House of Commons Hansard Debates for 11 Nov 1992

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except in emergency situations be consulted regarding any change in care objectives for service users."

Is all that to be paid for by the home?

Mr. Peter Robinson : Will my hon. Friend take into account that not only will the key worker have to be paid for by the homes if the system is to be self-financing, but the inspectorate, which is three or four times greater in Northern Ireland and therefore three or four times more costly than in Great Britain, will also have to be paid for by the homes?

Rev. Ian Paisley : Yes, I take that into account. That will tell against people who will be able to give proper care, because finances will be cut and a major cut in the finances of the health and social services boards in Northern Ireland will flow from what happens in the House tomorrow. The future is bleak. The Government seem to be saying that they will do away with the public sector and put such provision in to the private sector, but the private sector will have to finance it. The Government will not have that responsibility. The Minister must come clean with us about that tonight.

8.58 pm

Sir James Kilfedder (North Down) : I shall speak briefly to welcome the order. The hon. Member for Antrim, North (Rev. Ian Paisley) requested the Minister to withdraw the order, but I ask him not to do so.

First, I do not like the Order-in-Council procedure and I have criticised and attacked it in the Chamber on many occasions. I find it unacceptable, but it is the way in which legislation has been introduced in Northern Ireland.

Secondly, I do not like the Eastern health and social services board, which is the bureaucracy in charge of the health service in my area of North Down. The bureaucrats spend most of their time looking after their own welfare rather than the welfare of the people that I represent.

I must make plain my approach to the order. One subject which concerns me deeply is the welfare of the elderly in residential homes. Within the scope of the debate, strangely enough, we have heard mention of the Anglo-Irish Agreement, and of Protestantism and Catholicism, and Dublin has been dragged into it. We have heard mention of pay for councillors for sitting long hours, of the last Prime Minister of Northern Ireland, and of a former head of the civil service there. Allegations were made about dictatorship ; and a personal attack was made on the Minister. I ask him to brush such personal remarks aside. As I have said before, he is recognised as a person who has shown that he is genuinely sincere about Ulster and the Ulster people.

I care about the welfare of elderly people in residential homes, and I welcome the order for that reason, because it requires all residential care homes to be registered and and to be inspected regularly and properly. What is wrong with that? I am concerned because many of my constituents are in such homes. I have talked to them and have visited many of the homes in my constituency. I have also talked to relatives and friends of residents in care homes for the elderly. I am worried about the way in which they may be treated by unscrupulous proprietors.

As I said in an intervention in the speech of the hon. Member for Normanton (Mr. O'Brien), elderly people are among the most vulnerable in our community. We must do everything possible to defend them.

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Certain matters have been mentioned in the debate which would give cause for consideration, but if the order is defective let us put it into effect as quickly as possible and then introduce amendments to it.

For every day that goes by an elderly person may be left at the mercy of someone who cares more about profit than about the welfare of the people in their accommodation. There is nothing wrong with the profit motive. It acts as an incentive to encourage interested people to offer accommodation to those in need of care because of age and infirmity. The overwhelming majority of owners of residential homes look after residents properly.

I am worried about the unscrupulous few--and it is no use saying that there are only a few. If one elderly person is ill-treated by a proprietor of a residential home and we do nothing about it, we are as guilty as the people in charge of the home. That is why I praise the Minister for introducing the order. It is not his Department, but he has brought such matters before us in the past on behalf of the Minister with responsibility for health, the Earl of Arran, who is in another place. I know from my experience that he is only anxious to do what is best for people in Northern Ireland.

In the past five years residential care homes have mushroomed throughout the United Kingdom. Northern Ireland is no exception. As in the rest of the United Kingdom, Northern Ireland has a few unscrupulous owners who are not as caring about their residents as they should be. The order can deal with those few who, lamentably, have little or no regard for elderly residents. We all know what can happen to an elderly person in someone else's care. It may involve a tight budget for meals, providing food of a quality and quantity below what elderly residents should have. I have heard that accusation made against a particular home and I have relayed the complaint. It may also involve an unacceptable degree of sedation. We have read in the press--the report applied only to Britain but we must be aware that it happens elsewhere--about armchairs that were deliberately used to detain the person placed in them.

The order is to care for people in residential homes and ensure, on behalf of the people of Northern Ireland, that elderly people who are placed in the care of others for payment are not treated in a manner that insults their dignity, robs them of their pride or undermines their health.

The vast majority of residential care home owners are caring and the homes are well managed. Having seen some homes in my constituency, I have been impressed by the attentiveness of the staff and the homely atmosphere. It would be wrong of me to mention particular homes, but when one enters certain homes one feels the warmth of the staff--the matron and others--and when one talks to the elderly residents one knows that the staff really care for those in their charge. It gives me a great feeling of joy when I enter such homes, but makes me extremely concerned about other homes where things may be happening which we would not like to see happen to our elderly relatives.

Mr. Peter Robinson : That is precisely the point that I made during the course of my remarks. Does the hon. Gentleman agree that, if it is right to regulate and license those homes in the private sector, homes that are under the control of the board or any other statutory body and children's and young persons' homes should also be brought under the same inspectorate? If it is right in the

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case of one, is it not right in the case of the other? If the hon. Gentleman believes that it would be right to include them under the order, why pass defective legislation?

Sir James Kilfedder : It is a strange logic to say that, because the legislation is defective, legislation that would be beneficial to so many people should be denied to them simply because it could have incorporated something else. If I thought about it, I could probably extend the hon. Gentleman's list. The list has been put forward as an excuse for delaying the introduction of the order. It is not a justification for delay.

Naturally, I would welcome the extension of the order to other statutory homes, but I do not think that the Minister should delay the order. He is doing his duty by the people of Northern Ireland. He knows that I would be prepared to criticise him if I felt that he was failing in his duty. He would welcome suggestions from me or any other hon. Member who wishes to see the order approved, and I have no doubt that he will take them on board in the implementation of the order.

Mr. Rogers : I thank the hon. Gentleman for giving way, and excuse myself, as a fellow Celt, for interfering. I am in a dilemma. Earlier the hon. Gentleman said that we should accept the legislation although it might well be defective, as we could later alter it. He also said, as did other hon. Members, that the legislation cannot be altered. Does that mean that the hon. Gentleman is imploring us to support defective legislation because it can later be altered, when it cannot be? Does he mean that, in order for the legislation to be amended, it has to be thrown out and completely new legislation introduced?

If I understood him correctly, the hon. Member for Antrim, North (Rev. Ian Paisley) asked the Minister to take the order away for a month, look at it again and iron out the problems that have been highlighted. I know that I am making a rather lengthy intervention--

Madam Deputy Speaker : I think that that is an understatement, and the hon. Gentleman must resume his seat.

Sir James Kilfedder : I am only repeating what people have said, which is that there are defects in the order. If there are, I would welcome improvements to the order.

Mr. Rogers rose--

Sir James Kilfedder : I shall not give way to the hon. Gentleman, as we must get on.

I would welcome improvements to the order, but we should allow it to proceed. I have not received any representations from the registered home owners stating that the order should be amended line by line. I have heard from only one lady at the weekend, who told me about one aspect of the order. I have a high regard for her ; she runs a home of excellent standards. That is the only representation that I have heard.

If the order were defective, surely the Minister would have received a stream of complaints, recommendations and amendments. I am sure that hon. Members present would have been briefed about the order's defects ; I have not been briefed about any.

Mr. Rogers : Will the hon. Gentleman give way?

Sir James Kilfedder : Yes, I will.

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Madam Deputy Speaker : The hon. Member for Rhondda (Mr. Rogers) must make it snappy.

Mr. Rogers : I can tell the hon. Gentleman of one defect in the order, having made a quick perusal of it. If the so-called justices of the peace, who are symbolic in Northern Ireland, are asked to allow an appeal, action to close down the home is taken by a board, and any appeal is made to the board. Therefore, the board acts as judge and jury in its own action. Surely that is fundamentally wrong in any legislation.

Sir James Kilfedder : I cannot find the place now, but I think that if the hon. Gentleman studies the order he will see that there is a right of appeal to a tribunal against any of the board's decisions. I believe that the order will result in better protection for elderly people. The call that I issue from the House tonight is that residents in residential homes for the elderly, and their relatives and friends, should be aware of the fact that they are now provided with a more effective opportunity to lodge complaints about poor standards or ill treatment. That call must go out. It will comfort the relatives of those in care to know that there is an effective means of dealing with complaints. Good registered home owners should welcome that. The lady of whom I spoke--I do not wish to mention her name--is an excellent home owner.

If the Care Homes Association wishes to maintain a high standard, it should support any legislation that deals with the unscrupulous few.

There is a clear onus on all hon. Members to safeguard the person of the elderly, their dignity and their rights. Every law and every regulation that flows from it may seem irksome to many good people, whatever their sphere of activity. However, they must realise that we are legislating to root out those who have nothing but ill will for their residents. By doing so, we shall safeguard the welfare of the elderly in homes throughout Northern Ireland.

Hon. Members have spoken about inspection. Up to now, the inspection of homes has been inadequate, and I am not sure how the new legislation will operate. However, more inspections should improve the standards of homes. I have always said that the Government should spend more money on carers-- related or voluntary--who look after the elderly in their own homes with their possessions around them and a knowledge of the local shops and churches and so on.

Perhaps, when I was replying to the intervention of the hon. Member for Rhondda (Mr. Rogers), I should have mentioned statutory homes. In my area, the Banks statutory residential home for the elderly is threatened with closure. There are vacancies in the home but they are not filled because officials want to kick out the residents and take over the home. The officials already have a foot in the door and want to convert the home to palatial offices for Eastern board bureaucrats. The Minister must make sure that the board does not get away with that.

Rev. Ian Paisley : Will the hon. Gentleman give way?

Sir James Kilfedder : No. The hon. Gentleman had his say. [Interruption.] I ask the hon. Gentleman to keep quiet.

I urge the Minister to look into that matter because it would be a grave injustice to the residents of that home if

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the board suddenly closed it. Those elderly people are worried about their future. I shall shortly present a petition on behalf of the people of Bangor urging the House to save the Banks residential home and to block the door to the bureaucrats in the Eastern board. 9.18 pm

Mr. Allan Rogers (Rhondda) : The issues raised in the debate have general application in the United Kingdom.

The hon. Member for North Down (Sir J. Kilfedder) said that we should be extremely concerned about the condition and care of the elderly in the community. I agree. The Government should provide more resources so that the elderly can be looked after in their own homes rather than in hospital or residential homes where, occasionally, the standard of care is not all that we would wish.

Rev. Ian Paisley : If the board is such a wicked, bad, rascally body that the hon. Member for North Down (Sir J. Kilfedder) wants the Minister to take it in hand, is it not strange that he also wants it to be given more power so that it can inspect all the homes where old people are in care ?

Mr. Rogers : I would not want to get involved in the problems of any specific board in Northern Ireland, or in any other aspect of the government of Northern Ireland, with which I disagree entirely. If the hon. Member for North Down is saying that there is a problem with that home, and he has to petition Parliament in an attempt to rectify the problem, then there is obviously something wrong. From my admittedly superficial perusal of the order, I should not have thought that it would put that right. As I understand it, if someone objects to what is going on in any of these homes, the right of appeal under article 27 is to a tribunal. But the tribunal is appointed by the Minister. If both the tribunal and the board are appointed by the Minister, where is the independent review of any issue about which, for example, the hon. Member for North Down wishes to complain ?

There is something fundamentally wrong with the order, and we shall vote against it. The Minister should take it away and have another look at it. It would not be the first time that that had happened, but the Government are so arrogant in the way they govern the country that that is asking an awful lot. As I said earlier, my Northern Ireland colleagues should not feel too isolated on this. Scotland and Wales have the same problem all the time, with the arrogance of the viceroys who rule in the Welsh and Scottish Offices.

I wholeheartedly agree with Northern Ireland Members of Parliament and my own Front-Bench spokesman who have said that they will vote against the order. I am sure that I shall be told off for interfering in the debate, but as I have recently been appointed Front-Bench spokesman for foreign affairs--

Mr. Roger Stott (Wigan) : My hon. Friend will be debating Hong Kong soon.

Mr. Rogers : I shall leave Hong Kong for another occasion, but I may have a locus in this debate, too.

Northern Ireland is part of the United Kingdom and it deserves the best of legislation. Therefore, we should reject the order.

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9.23 pm

Mr. Hanley : I am pleased to be able to reply to the debate. Right hon. and hon. Members will know how assiduous Northern Ireland Members of Parliament are in carrying out their duties. On occasions such as this they find it easy to fill any time that becomes unexpectedly available to them. This is my first night off after six months of the talks process and I could not have thought of a better way to spend the evening. I never expected that the evening would end early and I intend to fill it as best I can by answering the points that have been raised. The extra time is a blessing.

I was interested in the little vignette of a speech made by the hon. Member for Rhondda (Mr. Roberts) a few moments ago. I note that it is the first time that the Labour party has said that it will vote against such legislation. I had a cursory glance in the Library earlier and I noted that the legislation on which the order is based, the Registered Homes Act 1984, was apparently not voted upon in the House. The Registered Homes (Amendment) Act 1991, the other Act upon which the order is based, was also not voted upon and went through almost formally.

It is interesting, therefore, that the Opposition intend to vote against the order tonight. I shall return to the impact of a defeat, which I would take as a vote of confidence [Interruption.] --in myself, of course. I want to answer as many points as possible, so I should be grateful for as few interventions as possible.

The decision to review the existing legislation governing the regulation of private and voluntary sector residential care and nursing homes in Northern Ireland was, as several hon. Members have said, the result of two major influences.

The first was the substantial growth in such homes in recent years and the growing pressure on the registering and inspecting authorities which existed at the time to ensure that there were satisfactory standards of care and accommodation and that they were maintained. The second influence was the legislation to which I have referred and its associated subordinate legislation. It is important to remember that that legislation was supported by the House without Division. The legislation gave registering authorities in England and Wales strength and powers to regulate residential care and nursing homes.

Following a comprehensive consultative exercise with a wide range of interested statutory, voluntary and private sector organisations and indviduals, the general consensus emerged that in Northern Ireland we should, as far as possible, bring our legislation broadly in line with that of the 1984 Act.

I mentioned earlier that there were more than 100 responses to the consultation on the draft order and then there were 13 responses. I mentioned that none of those 13 came from hon. Members. Hon. Members have explained why there were only 13, but the reason for such a small number of responses was not merely that no legislation could be altered at this stage in the House but that there was proper long-term consultation in designing that

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legislation. The legislation was therefore properly consulted on in advance.

The draft order has the great merit of drawing together in one piece of legislation all the primary provisions governing the registration and inspection of both categories of homes.

The hon. Member for Belfast, East (Mr. Robinson) asked if I could give an assurance that the Northern Ireland Care Homes Association would be consulted about regulations to be prepared by the Department. That was also mentioned by the hon. Members for South Down (Mr. McGrady) and for Antrim, North (Rev. Ian Paisley). I can give a categorical assurance that such consultation will take place. Draft regulations will be issued to a wide range of private, voluntary and statutory sector organisations within the next week, including the Northern Ireland Care Homes Association. The draft regulations will go to all representative bodies and all groups I welcome the hon. Member for Normanton (Mr. O'Brien) to his new post, and congratulate him on his speech. He suggested that the boards were not truly accountable, and that they would allow standards to slip. Standards will be governed both by subordinate legislation and by guidelines prepared by responsible professional bodies. I dealt with that point earlier. I do not believe that standards will be allowed to slip, nor do I accept that the boards are not truly accountable. Each board has had to establish an advisory committee to provide a link between the inspection units and the public interest. Moreover, I took pains earlier to stress the arm's-length establishment of the units. I hope that no one who reads my speech imagines that the units will be anything other than independent and reliable.

The hon. Member for Normanton should realise that, if home owners have any genuine complaints about the way in which inspection units have treated them under existing Northern Ireland legislation, my noble Friend Lord Arran will be anxious to hear about it. I shall suggest holding a meeting with those who have specific complaints. The new legislation will actually make it easier for home owners to appeal against decisions made by registration and inspection units. As I explained to the hon. Member for Antrim, North, that will be done by way of the Registered Homes Tribunal, to which a number of hon. Members have referred. The tribunal will benefit from the presence of a panel of professional experts who, as I said earlier, will build up a body of useful case law.

I must admit that the Department of Health and Social Services originally had no strong views about the need for a change from the existing courts appeal system, and doubted whether the likely number of appeals would justify the establishment of a separate tribunal system. In subsequently opting for such a system, it took account of several points.

First and most important, the majority of those who commented on the matter during the consultation exercise--in response to the initial consultative paper--were in favour of a tribunal system. Secondly, the positive feedback from registration authorities and proprietors of homes in regard to the performance of tribunals in England and Wales seemed to suggest that a similar system would be sensible in Northern Ireland. Thirdly, it was felt that Northern Ireland would benefit from the professional expertise of the tribunals' members and, as I have said, from the accumulation of a useful body of case law

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relating to a specialised aspect of health and social services activity. A fourth consideration was the speed with which cases could be dealt with, and the comparative cheapness of the process. Some hon. Members have suggested that tribunals might be full of "tainted" appointees. I assure them that the Lord Chancellor appoints a panel of legally qualified people to act as chairmen of tribunals. The Department appoints an independent panel of other experts, but they must have the appropriate medical, nursing and social work experience, and no officer of the Deparment can be appointed to a tribunal.

Mr. William O'Brien : I thank the Minister for the kind remarks that he made earlier. We are told that the Lord Chancellor will nominate some tribunal members, and that the boards will nominate others. Will any of the users of the services--residents, or people who work in the homes--be able to sit on tribunals and express their views on issues that are raised?

Rev. Ian Paisley : On a point of order, Madam Speaker. Can you confirm that this debate can run until 11.30 pm?

Madam Speaker : The hon. Gentleman is correct. The debate can run until 11.30 this evening.

Mr. Hanley : The hon. Member for Antrim, North ticked me off earlier in the debate. He said that I was laughing during his speech. I was not laughing ; I was wincing. At the moment that I winced, the volume control in some part of the House had clearly developed a fault. It was one of the speakers, I think--the speaker at the time, perhaps. I can assure the hon. Gentleman that nothing that he said was a laughing matter.

To the hon. Member for Normanton, the answer is no. These are medically qualified people. [Interruption.] If there are any failings in the system, we shall try to address them in due course, but my feeling is that in that instance there are unlikely to be any failings.

Mr. Peter Robinson : Will the Minister give way?

Mr. Hanley : I was about to refer to the hon. Gentleman, but if he would like me to give way I am prepared to do so.

Mr. Robinson : Yes, I should like the Minister to give way.

Mr. Hanley : I am trying to answer the questions that the hon. Gentleman raised in his earlier interventions, but if he would like to ask a few more questions, please carry on.

Mr. Robinson : I am grateful for the Minister's patience. In terms of many of the Northern Ireland tribunals--for example, the unfair constructive dismissal tribunals--it is recognised that a legally competent person should chair it, that somebody might represent the interests of the employers and that somebody else might represent the interests of the employees. Can the Minister not provide the same balance in the tribunals that he intends to set up?

Mr. Hanley : I have already answered that question. In answer to another comment, I said that we shall look at the issue. I believe that I have dealt sufficiently with that point.

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The hon. Member for Belfast, East (Mr. Robinson) referred to inspection units and said that they employed four times as many staff as the inspection units of local authorities in England and Wales. Arm's-length inspection units in England and Wales are provided by local authorities to inspect only residential care homes. They do not inspect nursing homes. Therefore, it is unfair to seek to compare their work load with those of arm's-length inspection units in Northern Ireland, which will be responsible for inspecting both residential care homes and nursing homes.

Reference was made to the costs involved. It will be for the Minister concerned to set the fee levels. The boards will have to tailor their costs to fit that particular cloth.

The hon. Member for Belfast, East also referred to article 25. Was it not unfair, he said, that owners of homes should be expected to represent themselves? They will be allowed legal representation. I am grateful to the hon. Gentleman for enabling me to clarify that matter.

The hon. Member for Normanton referred to accountability for the regulation of homes, by reference to the Northern Ireland Care Homes Association. So far as I am aware, the Northern Ireland Care Homes Association's request for a meeting with Lord Arran did not include any reference to the need to amend the draft order, nor did it say that it wished to influence its contents. I have already stated that there was considerable consultation and that, as the hon. Member for Belfast, East also mentioned, all the bodies in existence in Northern Ireland in January 1992 were asked to comment on the order. The Northern Ireland Care Homes Association is in existence now. That changes the matter greatly for the future. I shall refer again to the association in a few moments.

The hon. Member for North Down asked whether there should be tighter regulation of standards in the interests of vulnerable people. If we stick with the existing legislation, home owners will not have to pay fees. When we examine the establishment of fees, it is right to consider whether such establishment would be fair and reasonable. I assure the professional associations that the establishment of such fees will be done carefully. We shall not try to establish levels of fees which are seen as unfair.

That leads to the point which was raised by three or four hon. Members about the costs of key workers. I shall come back to that matter when I refer to the speech made by the hon. Member for Antrim, North.

The hon. Member for Normanton referred to Disability Action's commentary on the policy and planning research unit survey. Although that may or may not have been out of order, it was nevertheless an important point. The commentary is simply the first of seven studies to be published under the policy and planning research unit survey. I assure the hon. Gentleman that the matter is being taken fully into account. Disability Action will be called to give evidence to a steering group which is overseeing the survey and considering its implications for policy. Disability Action was consulted during the drafting of the order.

This is the first time that I have met the hon. Member for Thurrock (Mr. Mackinlay) across the Floor of the House. I met him for the first time a few weeks ago in Northern Ireland. I congratulate him on the keen interest that he takes in the affairs of the Province. We are grateful

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for the interest that he and his Back-Bench colleagues have shown. I hope that they benefited from their visit to Northern Ireland. The hon. Member asked whether the order was a back-door method of creating trusts. The provisions which schedule 1(2) inserts into the 1972 order have nothing to do with any health or social service trust. They merely put the private sector on a level playing field with the voluntary sector.

Perhaps I should explain that in more detail. The existing Northern Ireland legislation contained in article 71 of the Health and Personal Social Services (Northern Ireland) Order 1972 permits health and social services boards to enter into contracts with voluntary organisations--non-profit making organisations--to provide any of the health and personal social services. Unfortunately, similar powers do not exist to permit the boards to enter into contracts with private sector organisations for the provision of such services. Therefore, the provisions in paragraphs 2(1) and (2) in schedule 1 specifically ensure that, when implemented, boards will have clear powers to enter into contracts for the provision of any health or personal social services by both voluntary and private sector organisations. I can imagine the lobbying that would have taken place if such a provision had not been included in the order.

I should hate to see any delay in the implementation of provisions to allow local boards to enter into contracts with the private sector for the provision of health or personal social services. Such services include not only residential and nursing home care but day care, respite care and domiciliary support. If the House is saying that it does not wish the private sector to provide any of those services, I invite it to vote against the order tonight.

The hon. Member for Belfast, East referred to new article 50 which will amend the 1972 order. Proposed article 50, as amended, does not apply to registered homes. I assure the hon. Gentleman that it applies to other premises such as day centres. The rights of inspection and entry into registered homes are contained in proposed article 29. The hon. Member for Belfast, East asked whether children's homes should be included in the order. Children's homes are already protected through the provisions for registration and inspection in the Children and Young Persons Act 1969. That is probably what the hon. Member for North Down meant, too. However, I understand that my noble Friend Lord Arran intends soon to bring forward a new proposal for more up-to-date legislation based upon the children's order which operates elsewhere in the United Kingdom and to which other hon. Members have referred. That will all be taken into account shortly.

The hon. Member for Belfast, East also asked why schedule 1 discriminated against the public sector by allowing boards to sell their homes to voluntary organisations. There is no discrimination. As I have said before, schedule 1 is specifically designed to ensure that providers of services in the private sector can compete freely with voluntary organisations for contracts from health and social services boards to supply any of those services.

Another question asked by the hon. Members for Belfast, East and for North Down was whether the order applied to statutory homes provided directly by health boards. No, the order refers only to private and voluntary sector residential care homes and nursing homes, but the

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Government are determined that the same high standards of care should apply commonly across the statutory, the voluntary and the private sectors. With that aim in view, the four health boards created the arm's-length inspection unit, to which I have already referred.

The hon. Member for Belfast, East also said that the boards were not allowing open competition. The boards will purchase places from as wide a range of homes as possible. After all, it is their duty to offer their clients choice. It would not be in their interests to negotiate only a small number of block contracts. Boards are being encouraged to draw up clear specifications for their care requirements and to invite tenders from those interested in providing such care. That would include members of the association which the hon. Gentleman mentioned.

My noble Friend will wish to ensure that the boards' contractual operations are monitored carefully, so that clients' needs come first. The boards' primary duty will be to seek tenders against very precise specifications.

The hon. Member for South Down asked about approval for the closure of statutory homes. I can assure him that the case for the closure of any board homes must be defended by the board concerned and presented to the Minister. Then the Minister has to decide whether he prefers to approve the board's decision. That process has led certain hon. Members to say that consultation with the Minister had been refused. I was the Minister responsible for health and personal social services for nearly 18 months, and I remember that there were many requests for meetings and consultations on behalf of homes and other organisations. The practice is that, if there is a decision to be taken by a health and social services board, that decision must be taken first. Then, if the matter is passed to the Minister because it is major or controversial, consultations with him are welcomed, and are carried out. If we refuse to meet a delegation, that is merely because the proper time for such a meeting is after the local board has made its decision.

Mr. McGrady : The Minister has missed the point. De facto if not de jure, the homes are closed before the Minister has an opportunity to say whether they should be closed. The action on the ground by the health board is to run down the home by whatever means possible so as to ensure that it is not viable. The board then presents a valid case for closure to the Minister. The point we made was that representation should be allowed to take place with the Minister before that process is entered into.

Mr. Hanley : I hear what the hon. Gentleman says. If he wants to put specific cases to my noble Friend Lord Arran, I should be grateful if he would do so. I would certainly deprecate practices such as he has described.

The hon. Member for South Down asked whether all homes had been consulted. As I have said, there was earlier consultation. In 1988, the consultation document was sent to every home owner and the published proposals went to every home owners' body in existence at the time. I have already mentioned the subordinate legislation--the regulations--which will be issued next week. I have already promised hon. Members that if they want a copy of those, they can receive one.

The hon. Member for South Down said that small homes were not defined. They are defined in paragraph 4(5) as homes providing "residential accommodation with both board and personal care for fewer than 4 persons".

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