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2.43 pm

Mr. Frank Dobson (Holborn and St. Pancras): I strongly support the Bill. For the first time in 20 years, decisive action is being taken to improve the quality of services for vulnerable people. It is worth bearing in mind that we are considering services for people who are old or ill or infirm or handicapped, or children who have special needs. Our society is supposed to provide care for those groups. We have a special duty of care for vulnerable people because they are least able to look after themselves.

We must ensure that the approach in the new regulatory framework is based on the question: will the service be good enough for me, my children, parents, relatives or the people whom I love or hold dear? If the answer is no, the service is not good enough. We must start from there. The record for the provision of some of the services has been at best patchy and at worst shameful and deplorable. That

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is to everyone's shame. I do not blame only the staff. In cases of molestation of children that has gone on for years, everyone has been at fault, including hon. Members on both sides of the House, for failing to take the necessary action.

For many services, no standards have been set. That is bad for the people who are being cared for and their relatives because they do not know what they are entitled to expect. Sometimes, when relatives have pressed for higher standards in the private sector, the person in care has been threatened with being thrown out on the grounds that the relatives are troublemakers. That cannot be allowed to happen. It is also bad for staff and managers because they do not know what is expected of them. It is hard for people to do a proper job when they do not know what their job is.

Even when standards have been set, the regulatory and inspection system has clearly been grossly inadequate. Some caring services, such as small children's homes--to which my right hon. Friend the Secretary of State referred--or services for people in their own homes, have been left to inspect themselves. We all know what happens then. Local authorities have been responsible for inspecting themselves.

After a long series of reports and inquiries into scandalous failures, the previous Government did next to nothing. Almost the only change that took place was that child molesters managed to con the media into referring to them as paedophiles. That was the biggest change in the past decade. We must resolve that. The Government inherited a mess and we need decisive action, which is now being taken.

The Bill covers a wide range of services, from meals on wheels and home helps to children in care and old people in residential homes or people in day centres. I pay tribute to large numbers of hard-working staff who do their best in difficult circumstances. However, across the board, services are not good enough. The public are entitled to know that the meals on wheels will be okay, that home helps will not steal from, for example, people who are blind, and that residential homes will be safe and staffed by proper professionals. They need to know that there will be high-quality day care for elderly people, that children in care will not be molested but will be educated and that fostering agencies will be above board.

The proposal for the National Care Standards Commission places regulation of all the services that I have mentioned under one umbrella. That must be right. Standards must be set and the commission must ensure that they are fulfilled. Small children's homes will no longer be left unregulated. Councils will no longer be responsible for inspecting themselves. We shall have an independent, professional watchdog. It has been needed for years. The previous Government, in the face of mounting evidence and reports, did nothing about it. They made no changes. The Bill makes decisive changes, which are likely to lead to substantial improvement in services for vulnerable people.

The Bill covers the public sector, the voluntary sector and the private, profit-seeking sector. Proper complaints machinery will exist for the first time in the history of most of the services, even those in the public sector. We need to ensure that the complaints machinery does not deal simply with individual complaints. We need to analyse the pattern of complaints and ensure that we can

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identify systematic problems as they are exposed by the pattern of complaints. We must then make use of that. Any sensible business or public sector organisation wants to do that.

I commend the proposal for establishment of a register for people who are unsuitable for working with vulnerable adults. I pay tribute to the enormous amount of hard work by my hon. Friend the Member for Stourbridge (Ms Shipley) on the Protection of Children Act 1999. I urge my right hon. Friend the Secretary of State to go back to the Department, to say, "Stuff the lawyers in all the Departments," and to get on with implementing that Bill because children's safety is more important than a lot of nit-picking by Government Department lawyers--a minor aside.

Mr. Hammond: Given the right hon. Gentleman's intimate knowledge of the evolution of the Bill in the Department of Health, can he tell the House what he expects to be the impact on local authority provision of the proposals with regard to unified registration and regulation of care homes?

Mr. Dobson: I did not understand the question. I shall sit down again. If the hon. Gentleman asks it in plain English, I will try to answer it.

Mr. Hammond: In plain English, what will happen to the local authority care homes? Will there be a massive contraction in the number of local authority care homes after the Bill becomes law?

Mr. Dobson: It depends on the quality. I hope that the object is that quality will rise and be uniformly high, whether the home is in the private, voluntary or profit-seeking sector. Frankly, if the local authorities cannot do their job properly, they should not be doing it. That is the test: can they do the job properly? If they cannot, they should get out of the business. That applies to quite a few people in the private sector, too. There will be changes in all directions in different parts of the country.

There is the separate issue of the regulation of private hospitals that were greatly encouraged by the Conservative party during its 18 years in office. During that time, it did absolutely nothing to offer any protection to any people who resorted to the private sector, and was happy to continue to have such places treated as nursing homes.

That was ludicrous because there was a massive change over time. There was a development and extension of the activities of private hospitals. The regulation became increasingly inadequate. That has been recognised even by the people in the private sector itself.

Those people know that there are hospitals that carry out treatment for which they are not properly equipped. They know that operations are carried out in hospitals that do not have decent resuscitation equipment. They know that really difficult operations are carried out in hospitals that do not have the capacity to provide intensive care if anything goes wrong. They know that there are private hospitals where there is no 24-doctor on duty and, in some cases, scarcely a 24-hour nurse on duty. They know, as the public know, that there are private hospitals where doctors who have been suspended by the national health

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service have been allowed to carry out operations on patients in those hospitals. They know that the regulation--to the extent that there has been any--has been concerned largely with the physical aspects, rather than the state of care and the attention that people have been getting. We have a basic duty to protect the public. The new regulatory body will do that. It will regulate, register and inspect.

There was a plea from the Conservative Benches. After all these years of doing nothing, it appears that Tory policy is still to do very little in case it upsets owners of a few private homes. Decisive action is needed, but the only bit of decisive action that was proposed in that sphere was that, being so successful, the Commission for Health Improvement, which was developed basically as an NHS body and designed to even up and to improve the performance in NHS hospitals--as far as I can recall, unless my memory is playing tricks with me, the Tory Front-Bench team was totally opposed to it and voted against its establishment--should cover the private sector, too.

My view, for what it is worth, is that the National Care Standards Commission is there to provide minimum safety for people who have private treatment, but it is not the job of a public body to help the apparently competing and competitive private sector to raise its standards further. Why cannot such hospitals raise their standards, if they have the merits of the competitive private sector, with all their American connections and such like? They should be able, generally speaking, to raise their standards themselves.

The regulatory body, the National Care Standards Commission, may want to ask CHIMP to provide it with some regulatory or inspection services from time to time, but it should be left like that. Much improvement is needed in the NHS. The commission has its work cut out doing what people want it to do in the NHS. That, surely, must be the first priority, providing we have the minimum standards in place.

I do not want to detain the House any longer. I believe that the Bill is a substantial, major step forward. It will be difficult for the commission to establish itself, to get itself working and to do the job as well as we would like it to do. It is right that the bulk of the circumstances in which it will operate will have to be laid down by regulation. We in Parliament know, if we have any sense, that we are bound to get things wrong at the start. It would be better to recognise that, and not to be vain and proud and to say, "Oh we have got it right. We cannot change it." If it is laid out through regulation, we can change it more promptly and more effectively, and make it work.

I strongly support the main thrust of the Bill. I congratulate my colleagues on the Front Bench on what they have done in bringing it forward. It carries out exactly what we promised to do at the general election. It is another Labour promise being kept.


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