Care Bill [HL]

third
MARSHALLED
LIST OF Amendments
to be moved
on report

The amendments have been marshalled in accordance with the Order of 8th October 2013, as follows—

Clauses 47 to 70
Schedule 3
Clause 71
Schedule 4
Clauses 72 to 86
Schedule 5
Clauses 87 to 94
Schedule 6
Clauses 95 to 99
Schedule 7
Clauses 100 to 103
Schedule 8
Clauses 104 to 116

[Amendments marked * are new or have been altered]

After Clause 47

LORD LOW OF DALSTON

LORD PANNICK

LORD LESTER OF HERNE HILL

LORD MACKAY OF CLASHFERN

83

Insert the following new Clause—

“Human Rights Act 1998: provision of “care and support services” to be public
function

(1)   A person (“P”) who provides regulated “social care” is to be taken for the
purposes of subsection (3)(b) of section 6 of the Human Rights Act 1998
(acts of public authorities) to be exercising a function of a public nature in
doing so.

(2)   This section applies to persons providing services regulated by the Care
Quality Commission.

(3)   In this section “social care” has the same meaning as in the Health and
Social Care Act 2008.”

Clause 58

LORD PATEL

BARONESS FINLAY OF LLANDAFF

83A

Page 47, line 5, at beginning insert “When a child receiving services reaches the age
of 14 or”

EARL HOWE

84

Page 47, line 5, leave out from “Where” to “after” in line 7 and insert “it appears to
a local authority that a child is likely to have needs for care and support”

LORD PATEL

BARONESS FINLAY OF LLANDAFF

84A

Page 47, line 7, after “18” insert “(whichever is sooner)”

EARL HOWE

85

Page 47, line 8, leave out “may” and insert “must”

86

Page 47, line 16, leave out subsection (3)

87

Page 47, line 19, leave out from beginning to “the” in line 20

88

Page 47, line 25, at end insert—

“( )   Where a child refuses a child’s needs assessment and the consent condition
is accordingly not met, the local authority must nonetheless carry out the
assessment if the child is experiencing, or is at risk of, abuse or neglect.”

89

Page 47, line 26, leave out from beginning to “must” and insert “Where a local
authority, having received a request to carry out a child’s assessment from the
child concerned or a parent or carer of the child, decides not to comply with the
request, it”

LORD PATEL

BARONESS FINLAY OF LLANDAFF

89A

Page 47, line 40, at end insert—

“( )   The child’s needs assessment must be completed before the child reaches
the age of 16, or within two years of the commencement of services being
provided to the child, whichever is later.”

After Clause 58

LORD PATEL

BARONESS FINLAY OF LLANDAFF

89B

Insert the following new Clause—

“Transition plans

(1)   When a local authority has completed an assessment under this section and
is satisfied that the child has needs for care and support, is likely to have
needs for care and support after becoming 18, and has determined what
those needs are likely to be, the local authority must, before the child
reaches 16 or within two years of the child beginning to receive services
(whichever is later)—

(a)   secure that a transition plan is prepared for the child or young
person, and

(b)   once a transition plan has been prepared, it must maintain the plan.

(2)   For the purposes of this Part, a transition plan is a plan specifying, for the
proceeding five years of the child or young person’s life—

(a)   any health care and social care provision reasonably required by
him;

(b)   the outcomes sought for him, including intentions to enter further
or higher education, enter the workplace or move to independent or
assisted living;

(c)   the housing provision required by him.

(3)   “Health care provision” means the provision of health care services as part
of the comprehensive health service in England continued under section
1(1) of the National Health Service Act 2006.

(4)   Regulations may make provision about the preparation and content of
transition plans.

(5)   Where a local authority is required to secure that a transition plan is
prepared for a child or young person, it must consult the child’s parent or
the young person about the content of the plan during the preparation of a
draft of the plan.

(6)   The local authority must then send the draft plan to the child or parent or
carer.

(7)   The local authority must send a copy of the finalised transition plan to the
child or parent or carer.

(8)   A transition plan shall be maintained until the young person reaches the
age of 25.

(9)   A local authority in England and its partner commissioning bodies must
make arrangements about the health, care and housing provision to be
secured for children and young people for whom a transition plan is
prepared and maintained.

(10)   Where an Education, Health and Care (EHC) plan is being prepared for a
child or young person by a local authority under Part 3 of the Children and
Families Act 2013 and a transition plan is already maintained for the child
or young person, the transition plan must become part of the EHC plan.

(11)   Where an EHC plan is already maintained for a child or young person by
a local authority and a child’s needs assessment is undertaken under
section 58(1), the local authority must ensure that the child or young
person’s EHC plan includes the transition plan as set out under subsection
(2).”

Clause 59

EARL HOWE

90

Page 48, line 6, leave out paragraph (d)

91

Page 48, line 14, at end insert—

“( )   When carrying out a child’s needs assessment, a local authority must also
consider whether, and if so to what extent, matters other than the provision
of care and support could contribute to the achievement of the outcomes
that the child wishes to achieve in day-to-day life.”

92

Page 48, leave out line 16 and insert “child”

93

Page 48, line 24, at end insert—

“( )   But in a case where the child is not competent or lacks capacity to
understand the things which the local authority is required to give under
subsection (3), that subsection is to have effect as if for “must give the child”
there were substituted “must give the child’s parents”.”

Clause 60

LORD PATEL

BARONESS FINLAY OF LLANDAFF

93A

Page 48, line 38, at beginning insert “When a child receiving services reaches the
age of 14 or”

EARL HOWE

94

Page 48, line 38, leave out from “Where” to “after” in line 40 and insert “it appears
to a local authority that a carer of a child is likely to have needs for support”

LORD PATEL

BARONESS FINLAY OF LLANDAFF

94A

Page 48, line 40, after “18” insert “(whichever is sooner)”

94B

Page 48, line 46, at end insert—

“( )   The child’s carer’s assessment must be completed before the child reaches
the age of 16, or within two years of the commencement of services being
provided to the child, whichever is later.”

EARL HOWE

95

Page 49, line 1, leave out subsection (2)

96

Page 49, line 10, leave out “or (2)”

97

Page 49, line 11, at end insert—

“(3A)    Where a child’s carer refuses a child’s carer’s assessment, the local
authority is not required to carry out the assessment (and subsection (1)
does not apply in the carer’s case).

(3B)   Where, having refused a child’s carer’s assessment, a child’s carer requests
the assessment, subsection (1) applies in the carer’s case (and subsection
(3A) does not).

(3C)   Where a child’s carer has refused a child’s carer’s assessment and the local
authority concerned thinks that the carer’s needs or circumstances have
changed, subsection (1) applies in the carer’s case (but subject to further
refusal as mentioned in subsection (3A).”

98

Page 49, leave out lines 12 and 13 and insert “Where a local authority, having
received a request to carry out a child’s carer’s assessment from the carer
concerned, decides not to comply with the request, it must give the carer—”

99

Page 49, line 17, leave out subsection (5)

Clause 61

EARL HOWE

100

Page 50, line 10, leave out paragraph (f)

101

Page 50, line 21, at end insert—

“( )   When carrying out a child’s carer’s assessment, a local authority must also
consider whether, and if so to what extent, matters other than the provision
of support could contribute to the achievement of the outcomes that the
carer wishes to achieve in day-to-day life.”

102

Page 50, leave out line 23 and insert “carer”

Clause 63

EARL HOWE

103

Page 50, line 44, leave out from “Where” to “after” in line 1 on page 51 and insert
“it appears to a local authority that a young carer is likely to have needs for
support”

104

Page 51, line 2, leave out “may” and insert “must”

105

Page 51, line 10, leave out subsection (3)

106

Page 51, leave out line 13

107

Page 51, line 20, at end insert—

“( )   Where a young carer refuses a young carer’s assessment and the consent
condition is accordingly not met, the local authority must nonetheless carry
out the assessment if the young carer is experiencing, or is at risk of, abuse
or neglect.”

108

Page 51, line 21, leave out from beginning to “must” and insert “Where a local
authority, having received a request to carry out a young carer’s assessment from
the young carer concerned or a parent of the young carer, decides not to comply
with the request, it”

Clause 64

EARL HOWE

109

Page 52, line 7, leave out paragraph (f)

110

Page 52, line 14, leave out “whether” and insert “the extent to which”

111

Page 52, line 16, leave out “whether” and insert “the extent to which”

112

Page 52, line 23, at end insert—

“( )   When carrying out a young carer’s assessment, a local authority must also
consider whether, and if so to what extent, matters other than the provision
of support could contribute to the achievement of the outcomes that the
young carer wishes to achieve in day-to-day life.”

113

Page 52, leave out line 25 and insert “young carer”

114

Page 52, line 33, at end insert—

“( )   But in a case where the young carer is not competent or lacks capacity to
understand the things which the local authority is required to give under
subsection (3), that subsection is to have effect as if for “must give the
young carer” there were substituted “must give the young carer’s
parents”.”

Clause 65

EARL HOWE

115

Page 53, line 6, leave out subsections (2) and (3) and insert—

“(2)   A local authority may combine a child’s needs assessment or young carer’s
assessment with an assessment it is carrying out (whether or not under this
Part) in relation to another person only if the consent condition is met in
relation to the child to whom the child’s needs or young carer’s assessment
relates and—

(a)   where the combination would include an assessment relating to
another child, the consent condition is met in relation to that other
child;

(b)   where the combination would include an assessment relating to an
adult, the adult agrees.

(3)   A local authority may combine a child’s carer’s assessment with an
assessment it is carrying out (whether or not under this Part) in relation to
another person only if the adult to whom the child’s carer’s assessment
relates agrees and—

(a)   where the combination would include an assessment relating to
another adult, that other adult agrees, and

(b)   where the combination would include an assessment relating to a
child, the consent condition is met in relation to that child.

(3A)   The consent condition is met in relation to a child if—

(a)   the child has capacity or is competent to agree to the assessments
being combined and does so agree, or

(b)   the child lacks capacity or is not competent so to agree but the local
authority is satisfied that combining the assessments would be in
the child’s best interests.”

116

Page 53, line 24, leave out from “in” to “, the” in line 25 and insert “relation to the
person to whom the assessment relates or in relation to a relevant person”

117

Page 53, line 30, at end insert—

“( )   A person is a “relevant person”, in relation to a child’s needs, child’s carer’s
or young carer’s assessment, if it would be reasonable to combine an
assessment relating to that person with the child’s needs, child’s carer’s or
young carer’s assessment (as mentioned in subsections (2) and (3)).”

After Clause 66

EARL HOWE

118

Insert the following new Clause—

“Independent advocacy support: involvement in assessments, plans etc.

(1)   This section applies where a local authority is required by a relevant
provision to involve an individual in its exercise of a function.

(2)   The authority must, if the condition in subsection (4) is met, arrange for a
person who is independent of the authority (an “independent advocate”) to
be available to represent and support the individual for the purpose of
facilitating the individual’s involvement; but see subsection (5).

(3)   The relevant provisions are—

(a)   section 9(5)(a) and (b) (carrying out needs assessment);

(b)   section 10(7)(a) (carrying out carer’s assessment);

(c)   section 25(3)(a) and (b) (preparing care and support plan);

(d)   section 25(4)(a) and (b) (preparing support plan);

(e)   section 27(2)(b)(i) and (ii) (revising care and support plan);

(f)   section 27(3)(b)(i) and (ii) (revising support plan);

(g)   section 59(2)(a) and (b) (carrying out child’s needs assessment);

(h)   section 61(3)(a) (carrying out child’s carer’s assessment);

(i)   section 64(3)(a) and (b) (carrying out young carer’s assessment).

(4)   The condition is that the local authority considers that, were an
independent advocate not to be available, the individual would experience
substantial difficulty in doing one or more of the following—

(a)   understanding relevant information;

(b)   retaining that information;

(c)   using or weighing that information as part of the process of being
involved;

(d)   communicating the individual’s views, wishes or feelings (whether
by talking, using sign language or any other means).

(5)   The duty under subsection (2) does not apply if the local authority is
satisfied that there is a person—

(a)   who would be an appropriate person to represent and support the
individual for the purpose of facilitating the individual’s
involvement, and

(b)   who is not engaged in providing care or treatment for the
individual in a professional capacity or for remuneration.

(6)   For the purposes of subsection (5), a person is not to be regarded as an
appropriate person unless—

(a)   where the individual has capacity or is competent to consent to
being represented and supported by that person, the individual
does so consent, or

(b)   where the individual lacks capacity or is not competent so to
consent, the local authority is satisfied that being represented and
supported by that person would be in the individual’s best
interests.

(7)   Regulations may make provision in connection with the making of
arrangements under subsection (2); the regulations may in particular—

(a)   specify requirements that must be met for a person to be
independent for the purposes of subsection (2);

(b)   specify matters to which a local authority must have regard in
deciding whether an individual would experience substantial
difficulty of the kind mentioned in subsection (4);

(c)   specify circumstances in which the exception in subsection (5) does
not apply;

(d)   make provision as to the manner in which independent advocates
are to perform their functions;

(e)   specify circumstances in which, if an assessment under this Part is
combined with an assessment under this Part that relates to another
person, each person may or must be represented and supported by
the same independent advocate or by different independent
advocates;

(f)   provide that an independent advocate may, in such circumstances
or subject to such conditions as may be specified, examine and take
copies of relevant records relating to the individual.

(8)   This section does not restrict the provision that may be made under any
other provision of this Act.

(9)   “Relevant record” means—

(a)   a health record (within the meaning given in section 68 of the Data
Protection Act 1998 (as read with section 69 of that Act)),

(b)   a record of, or held by, a local authority and compiled in connection
with a function under this Part or a social services function (within
the meaning given in section 1A of the Local Authority Social
Services Act 1970),

(c)   a record held by a person registered under Part 2 of the Care
Standards Act 2000 or Chapter 2 of Part 1 of the Health and Social
Care Act 2008, or

(d)   a record of such other description as may be specified in the
regulations.”

119

Insert the following new Clause—

“Independent advocacy support: safeguarding enquiries and reviews

(1)   This section applies where there is to be—

(a)   an enquiry under section 42(2),

(b)   a review under section 44(1) of a case in which condition 2 in section 44(3) is met or a review under section 44(4).

(2)   The relevant local authority must, if the condition in subsection (3) is met,
arrange for a person who is independent of the authority (an “independent
advocate”) to be available to represent and support the adult to whose case
the enquiry or review relates for the purpose of facilitating his or her
involvement in the enquiry or review; but see subsections (4) and (6).

(3)   The condition is that the local authority considers that, were an
independent advocate not to be available, the individual would experience
substantial difficulty in doing one or more of the following—

(a)   understanding relevant information;

(b)   retaining that information;

(c)   using or weighing that information as part of the process of being
involved;

(d)   communicating the individual’s views, wishes or feelings (whether
by talking, using sign language or any other means).

(4)   The duty under subsection (2) does not apply if the local authority is
satisfied that there is a person—

(a)   who would be an appropriate person to represent and support the
adult for the purpose of facilitating the adult’s involvement, and

(b)   who is not engaged in providing care or treatment for the adult in
a professional capacity or for remuneration.

(5)   For the purposes of subsection (4), a person is not to be regarded as an
appropriate person unless—

(a)   where the adult has capacity to consent to being represented and
supported by that person, the adult does so consent, or

(b)   where the adult lacks capacity so to consent, the local authority is
satisfied that being represented and supported by that person
would be in the adult’s best interests.

(6)   If the enquiry or review needs to begin as a matter of urgency, it may do so
even if the authority has not yet been able to comply with the duty under
subsection (2) (and the authority continues to be subject to the duty).

(7)   “Relevant local authority” means—

(a)   in a case within subsection (1)(a), the authority making the enquiry
or causing it to be made;

(b)   in a case within subsection (1)(b), the authority which established
the SAB arranging the review.”

Clause 67

LORD LIPSEY

120

Page 57, line 17, leave out from “person” to “in” in line 18 and insert “fraudulently
or negligently misrepresents or fails to disclose any material fact that they might
have reasonably been aware would have a bearing on expenditure incurred by the
local authority”

Before Clause 69

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

121

Insert the following new Clause—

“Initial funding assessment

Before enactment of Part 1, the Secretary of State must 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 provisions in this Act;

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

(d)   in particular the short and long term costs of setting the eligibility
criteria at the level set out in regulations.”

Clause 69

LORD WARNER

122

Page 59, line 10, at end insert—

“( )   In advance of the first five-yearly review, the Secretary of State must
prepare and publish a review of the working of Part I and its funding
before the date in subsection (4) and after consultation with interested
parties.”

After Clause 69

BARONESS MEACHER

BARONESS HOLLINS

BARONESS FINLAY OF LLANDAFF

123

Insert the following new Clause—

“Appeals on care and support decisions

The Secretary of State shall make regulations setting out a system for
appeal or review of decisions made about their care and support, on a
question of fact or law, including where a local authority—

(a)   makes a decision under section 13(1) that some or all of an adults
needs meet the eligibility criteria, or none of their needs meet the
eligibility criteria,

(b)   exercises its power to charge for meeting needs under section 14,

(c)   completes a financial assessment under section 17,

(d)   makes a determination under section 18 or 19 that it must or may
provide services to meet the adults care and support needs,

(e)   makes a determination under section 20 that it must or may provide
services to meet a carer’s needs for support,

(f)   makes any other decisions about an individual’s care and support
as shall be prescribed.”

BARONESS GREENGROSS

124

Insert the following new Clause—

“Appeals on decisions for NHS continuing care

The Secretary of State shall make regulations setting out a system for
appeal or review of decisions made about NHS continuing care,
independent of the NHS, on a question of fact or law.”

Schedule 3

BARONESS GREENGROSS

125

Page 110, line 3, at end insert—

“( )   specify matters which the local authority and relevant partners
must have regard to in carrying out an assessment of a person
who may have care needs following discharge from a hospital or
other acute care setting, including the content of the admission
process to that acute setting.”

Clause 71

EARL HOWE

126

Page 59, line 24, at end insert—

“(aa)   if, immediately before being detained, the person concerned
was ordinarily resident in Wales, for the area in Wales in
which he was ordinarily resident; or”

127

Page 59, leave out lines 25 to 27

128

Page 59, leave out lines 30 to 33 and insert—

“(4)   Where there is a dispute about where a person was ordinarily
resident for the purposes of subsection (3) above—

(a)   if the dispute is between local social services authorities in
England, section 40 of the Care Act 2013 applies to the
dispute as it applies to a dispute about where a person was
ordinarily resident for the purposes of Part 1 of that Act;

(b)   if the dispute is between local social services authorities in
Wales, section 164 of the Social Services and Well-being
(Wales) Act 2013 applies to the dispute as it applies to a
dispute about where a person was ordinarily resident for
the purposes of that Act;

(c)   if the dispute is between a local social services authority in
England and a local social services authority in Wales, it is
to be determined by the Secretary of State or the Welsh
Ministers.

(4A)   The Secretary of State and the Welsh Ministers shall make and
publish arrangements for determining which of them is to
determine a dispute under subsection (4)(c); and the arrangements
may, in particular, provide for the dispute to be determined by
whichever of them agree is to do so.”

LORD PATEL OF BRADFORD

128A*

Page 59, leave out lines 35 to 42 and insert—

“(5)   In this section, “after-care services” means services that reduce the
risk of a deterioration of the person’s mental condition (and,
accordingly, to reduce the risk of the person requiring admission to
a hospital again for treatment for mental disorder).”

EARL HOWE

129

Page 59, line 35, after “services”” insert “, in relation to a person,”

130

Page 59, line 37, leave out “mental disorder of the person concerned” and insert
“person’s mental disorder”

131

Page 59, line 41, leave out “the” and insert “mental”

132

Page 60, line 28, after “purpose” insert “Part 1 of”

133

Page 60, line 29, at end insert—

“(7A)    In section 37 of the Social Services and Well-being (Wales) Act 2013 (direct
payments: further provision), at the end insert—

“(11)   The ways in which a local authority may discharge its duty under
section 117 of the Mental Health Act 1983 include by making direct
payments; and for that purpose Schedule A1 (which includes
modifications of sections 34 and 35 and this section) has effect.”

(7B)   Before Schedule 1 to that Act insert the Schedule A1 contained in Part 2 of
Schedule 4 to this Act.

(7C)   In section 163 of that Act (ordinary residence), after subsection (4) insert—

“(4A)    A person who is being provided with accommodation under
section 117 of the Mental Health Act 1983 (after-care) is to be treated
for the purposes of this Act as ordinarily resident in the area of the
local authority, or the local authority in England, on which the duty
to provide that person with services under that section is imposed.”

(7D)   In consequence of subsections (7) to (7B), in subsection (2C) of section 117
of the Mental Health Act 1983—

(a)   in paragraph (a), for “regulations under section 57 of the Health and
Social Care Act 2001 or” substitute “—

(i)   sections 31 to 33 of the Care Act 2013 (as
applied by Schedule 4 to that Act),

(ii)   sections 34, 35 and 37 of the Social Services
and Well-being (Wales) Act 2013 (as applied
by Schedule A1 to that Act), or

(iii)   regulations under”,

(b)   in paragraph (b), after “apart from” insert “those sections (as so
applied) or”.”

134

Page 60, line 33, at end insert—

“( )   In section 145 of the Mental Health Act 1983 (interpretation), for the
definition of “local social services authority” substitute—

““local social services authority” means—

(a)   an authority in England which is a local authority for
the purposes of Part 1 of the Care Act 2013, or

(b)   an authority in Wales which is a local authority for
the purposes of the Social Services and Well-being
(Wales) Act 2013.””

Schedule 4

EARL HOWE

135

Page 111, line 13, leave out paragraph 2

136

Page 111, line 21, at end insert—

“PART 2

PROVISION TO BE INSERTED IN SOCIAL SERVICES AND WELL-BEING (WALES) ACT 2013

“SCHEDULEA1

DIRECT PAYMENTS: AFTER-CARE UNDER THE MENTAL HEALTH ACT 1983

General

1 Sections 34 (direct payments to meet an adult’s needs), 35
(direct payments to meet a child’s needs) and 37 (direct
payments: further provision) apply in relation to section 117 of
the Mental Health Act 1983 but as if the following
modifications were made to those sections.

Modifications to section 34

2 For subsection (1) of section 34 substitute—

“((1))   Regulations may require or allow a local authority to
make payments to an adult to whom section 117 of
the Mental Health Act 1983 (after-care) applies that
are equivalent to the cost of providing or arranging
for the provision of after-care services for the adult
under that section.”

3 In subsection (3) of that section—

(a)   in paragraph (a), for “who has needs for care and
support (“A”)” substitute “in respect of the provision to
the adult (“A”) of after-care services under section 117
of the Mental Health Act 1983”, and

(b)   in paragraph (c)(i), for “of meeting A’s needs”
substitute “of discharging its duty towards A under
section 117 of the Mental Health Act 1983”.

4 In subsection (4) of that section—

(a)   in paragraph (a), for “who has needs for care and
support (“A”)” substitute “to whom section 117 of the
Mental Health Act 1983 applies (“A”)”, and

(b)   in paragraph (d)(i), for “meeting A’s needs” substitute
“discharging its duty towards A under section 117 of
the Mental Health Act 1983”.

5 In subsection (5) of that section—

(a)   in paragraph (a), for “A’s needs for care and support”
substitute “the provision to A of after-care services
under section 117 of the Mental Health Act 1983”, and

(b)   in paragraph (b), for “towards the cost of meeting A’s
needs for care and support” substitute “equivalent to
the cost of providing or arranging the provision to A of
after-care services under section 117 of the Mental
Health Act 1983”.

6 In subsection (6)(b) of that section, for “A’s needs for care and
support” substitute “the provision to A of after-care services
under section 117 of the Mental Health Act 1983”.

Modifications to section 35

7 For subsection (1) of section 35 substitute—

“((1))   Regulations may require or allow a local authority to
make payments to a person in respect of a child to
whom section 117 of the Mental Health Act 1983
(after-care) applies that are equivalent to the cost of
providing or arranging the provision of after-care
services for the child under that section.”

8 In subsection (3)(a), (b) and (c) of that section, for “who has
needs for care and support” (in each place it occurs) substitute
“to whom section 117 of the Mental Health Act 1983 applies”.

9 In subsection (5)(a) of that section, for “meeting the child’s
needs” substitute “discharging its duty towards the child
under section 117 of the Mental Health Act 1983”.

Modifications to section 37

10 In subsection (1) of section 37—

(a)   in the opening words, for “34, 35 and 36” substitute “34
and 35”,

(b)   omit paragraphs (a), (b) and (c),

(c)   in paragraph (i), for “a local authority’s duty or power
to meet a person’s needs for care and support or a
carer’s needs for support is displaced” substitute “a
local authority’s duty under section 117 of the Mental
Health Act 1983 (after-care) is discharged”, and

(d)   in paragraph (k), for “34 to 36” substitute “34 and 35”.

11 Omit subsections (2) to (8) of that section.

12 After subsection (8) of that section insert—

“((8A))   Regulations under sections 34 and 35 must specify
that direct payments to meet the cost of providing or
arranging for the provision of after-care services
under section 117 of the Mental Health Act 1983
(after-care) must be made at a rate that the local
authority estimates to be equivalent to the
reasonable cost of securing the provision of those
services to meet those needs.”

13 In subsection (9) of that section—

(a)   for “, 35 or 36” substitute “or 35”, and

(b)   for “care and support” substitute “after-care services”.

14 In subsection (10) of that section, for “care and support to meet
needs” substitute “after-care services”.””

Clause 72

LORD PATEL OF BRADFORD

136A*

Page 61, line 18, leave out from beginning to “not” in line 19 and insert “Section 42
and 47 does”

136B*

Page 61, line 22, leave out subsection (8)

After Clause 73

LORD WARNER

LORD PATEL

BARONESS GREENGROSS

137

Insert the following new Clause—

“End of life care

After consultation, the Secretary of State may make regulations for
terminally ill persons to—

(a)   have their preference for place of death recorded by local health and
social care services and for that preference to be implemented
wherever practicable;

(b)   have their care and support needs and those of their carer treated as
urgent by the local authority responsible for assessing those needs;
and

(c)   be exempt from any local authority charges for adult social care.”

Clause 74

EARL HOWE

138

Page 62, line 41, at end insert—

“( )   The Secretary of State must have regard to the general duty of local
authorities under section 1(1) (promotion of individual well-being)—

(a)   in issuing guidance for the purposes of subsection (1);

(b)   in making regulations under this Part.”

Clause 75

LORD LOW OF DALSTON

138A

Page 63, line 26, at end insert—

“( )   In exercising any function to which an authorisation under this section
relates, the person authorised is subject to the same legal obligations as the
local authority.”

138B

Page 63, line 30, after “as” insert “also”

After Clause 76

BARONESS BARKER

BARONESS TYLER OF ENFIELD

BARONESS BAKEWELL

139

Insert the following new Clause—

“Older Persons’ Commissioner

(1)   In the Health and Social Care Act 2008, after section 128 insert—

“PART 2A

OLDER PERSONS’ COMMISSIONER

128A          Establishment of an office of the Older Persons’ Commissioner

(1)   There shall be an office of the Older Persons’ Commissioner.

(2)   Schedule (The Older Persons’ Commissioner) shall have effect with
respect to the Older Persons’ Commissioner.

128B          Functions of the office of the Older Persons’ Commissioner

(1)   The Older Persons’ Commissioner has the function under this Part
of promoting the wellbeing, dignity and respect of older people and
safeguarding and promoting their rights and welfare.

(2)   In fulfilling their duties under subsection (1), the Older Persons’
Commissioner may review, and monitor the operation of,
arrangements falling within subsection (2), (3) or (4) for the purpose
of ascertaining whether, and to what extent, the arrangements are
effective in promoting the wellbeing, dignity and respect, and
safeguarding and promoting the rights and welfare of older people.

(3)   The arrangements falling within this subsection are the
arrangements made by the providers of regulated services in
England, or by the Secretary of State, for dealing with complaints or
representations in respect of such services made by or on behalf of
older people.

(4)   The arrangements falling within this subsection are arrangements
made by the providers of regulated services in England, or by the
Secretary of State, for ensuring that proper action is taken in
response to any disclosure of information which may tend to show
that, in the course of, or in connection with, the provision of
regulated services to older people—

(a)   that a criminal offence has been committed;

(b)   that a person has failed to comply with any legal obligation
to which he is subject;

(c)   that the health and safety of any person has been
endangered; or

(d)   that information tending to show that any matter falling
within one of the preceding paragraphs has been
deliberately concealed.

(5)   The arrangements falling within this subsection are arrangements
made (whether by providers of regulated services in England, by
the Secretary of State or by any other person) for making persons
available—

(a)   to represent the views and wishes of older people to whom
this Part applies; or

(b)   to ensure the adequate provision to older people of advice
and support of any prescribed kind.

(6)   The Secretary of State may, by regulations confer power on the
Older Persons’ Commissioner to require prescribed persons to
provide any information which the Older Persons’ Commissioner
considers it necessary or expedient to have for the purposes of his
functions under this section.

(7)   A statutory instrument containing regulations under subsection (5)
is not to be made unless a draft of the instrument has been laid
before, and approved by a resolution of, each House of Parliament.

128C          Examination of cases by the Older Persons’ Commissioner

(1)   The Secretary of State may, by regulations, make provision for the
examination by the Older Persons’ Commissioner of the cases of
particular older people.

(2)   The regulations may include provision about—

(a)   the types of case which may be examined;

(b)   the circumstances in which an examination may be made;

(c)   the procedure for conducting an examination, including
provision about the representation of parties;

(d)   the publication of reports following an examination.

(3)   The regulations may, for the purposes of enabling the Older
Persons’ Commissioner to examine or determine whether any
recommendation made in a report following an examination has
been complied with, make provision for—

(a)   requiring persons to provide the Older Persons’
Commissioner with information; or

(b)   requiring persons who hold or are accountable for
information to provide the Older Persons’ Commissioner
with explanations or other assistance,

for the purpose of an examination or for the purposes of
determining whether any recommendation made in a report
following an examination has been complied with.

(4)   For the purposes mentioned in subsection (3), the Older Persons’
Commissioner shall have the same powers as the High Court in
respect of—

(a)   the attendance and examination of witnesses (including the
administration of oaths and affirmations and the
examination of witnesses abroad); and

(b)   the provision of information.

(5)   No person shall be compelled for the purposes mentioned in
subsection (3) to give any evidence or provide information which
he could not be compelled to give or provide in civil proceedings
before the High Court.

(6)   The regulations may make provision for the payment by the Older
Persons’ Commissioner of sums in respect of expenses or
allowances to persons who attend or provide information for the
purposes mentioned in subsection (3).

(7)   A statutory instrument containing the first regulations made under
subsection (1), (2) or (3) is not to be made unless a draft of the
instrument has been laid before, and approved by a resolution of,
each House of Parliament.

(8)   A statutory instrument that contains regulations made under
subsection (6) is subject to annulment in pursuance of a resolution
of either House of Parliament.

128D          Obstruction

(1)   The Older Persons’ Commissioner may certify an offence to the
High Court where—

(a)   a person, without lawful excuse, obstructs him or any
member of his staff in the exercise of any of his functions
under regulations made under section 128B(5) or 128C; or

(b)   a person is guilty of any act or omission in relation to an
examination under regulations made by under section 128C
which, if that examination were proceedings in the High
Court, would constitute contempt of court.

(2)   Where an offence is so certified the High Court may inquire into the
matter; and after hearing—

(a)   any witnesses who may be produced against or on behalf of
the person charged with the offence; and

(b)   any statement that may be offered in defence,

the High Court may deal with the person charged with the offence
in any manner in which it could deal with him if he had committed
the same offence in relation to the High Court.

128E          Further functions

(1)   The Older Persons’ Commissioner may, in connection with his
functions under this Part give advice and information to any
person.

(2)   Regulations may confer power on the Older Persons’
Commissioner to assist an older person—

(a)   in making a complaint or representation to or in respect of a
provider of regulated services in England; or

(b)   in any prescribed proceedings.

(3)   For the purposes of subsection (2), assistance includes—

(a)   financial assistance; and

(b)   arranging for representation, or the giving of advice or
assistance, by any person.

(4)   Regulations under subsection (2) may also provide for assistance to
be given on conditions, including (in the case of financial
assistance) conditions requiring repayment in specified
circumstances.

(5)   Regulations may, in connection with the Older Persons’
Commissioner’s functions under this Part, confer further functions
on the Commissioner.

(6)   Regulations may, in particular, include provision about the making
of reports on any matter connected with any of his functions.

(7)   Apart from identifying any person investigated, a report by the
Older Persons’ Commissioner shall not—

(a)   mention the name of any person, or

(b)   include any particulars which, in the opinion of the Older
Persons’ Commissioner, are likely to identify any person
and can be omitted without impairing the effectiveness of
the report,

unless, after taking account of the public interest (as well as the
interests of any person who made a complaint and other persons),
the Older Persons’ Commissioner considers it necessary for the
report to mention his name or include such particulars.

(8)   For the purposes of the law of defamation, the publication of any
matter by the Older Persons’ Commissioner in a report is absolutely
privileged.

(9)   In subsection (1) of this section “proceedings” includes a procedure
of any kind and any prospective proceedings.

(10)   A statutory instrument containing the regulations under this
section is not to be made unless a draft of the instrument has been
laid before, and approved by a resolution of, each House of
Parliament.

128F          Restrictions

(1)   This Part does not authorise the Older Persons’ Commissioner to
enquire into or report on any matter so far as it is the subject of legal
proceedings before, or has been determined by, a court or tribunal.

(2)   This Part does not authorise the Commissioner to exercise any
function which by virtue of an enactment is also exercisable by the
prescribed person.

128G          Interpretation

(1)   For the purposes of this Part “regulated services” has the same
definition as “regulated activity” in section 8 of this Act as they
relate to older people.

(2)   This Part applies to any older person normally domiciled in
England.”

(2)   After Schedule 5, insert the following new Schedule—

“SCHEDULE 5A

THE OLDER PERSONS’ COMMISSIONER

Status

1    (1)   The Older Persons’ Commissioner is to be a corporation sole.

(2)   The Older Persons’ Commissioner is not to be regarded as the
servant or agent of the Crown or as enjoying any status,
immunity or privilege of the Crown; and the Older Persons’
Commissioner’s property is not to be regarded as property of, or
property held on behalf of, the Crown.

Appointment and tenure of office

2 Regulations may make provision—

(a)   as to the appointment of the Older Persons’
Commissioner (including any conditions to be fulfilled
for appointment);

(b)   as to the filling of vacancies in the office of Commissioner;

(c)   as to the tenure of office of the Older Persons’
Commissioner (including the circumstances in which he
ceases to hold office or may be removed or suspended
from office).

Remuneration

3 The Secretary of State shall—

(a)   pay the Commissioner such remuneration and
allowances; and

(b)   pay, or make provision for the payment of, such pension
or gratuities to or in respect of him, as may be provided
for under the terms of his appointment.

Staff

4    (1)   The Commissioner may appoint any staff he considers necessary
for assisting him in the exercise of his functions, one of whom
shall be appointed as deputy Commissioner.

(2)   During any vacancy in the office of Commissioner or at any time
when the Commissioner is for any reason unable to act, the
deputy Commissioner shall exercise his functions (and any
property or rights vested in the Commissioner may accordingly
be dealt with by the deputy as if vested in him).

(3)   Without prejudice to sub-paragraph (2), any member of the
Commissioner’s staff may, so far as authorised by him, exercise
any of his functions.

General powers

5    (1)   Subject to any directions given by the Secretary of State, the
Commissioner may do anything which appears to him to be
necessary or expedient for the purpose of, or in connection with,
the exercise of his functions.

(2)   That includes, in particular—

(a)   co-operating with other public authorities in the United
Kingdom;

(b)   acquiring and disposing of land and other property; and

(c)   entering into contracts.

Reports

6 Regulations may provide for the Commissioner to make periodic
or other reports to the Secretary of State relating to the exercise of
his functions and may require the reports to be published in the
manner required by the regulations.

Accounts

7    (1)   The Older Persons’ Commissioner must keep accounts in such
form as the Secretary of State may determine.

(2)   The Older Persons’ Commissioner must prepare annual
accounts in respect of each financial year in such form as the
Secretary of State may determine.

(3)   The Older Persons’ Commissioner must send copies of the
annual accounts to the Secretary of State and the Comptroller
and Auditor General within such period after the end of the
financial year to which the accounts relate as the Secretary of
State may determine.

(4)   The Comptroller and Auditor General must examine, certify and
report on the annual accounts and must lay copies of the
accounts and of his report before Parliament.

(5)   In this paragraph “financial year”, in relation to the Older
Persons’ Commissioner, means—

(a)   the period beginning with the date on which the Older
Persons’ Commissioner is established and ending with
the next 31st March following that date; and

(b)   each successive period of twelve months ending with 31st
March.

Payments

8 The Secretary of State may make payments to the Older Persons’
Commissioner of such amounts, at such times and on such
conditions (if any) as he considers appropriate.

General

9 In the House of Commons Disqualification Act 1975, in Part III of
Schedule 1 (certain disqualifying offices), the following entries
are inserted at the appropriate places—

“Older Persons’ Commissioner.”

“Member of the staff of the Older Persons’ Commissioner.”

10 In the Northern Ireland Assembly Disqualification Act 1975, the
same entries as are set out in paragraph 9 are inserted at the
appropriate places in Part III of Schedule 1.

11    (1)   Regulations may provide that the office of Older Persons’
Commissioner shall be added to the list of “Offices” in Schedule
1 to the Superannuation Act 1972 (offices etc. to which section 1
of that Act applies).

(2)   The Secretary of State shall pay to the Minister for the Civil
Service, at such times as he may direct, such sums as he may
determine in respect of any increase attributable to provision
made under sub-paragraph (1) in the sums payable out of money
provided by Parliament under the Superannuation Act 1972.””

Before Clause 77

EARL HOWE

140

Insert the following new Clause—

“Duty of candour

In section 20 of the Health and Social Care Act 2008 (regulation of regulated
activities), after subsection (5) insert—

“(5A)    Regulations under this section must make provision as to the
provision of information in a case where an incident of a specified
description affecting a person’s safety occurs in the course of the
person being provided with a service.””

Clause 77

LORD WARNER

141

Page 66, line 21, at end insert—

“( )   in so deciding in the case of an NHS trust, the Commission
must review the effectiveness of previous interventions
with that trust by the Trust Development Authority (or its
predecessor bodies) and consider whether to require the
Authority to advise the Secretary of State to appoint a trust
special administrator.”

After Clause 82

EARL HOWE

142

Insert the following new Clause—

“Chief Inspectors

After paragraph 3 of Schedule 1 to the Health and Social Care Act 2008
insert—

“Chief Inspectors

3A    (1)   The non-executive members must—

(a)   appoint an executive member to be the Chief Inspector of
Hospitals,

(b)   appoint an executive member to be the Chief Inspector of
Adult Social Care, and

(c)   appoint an executive member to be the Chief Inspector of
General Practice.

(2)   Each of those executive members is to exercise such functions of
the Commission on its behalf as it determines.

(3)   When exercising functions under sub-paragraph (2), an
executive member must have regard to the importance of
safeguarding and promoting the Commission’s independence
from the Secretary of State.””

143

Insert the following new Clause—

“Independence of the Care Quality Commission

(1)   Part 1 of the Health and Social Care Act 2008 (the Care Quality
Commission) is amended as follows.

(2)   In section 48 (special reviews or investigations), omit subsection (7)
(Secretary of State’s power to make regulations as to procedure for
representations before publication of report).

(3)   In section 54 (studies as to economy, efficiency etc), in subsections (1) and
(3), omit “, with the approval of the Secretary of State,”.


10

(4)   After subsection (2) of that section, insert—

“(2A)    The Commission may not exercise the power under subsection
(1)(a), so far as it relates to the activity mentioned in subsection
(2)(d), without the approval of the Secretary of State.”

(5)   In section 55 (publication of results of studies under section 54), omit
subsection (2) (Secretary of State’s power to make regulations as to
procedure for representations before publication of report).

(6)   In section 57 (reviews of data, studies and research), in subsection (1), omit
“, with the approval of the Secretary of State,”.

(7)   In section 61 (inspections carried out for registration purposes), omit—

(a)   subsection (1) (Secretary of State’s power to make regulations
specifying frequency etc. of inspections), and

(b)   subsection (4) (Secretary of State’s power to make regulations as to
procedure for representations before publication of report).

(8)   In section 83 (annual reports), omit subsection (3) (Secretary of State’s
power to direct preparation of separate reports).

(9)   In paragraph 5 of Schedule 4 (inspection programmes etc.), omit—

(a)   in sub-paragraph (1) (preparation of programme etc.), “, or at such
times as the Secretary of State may specify by order,”, and

(b)   sub-paragraph (3) (Secretary of State’s power to specify form of
programme etc.).

(10)   In consequence of subsections (3) and (6), omit section 293(3) and (4) of the
Health and Social Care Act 2012.”

LORD WARNER

[As an amendment to Amendment 143]

143A*


Line 10, leave out subsection (4)

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

144

Insert the following new Clause—

“Staffing numbers and skills mix

The Care Quality Commission shall, in carrying out its functions, have
regard to any official guidance on staffing numbers and skills mix.”

Clause 83

EARL HOWE

145

Page 72, leave out lines 16 to 27

146

Page 72, line 28, leave out “or local authority”

BARONESS GREENGROSS

147

Page 72, line 45, at end insert—

“( )   Indicators the Commission devises for the purposes of subsection
(5) should include indicators of the quality of services provided for
the identification and treatment of those conditions that most
frequently occur in a particular care setting.”

LORD HUNT OF KINGS HEATH

147A*

Page 72, line 45, at end insert—

“( )   Indicators the Commission devises for the purposes of subsection
(5) may include indicators relating to the uptake of medicines
recommended for use by the National Institute for Health and Care
Excellence.”

EARL HOWE

148

Page 73, line 14, at end insert—

“(13)   Consultation undertaken before the commencement of this section
is as effective for the purposes of subsection (9) as consultation
undertaken after that commencement.”

149

Page 73, line 16, at end insert—

“( )   In section 48 (special reviews and investigations), in subsection (1)—

(a)   omit “, with the approval of the Secretary of State,”, and

(b)   at the end insert “; but the Commission may not conduct a review
or investigation under subsection (2)(ba) or (bb) without the
approval of the Secretary of State.”

( )   Omit subsection (1A) of that section.

( )   In subsection (2) of that section, for “a periodic review” substitute “a review
under section 46”.

( )   In that subsection, after paragraph (ba) (but before the following “or”)
insert—

“(bb)   the exercise of the functions of English local authorities in
arranging for the provision of adult social services,”.

( )   After subsection (3) of that section insert—

“(3A)    A review or investigation under subsection (2)(b), in so far as it
involves a review or investigation into the arrangements made for
the provision of the adult social services in question, is to be treated
as a review under subsection (2)(bb) (and the requirement for
approval under subsection (1) is accordingly to apply).””

150

Page 73, line 25, at end insert—

“( )   in section 293 of the Health and Social Care Act 2012, omit
subsections (1) and (2);”

After Clause 83

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

151

Insert the following new Clause—

“Periodic reviews and assessments of standards of employment and impact of
quality of care

The Commission shall have a duty to carry out periodic reviews and
assessments of standards of employment in health and social care
provision with particular emphasis on workforce conditions which
support continuity and quality of care, and are consistent with the
wellbeing principle as set out in section 1.”

Before Clause 84

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

BARONESS MASHAM OF ILTON

152

Insert the following new Clause—

“Duty of candour

(1)   Every organisation registered with the Care Quality Commission to
provide health or social care services must be honest, open and truthful in
all their dealing with patients and the public.

(2)   Organisational interests of those so registered must never be allowed to
outweigh the duty to be honest, open and truthful.

(3)   Where death or serious harm has been or may have been caused to a patient
by an act or omission of the organisation or its staff, the patient or any
lawfully entitled personal representative or other authorised person
should be—

(a)   informed of the incident;

(b)   given full disclosure of the surrounding circumstances; and

(c)   be offered an appropriate level of support,

whether or not the patient or representative has asked for this
information.”

Clause 84

EARL HOWE

152A

Page 73, line 42, leave out “exercises functions in connection with the provision of”
and insert “provides”

152B

Page 74, line 1, leave out “body (other than a public body) which” and insert
“person who”

152C

Page 74, line 4, at end insert “, or

(c)   a person who provides health services or adult social care in
England all or part of the cost of which is paid for by means of a
direct payment under section 12A of the National Health Service
Act 2006 or under Part 1 of this Act.”

Clause 85

EARL HOWE

152D

Page 74, line 35, leave out “care provider” and insert “person”

152E

Page 74, line 35, leave out from “liable” to end of line 36 and insert “—

(a)   on summary conviction, to a fine;

(b)   on conviction on indictment, to imprisonment for not more than
two years or a fine (or both).”

After Clause 85

EARL HOWE

152F

Insert the following new Clause—

“Offences by bodies

(1)   Subsection (2) applies where an offence under section 84(1) is committed
by a body corporate and it is proved that the offence is committed by, or
with the consent or connivance of, or is attributable to neglect on the part
of—

(a)   a director, manager or secretary of the body, or

(b)   a person purporting to act in such a capacity.

(2)   The director, manager, secretary or person purporting to act as such (as
well as the body) is guilty of the offence and liable to be proceeded against
and punished accordingly (but section 85(2) does not apply).

(3)   The reference in subsection (2) to a director, manager or secretary of a body
corporate includes a reference—

(a)   to any other similar officer of the body, and

(b)   where the body is a local authority, to a member of the authority.

(4)   Proceedings for an offence under section 84(1) alleged to have been
committed by an unincorporated association are to be brought in the name
of the association (and not in that of any of the members); and rules of court
relating to the service of documents have effect as if the unincorporated
association were a body corporate.

(5)   In proceedings for an offence under section 84(1) brought against an
unincorporated association, section 33 of the Criminal Justice Act 1925 and
Schedule 3 to the Magistrates’ Courts Act 1980 apply as they apply in
relation to a body corporate.

(6)   A fine imposed on an unincorporated association on its conviction for an
offence under section 84(1) is to be paid out of the funds of the association.

(7)   Subsection (8) applies if an offence under section 84(1) is proved—

(a)   to have been committed by, or with the consent or connivance of, an
officer of the association or a member of its governing body, or

(b)   to be attributable to neglect on the part of such an officer or
member.

(8)   The officer or member (as well as the association) is guilty of the offence
and liable to be proceeded against accordingly (but section 85(2) does not
apply).”

153

Insert the following new Clause—

“Training for persons working in regulated activity

In section 20 of the Health and Social Care Act 2008 (regulation of regulated
activities), after subsection (4) insert—

“(4A)    Regulations made under this section by virtue of subsection (3)(d)
may in particular include provision for a specified person to set the
standards which persons undergoing the training in question must
attain.””

Schedule 5

EARL HOWE

154

Page 112, line 6, at end insert—

“(0 )   The non-executive members of HEE must include a person who will
represent the interests of patients.”

155

Page 114, line 33, at end insert—

“(1A)    HEE may arrange for any of its committees, sub-committees or members
or any other person to exercise any of its functions on its behalf (but see
sub-paragraph (4)).”

156

Page 114, line 36, after “sub-paragraph” insert “(1A) or”

157

Page 115, line 1, after “LETB” insert “, or for a sub-committee, member or any other
person,”

After Clause 89

LORD WILLIS OF KNARESBOROUGH

BARONESS EMERTON

LORD PATEL

LORD WARNER

158

Insert the following new Clause—

“Mandatory training and certification for health and care support workers and
nursing assistants

(1)   HEE must develop a mandatory training curriculum and certification
standards, with two levels, for health and care support workers who are
delivering direct care to service users and for nursing assistants.

(2)   For the purposes of subsection (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)   The training curriculum, under subsection (1), will have—

(a)   a basic level; and

(b)   an advanced level,

of certification in health and care standards.

(4)   Providers of health or care services must be reponsible for ensuring that all
health and care support workers hold a certificate in health and care
standards.

(5)   Any individual working directly with patients or clients must have
completed training and hold, at least, a basic level certificate in health and
care standards.

(6)   A nursing assistant must have completed training and hold an advanced
level certificate in health and care standards.

(7)   The training curriculum and certification standards set out in subsection (1)
will be set by the Nursing and Midwifery Council and approved by HEE.

(8)   Employers must retain a register of individuals who hold any certificate in
health and care standards.

(9)   It is an offfence for any employer to employ—

(a)   an individual to work directly with patients or clients who is not
registered as holding at least a basic level certificate in health and
care standards; or

(b)   a nursing assistant who is not registered as holding an advanced
level certificate in health and care standards.”

159

Insert the following new Clause—

“Safeguarding patients

(1)   The first duty that a health or care service provider must consider for any
decision is patient safety.

(2)   Health or care service providers must publish a report containing staffing
levels based on evidence of safe staffing levels supported by acuity and
dependency levels for each patient.

(3)   The report must relate safe staffing levels to patient outcomes and
mortality rates.

(4)   The report must be presented to the hospital management board or any
other relevant board of management.

(5)   The frequency of the report will be determined by the Secretary of State.

(6)   The Care Quality Commission or Monitor will be able to request to see the
report, under subsection (2), at any time.”

LORD HUNT OF KINGS HEATH

BARONESS WHEELER

160

Insert the following new Clause—

“Regulation of health and care support workers

(1)   The Secretary of State shall, by regulations and in consultation with the
Care Quality Commission, HEE and such other persons as it considers
appropriate, ensure the establishment of a system of regulation of health
and care support workers.

(2)   For the purpose of subsection (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.”

Clause 91

LORD ABERDARE

160A*

Page 78, line 43, at end insert—

“( )   the needs of patients to have their conditions diagnosed promptly,”

Clause 93

EARL HOWE

161

Page 80, line 5, at end insert—

“( )   Subsections (1), (2) and (4) of section 89 (quality improvement in education
and training etc.) apply to an LETB in the exercise of its functions as they
apply to HEE in the exercise of its functions.”

Clause 94

EARL HOWE

162

Page 80, line 23, at end insert “, and

( )   a person who will represent the interests of patients.”

163

Page 80, line 24, leave out “The regulations” and insert “Regulations under
paragraph (b) of subsection (3)”

164

Page 80, line 24, leave out “that expertise” and insert “the expertise mentioned in
that paragraph”

Schedule 7

EARL HOWE

165

Page 126, line 36, after “any” insert “of its committees, sub-committees or members
or any other”

Clause 100

EARL HOWE

166

Page 85, line 12, leave out “such research” and insert “research that is safe and
ethical (including by promoting transparency in research)”

167

Page 85, line 25, at end insert—

“( )   Promoting transparency in research includes promoting—

(a)   the registration of research;

(b)   the publication and dissemination of research findings and
conclusions;

(c)   the provision of access to data on which research findings or
conclusions are based;

(d)   the provision of information at the end of research to participants in
the research;

(e)   the provision of access to tissue used in research, for use in future
research.”

Schedule 8

EARL HOWE

168

Page 132, line 45, leave out from second “a” to end of line 3 on page 133 and insert
“research ethics committee recognised or established by or on behalf of the Health
Research Authority under the Care Act 2013.”

Clause 112

EARL HOWE

169

Page 92, line 25, leave out “or duty”

Clause 114

EARL HOWE

170

Page 94, line 23, after “cases)” insert “or 71 (after-care under the Mental Health Act
1983)”.

Prepared 15th October 2013