My Lords, I rise to speak to Amendments 83ZA and 86A, tabled in my name. For individuals entering the world of care and support for the first time, it can be a confusing, complex and protracted process. The introduction of information and advice services for those individuals will be very welcome.
I mentioned earlier that I chair the APPG on Parkinson’s and that we are currently conducting an inquiry into NHS continuing care. Continuing care is a package of care that is arranged and funded by the NHS and is free of charge to the person receiving it. The decision for eligibility rests not on a person’s condition but on whether the need for care is primarily due to health needs. While there are just over 57,000 people in receipt of NHS continuing care in England, it is unknown how many people may actually be eligible in law and have not even applied for it, or who have failed in their attempts to be assessed properly for it. As part of the inquiry into NHS continuing care, I have been hearing from people about their real problems in accessing NHS continuing care. We found during our inquiry that people with Parkinson’s and other long-term conditions are not given information about NHS continuing care. The impression that I have been given is that, because it will cost the NHS considerably, people are not encouraged to apply for it. This leaves people with no option but to go to the means-tested social care system to have their health needs met. That situation is entirely unacceptable.
As Clause 4 introduces a duty on local authorities to establish and maintain an information and advice service, it is important that all the appropriate information and advice are provided. With the further integration of health and social care, it is essential that individuals are in full possession of the facts about all aspects of the support to which they are entitled. While the list currently provides some crucial aspects for people receiving care and support, I believe that NHS continuing care is a glaring omission. We hear of the two services arguing the differences between what is a health need, which is free at the point of use, and what is a social need, which is currently charged to the individual. This can often lead to the individual either being forced unnecessarily to pay for their own care while the debate goes on or being left trapped in their hospital bed. Although NHS continuing care is part of the health system, it must be included in the list provided by the local authorities as set out in Clause 4. People who may be eligible for NHS continuing care are also likely to have such needs that they could be in receipt of support provided by their local authority. If their needs change so as to render them eligible for NHS continuing care, there should be a seamless transition to that system that does not affect the standard of support they receive.
A strong information and advice service must include information about an assessment for health provision, so that individuals can go to this service confident that they will find out everything they need about care and support. The Care Bill offers an unprecedented
opportunity to address these defects within the NHS continuing care system. Including it in the list of matters about which people should be given information and advice would promote awareness of its existence and prompt councils to refer people for assessment where they appear to be eligible for NHS continuing care. I trust that the Minister will take note of the points that I have made and that he will be able to accept these amendments.