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Amendments made: No. 42, page 167, line 33, after first ‘in’, insert ‘Part 2 of’.

No. 43, page 167, line 33, after ‘Schedule’, insert ‘—

(a) ’.

No. 44, page 167, line 35, at end insert ‘, and

(b) at the appropriate place insert—

“The Office of the Health Professions Adjudicator.”’.

No. 45, page 167, line 38, leave out from beginning to ‘for’ and insert ‘—

(a) in paragraph 1 (bodies to which in England and Wales Act applies),’.

No. 46, page 167, line 41, after ‘Excellence’, insert ‘;

(bcb) the Office of the Health Professions Adjudicator;”, and

(b) in paragraph 2 (bodies to which in Scotland Act applies), before paragraph (d) insert—

“(ca) the Council for Healthcare Regulatory Excellence;

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(cb) the Office of the Health Professions Adjudicator;”.’.

No. 47, page 168, line 3, after ‘disqualified)’, insert ‘—

(a) ’.

No. 48, page 168, line 5, at end insert ‘, and

(b) at the appropriate place insert—

“The Office of the Health Professions Adjudicator.”’.

No. 49, page 168, line 8, after ‘disqualified)’, insert ‘—

(a) ’.

No. 50, page 168, line 10, at end insert ‘, and

(b) at the appropriate place insert—

“The Office of the Health Professions Adjudicator.”’.

No. 51, page 168, line 12, leave out ‘Part 3 of’.

No. 52, page 168, line 13, after ‘duty)’, insert ‘—

(a) in Part 2, at the appropriate place under the heading “Health” insert—

“The Office of the Health Professions Adjudicator.”, and

(b) in Part 3,’.

No. 53, page 168, line 16, at end insert—

‘ In section 27 of the Dentists Act 1984 (allegations against registered dentists), in subsection (2)(g), after “social care profession” insert “, or by the Office of the Health Professions Adjudicator,”.’.

No. 54, page 168, line 20, at end insert—

‘ In section 36N of the Dentists Act 1984 (allegations against registered dental care professionals), in subsection (2)(g), after “social care profession” insert “, or by the Office of the Health Professions Adjudicator,”.’.

No. 55, page 169, line 16, after ‘authorities)’, insert ‘—

(a) ’.

No. 56, page 169, line 18, at end insert ‘, and

(b) at the appropriate place insert—

“The Office of the Health Professions Adjudicator.”’.

No. 57, page 169, line 18, at end insert—

No. 58, page 169, line 18, at end insert—

In article 22 of the Health Professions Order 2001 (allegations), in paragraph (1)(a)(v), after “social care profession” insert “, or by the Office of the Health Professions Adjudicator,”.’.

No. 59, page 170, line 34, at end insert—

In article 48 of the Pharmacists and Pharmacy Technicians Order 2007 (impairment of fitness to practise), in paragraph (1)(k), after “social care profession” insert “, or by the Office of the Health Professions Adjudicator,”.’ .— [Mr. Watts.]

Schedule 15

Repeals and revocations

Amendments made: No. 73, page 188, line 39, at end insert—

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    ‘Audit Commission Act 1998 (c. 18)

    In section 4(7)—

    (a) in paragraph (a), the words “the Commission for Healthcare Audit and Inspection and”, and

    (b) in paragraph (b), the words “the Commission for Social Care Inspection and”.

    In section 49(1)—

    (a) paragraph (ba), and

    (b) in paragraph (c), the words from “or for the purposes of the functions of the Commission” to the end.

    In Schedule 2A, paragraph 1(1)(g) (together with the word “or” at the end of it).’.

No. 74, page 189, line 44, at end insert—

    ‘National Health Service (Wales) Act 2006

    In section 30(2), paragraph (d) (together with the word “and” at the end of that paragraph).

    Safeguarding Vulnerable Groups Act 2006 (c. 47)

    Section 45(7)(d).

    In Schedule 4—

    (a) paragraph 1(10)(f),

    (b) paragraph 1(11)(a), and

    (c) paragraph 7(6)(a) and (b).’.

No. 60, page 190, line 2, column 2, leave out ‘(7),’ and insert ‘—

    (a) in subsection (7),’.

No. 61, page 190, line 4, column 2, at end insert ‘, and

    (b) subsection (8).’.— [Mr. Watts.]

Order for Third Reading read.

8.38 pm

Mr. Bradshaw: I beg to move, That the Bill be now read the Third time.

I would like to begin by thanking hon. Members for their contributions in scrutinising and improving this Bill both in Committee and on the Floor of the House today. I think that the Bill benefited from the evidence-giving process—a young but positive reform of the procedures of this House.

We are not here discussing one of the more controversial or hotly politically contested Bills. In fact, our deliberations have shown a broad consensus of support for the main provisions of the Bill—the integration of the way we regulate health, including mental health and social care, and the modernisation of the way we regulate the medical professions. Central to this Bill is the aim of assuring safety and quality of care for all patients and service users.

The establishment of a new independent, integrated regulator with enhanced powers to succeed the three existing bodies—the new Care Quality Commission—is both timely and right. Patients and service users expect
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a comprehensive and seamless system of regulation that focuses on the quality and safety of services, rather than their setting.

The Care Quality Commission will bring several improvements. First, it will bring a joined-up system of regulation for health and adult social care, and I emphasise the importance that we expect the new regulator to place on both areas. That joined-up approach has been welcomed by both sides of the House. Secondly, it will extend regulation to the provision of NHS services for the first time ever. Thirdly, the set of new enforcement and sanction powers, which were again broadly welcomed from both sides of the House, will enable the new commission to deal with unsafe practices, such as poor standards of cleanliness and hygiene. Finally, the commission will allow a flexible and proportionate approach to regulation. The Mental Health Act Commission’s existing functions will be set, with some enhancement of the core of the new regulator’s work. All hon. Members who have spoken have stressed the importance of the regulator’s freedom to carry out its functions in the way that it sees fit, through arrangements that encourage its independence.

During our discussions on the Care Quality Commission we listened to the views expressed by Members on both sides of the House and, as we discussed earlier, we made a number of changes. We have clarified that the Care Quality Commission must have regard to those who represent the views of the public. We also listened to the points raised by the hon. Member for Romsey (Sandra Gidley), among others, about the need for the commission to publish its reports. That has always been the Government’s intention, but we are happy to have put that beyond doubt by clarifying it further on the face of the Bill.

As I mentioned earlier, we also intend to address the issue of the application of the Human Rights Act 1998 to health and social care when the Bill reaches the other place. On the regulation of health and social care professions, we have also listened carefully to the representations made, not least to those made by Lady Justice Smith, whose original reports on the Shipman murders helped to inform many of the changes that the Bill will bring about. We have tabled and agreed an amendment just now on the issue of legally qualified chairs for hearings of the new independent adjudicator.

Of course, we fully scrutinised the parts of the Bill that we have not discussed today in Committee, including the health protection elements and the health in pregnancy grant. I am sure that those issues will be scrutinised carefully in another place.

By reforming health and social care regulation, and by introducing tough new sanctions as well as reforming professional regulation, the Bill puts safety and quality at the heart of the health and social care system. I commend it to the House.

8.41 pm

Mr. Stephen O'Brien: This portmanteau Bill is incredibly wide ranging in content and it leaves vast amounts to secondary legislation—both things cause concern to the House in terms of proper parliamentary scrutiny. We have debated only a fraction of the outstanding issues this afternoon, and no doubt further clarification will be sought on a number of
18 Feb 2008 : Column 114
points in another place. However, as the Minister rightly observed, the broad thrust of the Bill is right, even if it is not necessarily timely. That makes getting the detail correct even more important.

We have sought many improvements, and we will no doubt seek more as the Bill goes on its way. We were grateful for the 12 sittings in Committee, which included some long sittings in order to bring proceedings to a close. We were able to time that almost to the minute so that both sides felt that the Committee had offered adequate consideration. That was the first time that I have been involved in a Committee of which that could be said.

It was disappointing that the Government did not accept our full witness list for oral evidence, but both sides of the House will agree that that was a useful procedure for the Committee. I dare say that the model will be looked at further—it is yet to be perfected. It is important that the witness list is not just a list of the Government’s bidding—it was not in our case.

I pay tribute to my colleagues in the Committee, and not only to those on the Front Bench. My hon. Friend the Member for Guildford (Anne Milton) guided us through many parts of the Bill during the Committee. Those on the Benches behind me, including my hon. Friend the Member for Tiverton and Honiton (Angela Browning)—[Hon. Members: “Where are they?”] My hon. Friends might not have expected Third Reading to begin at this hour and are not yet in their places, but they have certainly been in evidence for a great deal of the debate and have added a great deal of thought and sensitivity to our deliberations.

It was important to have the presence of my hon. Friend the Member for Preseli Pembrokeshire (Mr. Crabb) in Committee. Despite the Bill’s significant ramifications for the devolved Administrations, he was the only MP in the Committee whose seat is in a devolved Administration. I also pay tribute to the way in which the Committee was chaired and to all the Clerks.

We have won two important Government concessions. We are grateful for the fact that the Minister has if not bowed, then at least nodded to the force of our arguments on, first, the inclusion of a strong patient voice in the CQC. Despite our best efforts, the Government will not include LINks—local involvement networks—in the Bill. No doubt such efforts will continue in another place, and we urge the Government to reconsider. We are also glad that there is now scope for legally qualified chairs and that they will be piloted. However, we remain concerned, particularly given the application of the civil standard of proof, that their role should be universal. Again, I am sure that that debate will be continued in another place.

We have not been able to change the Government’s mind on a number of issues. Obviously those issues will be pursued, particularly those that I raised earlier on Report in relation to HealthWatch. A clear function is required for the CQC, particularly given the concerns about its proposed governance structure. That is not merely a cosmetic legislative issue. The House has an opportunity—indeed, I think that it has an obligation—to send a very clear message to the new commission about what the House expects it to achieve, particularly given, as was agreed, the achievements of the bodies that it will succeed and especially as they were just getting into their stride in a way that was adding value.

18 Feb 2008 : Column 115

Independence and the complaints process remain concerns, as do the reviews and the general ability to give opinions on the basis of the evidence that has been gained and on the basis that visits must be properly maintained, particularly in relation to those who are detained under the mental health Acts.

We have had useful debates on the extent to which human rights and a rights-based approach should be at the core of health and social care in particular. Again, such debates will continue, as will the discussion of malnutrition and the extent of professional regulation, which we have only just discussed.

Public health measures have not featured in today’s discussions, although they have been scrutinised with care and determination by my hon. Friend the Member for Guildford. That needs to be placed on record. Although we broadly welcome such measures towards appropriate legislation to deal with modern-day contingencies, we and others, including the organisation Liberty, remain concerned about the length and reporting of detention under such powers. We hope that the Government will introduce in another place the relevant draft regulations and examples of instances where such legislation might be necessary and that there will be an opportunity to discuss the amendments that we were unable to touch on today. The Government may well want to reflect on those issues, and we might need to consider them again if they come back as Lords amendments, even Government Lords amendments.

The health in pregnancy grant is another area that we have not touched on today. It is therefore appropriate to use Third Reading to highlight the grant, which was discussed at length in Committee. It is an important part of the Bill. Indeed, the Government have made much of what they are seeking to do with the health in pregnancy grant. Unfortunately, although we used an extensive series of arguments, backed by evidence, we never managed to get the Government to accept that there was a better way to approach the benefits that are sought with the grant. Ours is a different way from that proposed by the Government. I encourage hon. Members to read column 455 of the report of the proceedings in Committee. Quite rightly, it would be inappropriate to repeat those arguments now, but the Government need to put more thought into the grant, because the evidence base does not support what the Prime Minister and the Government are pursuing.

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