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New Clause 16

General powers of the Commission

'. The Commission may at any time give advice to the Secretary of State on--

(a) any changes which the Commission thinks should be made, for the purpose of securing improvement in the quality of services provided by local authorities in England in the exercise of relevant functions, in the standards set out in statements under section 48; and
(b) any other matter connected with the exercise by local authorities in England of relevant functions.'--[Mr. Hutton.]

Brought up, and read the First time.

4.6 pm

The Minister of State, Department of Health (Mr. John Hutton): I beg to move, That the clause be read a Second time.

Mr. Deputy Speaker (Mr. Michael Lord): With this it will be convenient to discuss the following: Government amendment No. 53.

Amendment No. 31, in clause 31, page 17, line 6, after "functions", insert "of regulation and inspection".

Amendment No. 96, in clause 44, page 22, line 40, at end insert--

'(1A) The description of premises referred to in paragraph (1)(b) does not extend to the private dwelling-house of a foster parent'.

Amendment No. 3, in schedule 1, page 84, line 3, at end insert--'Committees and Directorates--

6A. The Commission shall establish--
(a) an Independent Healthcare Committee chaired by a Commissioner who shall have specific responsibility for the Commission's functions in respect of independent hospitals; and
(b) a Nursing and Care Homes Committee chaired by a Commissioner who shall have specific responsibility for the Commission's functions in respect of nursing and care homes.
6B. The Commission shall establish--
(a) a Directorate of Independent Healthcare under a Director of Independent Healthcare, who shall report to the Independent Healthcare Committee; and
(b) a Directorate of Nursing and Care Homes under a Director of Nursing and Care Homes, who shall report to the Nursing and Care Homes Committee.
6C. The Secretary of State may by regulations define the respective responsibilities of the Committees established in accordance with paragraph 6A.'.

Amendment No. 32, in page 84, line 3, at end insert:--'Healthcare Committee--

6A. The Commission shall establish a Healthcare Committee chaired by a Commissioner who shall have specific responsibility for the Commission's functions in respect of independent hospitals.
6B. The Secretary of state shall appoint a Deputy Chairman of the Healthcare Committee from the staff of the Commission for Health Improvement ("CHI"), and the Deputy Chairman shall have

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specific responsibility for ensuring that the system of inspection of independent hospitals is common and comparable to the system used to inspect NHS hospitals.
6C. The Secretary of State may by regulation define further specific responsibilities of the Committee established in accordance with paragraph 6A.'.

Government amendment No. 82.

Mr. Hutton: In Committee, the hon. Member for Runnymede and Weybridge (Mr. Hammond) tabled a similar amendment, which would have allowed the commission to advise the Secretary of State on national minimum standards and other matters relating to part III services. I accepted the principle of the amendment but was unable to accept the wording. I am happy to put this more suitably worded new clause before the House.

The new clause is similar in effect to clause 7(5), which gives the commission the power to provide the Secretary of State with any information that it thinks would improve the quality of part III services, as defined in the Bill. The clause allows the commission, in the course of fulfilling its inspection role, to report to the Secretary of State if changes need to be made to the national minimum standards to secure improvements to local authority fostering and adoption services, and on any other matter connected with the exercise of these functions.

Through its inspection of local authority fostering and adoption services, the commission will be able to make a judgment on how effective the standards are. It is important that it should be able to pass on advice that would improve the quality of these services to the Secretary of State. This will ensure the continuing improvement of standards across the country. The Government are strongly committed to that. I thank the hon. Gentleman for raising this issue, as that will be an important function for the commission.

On amendment No. 53, the hon. Gentleman tabled an amendment in Committee that would have had the effect of requiring Ministers to publish the reports of all inquiries held under clause 10. As I made clear to the hon. Gentleman in Committee, we certainly intend to publish the inquiry reports. It is crucial for the public to have confidence in the commission and in the services that it is regulating. It is clearly desirable for failings in those services, or in the regulatory system, to be open to public scrutiny, so that lessons can be learned for the future.

The amendment makes it absolutely clear that all inquiry reports will normally be published, but allows the Government to withhold publication in exceptional circumstances only. As hon. Members will appreciate, there could conceivably be rare instances in which it would not be appropriate to publish a report--if, for example, it included unproven allegations against an individual that could possibly be interpreted as being defamatory. I hope, however, that that will never happen, and that it will be possible to publish all reports.

Let me now deal with amendment No. 82. The Government have made it clear throughout that they intend the commission and the councils to employ their own staff, and intend their functions normally to be carried out by members of their staff. On occasion, however, they may need to sub-contract work to outside people and organisations. For example, the commission may on occasion need to contract some of its inspections to self-employed inspectors if its own inspectorate is

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reduced owing to illness or a sudden surge of vacancies, although I hope that such problems will not occur. More important, however, the commission may want to contract specialist expertise to help it in its inspection function. It may, for instance, want to contract an NHS trust to provide specialist pharmaceutical advice. Similarly, the councils may wish to contract an outside organisation to provide them with specialist advice.

The purpose of this amendment to paragraph 13 of schedule 1 is simply to ensure that the commission and the councils have the power to sub-contract work, in an entirely sensible and pragmatic fashion.

Mr. Philip Hammond (Runnymede and Weybridge): It is perhaps fitting for us to start with a Government new clause that reflects our constructive discussion in Committee. On a number of occasions the Opposition tabled amendments that the Government could not accept--sometimes for drafting reasons, sometimes because they were not entirely happy with the precise way in which the Opposition had sought to amend the Bill--although they were willing to accept the principle.

Although, in the true traditions of this place, we had heated discussions on some issues, by and large the Committee engaged in constructive consideration, which has led to significant changes. I believe that some 37 of the Government amendments and new clauses with which we shall deal today respond to issues raised by Opposition parties in Committee. The Government have reshaped those ideas into a form acceptable to them, and we appreciate that.

New clause 16 gives the National Care Standards Commission a role in relation to the functions of local authorities which mirrors the role that the Bill gives it in clause 7(5) in relation to what it describes as part II services. The clause allows the commission to act as the Secretary of State's eyes and ears--to advise him on changes that might be required to national minimum standards in order to secure improvements in the delivery of services.

As the Minister has acknowledged, we proposed such a measure in Committee. We referred to part III services, thinking that that would nicely reflect the reference to part II services in what is now clause 7. Sadly, however, while part II services are defined, part III services are not. The Minister therefore rightly described our proposal as defective, but, following consideration, has presented a way of achieving the objective within the confines of the definitions in the Bill. "Relevant functions" in relation to local authorities is defined in clause 43.

4.15 pm

During discussions in Committee on the role of the National Care Standards Commission, particularly in providing information and advice to the Secretary of State, we expressed the view that it would be good if the commission could be a watchdog out and about among providers and users of services, and if it were able to flag up issues to the Secretary of State, quite apart from any areas where the Secretary of State might specifically require it--as he has the power to do--to investigate a matter and to report back. In other words, it might instigate such investigations itself.

To give that role of watchdog, it would be necessary for that information to be published and widely known, so that people outside were aware of the concerns that the

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commission had identified and had reported back to the Secretary of State. We would have preferred a provision that required publication of the advice given to the Secretary of State in order to stimulate public debate.

The Government were not prepared to concede that point. We had that argument and lost it. That somewhat limits the power of the care standards commissioner to flag up problems effectively for public scrutiny. Nevertheless, new clause 16 is a worthwhile extension to the powers and capabilities of the commission and we welcome it. I am grateful to the Minister for taking the time and trouble to redraft what we originally tabled and to bring it forward for inclusion in the Bill.

Government amendment No. 53 deals with a slightly different issue that touches on some of the same concerns. I mentioned in relation to new clause 16 our preference for advice that was given to the Secretary of State to be published, so that it was available for public scrutiny. The amendment addresses a concern raised in Committee about the publication of inquiry reports. It makes it clear, as the Minister has said, that the norm will be that such inquiry reports will be published in a manner determined by the Minister. He has reserved for himself the power in exceptional circumstances not to proceed with publication.

Again, in Committee, we sought to change that arrangement, so that it would be the person conducting the inquiry who determined whether the report should be published and, indeed, the mode of publication. The Minister was not able to agree with us on that point, but he acknowledged then that he expected the norm to be publication and that publication would be withheld only in exceptional circumstances.

The amendment meets the Government's commitment in Committee to provide for that point on Report. The Minister gave us one example of what he might consider to be an exceptional circumstance: a situation where the contents of a report might be considered libellous. I had thought that he probably had in mind a situation where criminal proceedings might be contemplated and the material in the report might prejudice those proceedings and, thus, be inappropriate for publication at that time. I hope that he will acknowledge that in a case where, for example, criminal proceedings are contemplated, there is an argument for delaying publication of an inquiry report in order to allow those criminal proceedings to continue uncompromised by publication of the report. However, I suggest that, in those circumstances, it would be in the public interest that the report was published eventually.

I can think of very few circumstances beyond the one that the Minister mentioned in which it would be appropriate not ever to publish. Even the circumstances that the Minister mentioned might be an argument only for delay, until the matters giving rise to the possible libel had been resolved.

I should be grateful if, later in the debate, the Minister will say whether the libel situation that he intimated and the possibility of criminal prosecution are the only situations in which he envisages immediate publication not being possible, and also whether he agrees that, in the case of pending criminal proceedings, it would be possible for the report to be published eventually, at an appropriate time.

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The Liberal Democrats' amendment No. 31, which was tabled by the hon. Members for Sutton and Cheam (Mr. Burstow) and for Isle of Wight (Dr. Brand), seeks to tighten the commission's power to require disclosure of any information that it considers to be "necessary or expedient"--I emphasise those words--

The amendment would tighten that power by making it clear that subpoenas can be used only in relation to material that is "necessary or expedient" for the purposes of the commission's functions of regulation or inspection.

I expressed a concern in Committee that I am sure Liberal Democrat Members share--amendment No. 31 expresses a similar concern--but I am not sure that their amendment, albeit well meaning, really deals with the mischief that concerns us. The real concern that we expressed was that the Bill enables the care standards commission to conduct fishing expeditions--to seek information from registered persons without necessarily having to indicate a specific reason why it needs that information, and perhaps even to trawl widely in the hope of finding something that might incriminate the person or persons in question, leading ultimately to the deregistration of those people or that establishment.

In this debate, it is important for us to explore with the Minister how he intends to prevent the commission from undertaking that type of fishing expedition. Perhaps he will be able to reassure us that he can use the extensive regulation-making power that the Bill gives to the Secretary of State to prevent that type of activity.

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