---

Personal Care at Home Bill

There is no evidence in the impact assessment that any of this has been thought through. All that is included by way of costs is the Government estimate that it will cost £1,000 per person, made up of 30 hours at £30 an hour. But Governments wishing to provide additional services have to think about the inclusive costs. They cannot say that the marginal cost of trained staff is £30 an hour, because they have to think about the average costs over the long run. They have put marginal costing in the assessment on the basis that, magically, all those staff would be available from October 2010. We know that that will not necessarily be the case. It is important to be clear about what we want to see forming part of this consensus. I do not wish to give the impression that we oppose everything about this Bill—or its purposes. We have made it clear that we need a much more preventive focus on the shape of social care for the longer term. The NHS and local authorities can and should come together to deliver better preventive services. Those should not be confined to reablement, and the measures that often work best—as we have seen from examples—are telecare, telemedicine and home adaptations, for example, which are being done early rather than just waiting until people have had falls or operations and have to be discharged home.