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Mr. Hinchliffe: The hon. Gentleman paints a bleak picture of the wholesale closure of care homes and private nursing homes. Will he consider the fact that the private sector says that it has 25,000 empty beds? Does he accept that the previous Government used a £10 billion public investment programme and changes in income support and supplementary benefit hugely to expand a sector that most people do not want to use? People want to retain their independence in their own homes, as my right hon. Friend the Secretary of State said.
Dr. Fox: Would that things were as simple as the hon. Gentleman suggests. Not only total capacity but its geographical distribution are important. The provisions, if implemented as the Government intend, could result in a loss of private sector capacity and reduced local authority provision in some areas. That would create major problems for the patients involved. We must not deal with that matter lightheartedly or in the hon. Gentleman's typically party political way.
Mr. Bercow: Does my hon. Friend accept that I asked the Secretary of State about the regulatory procedure precisely because, whatever the intrinsic merits or demerits of particular regulations, they should not be allowed to go through the House on the nod? Does my hon. Friend agree that the regulations should be fully debated in the House, that the sector should be consulted on them and that it should be granted the courtesy of adequate notice of the requirements for their implementation?
Dr. Fox: As my hon. Friend knows, there is scarcely a word that he utters in the House with which I do not fully agree--he will notice that I chose the word "scarcely".
The national minimum standards, which are among the most important matters, will be decided by Ministers. They will not be subject to scrutiny in the House. In other
words, the potentially most damaging economic changes for a huge number of care providers will not be debated by those who represent them or those in their care. Our general concern is that the Bill is largely an empty box; it is hugely dependent on regulations that have not even been published in draft.
The Minister of State, Department of Health (Mr. John Hutton): It might help us to make progress if the hon. Gentleman would take another look at the Bill. If he were to read it carefully, he would understand that the national minimum required standards will take effect not on their own but only through the implementation of the regulations. We have made it clear that consultation on the regulations will take place under the procedures normally applied in the House and that the regulations will be developed only after the fullest public consultation.
Dr. Fox: The standards may be implemented as a result of the regulations, but the decisions will be left entirely to Ministers, which is what we find difficult to swallow.
Mr. Simon Thomas (Ceredigion): Will the hon. Gentleman give way?
It is bad enough that proceedings on the Bill began in the other place before consultation was finished, but there is now every chance that it will complete all its parliamentary stages before we know how the regulations will be implemented. That is typical--a contempt for Parliament that is dangerous, and that is destabilising for providers and patients.
The Secretary of State referred to child minders. I have reservations about the excessively heavy-handed intrusiveness and the bureaucracy involved in allowing inspectors from the Office for Standards in Education to inspect the private homes of all child minders. Before we can accept the Government's proposals, we need to know whether any evidence exists to show that there is a problem in that sector and, if so, what is its magnitude. We simply seek information. Many decent people will feel threatened by the proposals, so we would need to hear a good justification for them before we could agree to them.
As those proposals are a new distraction for Ofsted, will the Minister tell us what new funds will be made available to it for that function? What staff increases will be required? What discussions has he has had with the Secretary of State for Education and Employment on that matter?
Caroline Flint (Don Valley) rose--
Dr. Fox: I give way to the hon. Lady.
Caroline Flint: Is the hon. Gentleman aware that, under the current system of registering child minders, a visit to the home is an important part of the inspection process? The Government have listened and included the best of the current process in the new one.
Dr. Fox: If the Government can tell us why Ofsted is a better choice than the local authority, we shall be willing
to listen to their arguments. If they can also tell us why it is entirely legitimate to be able to seize computer records and so on, we shall listen. I want to ensure that there is a good justification for such powers and the changes that the Government propose before they are introduced.I turn now to the proposals that we support but would like to take further. The Secretary of State did not mention adoption; there are too few measures in this connection and the proposals should be extended. We should like several principles to be included in any adoption measures. A national register for those who wish to adopt children should be drawn up according to objective criteria so that those who meet the criteria can adopt children from any part of country. We should not have the petty bureaucratic restrictions that are, sadly, put in place by too many local authorities, with far too much emphasis being placed on their own political bigotry and political correctness and too little on what decent people can offer children in the adoption process.
An adoption plan should be drawn up for all children in care so that the best and most specific type of prospective adoptive or foster parents can be found. All children in care should be allowed by law to have contact with outside groups--whether charities, Churches or families--to give them a full range of cultural experiences, not only those offered by social services.
Mr. Steve McCabe (Birmingham, Hall Green) rose--
Dr. Fox: I will not give way on that point.
The hon. Member for Isle of Wight anticipated a point that I want to make. We should go further than the Government and consider establishing a children's commissioner for England, if the post is confined to certain criteria. The commissioner must be independent and not answerable to the Secretary of State, although an annual report to Parliament could be made. There should be oversight of the statutory provision of services to children and the effectiveness of legislative safeguards and regulations relating to education, children's services or health services. However, there should be no remit to take up individual cases or to act as the champion for individuals. The commissioner should be mandated to identify weaknesses in policy or delivery. There should be no remit to interfere in the relationship of children with non-statutory providers, especially their parents.
There should be such a commissioner solely for children because children do not have a voice through the ballot box and cannot enact change for themselves. Those in care and those whose parents do not care do not even have a natural adult sponsor. There are differences in the regimes that might be suggested for England and for Wales. I believe that we have to give children in England the same protection as children elsewhere receive.
The Government are committed to providing a children's rights director only for looked-after children. We believe that the provision should go further. Almost all children's charities and professionals support the idea of a children's commissioner. The model that I suggest would allow protection and advocacy without interfering in the rights of parents.
Mr. Brazier: All the independent bodies--including, most recently, the Prince's Trust--support allowing
mentors to have access to people, yet the Bill provides for one set of professionals to check up on another set of professionals.
Dr. Fox: My hon. Friend makes not only an important point but the best attempt by an hon. Member to get on to the Committee that will consider the Bill. I congratulate my hon. Friend on his successful attempt to gain a place on that Committee.
Mr. Hinchliffe: Will the hon. Gentleman give way?
Dr. Fox: No, I must make progress.
I want to consider equal regulation for all acute health care, in both the national health service and the private sector. We need to move from a managed to a regulated service in our general health care system. It is not possible--and even less desirable--to try to micro-manage a system in the NHS, which employs 1 million people. We need a single regulatory body, which operates in the interests of patients and not providers, for the acute health care sector.
The Government have accepted the logic of unified inspection for care homes. Why do they not accept it for the whole acute sector? Why cannot a single body guarantee the same standards for patients, irrespective of whether they are treated in the private sector or by the NHS? We should legislate for the benefit of patients and our fellow citizens; we should not take account of whether different providers are involved.
The Government have increasingly used the private sector to reduce NHS waiting lists. It is unacceptable to have one regulatory body for one sector and a different regulatory body for another when patients are increasingly interchanged between them. Single uniform regulation is logical. The Bill gives us an opportunity to provide for that. If it receives a Second Reading--I imagine it just might--such regulation can be considered in Committee.
The Bill has much to commend it, but there is also much to be regretted. It provides much more protection for some, but more uncertainty for many. I hope that hon. Members will consider all those points and support the amendment. Good intentions do not make good law; we are in the House of Commons to ensure good law.
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