Care Bill [HL]

marshalled
list of Amendments
to be moved
in committee

The amendments have been marshalled in accordance with the Instruction of 22nd May 2013, as follows—

Clause 83
Schedule 5
Clauses 84 to 91
Schedule 6
Clauses 92 to 96
Schedule 7
Clauses 97 to 100
Schedule 8
Clauses 101 to 106
Clauses 74 to 82
Clauses 1 to 38
Schedule 1
Clauses 39 to 42
Schedule 2
Clauses 43 to 67
Schedule 3
Clause 68
Schedule 4
Clauses 69 to 73
Clauses 107 to 113

[Amendments marked * are new or have been altered]

Schedule 5

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

LORD COLLINS OF HIGHBURY

1

Page 104, line 28, leave out sub-paragraph (1)

LORD TURNBERG

LORD PATEL

2

Page 104, line 28, after “expertise” insert “including one or more members with
expertise in research and one or more with expertise in medical education and
training”

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

LORD COLLINS OF HIGHBURY

3*

Page 104, line 29, at end insert “including a registered nurse”

4

Page 104, line 29, at end insert—

“( )   The members of HEE must include someone with experience in staff
groups that are not professionally registered.”

5

Page 106, line 16, at end insert “and the consent of the Health Select Committee of
the House of Commons”

6

Page 106, line 20, leave out sub-paragraph (1)

7

Page 107, line 17, leave out sub-paragraph (2)

8

Page 107, line 22, at end insert—

“( )   HEE must exercise its functions consistent with the promotion of a
comprehensive health service, giving equal consideration to the
importance of physical and mental health.”

LORD TURNBERG

LORD PATEL

9

Page 107, line 33, at end insert—

“( )   HEE should seek the advice of those bodies concerned with setting
standards for education and training, including the regulatory bodies
and Royal Colleges.”

Clause 84

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

LORD COLLINS OF HIGHBURY

10

Page 71, line 20, at end insert—

“( )   In performing any of its functions or duties as laid out or applied to it under
this Act or any other legislation, HEE must ensure equal consideration of
importance is given to—

(a)   physical health and mental health; and

(b)   the training and education of health workers who work in physical
health, mental health or with people with learning difficulties.”

11

Page 72, line 11, leave out “, with the consent of the Secretary of State,”

12

Page 72, line 14, at end insert—

“( )   work with persons who provide health services to ensure an
adequate provision of continuing professional development for
health care workers.”

Clause 85

LORD WARNER

13

Page 72, line 33, at end insert “and having regard to the promotion of integration
with care and support provision required by section 88(1)(h).”

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

LORD COLLINS OF HIGHBURY

14

Page 72, line 36, at end insert—

“( )   In carrying out its functions under this section, HEE should have regard to
any official guidance on staffing numbers and skills mix.”

BARONESS EMERTON

LORD PATEL

LORD WILLIS OF KNARESBOROUGH

15

Page 72, line 36, at end insert—

“( )   HEE must seek to ensure that it receives representations from relevant
organisations to define sufficient workforce and appropriate skill mix.”

After Clause 85

BARONESS GREENGROSS

16*

Insert the following new Clause—

“Regulation of healthcare and care assistants

(1)   HEE shall establish and maintain a register of qualified healthcare
assistants and care assistants.

(2)   HEE shall, from time to time—

(a)   establish the standards of proficiency necessary to be admitted to
the register being the standards it considers necessary for safe and
effective practice under the register; and

(b)   prescribe the requirements of to be met as to evidence of good
health and good character in order to satisfy HEE that an applicant
is capable of safe and effective practice as a healthcare assistant of
care assistant.

(3)   Regulations may prescribe—

(a)   access to the register;

(b)   the process of application to and acceptance on the register;

(c)   the process of registration and readmission;

(d)   deemed registration of EEA health care assistants and care
assistants;

(e)   lapse of registration;

(f)   approved qualifications;

(g)   EEA qualifications; and

(h)   fitness to practice under the register.

(4)   HEE shall, before carrying out duties prescribed in (1) and (2) consult—

(a)   the Secretary of State;

(b)   the Care Quality Commission;

(c)   such other persons, or other persons of such a description, as may
be prescribed; and

(d)   any other person it considers appropriate.

(5)   “A Healthcare assistant” is an individual who provides personal care for
the health service, but who is not—

(a)   a carer as defined under this Act;

(b)   a healthcare worker currently registered with the General Medical
Council or Nursing and Midwifery Council; or

(c)   any other healthcare worker as may be prescribed.

(6)   A “care assistant” is an individual who provides personal care for the
purposes of adult social care, but who is not—

(a)   a carer as defined under this Act;

(b)   a healthcare worker currently registered with the General Medical
Council or Nursing and Midwifery Council; or

(c)   any other healthcare worker as may be prescribed.

(7)   “Adult social care”—

(a)   includes all forms of personal care and other practical assistance for
individuals who, by reason of age, illness, disability, pregnancy,
childbirth, dependence on alcohol or drugs, or any other similar
circumstances, are in need of such care or other assistance, but

(b)   does not include anything provided by an establishment or agency
for which Her Majesty’s Chief Inspector of Education, Children’s
Services and Skills is the registration authority under section 5 of
the Care Standards Act 2000.”

Clause 86

LORD TURNBERG

LORD PATEL

17

Page 73, line 5, leave out paragraph (b) and insert—

“(b)   the use of research evidence to ensure the rapid uptake of
innovations into practice.”

18

Page 73, line 5, at end insert—

“(c)   co-operation with bodies, including the Academy of Medical Royal
Colleges, the General Medical Council, the General Dental Council
and the Nursing and Midwifery Council, engaged in education and
training.”

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

LORD COLLINS OF HIGHBURY

19

Page 73, line 5, at end insert—

“( )   the importance of practical based training in the education of
clinicians”

LORD TURNBERG

LORD PATEL

20

Page 73, line 12, at end insert—

“( )   HEE must exercise its functions to secure that research and innovation are
incorporated into education and training.”

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

LORD COLLINS OF HIGHBURY

21

Page 73, line 13, leave out subsection (5)

22

Page 73, line 15, at end insert—

“( )   HEE has a responsibility to ensure that its duties under this section are also
extended to the Local Education and Training Boards.”

After Clause 86

BARONESS EMERTON

LORD PATEL

LORD WILLIS OF KNARESBOROUGH

23

Insert the following new Clause—

“Mandatory training for health and care support workers

(1)   HEE must develop a mandatory training curriculum for health and care
support workers who are delivering direct care to service users.

(2)   For the purposes of (1) a health or care support worker shall be an
individual who works in support of health or care professionals and
delivers direct care to service users.

(3)   In setting the training curriculum set out in subsection (1), HEE must seek
to ensure that standards and competencies are developed in conjunction
with the Nursing and Midwifery Council and other relevant organisations.

(4)   Providers of health or care services must be responsible for ensuring that
all health care support workers have completed the mandatory training
curriculum in subsection (1).”

Clause 87

LORD RIX

LORD TOUHIG

24

Page 73, line 17, after “must” insert “consult on and”

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

LORD COLLINS OF HIGHBURY

25

Page 73, line 23, after the first “the” insert “short and long-term”

BARONESS EMERTON

LORD WILLIS OF KNARESBOROUGH

LORD PATEL

26*

Page 73, line 35, at end insert—

“( )   specifies a workplan of at least 5 years including reference to the
nursing workforce.”

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

LORD COLLINS OF HIGHBURY

27

Page 73, line 38, at end insert—

“( )   In performing its duties under subsections (4) and (5), HEE must ensure
that the document produced should—

(a)   include one plan looking 5 years ahead,

(b)   include one plan looking 10 years ahead,

(c)   be updated annually.”

Clause 88

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

LORD COLLINS OF HIGHBURY

28

Page 74, line 20, at end insert—

“( )   the need for equality of funding for education and training across
England, and consistency of education and training opportunities,”

29

Page 74, line 30, at end insert—

“( )   the need for speciality training places to be planned nationally,”

30

Page 74, line 30, at end insert—

“( )   the need for HEE to co-ordinate its activities with the NHS in
Scotland, Wales and Northern Ireland,”

LORD REA

31

Page 74, line 32, at end insert “to this end promoting the use of joint
interprofessional education of clinical and social care staff where appropriate,”

LORD TURNBERG

LORD PATEL

32

Page 74, line 32, at end insert—

“( )   the desirability of promoting research and innovation in clinical
practice,”

BARONESS EMERTON

LORD PATEL

LORD WILLIS OF KNARESBOROUGH

33

Page 74, line 36, at end insert—

“(k)   guidance and standards on staffing levels.”

Clause 89

LORD TURNBERG

LORD PATEL

34

Page 75, line 6, at end insert “, including the Academy of Medical Royal Colleges,
the General Medical Council, the General Dental Council, the Nursing and
Midwifery Council and other bodies involved in the provision of education and
training and the maintenance of their standards”

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

LORD COLLINS OF HIGHBURY

35

Page 75, line 6, at end insert—

“( )   CQC and Monitor”

BARONESS EMERTON

LORD WILLIS OF KNARESBOROUGH

LORD PATEL

36*

Page 75, line 9, at end insert “, including all Royal Colleges”

Clause 90

LORD WILLIS OF KNARESBOROUGH

LORD TURNBERG

LORD PATEL

37

Page 75, line 21, leave out from “84(1)” to “, so” in line 23 and insert “, 85(1) and
86(2) (planning and delivering education for health care workers, ensuring
sufficient skilled health care workers and promoting research and the use of
research evidence in the health service)”

LORD TURNBERG

LORD PATEL

38

Page 75, line 30, at end insert—

“(6)   In performing its functions, an LETB must take account of advice from
university medical and nursing schools in its area.”

LORD WILLIS OF KNARESBOROUGH

LORD TURNBERG

LORD PATEL

39

Page 75, line 30, at end insert—

“( )   As a committee of HEE, an LETB must support HEE in exercising its
functions under section 86 (quality improvement in education and
training, etc.), including subsection (2) of that section, so far as it is
exercisable in or in relation to the LETB’s area.”

Clause 91

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

LORD COLLINS OF HIGHBURY

40

Page 75, line 42, at end insert—

“( )   persons who deliver education and training to health care
workers,”

LORD TURNBERG

LORD PATEL

41

Page 76, line 2, at end insert—

“(c)   persons with expertise in education and training, including
postgraduate deans or their representatives.”

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

LORD COLLINS OF HIGHBURY

42

Page 76, line 2, at end insert—

“( )   a registered nurse”

43

Page 76, line 2, at end insert—

“( )   persons with experience in staff groups that are not professionally
registered”

44

Page 76, line 2, at end insert—

“( )   health care workers who receive education and training from
within the LETB’s area”

45

Page 76, line 2, at end insert—

“( )   patients and carers or their representatives”

46

Page 76, line 2, at end insert—

“( )   a representative of the local Health and Wellbeing Board”

Clause 92

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

LORD COLLINS OF HIGHBURY

47

Page 77, line 23, at end insert—

“( )   HEE shall provide guidance on how this section is to be implemented.”

Clause 93

LORD PATEL

48

Page 77, line 36, at end insert—

“(e)   support the continuing professional development of medical
professionals in its area.”

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

LORD COLLINS OF HIGHBURY

49

Page 78, line 8, at end insert—

“( )   a representative of the relevant local authority or authorities,”

LORD TURNBERG

LORD PATEL

50

Page 78, line 8, at end insert—

“( )   universities and other educational bodies engaged in education and
training of health professionals,”

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

LORD COLLINS OF HIGHBURY

51

Page 78, line 8, at end insert—

“( )   patient and carer groups or their representatives,”

52

Page 78, line 20, at end insert—

“( )   HEE must direct a LETB to amend the local education and training plan if
not doing so would lead to a failure to ensure national workforce priorities
are implemented.”

Clause 95

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

LORD COLLINS OF HIGHBURY

 


The above-named Lords give notice of their intention to oppose the Question that Clause 95
stand part of the Bill.

Schedule 7

EARL HOWE

53

Page 118, line 27, at beginning insert—

“(A1)   The HRA must appoint a committee for the purpose of giving advice—

(a)   to the HRA in connection with the exercise of the HRA’s function
under regulation 5(1)(a) of the Health Service (Control of Patient
Information) Regulations 2002 (S.I. 2002/1438) (approval for
processing confidential patient information);

(b)   to the Secretary of State in connection with the exercise of the
Secretary of State’s functions under regulations 2, 3(4) and 5 of
those Regulations (processing of confidential patient
information).”

54

Page 118, line 27, after “appoint” insert “other”

55

Page 118, line 27, at end insert—

“(1A)    The committee appointed under sub-paragraph (A1) must consist of
persons who are not members or employees of the HRA.”

56

Page 118, line 28, leave out “A” and insert “Any other”

57

Page 118, line 28, leave out from “include” to end of line 29 and insert “such
persons”

Clause 97

LORD WARNER

58

Page 80, line 35, at end insert “and the publication of its findings fairly and frankly”

Clause 98

BARONESS EMERTON

LORD WILLIS OF KNARESBOROUGH

LORD PATEL

59*

Page 81, line 28, at end insert—

“( )   the Chief Nursing Officer of the Department of Health”

LORD TURNBERG

LORD PATEL

60

Page 81, line 38, after “research” insert “, including that undertaken by the research
and development committees of NHS trusts”

LORD WILLIS OF KNARESBOROUGH

LORD TURNBERG

LORD PATEL

61

Page 82, line 11, after “2006” insert “, providers commissioned to deliver services
for the NHS”

62

Page 82, line 12, leave out “have regard to” and insert “comply with”

LORD TURNBERG

LORD PATEL

63

Page 82, line 14, at end insert “and transparency in reporting clinical trials”

After Clause 104

LORD WILLIS OF KNARESBOROUGH

LORD PATEL

64

Insert the following new Clause—

“Human Tissue and Embryo Authority

(1)   There shall be a body corporate called the Human Tissue and Embryo
Authority.

(2)   The Authority shall consist of—

(a)   a chairman and deputy chairman, and

(b)   such number of other members as the Secretary of State appoints.

(3)   The Authority shall keep proper accounts and proper records in relation to
the accounts and shall prepare for each accounting year a statement of
accounts.

(4)   The annual statement of accounts shall comply with any direction given by
the Secretary of State, with the approval of the Treasury, as to the
information to be contained in the statement, the way in which the
information is to be presented or the methods and principles according to
which the statement is to be prepared.

(5)   Not later than five months after the end of an accounting year, the
Authority shall send a copy of the statement of accounts for that year to the
Secretary of State and to the Comptroller and Auditor General.

(6)   The Comptroller and Auditor General shall examine, certify and report on
every statement of accounts received by him under subsection (5) above
and shall lay a copy of the statement and of his report before each House of
Parliament.

(7)   The Secretary of State and the Comptroller and Auditor General may
inspect any records relating to the accounts.

(8)   In this section “accounting year” means the period beginning with the day
when the Authority is established and ending with the following
31st March, or any later period of twelve months ending with the
31st March. Schedule 1 to this Act (which deals with the membership of the
Authority, etc) shall have effect.

(9)   The Authority shall prepare—

(a)   a report for the period beginning with the 1st August preceding the
day when the Authority is established (or if that date is a
1st August, beginning with that date) and ending with the next
31st March, and

(b)   a report for each succeeding period of 12 months ending with
31st March.

(10)   The Authority shall send each report to the Secretary of State as soon as
practicable after the end of the period for which it is prepared.

(11)   A report prepared under subsection (9) for any period shall deal with the
activities of the Authority in the period and the activities the Authority
proposes to undertake in the succeeding period of twelve months.

(12)   The Secretary of State shall lay before each House of Parliament a copy of
every report received by him under subsection (10).

(13)   The following provisions of the Human Fertilisation and Embryology Act
1990 are repealed—

(a)   Sections 5 to 10, and

(b)   Sections 11(1)(a) and 11(1)(aa).

(14)   Save for the provision in subsection (13), references in the Human
Fertilisation and Embryology Act 1990 to “the Authority” shall be taken to
be references to the Human Tissue and Embryo Authority.

(15)   The Care Quality Commission may grant the following licences—

(a)   licences under paragraph 1 of Schedule 2 to the Human Fertilisation
and Embryology Act 1990 authorising activities in the course of
providing treatment services,

(b)   licences under paragraph 1A of that Schedule authorising activities
in the course of providing non-medical fertility services.

(16)   Sections 12, 13 and 13A, and paragraph 4 of Schedule 2 to the Human
Fertilisation and Embryology Act 1990 have effect in the case of all licences
granted under subsection (15) as they would do for licences granted under
that Act.

(17)   Section 13 of the Human Tissue Act 2004 is repealed.

(18)   Save for the provision in subsection (17), references in the Human Tissue
Act 2004 to “the Authority” shall be taken to be references to the Human
Tissue and Embryo Authority.

(19)   In Schedule 5 (power to modify or transfer functions) of the Public Bodies
Act 2011 omit—

(a)   the entry for the Human Fertilisation and Embryology Authority,
and

(b)   the entry for the Human Tissue Authority.”

Clause 74

LORD WARNER

65

Page 62, line 17, at end insert—

“(c)   send a copy of the warning notice to Monitor in the case of
an NHS foundation trust and the Trust Development
Authority in the case of an NHS trust”

66

Page 62, line 25, at end insert—

“(c)   must in the case of an NHS trust require the Trust
Development Authority to consider advising the Secretary
of State to appoint a trust special administrator to run the
trust and ensure high quality sustainable services for the
future”

Clause 76

LORD WARNER

67

Page 63, line 38, at end insert—

“( )   The Commission and the Trust Development Authority must act in
accordance with equivalent arrangements to those for foundation
trusts when appointing a trust special administrator to run an NHS
trust.”

Clause 77

EARL HOWE

68

Page 64, line 8, leave out “(2A)” and insert “(5)”

69

Page 64, line 11, leave out “(2AA) Nor” and insert “(5A) Nor, in the case of an NHS
foundation trust,”

70

Page 64, line 16, leave out “(2B)” and insert “(6)”

71

Page 64, line 18, leave out “(2A) or (2AA)” and insert “(5) or (5A)”

72

Page 65, line 10, at end insert—

“( )   In paragraph 15(4) of Schedule 14 to the Health and Social Care Act 2012
(abolition of NHS trusts in England: consequential amendments to section
65F of the National Health Service Act 2006)—

(a)   in the new subsection (2A) to be inserted by paragraph 15(4), in
paragraph (a), for “65DA” substitute “65DA(1)(a)”,

(b)   after that new subsection, insert—

“(2AA)   Nor may the administrator provide the draft report to the
regulator under subsection (1) without having obtained
from the Care Quality Commission a statement that it
considers that the recommendation in the draft report
would achieve that part of the objective set out in section
65DA(1)(aa).”, and

(c)   in the new subsection (2B) to be inserted by paragraph 15(4)—

(i)   after “Where the Board” insert “or the Care Quality
Commission”,

(ii)   for “to that effect” substitute “to the effect mentioned in
subsection (2A) or (2AA)”, and

(iii)   after “, the Board” insert “or (as the case may be) the
Commission”.”

LORD WARNER

 

Lord Warner gives notice of his intention to oppose the Question that Clause 77 stand part
of the Bill
.

Clause 79

LORD WARNER

73

Page 66, line 13, at end insert—

“( )   a Chief Inspector of Hospitals,

( )   a Chief Primary and Community Care Inspector,”

Clause 80

LORD WARNER

74

Page 67, line 19, at end insert “including their integration with other relevant
services”

75

Page 67, line 33, at end insert “including their integration with other relevant
services”

76

Page 67, line 43, at end insert “providing such indicators as enable fair comparisons
to be made on the performance of providers of similar classes of services”

Clause 81

LORD WARNER

77

Page 69, line 2, at end insert—

“( )   Under the terms of registration the Commission must require a care
provider to ensure that all personnel exercise a duty of candour in their
contacts with patients, service users and their families or representatives.”

Clause 1

LORD HUNT OF KINGS HEATH

78

Page 1, line 4, at end insert—

“( )   The Secretary of State in making regulations or issuing guidelines under
this Part must have regard to the general duty of local authorities, in
exercising a function under this Part in the case of an individual, to
promote that individual’s well-being.”

LORD WARNER

79

Page 2, line 31, at end insert—

“( )   In exercising any function under this Part the Secretary of State shall also
have regard to the principles of well-being for individuals in subsection
(2).”

Clause 2

LORD BEST

80*

Page 3, line 2, at end insert—

“( )   the importance of identifying housing options required to exercise
that duty”

Clause 3

LORD BEST

81*

Page 3, line 32, leave out “health provision and health-related provision” and insert
“health-related provision and housing provision”

LORD WARNER

82

Page 3, line 41, at end insert—

“( )   In pursuit of integrating care and support with other relevant services, a
local authority is enabled to participate in any form of joint working or
funding with such services without let or hindrance.”

Clause 4

BARONESS GREENGROSS

83

Page 4, line 11, at end insert—

“( )   A local authority must only offer a financial product to pay for care to
people who have received regulated financial advice or are customers who
have opted out of taking regulated financial advice.”

84*

Page 4, line 19, leave out “independent financial” and insert “information and”

85*

Page 4, line 21, after “arise,” insert “including mandatory regulated financial
advice for those taking out a care-related financial product, and”

LORD BEST

86*

Page 4, line 23, at end insert—

“( )   available housing options, and the choice of providers, available in
the authority’s area”

Clause 5

LORD BEST

87*

Page 5, line 36, at end insert—

“( )   housing options for meeting adults’ needs for care and support.”

Clause 9

LORD BEST

88*

Page 8, line 25, at end insert—

“(e)   housing options to contribute to the achievement of those
outcomes”

Clause 13

LORD WARNER

89

Page 12, line 22, at end insert—

“( )   In making regulations under this section, the Secretary of State must have
regard to—

(a)   the well-being principles in section 1,

(b)   preventing the need for NHS Services,

(c)   establishing criteria for service provision that applies to all local
authorities in England without variation in charging policies
between areas,

(d)   making available funding to meet the requirements of paragraph
(c).”

Clause 15

BARONESS GREENGROSS

90

Page 13, line 46, at end insert—

“( )   The Secretary of State has a duty to make people aware of the terms of the
cap on the cost of care through a national public awareness campaign.”

Clause 17

LORD LIPSEY

91

Page 15, line 23, at end insert—

“( )   The regulations must provide that where the financial resources of a carer
who has needs for support or of the adult needing care (whether in terms
of income, capital or a combination of both) as calculated in accordance
with the regulations exceed the financial limit, payments by the local
authority shall be tapered in such a way that each complete increase of £500
in resources held by the carer or adult over and above the financial limit
shall result in a reduction of annual payments of £1.”

92

Page 15, line 23, at end insert—

“(10A)   The regulations must provide that where the financial resources of a carer
who has needs for support or of the adult needing care (whether in terms
of income, capital or a combination of both) as calculated in accordance
with the regulations exceed the financial limit, a reduction of annual
payments of £1 shall be made for each complete increase by a sum that the
Secretary of State may from time to time specify in resources held by the
carer or adult over and above the financial limit.

(10B)   When specifying a sum for the purposes of subsection (10A), the Secretary
of State must ensure that any such sum is greater than £250.”

Before Clause 66

LORD WARNER

93

Insert the following new Clause—

“Review by the Office for Budget Responsibility

The Secretary of State must on enactment ask the Office for Budget
Responsibility to complete by the end of 2014 a review of the funding of
adult social care that assesses—

(a)   the adequacy of current public funding of these services;

(b)   the proposals for funding the provision in this Act; and

(c)   the implications of the Act and its funding for the NHS over the
next five years.”

Prepared 2nd June 2013