframe for it. When the current investigatory powers of the Healthcare Commission are removed, that is one more element of protection that will be lost. The capacity of the health service ombudsman to deal with complaints is in question. I know that the ombudsman has gone before Select Committees in the other place and stated on record that there are no delays, but older people are still reporting considerable delays in having their cases taken up by the ombudsman. It is important that we have a timescale. Older people in care homes do not have long to hang about and get their complaints looked at because their average lifespan is very short. I thank the noble Earl, Lord Howe, for raising this matter again. We need to nail down those two issues to get something that will be at all workable.