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Personal Care at Home Bill

My Lords, as one of the last speakers in this debate tonight, I am very pleased to say that I support the Bill. I was just as delighted when the Prime Minister announced this Personal Care at Home Bill at the Labour Party conference. I am very pleased to have the opportunity to contribute to this important debate, and will focus my speech on the impact that the Bill will have on people with Parkinson’s. I am confident that the Bill is an important first step on the road towards improving social care support for people with Parkinson’s. However, it is important to recognise, as other noble Lords have tonight, that it is only a first step towards achieving a much-needed national care service. I declare an interest, as I chair the All-Party Parliamentary Group on Parkinson’s Disease. I am pleased that Parkinson’s has featured so prominently in both the Bill and the debates about it. Last July, the all-party parliamentary group published a report on services for people with Parkinson’s, which clearly highlighted inequalities that people currently face when trying to access health and social care. I am hopeful that the Bill will address some of the major gaps in social care for people with Parkinson’s, as illustrated in our inquiry, because one of the key issues highlighted in our report was inequalities in social care services across the country. I am particularly pleased to see that the consultation documents published alongside the Bill indicate that a standard assessment tool will be developed. That is an important step towards ensuring consistent implementation of the Bill across the country. I am equally pleased to see that the Bill will introduce a period of reablement. Preventive intervention, such as therapy services and aids and adaptions in the home, are proven to be cost-effective in the long-term, and can make a huge difference to the lives of people with Parkinson’s. However, I raise a concern about waiting lists for aids and adaptations in the home, which are currently not mentioned in any of the regulations and guidance for the Bill. The Bill aims to reduce unnecessary admission to care homes, but to achieve that, it is vital that waiting lists for aids and adaptations be addressed. Although the Bill offers additional funding for equipment, which would be provided as part of the reablement process, without a clear requirement for that equipment to be delivered promptly, the Government will not be able to achieve their stated aim of reducing avoidable admissions to care homes. Is it a clear commitment that the regulations under the Bill will address that important issue? I am also concerned that the focus of the Bill on those with high needs may have the unintended effect of diverting therapy resources from those with less severe needs. It is extremely important that preventive interventions, such as physiotherapy, are available to people at the earlier stages of Parkinson’s disease. Our inquiry showed that those services are extremely patchy and difficult to access. Provision of those services is cost-effective, and capacity needs to be increased urgently to meet the demand. There are also a few concerns about the assessment process. In Clause 1, new subsection (4C) authorises local authorities to make a person’s eligibility for free personal care conditional on that person undergoing an intensive intervention or reablement package. Although the focus on prevention and reablement is extremely welcome, the compulsory nature of it appears to go against a personalisation agenda in some ways. Again I ask the Minister whether she can give assurances that this matter will be dealt with sympathetically. The Bill is understandably limited and I recognise the reasons why carers’ services are not covered under the proposals for personal care. However, the APPG report found that far too many carers are struggling to get the support they need, not only to continue caring but to remain fit and healthy themselves. Can the Minister confirm that the guidance will explore ways in which carers can be supported in the rehabilitation phase of the assessment process—for example, through support such as respite breaks, training in moving and handling and in medication management? I said at the beginning of my speech that I welcome the Bill. I certainly do and I will be supporting the Government tonight.