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Personal Care at Home Bill

Just to help my hon. Friend, I should say for the record that he speaks in an ironic fashion—and so the record will show. I do not know whether the Secretary of State had any choice in the matter, and I am not sure that the Prime Minister intended that local authorities would have much choice. The consultation has gone out. It is not about whether the Bill should be introduced or its principles; nor is it based on its economic modelling. It is not based on the underlying argumentation. The consultation is based on a practical question: if the Government are to distribute money for this purpose, is it best to do it on this measure of need, or that measure of the number of older people with particular characteristics? That question is perfectly reasonable; it just assumes that local authorities have no say whatever in whether the service should be provided or how they should exercise discretion about it. It seems to me that a consensus is available, if the Government wish to proceed on the basis of consensus. There is a consensus on the necessity for prevention and preventive processes. Therefore, we agree that reablement should indeed form part of these proposals, but it should not be the only preventive measure. There is a consensus on personalisation, but much more needs to be done. We see access to cash benefits as an essential part of that. There is a need for partnership—in our view, a partnership with local government, with discretion for local government in deciding how council tax payers' money is used. That is essential. The Green Paper itself says that if elected representatives are to decide how council tax payers' money should be used, they must have some discretion in that. From our point of view, that partnership should also include the opportunity for people to protect their home and their assets through a voluntary process of insuring against those risks. Does the Bill provide any of those things? Not too many. I say that the Bill might be flawed because its stated purpose is to provide free personal care beyond the six-week point. I did not notice the Secretary of State explaining the Bill in these terms, but let us get to this point. The Government are proposing virtually to abolish consideration in Committee, so we might as well have some of that debate now. The Government propose the abolition of the six-week limit on the time during which free personal care can be provided at home. Simply removing the limit would allow free personal care to be provided to people whether they were at home or in long-term residential care, but the Government have introduced a further restriction in clause 1(2), whose effect is that this will not apply""to a person living in accommodation that an establishment provides to the person together with the care"." The effect of that is to exclude people living in long-term residential care who receive both accommodation and care together. The Government argue in the explanatory notes that the restriction means that people living in care homes will not get access to personal care. I put a perfectly reasonable question to the Secretary of State, which he did not satisfactorily answer: why are people who go into long-term residential care with high care needs to be discriminated against in this way, compared with people who stay at home? None the less, we shall leave that question on one side. For the sake of argument, let us say that there is a legitimate distinction to be drawn. However, the Government then say, "But people who live in sheltered accommodation or extra care housing are not to be excluded." We have arrived at the position where they say, "Why is this so?" On extra care housing, the explanatory notes state:""The accommodation and care provided in such accommodation are not provided together but under separate arrangements made by the individual."" Fine. We know what is going to happen, do we not? As soon as legislation of this kind is introduced, large numbers of care services providers that currently make provision by way of a single contract with people—one that provides accommodation and care together—will suddenly find it necessary, no doubt for business reasons, to provide different, separate contracts for accommodation and for care services. Providers will say to the Government, "If people are in extra care housing and they have two contracts, one for care and one for accommodation, they are eligible for free personal care that pays for their personal care needs. I am a care provider. I have a contract for accommodation and a contract for care services. I want exactly the same services provided to me." For the life of me, I cannot see how that evident flaw in the legislation can be reconciled. At best, we will end up with an enormous distortion to the care market, with large numbers of care providers recreating their services so as to distinguish between accommodation and care.