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Personal Care at Home Bill

Members have raised a range of issues, and I shall try to deal with them all. Amendment 13 would limit the functions that may be imposed on a local authority through regulations by removing reference to their""including the exercise of a discretion"." That could severely reduce local authorities' ability to manage the costs of care. They are best placed to judge what is appropriate in their own situation, depending on their clients and the availability of their services. It is right that functions imposed on local authorities relating to eligibility for free provision should include the exercise of discretion, so that they can effectively manage the provision of free personal care in their local area. The Bill will enable the Secretary of State to make regulations in specific circumstances, constrained by their having to relate to the provision of free personal care in certain settings. I draw Members' attention to the current consultation document on various regulations and guidance. I shall come to that in relation to new clause 5 in a moment. We need to include in the Bill the power to ensure that local authorities can properly be given a discretion, which will be specified in regulations. I urge the Committee not to support amendment 13, because we need to enable the Secretary of State to issue appropriate regulations. Amendment 16 would enable regulations to exempt local authorities from providing free personal care to those eligible for or in receipt of continuing care. Continuing care means care provided over an extended period to a person aged 18 or over to meet physical or mental health needs that have arisen as a result of disability, accident or illness. An individual who needs continuing care may require services from NHS bodies and/or local authorities, and local authorities should also be able to provide free personal care to such people if they qualify for it. Where personal care is provided at home as part of a package of continuing care that it falls to the local authority to provide, there is no reason why the local authority should not be required to provide it free in the same way as personal care that is not provided as part of a package of continuing care. If an individual is entitled to services as part of NHS continuing health care, their package of care will be provided solely by the NHS and not by the local authority. It is important that NHS continuing care and free personal care are recognised as different ways of delivering health and social care. In all cases in which it appears to a primary care trust that there may be a need for NHS continuing health care, the PCT has a duty to take reasonable steps to ensure that an assessment of eligibility is carried out. I hope that that directly addresses the concern of the hon. Member for Eddisbury (Mr. O'Brien). On the Coughlan case, the position was confirmed in directions issued by the Secretary of State after the judgment. If a person is assessed for physical and mental health services under continuing care, that package should be provided solely by the NHS when the primary need is health-related. I hope that that clarifies the relationship between the two sets of funding. Amendment 41 would provide the Government with regulation-making powers to authorise local authority transitional arrangements when a person moves to or from care home accommodation. Extending free personal care to care homes to cover transitional arrangements is outside the policy proposals that inform the Bill, which is about personal care at home, not care in a care home. Extending the policy as the amendment suggests would also substantially increase the costs of providing free personal care beyond the agreed financial envelope. For that reason, we cannot support it. The hon. Gentleman talked in passing about a slightly different issue of transition—people who qualify for free care in their own home but whose situation improves to the extent that they may no longer need it. We believe that it would be unreasonable to continue to provide it. People are regularly assessed as their needs change, and that would apply in the circumstances that he described. New clause 5 would place a duty on the Secretary of State to make regulations to introduce a standardised assessment process for free personal care, so that a centrally standardised process could ensure that care packages were portable between different local authorities. I hope that I can reassure the hon. Member for Leeds, North-West (Greg Mulholland) and others who expressed support for the idea. We believe that to make free personal care fair and simple to understand, it will be necessary to develop a standardised assessment tool to assist councils in applying the eligibility criteria fairly, which I believe is exactly what the new clause is designed to achieve. We have already suggested that in our consultation document on regulations and guidance. I draw the hon. Gentleman's attention to page 16, which describes our intention to develop a standardised assessment tool for that purpose. That will be set out in regulations and guidance that will accompany the Bill, and we will begin commissioning for such a tool very shortly, so we do not believe it is appropriate to include that level of detail in primary legislation.