The Joint Committee on the Draft Care and Support Bill has completed its scrutiny of the draft bill, and published a report and recommendations. The committee is supportive of much of the bill, but suggests that further measures to promote preventative services and early intervention, and to promote integration between local authority social care, housing services and the NHS, could be included.
The committee also argues that the government has underestimated the cost of implementing the proposals contained in the bill. In launching the report, the committee’s chair, Paul Burstow, argued that “The government must take stock of its funding for adult care and support and think seriously about whether the transformation we all want to see can truly be delivered without greater resources’. Age UK has similarly called for the government’s forthcoming spending review to make provision for funding a fair and dependable care system.
The committee has made a number of recommendations for strengthening the draft bill;
- The government’s decision to implement many of the Dilnot Committee’s proposals came too late for the scrutiny committee to comment on. However the scrutiny committee has recommended regulations on how the spending cap and individual spending toward the cap should be defined and uprated in line with inflation.
- A general principle to promote the wellbeing of the individual should apply to carers as well as people who need care and support. The principle should, as advocated by Age UK, include consideration of dignity, and the bill should include a requirement for the Secretary of State to have regard to the principle when issuing regulations.
- The draft bill includes strengthened duties on local authorities to provide advice and information – the committee recommends that this should include financial advice. The committee notes that the Department of Health has given assurances that this requirement is intended to include advocacy. The committee welcomes this assurance and recommends that it should be made clear on the face of the bill.
- Duties to promote integration should include housing services as well as health and social care. There should be a specific duty on local authorities to ensure integration at the point of discharge from hospital.
- The boundary between social care and NHS care is currently based on a prohibition on local authorities providing services that are ‘authorised or required’ to be provided by the NHS. The draft bill drops the word ‘authorised’ and just bars local authorities from providing services that the NHS is ‘required’ to provide. The committee is alarmed that this change would dramatically shift the barrier between health and social care.
- The bill should go into more detail about how the government’s commitment to end ‘commissioning by the minute’ should be implemented.
- The draft bill includes, for the first time, duties on local authorities to take action where abuse or neglect is suspected. The committee recommends that local authorities, and independent sector providers of care and support, should also have responsibilities to take action to prevent abuse or neglect arising.
- At the same time as the publication of the draft bill, the Department of Health consulted on the need for new powers of entry to premises where abuse or neglect of an adult was suspected. The committee’s view is that there should be stronger powers of entry where a third party refuses access.
- Legislation should state that all providers of publicly arranged care and support should be bound by the obligations of the Human Rights Act. Where (as the draft bill proposes should be made possible) public functions are delegated to independent bodies the organisation should be subject to the same legal obligations (including the Human Rights, Equalities and Freedom of Information Acts) as the local authority itself.
Age UK has been campaigning to put pressure on the Government to bring about wide-ranging changes to social care. Find out more about Age UK’s Care in Crisis campaign