My Lords, in tabling these amendments, the noble Lords, Lord Hunt of Kings Heath and Lord Beecham, and the noble Baronesses, Lady Greengross and Lady Emerton, bring to the attention of the Committee the important role that local authorities have to play in fostering a market that offers people genuine choice between a range of high-quality care and support services.
To support choice and control for individuals, and to improve quality of care, it is critical that a range of types of care and support is available locally, and that the market in services is able to grow and adapt over time to meet people’s needs.
The Care Bill marks the first time that local authorities’ responsibilities to promote the market in local care and support services has been captured in law. This recognises the importance of ensuring the availability of a variety of high-quality services to meet the needs and preferences of all local people, not just those whose care is arranged by the local authority.
The duty is about ensuring that the market meets the needs of local people with a choice of quality services; it is not simply about promoting a market for
its own sake. This focus on quality should be understood in a broad sense. High-quality services will be fit for purpose and appropriate to an individual’s needs. Consequently, the important issue raised by Amendment 86J, of ensuring that local authorities shape markets that offer people a choice between appropriate services, is already covered by the clause: propriety is an important component of quality. I say to the noble Baroness, Lady Greengross, that Clause 5 requires local authorities to shape diverse markets in care and support services. I do so in the light of her concern that low-paying local authority contracts might preclude smaller, voluntary sector organisations from playing a part in the market. The provision will include ensuring that people are able to choose from a range of providers, including small and micro providers.
In fulfilling the duty, it is vital that local authorities engage with adults using services, their carers and providers, as Amendment 86K emphasises. The Bill therefore requires local authorities to consider how providers can meet current and future demand for services, and the importance of fostering innovation and improvement in their local area. Consequently, I reassure noble Lords that it would not be possible to fulfil the duty as it stands without engaging providers, adults who are using care and support services, and carers.
A number of the amendments relate to one of the most important ways in which local authorities can shape local markets: their commissioning decisions. Local authorities are required by Clause 5 to consider the importance of ensuring sustainability. This requires a strategic perspective on the strengths and demands placed on care and support providers now and in the future. It means that local authorities must consider how their actions may impact on the stability of their local market. They should not act in a way which might risk the sustainability of the market. Looking especially at Amendment 86L, local authorities that set unreasonable or undeliverable prices which undercut the financial sustainability of the provider market would therefore not be fulfilling this duty. However, it is important to emphasise that the normal and effective operation of any market includes some providers entering and exiting the market. The Government do not wish to prevent exit, or require local authorities to prevent exit. It would not, therefore, be appropriate for local authorities to promote the sustainability of individual providers rather than the market in general. For that reason, I cannot support the amendments proposed by the noble Baroness, Lady Emerton, although, of course, I sympathise with her concerns.
The noble Baroness, Lady Greengross, expressed the worry that low-paying local authority contracts might lead to the subsidy of providers by self-funders. The introduction of the cap on care costs will mean that a person who chooses to meet their own needs will be able to compare what they might pay to meet their needs with what the local authority pays. If a person wants to, they will be able to ask the local authority to arrange to meet their eligible care needs so that what they pay to the local authority to meet their needs would be the same as the figure that counts towards the cap. I hope that is helpful.