|Health and Social Care (Community Health and Standards) Bill
Chris Grayling (Epsom and Ewell): No one could dispute or disagree with the aspirations of the hon. Member for Sutton and Cheam in wanting to ensure that all vulnerable people in our society receive the support that they need. I am sure that I am pre-empting the Under-Secretary's comments—I offer my support for them in advance—by saying that if we wrote vulnerable adults into the Bill along with vulnerable children, we would either have to go to the extreme of listing every group in society that could be looked after by the bodies, or everybody would have to become a priority. That is the job that those organisations are there to do.
Mr. Burstow: I understand that argument, which was last paraded when we made the point during the passage of the Care Standards Bill a few years ago. Is the hon. Gentleman arguing that there should not be equity in the treatment of vulnerable adults and children in securing the very highest standards of care and treatment?
Chris Grayling: My argument is simply that that is the job of those organisations. If we bracket vulnerable children and vulnerable adults, that equals everyone in our society who is vulnerable. The job of those organisations is, in the case of CHAI, to look after patients, and in the case of CSCI, to look after the vulnerable. Incidentally, I am a bit confused as to whether it is pronounced ''sea-sky'', which sounds like a motto for the Fleet Air Arm, or ''Ciskei'', which is a province in South Africa. CSCI's job is to look after all vulnerable people, and I am not persuaded that we need to amend the Bill or make it more complicated to reflect that.
Dr. Andrew Murrison (Westbury): My hon. Friend may have received some correspondence from Help the Aged, as I did today, that deals with that specific point. Its concern is that it has noted the special treatment that the Bill gives to children, and is wondering what is in it for elderly people. One could go on and on. I entirely agree with my hon. Friend. He is right to point out that the NHS is there for everyone and if we start balkanising it in the way that some suggest, we will have real problems.
Chris Grayling: I am grateful to my hon. Friend for that comment. There is a particular issue relating to children. Society as a whole wants to ensure that children who are not in a position to fight their own corner, as they do not have age or experience, are adequately protected. None the less I agree, as I too have regular dealings in my constituency with people who have learning disabilities and those who have mental health problems. I want to see this organisation do the job for them.
I do not disagree with the aspirations of the hon. Member for Sutton and Cheam. In order to keep the
Column Number: 533Bill simple, however, it is the Committee's message to those who are going to work for CSCI—and the intention of the whole House—that we expect them to ensure that they look after the interests of those vulnerable people. I am not persuaded that we need to add to the Bill to achieve that.
Mr. Lammy: The hon. Member for Epsom and Ewell (Chris Grayling) makes the point incredibly well. There is not much to add. The amendment would place an obligation on the new inspectorate to appoint a director of rights for vulnerable adults, and would provide an additional duty to have a regard for and to safeguard and protect the rights of vulnerable adults. I am sure that those motives are laudable, but they must be resisted for two reasons.
There is nothing to prevent CHAI or CSCI from having a director responsible for vulnerable adults but we do not see the need for legislation in that area. The original reasons for the role of a director of children's rights were very clear. Children in care who are looked after in boarding schools away from home are especially vulnerable and there is public consensus about that. There is not, however, public consensus about vulnerable adults, and it is unclear how we would define vulnerable adults, when social services are in the business of providing care standards services for vulnerable people.
The hon. Gentleman has a point, philosophically, but technically, we do not see the need to put this issue in the Bill. I would gently make the case that there is a view—as articulated so well by the hon. Member for Epsom and Ewell—that the rights of the child are well established. Vulnerable adults are a much larger group, and there is a point of view that having a director for vulnerable adults might mean that the case for vulnerable people achieving their rights might be undermined. After all, they are adults, and people might look to the director, not to themselves. For that reason, I resist the amendment.
Mr. Burstow: I am grateful to the hon. Member for Epsom and Ewell and to the Under-Secretary for clearly setting out the Government's position. [Interruption.] I deliberately conflated that. I just want to pick up on a couple of points that the Under-Secretary made. He talked about how one would go about defining a vulnerable adult. I simply draw his attention to section 86 of the Care Standards Act 2000. The Government seemed to have no difficulty in coming up with what was presumably then conceived by parliamentary counsel as a working definition. In respect of children's services there is now a means to ensure that the interests of the child are central to the work of the commission, which is, after all, under pressure from the providers—the subject of regulation in many respects. My concern is that there is a buttress, through regulations and statute, for the rights of children, but there is no similar buttress in respect of the rights of adults.
The hon. Member for Epsom and Ewell rightly asked what groups of people we were talking about. He went on to talk about people with learning disabilities. I would add to that people who lack mental capacity. The Government have, for some years, been contemplating introducing mental
Column Number: 534incapacity legislation. They have not yet done so. Such legislation is long overdue and would go some way to allay some of my anxieties about the absence of something within CSCI to deal with the issues. It is clear that we will not make progress on the matter today. This is a missed opportunity to establish parity of esteem and treatment in relation to the rights of adults who are vulnerable and lack capacity to make decisions for themselves and those of children, who the Minister is rightly concerned about and who similarly lack the ability to articulate their needs as clearly as we would wish. I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Schedule 6, as amended, agreed to.
Clause 38 ordered to stand part of the Bill.
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