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Personal Care at Home Bill

The hon. Lady is absolutely right. That is why I call attendance allowance the ultimate direct payment: it is cash to meet people's care needs however they want to meet them—and they could meet them through telecare; they could meet them through providing money for a carer; they could even use it to save up to provide respite care and pay it to a voluntary carer or a family member. As I say, it is theirs to do with as they like; for that reason, it is an incredibly powerful benefit. I take slight issue with how the hon. Member for South Cambridgeshire put it. If the Government chose to pass the value of the attendance allowance to the local council to meet someone's care needs, other legislation that we have at the moment means that someone can simply ask their local council to have their care needs met by a direct payment, rather than with direct care. In other words, they would get the cash back by another means if they wanted to go through that route. My argument is: why go through that route? Why not just leave the attendance allowance in place, with all its benefits, and top it up to the level of free personal care? I hope that the Government will ultimately come to that conclusion. In terms of how the money is to be provided to people to meet their care needs, I hope the norm will be that it should be provided in terms of a direct payment that they can spend how they want to meet their care needs the way that they want, which raises the question, of course, of how it will be assessed, whether it will be assessed by the normal processes councils go through at the moment when costing someone's care plan, or whether it will be some sort of flat-rate payment. Although a flat-rate payment might be simple, I would certainly not want to choose that particular route. The Government could have met their objectives in several ways, I guess. They could have had a much more complex Bill, which would clearly not have been passed before the general election, so it would not have given people in the most urgent categories of need the care that they need in the time scale that we are talking about. They could have done it as they have done by essentially putting the onus on local authorities to decide the care package. There was a third choice, which I do not know whether the Minister considered. That was to alter the criteria for NHS continuing care—bringing those criteria down to include the category of people with the most serious needs, so that the funds would effectively have come through the national health service. The Minister has chosen the route that he has chosen for good or ill, but I would like to suggest one way of achieving flexibility in the arrangements and perhaps even a better outcome for people. At the moment, local councils and local national health services can voluntarily choose to set up a care trust to manage the care of older people, in which case both parties put money together, which can be spent as the care trust decides. That gets over the problem that there are certain legal limitations on what the NHS can spend money on. Equally, there are certain legal limitations on what local councils can spend money on, but those limitations do not exist for a care trust. If everyone has put the money in together, it can be spent in the best way possible for the people concerned. At the moment, that is a voluntary arrangement for older people; it is not a voluntary arrangement for children, as we have reached a position where we insist on children's trusts being created to manage the funds from all the various agencies on behalf of children. I have never quite understood why we have not gone the next step and insisted on the creation of care trusts throughout England, which would also help to leverage in some extra money, I suspect, from the national health service, as well as from local government. It would give us considerable benefits in implementing this type of care plan.