Private and Voluntary Health Care (England) and Care Home Regulations 2001

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Ms Shipley: I am sure that the hon. Gentleman would agree that police checks are vital. Given the thrust of his argument, who does he think should pay for them—the taxpayer through Government funding, the employer or the potential employee?

Mr. Burns: That is a good point. I would follow the precedents laid down by the Government on checking in the voluntary sector. As the hon. Lady will remember, probably from pressure in her own constituency, there was much concern about the fees for checking people in the voluntary sector. The scout movement was particularly vociferous in lobbying us all on the financial implications of the fees to check people working in it. As the hon. Lady knows, I am not a cynic, but that happened in the run-up to the previous general election; having said that it was up to the voluntary sector to pay the fees, the Government rescinded at the last minute, before the election was called, and decided that the Government would pay them. There is a precedent for the Government paying for criminal checks on a certain group of people.

Ms Shipley rose—

Mr. Burns: I thought that the hon. Lady would want to intervene on that.

Ms Shipley: Yes, not least because the most recent lobby was in connection with my Bill on the protection of children. If the Government are picking up the bill, the hon. Gentleman will realise that that means the taxpayer. So of the three groups I gave, his answer is the taxpayer.

Mr. Burns: I had not answered the question; I was just giving the hon. Lady a precedent of where the Government, and to use her words ''the taxpayer'', were picking up the bill in the charity and voluntary sector. I recognise as much as she that a general election is not in the offing and that the Government would therefore be more reticent about the matter.

Peter Bottomley: I think that I am right in saying that most of the people to whom the check would apply would be in catering or cleaning positions or be those giving other forms of assistance in the care home. It does not apply only to those with professional qualifications. I believe that, by the age of 30, a third of all men have been convicted of an offence for which they could have been sent to jail for six months or more. I hope that people do not have the notion that all criminal convictions disqualify people from working in a care home. The cost to the taxpayer and the public purse is far greater if people who could have been or were sent to jail for six months or more are denied employment in the sorts of fields where they could appropriately be employed. Were the taxpayer to pay £12 to get someone into work who would otherwise be on benefit, the taxpayer would gain significantly.

Mr. Burns: My hon. Friend makes an interesting point, to which I hope that the Minister will respond. To return briefly to the hon. Lady's point, let me say

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that the measure will place a financial burden on care homes, particularly smaller ones, at a time when there are considerable other pressures on the sector.

My hon. Friend the Member for Worthing, West made an interesting point, because the regulations do not distinguish between the different types of criminal record. It is dangerous to start evaluating the seriousness of criminal convictions and criminal records on a sliding scale, but we all live in the real world and we know that there are criminal records and there are criminal records, and some are infinitely more serious than others.

My third point relates to a group of individuals—they may be numerous, although we do not know, because we cannot quantify them yet—who start working in a care home and on whom, not unnaturally, a check must be made. Given the time scale for such checks, it is possible that such individuals may decide, before the results have become known, that they have made a mistake and do not want to work in that area. The care home owners will, however, still be charged a fee. Could the time scales be adjusted slightly to minimise that additional burden, which will fall on smaller care homes in particular?

Dr. Harris: I am listening with interest to the hon. Gentleman, but I want to raise a point that he could factor in. Would it not be reasonable, in the interests of fairness, for private sector providers that compete for contracts with the state sector where there is no shortage—as there is now—of care home places to absorb the charges and to reflect them in their tenders, just as the state sector does? There would be an argument for the state sector to pick up the costs only where it imposed them on the private sector but not on its state sector competitors.

Mr. Burns: The hon. Gentleman makes an extremely telling and valid point.

Regulation 25 deals with the financial position. Regulation 25(2) sets out an exhaustive list of the documents that care homes must produce. The minutiae will have a considerable impact on smaller care homes, and I wonder whether the sheer plethora of information that will be required is absolutely necessary. I also wonder whether those who will carry out the inspections will fully understand what they are required to inspect. If the answer is no, why are the Government demanding such documentation?

Why does regulation 25(3)(c) require a care home to give a copy of its management accounts to an inspector on request? It would be interesting to know who the Minister expects to be the inspectors, but my understanding is that they are usually social workers or nurses. I wonder what sense they will make of the documents, given that their expertise and training are in nursing and social work, not in looking at management accounts, which can be technical and incomprehensible even for a Member of Parliament.

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Furthermore, why does the commission need such sensitive business information, and what purpose do the Government think that it will serve? Who else is required by a Government agency—I am leaving aside the Revenue—to make such information available? Is this just another example of the Government inadvertently—I must be fair—placing a burden on an embattled sector because they have not thought matters through properly?

Are the Government confident that there will be enough staff to carry out and monitor the inspections? If the answer is that they may have difficulties, or that there will not be enough initially, it begs the question of why the information is needed if no one is to look at it or do anything with it, particularly for the smaller homes. It seems rather unnecessary to collect the information, or at least part of it, simply for the sake of it.

Clarification is important on a few further minor points, because it will highlight the complexities of such prescriptive and all-embracing regulations. For example, regulation 16(2)(k) states that a registered person shall keep the care home ''free from offensive odours''. No one here, including yourself, Mr. Cran, would wish there to be offensive odours in a care home or anywhere else, but could the Minister tell the Committee what is an offensive odour as defined in the regulations? Who will define it? How will it be enforced? What standard will be applied? Will there be discrepancies between homes and odours?

It seems quite extraordinary that something that most people would accept as common sense has to be laid down in a statutory instrument. It defies belief. I do not imagine that any legislation, either primary or more appropriately secondary, on the national health service and hospitals has laid down such a fatuous regulation as this. There is no definition of an odour, or of the degree to which an odour has to be offensive. I question whether it is sensible for even this Government, with their control freakery and their desire to interfere in the all the nooks and crannies of our lives, to start laying down such regulations.

Dr. Harris: I congratulate the hon. Gentleman on his observation, if only because I was going to make it. I am somewhat disappointed that he got in first. Nevertheless, although one can see what the Government are getting at, the other senses are just as important as smell. One might say that the care home should be protected from offensive noises, sights, tastes and feelings. The regulation is bizarre.

Mr. Burns: ''Bizarre'' is the right word. I am surprised that the Government have resisted the temptation to go down that route. They do not usually resist such temptations, and I am surprised that the list is not even longer. As the hon. Gentleman said, it could include noise and a list of other senses. My point is that none of them should be included. It is the nanny state gone mad.

Regulation 37(1) provides in sub-paragraphs (c) and (d) that a person shall

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    ''give notice to the Commission without delay of the occurrence of . . . any serious injury to a service user . . . and serious illness of a service user at a care home at which nursing is not provided''.

I would be interested to know the need for that, although I accept that there may be a valid need. What is a ''serious illness'' in such circumstances? To the best of my knowledge, there is no reference to that in the regulations. It depends on how wimpish the individual is. A common cold can be a serious illness to a hypochondriac.

Jacqui Smith: To a man.

Mr. Burns: Well, that is amazing. Only because the Minister is female could she get away with that. I congratulate her on not being politically correct and on living in the real world.

Peter Bottomley: On a point of order, Mr. Cran. My hon. Friend's remarks will be recorded in the Official Report, but I am not sure that the Minister's will. Will she or my hon. Friend tell us what she said?

Mr. Burns: My hon. Friend is very cruel. Because I congratulate the Minister on her honesty and on not being governed by political correctness, I shall leave the subject. What she said was fair, reasonable and sensible.

I digress, so I shall return to the subject of serious illness. Different people have different views of what a serious illness is. So far as I know—I may be wrong, in which case the Minister can correct me—it has no legal definition. Therefore, how is the provision enforceable if it depends on a matter of opinion about what a serious illness is?

The regulations deal with care homes for youngsters and young adults. Again, the Minister can correct me if I am wrong—I would appreciate it if she did so now, as it would save her about three minutes and so be a considerable relief to her—but I think that they apply to people between the ages of 14 and 25.

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