This is the text of Sir George's speech on the Third Reading of the Community Care (Delayed Discharge) Bill
Sir George Young : I hope that the Government will take to heart the very measured comments that we have just heard from the Chairman of the Select Committee on Health.
I preface my brief remarks by saying that, given the terrible hand the Minister was dealt in being asked to take the Bill through, she did so with competence and patience, both in Standing Committee and on Report.
I said on Second Reading, which seems very recent, given the speed at which the Bill has gone through the House, that the Bill was one of the worst I had seen in some 30 years. Despite the heroic attempts by the Opposition parties and the welcome amendment that we have just passed on carers, I think that it is one of the worst Bills to go through the House in those 30 years. If there is one discharge that should be delayed, it is the discharge of this Bill from the other place.
I hope that the Government will find that their ambitions to get the Bill through quite quickly, by April this year, are dashed by the very serious consideration that those in another place give it. We have not had proper time to consider it. There were chunks that we did not debate in Standing Committee. We lost an amount of time on Report because of the statements that, understandably, were made.
Not only has the Bill been rushed through, but the timetable for implementation is very challenging. The Minister has ignored the many pleas from those who have to implement the Bill to delay it until April 2004. That was a concession that she might well have made.
Of course, the Bill is unwanted by local authorities, but it is also unwanted by the health service. We heard in Standing Committee of representatives of the NHS Confederation and of the medical profession saying that they did not want it either, because it will damage the relationships that they value between them and social services.
The Bill has been condemned by all the voluntary organisations. Just today, we heard from Help the Aged, Age Concern and the Alzheimer's Society. I cannot think of a single voluntary organisation that has welcomed the Bill. The point made by those to whom I have referred is that the Bill is misguided, because it focuses on one very narrow part of the problem—the discharge from hospital to care in the community, a care home—instead of standing back and taking a holistic look at the problem from start to finish.
The Bill is unfair and unilateral. It involves a unilateral fine by one part of the public sector on another, with no opportunity for that other sector to obtain reimbursement when it faces costs because of delays by the NHS. If there is a dispute, as we heard earlier today, the jury is not wholly unbiased.
The Bill ignores the role that the Government have played in reducing the capacity in the care home sector, which is one of the strategic reasons behind delayed discharges. It will distort local government priorities. Local authorities will spend less time and energy on prevention to avoid the fines. As we heard today, if one wants to get somebody into a care home, the best way to do it now is to get them into hospital first. The law of unintended consequences and perverse incentives will apply.
On Second Reading, the Bill was virtually friendless on the Government Benches. Indeed, the only contribution from Labour Members on Third Reading has been deeply hostile. At a time when the NHS needs less bureaucracy it will get more, with invoices flying backwards and forwards between social services and the NHS. I know of no right-wing economist in this country who ever proposed an internal market of this nature to deal with the problem.
I believe that the Bill is flawed in concept and will be divisive in its consequences. I shall walk through the No Lobby with a spring in my step to register in the only way still available to me my deep-rooted objection to this legislation.