| Previous Section | Index | Home Page |
Mr. Andrew Rowe (Mid-Kent): I am listening with great attention to the hon. Gentleman, who was good enough to make some kind remarks about me. He said something which I think might well have been a slip of the tongue. If it was not, it was a rather important statement. He said that he was in favour of having a registration and inspection company. That is an interesting concept, but not one that I would automatically expect to come from the hon. Gentleman's lips.
Mr. Hinchliffe: It was probably a misunderstanding of my Yorkshire accent. If I did say that, it was most certainly a slip of the tongue.
The hon. Member for Mid-Kent will remember that when I introduced the Registration of Domiciliary Care Agencies Bill--of which he is a sponsor--and subsequently, that all-party campaign was supported by virtually every individual and organisation concerned with the care of elderly and disabled people, and particularly by those concerned with the provision of domiciliary care.
I am sure that the principle of new clause 5, which was drafted rather hurriedly last week, will be supported by all those agencies, which include the Joint Advisory Group of Domiciliary Care Associations, the United Kingdom Homecare Association--which has more than 300 voluntary and private agencies as members, the National Association of Registration and Inspection Officers, the British Association of Social Workers, the Social Care Association, the Association of Directors of Social Services and Age Concern. It is important to reiterate that some of those organisations have, along with individual local authorities, developed local voluntary accreditation schemes for domiciliary care, and that all of them are still actively campaigning for a proper statutory system to register and inspect domiciliary care.
I am concerned about the Government's position on the issue. Knowing the Minister reasonably well, I suspect that he, too, is probably a bit uneasy about the Government's position. The deregulation theme pursued by the Prime Minister has been applied to certain areas where serious questions need to be asked--care deregulation, for example. The Government's dogma in that area, and their reluctance to legislate or to bring about
by statutory instrument a proper system of regulation and inspection, are leaving vast numbers of extremely vulnerable people seriously at risk.
There are other policy changes of which the Government should be aware. Those changes make it even more urgent that, when the Registration of Domiciliary Care Agencies Bill is considered by the House, it is amended to include a proper registration procedure to protect people who are in receipt of direct payments.
The first change is that, as part of the deregulation initiative, on 3 January last year the Government removed the licensing of employment agencies. There are no longer arrangements to offer monitoring of employment agencies, although, on 3 January last year, some 3,000 licensed agencies included domiciliary care among their activities. So many organisations are obviously involved in the provision of domiciliary care in the private and independent sector.
Secondly, to illustrate the anomaly in the current legislation, I draw the Minister's attention to the nonsense of there being more private care homes that offer care not only inside but outside them, in a locality near the private care home. They are now registered for care in the home, but they are not registered or inspected for care in the individual's home in the community, which is where equally vulnerable people are in receipt of care.
That is nonsense. If a person is in a care home or a nursing home, there is some public accountability and some visibility of that person's care. People visit care homes and nursing homes and can see individuals sitting in lounges there. The same does not apply to people who receive care in their own homes. There is doubly cause for concern about that anomaly when care homes are only half registered in their work. Those who run private care homes whom I know would probably say that they realise that the present situation is nonsense and that they would be perfectly happy to be included in proper registration and inspection arrangements.
There are increasing signs that we are, rightly, moving more and more towards domiciliary care as an alternative to institutional care. The Minister knows of my concerns. I think that, from a policy point of view, we should move much more rapidly towards domiciliary care, but to do so, we need to ensure proper safeguards for people in receipt of that care. My worry is that those safeguards are not there.
There have been rapid advances to enable people to be cared for in their own homes. With improvements in communications technology, people can be monitored by telephone systems that are operated by a number of private companies and by local authorities. In some instances, through that telephone care network system, people can be monitored through the night. That means that many more people who are dependent can live in their own homes in the community. That trend reinforces the argument that the care provided for some very vulnerable people should be properly registered and inspected, as we suggest in the new clause.
Increasingly, there are moves towards housing models of care, which some of us discussed during the debate on dementia last week. That means that we should make checks on people who are not otherwise covered by a registration system. Sheltered housing, for example, is not covered by the Registered Homes Act 1984, yet I know of many people in sheltered housing schemes and in
receipt of domiciliary care who are more vulnerable and more disabled than many people who are in care homes or nursing homes.
The Carers (Recognition and Services) Act 1995 has contributed to the push towards domiciliary care. We must recognise that as people are asking for increased packages of domiciliary care, that care should be properly regulated and inspected.
Other policy developments, with which the Minister is very familiar, raise questions about how we can operate a general social services council, which the Department of Health is currently looking at in some detail. It would be a form of registration for carers and social workers. How could that operate in relation to people concerned with domiciliary care if there was no proper regulation and inspection system for domiciliary care? How on earth would a complaint come to that council if the person providing care was not monitored through an inspection system? The whole thing does not stand up, and the Minister must accept that we lack proper provision in the area.
The Minister will have talked to his Home Office colleagues about what has been called a paedophile register. The Government may introduce such a register, but what safeguards will there be to ensure that somebody who is on that register is not providing care privately in a domestic setting? As far as I can see, that safeguard will not be there. The Minister must accept that the Home Office's policy initiatives look a bit silly alongside the lack of any attempt by his Department properly to regulate and inspect domiciliary care.
The whole purpose of the Bill is to enhance the ability of individuals to remain in their own homes and to make their own choices about securing care. People in receipt of care will be put in control of determining the nature of that care and how they acquire it. I believe that if the Bill is passed without an amendment relating to the quality of care--to the inspection of care--we shall be accused of being very irresponsible, because we shall have passed legislation that is not properly thought through. We are meant to be giving people control of their care. Is that seriously possible when the care recipient has no guarantee that a provider is operating at an acceptable or an agreed standard? We are putting a number of people at risk by not thinking the matter through, despite the good will on both sides of the House in support of the Bill.
The Bill as it stands allows the potential for abuse and exploitation. It allows for financial exploitation if people involved in the provision of care are dishonest and not properly monitored, which can happen. In my time working in local authority social work, I came across complaints about the provision of home care, such as elderly people being subjected by their carers to the alteration of wills, and pensions and benefits being taken by home carers. The vast majority of home care is provided by perfectly decent, honest and responsible people. But in every walk of life, some will try to take advantage of the vulnerable. I have come across instances of physical ill treatment of vulnerable, elderly people, a number of examples of sexual abuse of people who were being cared for in their own homes, and instances of poor-quality care.
| Next Section
| Index | Home Page |