The Bill would consolidate existing legislation for adult social care in England into a single framework, and introduce reforms to the way care and support is accessed and funded. It also includes reforms to the regulation of health services and care standards, and would establish Health Education England (HEE) and the Health Research Authority (HRA) as statutory non-departmental public bodies. The final section of the Bill would enable the establishment of the Better Care Fund to promote joint working between the NHS and care and support services.Jump to full report >>
The Care Bill was introduced in the House of Lords as HL 1 and had its First Reading on 9 May 2013. The Bill had its First Reading in the House of Commons as Bill 123 on 30 October 2013.
The Bill includes provision for:
• A new legal framework for the provision of adult social care and support in England (Part 1)
• The reform of quality and safety regulation for healthcare providers, providing the Government’s main legislative response to the recommendations of the Francis Inquiry into the failings at Mid-Staffordshire Foundation Trust (Part 2)
• The establishment of Health Education England (HEE) and the Health Research Authority (HRA) as non-departmental public bodies (Part 3)
• The establishment of the Better Care Fund to promote joint working between the NHS and care and support services (Part 4)
The Bill had its Second Reading in the Commons on 16 December 2013.
Part 1 of the Bill would consolidate existing legislation for adult social care in England into a single framework, and introduce reforms to the way care and support is accessed and funded. The issues of eligibility criteria to receive social care eligible for the Bill’s cap on social care costs, and that cap itself, provoked particular debate, as did deferred payments for social care and the Bill’s provisions on the safeguarding of adults at risk of neglect or abuse. The Government introduced a new clause providing for appeals of decisions under this part of the Bill, which was agreed.
The Bill as brought from the Lords included provision that providers of care and support are to be taken to be exercising a function of a public nature for the purposes of section 6 of the Human Rights Act 1998. The Government opposed this provision, which had been added to the Bill during Report Stage in the Lords. The Care Minister proposed that the Bill be deleted from the Bill, and following a division it was removed.
The measures in Part 2 of the Bill largely address specific recommendations from the Francis Report about transparency and care standards, and also respond to wider concerns about how regulatory systems are co-ordinated to ensure patient safety.
There were debates on clauses introducing a duty of candour for health and social care providers and on the new offence of giving false or misleading information. Ministers introduced a new clause to the Bill setting out a right of appeal for individuals who are removed from their post as a result of action taken following a new “fit and proper person” test for senior managers. There were also debates on the single failure regime for hospitals and the powers of Trust Special Administrators (TSAs), appointed where there are failures in care quality or financial performance at NHS hospitals . A new clause was introduced in the House of Lords to ensure the TSA powers can be used to fast-track changes to services at a hospital other than the one to which the TSA is appointed. In Committee, the Government introduced amendments to this clause to clarify and strengthen the consultation requirements for TSAs in these cases.
Part 3 of the Bill would establish Health Education England (HEE) and the Health Research Authority (HRA) as statutory non-departmental bodies. A number of amendments were tabled although none were successful.
A new clause, enabling the creation of pooled budgets to improve the integration of health and social care services was introduced in Committee and this clause forms a new Part 4 of the Bill.
No divisions took place on any of the health related provisions in the Bill.
Commons Briefing papers RP14-13
Authors: Robert Long; Tom Powell