Care Act 2014: Passage through the Lords

The Care Bill received royal assent, becoming law, on Wednesday 14 May.

During its passage through the House of Lords the bill spent eight days in committee, the chance for line by line scrutiny. It spent four days in report, a further opportunity for peers to examine the bill and make changes. It then went though third reading, the final amending stage, where potential loopholes can be plugged.

Lords consideration of Commons' amendments: Wednesday 7 May

Lords discussed an amendment that proposed to change the terms covering when the use of confidential information is permitted, from ‘promotion of health’ to ‘biomedical and health research,’ went to a vote with 169 for and 293 against, so the change was not made.

Peers also voted on amendment to set up an ‘Independent Information Governance Oversight Panel for Health and Social Care’, to provide outside scrutiny over the handling of medical data. The result of the vote was 165 for and 259 against, so the change was not made.

Care Bill third reading: Tuesday 29 October 2013

Members began by discussing the promotion of individual wellbeing. An amendment to clarify the list of needs that a local authority must have regard for when exercising care and support functions went to a vote with 96 for and 271 against.

Discussion also focused on the provision of financial advice for those seeking ways to fund their care and the provision of care for people in prisons.

Care Bill report stage day four: Monday 21 October

Members of the Lords began by discussing trust special administration, which enables a failed trust to be put into administration. An amendment to delay the introduction of an extension of the scope of the administration process was proposed, which went to a vote, with 176 for and 242 against.

The debate then moved on to the Care Quality Commission (CQC), and an amendment to maintain the ability of the CQC to decide if there is an issue with commissioning, went to a vote with 194 for and 220 against.

Lords continued discussing the CQC, an amendment looking to ensure the CQC has sufficient focus on staffing levels went to a vote with 194 for and 204 against.

Care Bill report stage day three: Wednesday 16 October

Lords began by discussing an amendment proposing to provide the full protection of the Human Rights Act to everyone eligible for care, including those who have to pay for their own care. The amendment went to a vote with 247 for and 218 against.

Peers then discussed benefit claims, and the circumstances in which councils could recover money paid out. An amendment seeking to protect claimants who make mistakes, rather than committing fraud, when applying for benefits went to a vote with 198 for and 224 against.

Members also discussed the definition of ‘after-care services’ and an amendment to broaden the definition went to a vote with 178 for and 198 against.

Care Bill report stage day two: Monday 14 October

Members of the Lords began by considering the assessment of an adult’s needs for care and support, including support for young carers and assessment and contingency plans in case of emergencies, for example if a carer is ill.

They went on to discuss the deferred payment scheme. An amendment creating a model scheme, to act as a framework, went to a vote with 202 for and 224 against.

Lords also voted on an amendment concerning abuse of elders. They looked at ways in which access to help an adult at risk can be granted. The result of the vote was 72 for and 143 against.

Care Bill report stage day one: Wednesday 9 October

Members of the Lords began by discussing the most effective ways to promote individual wellbeing and the rights of adults caring for disabled children.

They went on to discuss an amendment proposing to make the integration of health and social care, through health and wellbeing boards, a requirement for the NHS. The amendment went to a vote with 206 for and 224 against.

Care Bill committee stage day eight: Monday 29 July

Members of the Lords discussed a proposal for a funding review of adult social care to be carried out by the Office for Budgetary Responsibility by the end of 2014. The establishment of a tribunal system to help individuals challenge the decisions of local authorities - especially concerning individual eligibility, care plans and the level of personal budgets - was also considered.

Other suggested changes related to the provision of aftercare for those treated under the Mental Health Act 1983 and the duty of local authorities to maintain registers of adults who are sight-impaired. Members also called for clarity around the provision of adult social care for prisoners and discussed several amendments relating to end of life care.

Care Bill committee stage day seven: Monday 22 July

Members of the Lords discussed continuity of care - how users of care services can be guaranteed the same quality of care when they move to a new home in a new local authority. They also looked at how to ensure service users are provided with a high level of protection from abuse.

Care Bill committee stage day six: Tuesday 16 July

Members of the Lords began by discussing the circumstances in which a specially trained person should carry out a care assessment, for example in the case of deafness or autism. They also discussed eligibility for social care and the proposed cap on care costs.

Care Bill committee stage day five: Tuesday 9 July

Members of the Lords discussed ways to help prevent the need for care and support, including the role housing can play. They also looked at how care can be better integrated with health services, including the responsibility for cooperation and collaboration between local authorities and relevant partners, such as NHS bodies in their area.

Care Bill committee stage day four: Wednesday 3 July

Members of the Lords discussed the integration of health and social care services, and the role of the Care Quality Commission (CQC) in developing a system of performance assessment for providers of health and adult social care.

They also looked at how local authorities and health bodies could ensure an individual’s wellbeing when issuing guidance or regulations.

Care Bill committee stage day three: Wednesday 12 June

The discussion began on the functions of the Health Research Authority (HRA), and how it can encourage research and innovation to be adopted by the NHS.

Lords also looked at the establishment of the Human Tissue and Embryo Authority, a new body that would replace the Human Fertilisation and Embryology Authority and the Human Tissue Authority. They also considered the powers of the Care Quality Commission in reviewing the quality of healthcare services.

Care Bill committee stage day two: Monday 10 June

Lords discussed the role of Health Education England (HEE) in ensuring the staff they train are able to work across the health and social care boundary in an integrated way. Following this peers considered whether HEE should set up a register of qualified care assistants, in order to prevent unqualified or unregistered carers looking after patients.

The discussion also covered quality improvement in education and training, and whether HEE should develop a mandatory training curriculum for health and care support workers who are delivering direct care to service users.

Care Bill committee stage day one: Tuesday 4 June

Members of the Lords discussed Health Education England (HEE), an organisation that provides leadership for training and development in healthcare. Peers questioned the role of HEE in setting national training standards, and also looked at how it could co-ordinate its activities with the NHS in Scotland, Wales and Northern Ireland.

Care Bill second reading: Tuesday 21 May

Earl Howe (Conservative), the parliamentary under-secretary of state for the Department of Health, opened the debate, outlining the key features of the bill. He explained that the Care Bill is intended to give people a better understanding of what is available and how to get help when they need it. He said: ‘While many have good experiences, the system can often be confusing, disempowering and not flexible enough to fit around individuals’ lives.’

Baroness Wheeler (Labour) responded, welcoming the bill, but highlighting a number of concerns, including its impact on pensioners, and where the resources for local authorities will come from. She concluded by saying: ‘we on these benches will work hard to meet this challenge, and ensure that older and disabled people, and their carers and families, get the best possible deal.’

Baroness Jolly (Liberal Democrat) also welcomed the bill, in particular the prospect of a coherent future care framework, a cap for those with high care costs and new methods of dealing with hospital failure.

Care Bill summary

The bill will reform the law around care and support for adults, including measures to:

put in place safeguards for adults from abuse or neglect
make provision about care standards
establish Health Education England
establish the Health Research Authority.