COURT OF APPEAL (CIVIL DIVISION)
ON APPEAL FROM THE HIGH COURT OF JUSTICE
QUEENS BENCH DIVISION
ADMINISTRATIVE COURT
MR JUSTICE KEITH
Strand, London, WC2A 2LL |
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B e f o r e :
LORD JUSTICE WALL
and
MR JUSTICE RICHARDS
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The Queen on the Application of Stephenson |
Appellant |
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v |
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Stockton on Tees Borough Council |
Respondent |
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Smith Bernal Wordwave Limited, 190 Fleet Street
London EC4A 2AG
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Official Shorthand Writers to the Court)
Clive Sheldon (instructed by Stockton on Tees Borough Council) for the Respondent
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Crown Copyright ©
Lord Justice Wall :
The appeal
The facts
1. The Claimant, Mrs Evelyn Stephenson, is 78 years old. She lives alone in warden-controlled sheltered accommodation which she rents from the Defendant, Stockton-on-Tees Borough Council ("the council"). She is in poor health, and is virtually housebound as a result. She receives a severe disability premium and an attendance allowance to enable her to pay for her additional needs.
2. In addition, the Council provides her with home care support four times a day. Carers help her to get washed and dressed, they prepare her meals for her and do some housework for her. Her needs were recently assessed by the Council and the care plan produced as a result of that assessment suggested 13Ύ hours of home care support each week.
3. Mrs Stephenson is fortunate to have much support from her daughter, Mrs Diane Pennock, who is an experienced nurse. Mrs Pennock does many of the things which Mrs Stephenson's carers do not do. For example, she does Mrs Stephenson's laundry and ironing, she deals with her correspondence and finances, she does some of the housework which the carers do not do, and she looks after her feet and cuts her nails. In addition, she takes Mrs Stephenson out in her car once a week. In that way, Mrs Stephenson can regularly see her elderly brother, and can do her own shopping.
4. Mrs. Pennock used to work a normal working week. In October 2002, she decided to reduce her working week to thirty hours over four days in order to spend more time with her mother. Mrs Stephenson was unwilling to let Mrs Pennock do that without at least partly compensating her for her loss of earnings. It was agreed that Mrs Stephenson would pay her £45.00 a week for the care which she was providing. In August 2003, Mrs Pennock stopped working even a four day week. This allowed her to spend even more time with her mother, and she now looks after her mother for at least two days a week.
5. The Council charges Mrs Stephenson for the home care support it provides. Those charges take into account Mrs Stephenson's income. In assessing what her income is, the Council took into account the severe disability premium and attendance allowance which she was receiving. It then had to decide what Mrs Stephenson's expenditure was in respect of her disabilities, because the Council proposed to reduce the amount which her income was assessed as being by the amount of that expenditure. In determining what that expenditure was, the Council ignored the £45.00 a week which Mrs Stephenson was paying to her daughter. That approach was in accordance with the Council's policy, when assessing income, of not taking into account the cost of care provided by a family member. That policy is challenged on this claim for judicial review. There is also a challenge to some aspects of the calculation of Mrs Stephenson's expenditure in respect of her disabilities.
The statutory framework
6. Section 17(1) of the Health and Social Services and Social Security Adjudications Act 1983 gives local authorities "providing a service to which [section 17] applies [the power to] recover such a charge (if any) for it as they consider reasonable". It has not been suggested that the services provided by the Council to Mrs Stephenson are not services to which section 17 relates. Section 17(3) provides relief for persons who may not be able to pay for such services. It provides:
"If a person
(a) avails himself of a service to which this section applies, and
(b) satisfies the authority providing the service that his means are insufficient for it to be reasonably practicable for him to pay for the service the amounts which he would otherwise be obliged to pay for it,
the authority shall not require him to pay more for it than it appears to them that it is reasonably practicable for him to pay."
It has not been suggested that Mrs Stephenson's means are insufficient for it to be reasonably practicable for her to pay what the Council is charging her for the services which it provides to her .
7. In Avon County Council v Hooper [1997] 1 WLR 1605, Hobhouse LJ (as he then was) said at p. 1610B that "there is an overriding criterion of reasonableness which governs the local authority's exercise of the power which is given by subsection (1)". That was said in the context of the issue in that case, which was whether the local authority should have exercised its power to charge for the services which it provided at all. In the present case, it is not suggested that it is unreasonable for the Council to charge Mrs Stephenson for the services provided to her. It is the amount of the charge which is in question. Since the Council can recover such charge "as they consider reasonable", it is for the Council to determine what amount is reasonable, and its view as to what is reasonable can only be interfered with on conventional public law grounds. This analysis was not disputed by Mr. Ian Pennock for Mrs. Stephenson.
8. However, that is subject to section 7(1) of the Local Authority Social Services Act 1970, which provides:
"Local authorities shall, in the exercise of their social services functions, including the exercise of any discretion conferred by any relevant enactment, act under the general guidance of the Secretary of State."
The Guidance
(i) "For users who receive other income in addition to Income Support .. taking them above the basic levels, (usually disability-related benefits such as Attendance Allowance (AA) .. but also including SDP [severe disability premium]) councils may choose: either to exempt such users from charges regardless of their additional income, or to include the user's overall income within a charge assessment. Where councils choose the latter, the aim should be to ensure that any charge levied does not reduce the user's net income below basic levels of income support . plus 25% (para 22)
(ii) "[Severe disability premium and attendance allowance] may be taken into account as part of a user's income although it is open to councils not to do this. Where these benefits are taken into account, councils should be guided by the overriding principles that charges:
-do not reduce the user's net income below basic levels of income support, plus 25% and
-do not result in the user being left without the means to pay for any necessary care or support or for other costs arising from their disability" (para. 32).
(iii) "This aim is best achieved through charge assessments, which assess both the resources and expenditure of the user expenditure should include any disability-related expenditure. Councils are expected to assess disability-related expenditure specifically for all users whose disability-related benefits are taken into account as income" (para 33)
(iv) "It is not possible to give a completely comprehensive list of disability-related expenditure, which could legitimately be claimed for. Councils will need to develop local policies consistent with this guidance .. The overall aim should be to allow for reasonable expenditure needed for independent living by the disabled person. Items where the user has little or no choice other than to incur the expenditure, in order to maintain independence of life, should normally be allowed" (para 44)
(v) "The process of assessment and claiming for items of disability-related expenditure should not be made unduly complex, particularly for users without high care needs .. The approach should support self-assessment by the user as much as possible, taking a holistic view of the user's finances and personal needs, both to support the user's own independence of living and to ensure that any charge assessed is reasonable" (para 45).
(vi) "In assessing disability-related expenditure, councils should include the following: ..
- Costs of any privately arranged care services required ..
- Costs of any speciality items caused by disability eg: .. purchase, maintenance, and repair of disability-related equipment .." (para. 46).
(vii) "Costs of infrequently purchased equipment will normally be annualised or amortised over a reasonable period for replacement and divided into a weekly equivalent" (para. 48).
10. Thus, what the guidance contemplates is that if a local authority decides to charge for a particular service, it should assess what the recipient's income is. In making that assessment, it should decide whether to include in the recipient's income any severe disability premium or attendance allowance which the recipient is receiving. If it decides to include those benefits in the recipient's income, it should assess what the recipient's expenditure relating to his or her disability is, and reduce the amount which the recipient's income is assessed as being by the amount of that expenditure. However, the result of that assessment should leave the recipient with a basic level of income (plus a buffer of 25%), and should not leave him or her "without the means to pay for any other necessary care or support". It is not suggested that the assessment left Mrs Stephenson with an income which was less than the basic level of support (plus a buffer of 25%), or without the means to pay for necessary care or support.
The policy of the council
11 . It (the council) decided to include any severe disability premium and attendance allowance received by the recipient in the recipient's income, and to take the recipient's expenditure relating to his or her disability into account. It followed the formula of ensuring that the recipient would not be left with less than a basic level of income plus a buffer of 25%. As for the assessment of the recipient's expenditure relating to his or her disability, the council's policy was:
"The council will carry out an assessment of disability-related expenditure to allow reasonable costs to be taken into account before charges are calculated based on the items shown and will consider any other items identified by Service Users."
12. Pursuant to the council's scheme of delegation, the council's Director of Social Services (now known as the Head of the Health and Social Care Service) had to work out the details of how a recipient's expenditure relating to his or her disability was to be calculated in the light of this broad policy statement. Those details were set out in a document headed "Social Services Framework for Disability Related Expenditure". For privately arranged care services, the document read as follows:
"Allow the number of hours identified (and not provided for) at an hourly rate of no more than the current rate Stockton Social Services pay to Independent provider (currently £8.20 per hour)
note
Allowance will not be made if care is provided by a family member.*
* exception to this rule is when the assessment identifies cultural issues."
The council has developed framework guidelines for use by the council's Assessment Teams ("the framework)". The framework provides that allowance is to be made for "privately arranged care services". However, the framework contains a general rule that such allowance is not made if the care is provided by a family member ("the family member rule"). An exception to this rule is when the assessment identified cultural issues.
It is the manner in which the council applied this "rule" to the appellant's payments to her daughter which is at the heart of this case.
The family member rule: rule or policy?
13. Although the note suggests that the exception to the family member rule will only be permitted where cultural issues come into play, that is not the case. That emerged in correspondence following Mrs Stephenson's internal appeal against the Council's refusal not to take into account the £45.00 a week which she paid to Mrs Pennock. In a letter to Mrs Stephenson's solicitors dated 26 March 2004, the Council's Head of Legal Services wrote:
" .. where care is provided by a family member from necessity, (because of cultural or other exceptional circumstances), rather than by choice, an exception to the general rule will be considered to enable persons of particular racial groups, or with particular needs, fair access to services that meet their special needs. However, if a special need cannot be identified, the exception to the general rule will not apply."
Although there was no evidence to this effect, I was told by Mr Clive Sheldon for the Council that the reason why this was not mentioned in the document referred to in the previous paragraph was because the Council was always willing not to apply the family member rule if exceptional circumstances justified treating someone exceptionally.
14. The council does not accept that everything which Mrs Pennock does for Mrs Stephenson amounts to care. But it does accept that those things which Mrs Pennock does for Mrs Stephenson which the Council accepts amount to care would, if done by an agency or professional carers, cost Mrs Stephenson more than £45.00 a week. Accordingly, it is common ground that the only reason why the £45.00 was not taken into account by the Council in determining what part of Mrs Stephenson's expenditure related to her disability was because the care was provided to her by her daughter, and because the family member rule therefore applied.
The manner in which the case was advanced to the judge
15. Mr Pennock's principal attack on the family member rule was that it was irrational. If a family member provides care which would have been provided by an agency or professional carers, and if the family member is paid by the person to whom the care is provided no more than the agency or professional carers would have charged, why should the cost of that care be treated differently? The Council might well be concerned to avoid fraudulent claims, i.e. claims that the family member makes a charge for the care which is being provided when in truth no such care is being provided or no such charge is being made, or when no such charge would be made but for the fact that expenditure relating to the recipient's disability reduces the recipient's income for the purpose of determining what charges are to be made for home care support. But that concern could be met by the Council deciding each case on an individual basis rather than imposing a blanket ban on the cost of care provided by a family member being taken into account. If the Secretary of State had thought that the adoption by local authorities of the family member rule was appropriate, he could have chosen to provide for it in the guidance. The fact that he did not do so suggests that he thought that the family member rule would be too prescriptive.
16. I cannot go along with these arguments. If the letter of 26 March 2004 is anything to go by, the rationale for the family member rule is that care which is provided by family members is normally provided voluntarily. That is so even if the care which is provided is essential to the disabled person's needs. Care which is given voluntarily is not usually charged for. Thus, if a disabled person chooses to pay for care which the carer would have been prepared to provide without charge, payment for that care should not be treated as expenditure relating to the disabled person's disability. As Mr Anthony Beckwith, the Head of Policy of the Council's Health and Social Care Service, said in para. 5 of his first witness statement:
"It has been a general premise within Social Care nationally that any care provided by close family members is done so on a voluntary basis. Rather as children do not typically pay parents for the care given in childhood it is expected that parents do not pay their children to provide care in later life. Clearly such arrangements may well exist but the view is taken within this Council that there are other means by which a carer can be compensated for providing care especially through benefits."
There may be exceptional cases in which the care has to be provided by a close relative. In those circumstances, the care would be provided (to use the language of the letter of 26 March 2004) "from necessity .. rather than by choice". Where that is the case, an exception may be made.
17. I do not regard thinking along these lines as irrational. Indeed, there is some support for it in the reference to choice in the sentence in para. 44 of the ministerial guidance that "[i]tems where the user has little or no choice other than to incur the expenditure, in order to maintain independence of life, should normally be allowed". The care which Mrs Pennock provides is extremely important for Mrs Stephenson. It gets her out of the house, it enables her to maintain her links with her brother, and it makes her feel more in touch with the world. And the tasks which Mrs Pennock does for Mrs Stephenson at her home supplements the home care support she receives. But the Council was entitled to assume that the arrangement between Mrs Stephenson and Mrs Pennock was what one might expect within families, namely that Mrs Stephenson did not have to pay Mrs Pennock for what Mrs Pennock was doing for her. Mrs Pennock would have provided this care without charge, and it was Mrs Stephenson who chose to pay her for it. In other words, the Council was entitled to assume that the £45.00 a week was expenditure which she chose to incur. Neither Mrs Stephenson nor Mrs Pennock ever told the Council otherwise, not even when Mrs Stephenson lodged her internal appeal against the Council's decision.
Was the family member policy properly applied in this case?
Your complaint is: -
1. The council has not acted in accordance with statutory guidance, namely the refusal to take account of disability related expenditure paid to Mrs. Stephenson's daughter ..
With regard to your first point, the Council has taken account of the disability related expenditure paid by Mrs Stephenson to her daughter. Although I am not clear from the information submitted if this sum is £10.00 or £45.00 per week. However, the list of services provided to Mrs. Stephenson by her daughter and the costs were considered both by the Assessment Team and by the Appeal panel.
The Council's position is that it does not, as a general rule, allow disability related expenditure for care or services provided by a family member when assessing the service user's contribution to the care provided by the local authority. I do not consider this practice to be unreasonable. The overall aid of the guidance is to allow for reasonable expenditure needed for independent living. The Council has assessed Mrs. Stephenson's reasonable weekly disability related expenditure as: -
Special equipment £3.46
Window cleaning £1.50
Excess heating £1.71
Any additional payment Mrs. Stephenson makes to her daughter is not permitted by the Council's charging policy. In formulating the policy and the framework guidelines for use by the Assessment team, the Council has followed guidance issued by the Department of Health dated September 2003 made under section 7 of the Local Authority Social Services Act 1970. Whilst the Council may allow costs of privately arranged care services as disability related expenditure, it does not regard care provided by a family member as privately arranged care services.
I should also explain that when considering what expenditure is reasonable, the Council will take into account services that form a significant part of the care plan. The Council's policy is not to restrict what may be allowed as disability related expenditure. Following consultation with users it was decided that "any reasonable disability related expenditure" should be allowed. This is a judgment that the Council has to make. In Mrs. Stephenson's case the list of disability related expenditure paid to her daughter is not allowed due to the services being provided by a family member. If such services were provided privately, they would need to be reasonably necessary taking into account the care plan before they could be allowed as disability related expenditure.
I therefore feel you disagree with the Council's judgment in a situation where it has a certain amount of discretion and where it has exercised that discretion reasonably.
(emphases added)
The reliance on ECHR
25. The alleged breach of Art. 8(1) is based on the proposition that the family member rule in effect denies the disabled person the choice of being cared for by a family member. I do not agree. The disabled person is not being prevented from being cared for by a family member. What he or she is being prevented from is having payment made to the family member treated as expenditure relating to his or her disability. If the Council is persuaded that the family member rule impacts unfairly in any particular case, it can treat the case as an exceptional one. Since care is usually provided by a family member voluntarily and is not usually charged for, what the disabled person is being denied is something which would be unusual. The right to respect for family life in Art. 8 is all about the preservation of family relationships and the maintenance of family life. The family member rule does not prevent those relationships from continuing to flourish, nor does it interfere with the maintenance of family life.
26. But even if Art. 8(1) is engaged, and the family member rule constitutes an interference with the right to respect for family life, a respectable argument could be mounted for saying that the interference is justified under Art. 8(2). Apart from the need to prevent crime, the economic well-being of the State could be said to justify the family member rule on the basis that if care which is ordinarily provided voluntarily without charge is charged for, the cost of that care should not be discharged out of public funds.
Mr Justice Richards:
Lord Justice Sedley: