Schedule
2
Transfers
of property and staff
etc.
Question
proposed, That this schedule be the Second schedule to the
Bill.
12
noon
Mr.
O'Brien:
Clause 3 introduces schedule 2. It is the
enabling clause for the schedule, which transfers property, rights and
liabilities. The Minister told us on Thursday that although
establishing the CQC will cost £7 million, as outlined in the
regulatory impact assessment, the transition costs will be £140
million. He said:
“The £140
million includes the cost of redundancies, estates rationalisation and
planned reduction of the operating
costs.”——[Official Report, Health and Social
Care Public Bill Committee, 10 January 2008; c.
120.]
I hope the Minister will
take the opportunity, as we examine the schedule, to detail what that
£7 million covers, the current estates and the length and value
of their leases. He will want to take note of information provided to
me that, in relation to the Healthcare Commission, Finsbury tower is on
a long lease taken out by its predecessor organisation, the Commission
for Health Improvement, running until 2020, with a lease-break clause
in 2015. That goes straight to the heart of the point.
Will the downsizing be
anything beyond that already planned by the various regulators? I hope
it is clear that by the end of March, the CSCI will have closed two
thirds of its inherited estate of 84 offices: 56 closed, 28 remaining.
As I understand it, that is the position, but I have not had the chance
to confirm it with the CSCI. Where will the CQC be based? Given the
Prime Minister’s 2004 commitment to relocate 20,000 civil
service jobs outside London following the Lyons review, how many jobs
will be moved out of London? As an MP representing a north-west
constituency, I can tell the Minister that that is of very significant
interest to my area, and I dare say that other Members have a not
dissimilar interest, although we from the north-west will compete for
those relocated jobs.
Will the Minister outline the
liabilities of the three regulators? That will be vital before they are
disbanded and transferred. How many staff are employed by each
regulator in England, with an inside/outside London split, if possible,
in Wales and in Northern Ireland? That is the context and background,
and it is absolutely vital that we understand the operative part of
clause 3, which brings into force schedule 2.
Schedule 2 deals with
transfers of property, staff and the rest, so how much of the property,
rights and liabilities will revert to the Crown? What is the
expectation of paragraph 1(4), which says:
“A scheme under this
paragraph may contain provision for the payment of compensation by the
Secretary of State to any person or body (other than one mentioned in
sub-paragraph (1)) whose interests are adversely affected by the
scheme.”?
The
Minister will note that the paragraph is italicised, which means that
it involves taxpayers’ money, so it is incumbent on all of us to
find out what is intended. Does he have an estimate of the possible
compensation? It is taxpayers’ money, so not only should he
know, but we have a right to know, and so do the public. Has the amount
been crystallised, or is it open to increase?
What is the process for
obtaining the consent of Welsh Ministers under paragraph 1(6)? There is
a very important point to be made at this juncture. There has been a
puerile and crass attempt by the Labour party of Wales to try to
undermine some of the amendments to the Bill, which quite rightly seek
to put pressure on the Minister to decide whether he or Welsh Ministers
will have responsibility for the legislation in Wales. Instead, the
Government have kept the options open and not made a decision, and the
legislation is all over the shop. They have got their little cronies in
Wales to concoct a press release to try to undermine the amendments.
Look at the evidence: only the Opposition have a Welsh MP on the
Committee. The Labour Government do not, so they do not have somebody
in the Committee who understands how the devolved powers work and can
stand up for the interests of patients in Wales, be they in the health
service or social care.
It was not
only puerile but absolutely misplaced and deeply misjudged for the
Labour party of Wales to start a nasty political spat when, in fact,
only the Conservative party has managed to put on the Committee
somebody who can stand up for the interests of Welsh people. I hope
that my hon. Friend the Member for Preseli Pembrokeshire will have an
extremely enjoyable time ensuring that he stands up for the people of
Wales and his constituents where the Government have failed, given that
they had the option to select somebody representing a Welsh
constituency. We did so, and we are glad to have had that
opportunity.
On
paragraph 2, it will be important to ensure that the day that the
Secretary of State is likely to appoint for the transfers to take place
is named. Failing that, many things will be difficult to determine. I
hope that the Minister will take the opportunity to spell out why
paragraph 3 is drafted as it is with regard to transfers under the
Transfer of Undertakings (Protection of Employment) Regulations 1981,
which I would have thought would be of grave interest to all members of
the Committee. We have a duty to understand the rights that attend upon
transfers of responsibilities and employment expectations, which are
beyond the power of those involved in legislating in this
place.
Finally, how
many posts has each regulator already cut since the inception of the
Gershon review? How many staff have the regulators lost through wastage
due to the anticipated merger of their responsibilities? Without those
numbers, we can make no sense of the claims made by the Minister and
his
colleagues.
Mr.
Stephen Crabb (Preseli Pembrokeshire) (Con): It is a
convention—and also heartfelt from me—to say what a
pleasure it is to serve under your chairmanship, Mr.
Conway.
As my hon. Friend said, the
schedule provides for the transfer of the property, rights and
liabilities of the various bodies affected by the Bill—in the
case of Wales, the Mental Health Act Commission. I should like to ask
the Minister a few brief questions about how the Bill applies to Wales,
with a view to helping the scrutiny process. Those who follow closely
the proceedings of the Select Committee on Welsh Affairs, as I am sure
many do, will know that the quality of scrutiny given to legislation
made here that affects Wales, particularly framework legislation and
the new legislative competence orders, is a live question.
Although Members from all
parties might feel comfortable devolving further functions and powers
to Welsh Ministers as part of the ongoing devolution process, it is
surely incumbent on us to ensure that there is the best possible
scrutiny at an early stage. To that end, will the Minister update the
Committee on the discussions that he and his officials have had with
Welsh Assembly Ministers about how the Bill will apply to Wales?
Specifically, what does he understand the property, rights and
liabilities of MHAC in Wales to be? Did Welsh Ministers, during his
discussions with them, identify any additional resources that they
would need to be able properly to fulfil their new functions and powers
under the Bill?
Given
the benefit that the Minister anticipates the creation of the new
independent and integrated Care Quality Commission will achieve in
England, my main question and concern about the application of the Bill
to Wales is how comfortable he is about investing Welsh Ministers with
many of the relevant functions, and the extent to which he thinks that
the spirit of independence that has been discussed in relation to the
CQC in England will be observed in Wales. Perhaps he will update us on
what Welsh Ministers have said and on how they intend to use the powers
to ensure that people in the Principality benefit to the same extent as
those in England from the new provisions in the
Bill.
Mr.
Bradshaw:
I regret that I do not have to hand the exact
figures on liabilities and the length of the leases of various
buildings, but I have written to Committee members following last
Thursday’s sitting when evidence was taken about costs. If the
Committee so desires, I can hold on to that letter a little longer and
add some of the detail that has been requested, or send the first
letter and include in a further letter some of the issues of liability
in as much detail as we can gather in the time. Does the hon. Member
for Eddisbury have a preference on
that?
Mr.
O'Brien:
I am most grateful for the Minister’s
offer, and indeed for allowing us to express a preference. It would be
very helpful to us, in getting a handle on the issue, if he would send
the letter that he has taken the trouble to put together as soon as
possible, and send a further letter when the other details are to hand,
so that we can give the matter proper
consideration.
Mr.
Bradshaw:
On the questions about Wales, hon. Members will
know that the Care Quality Commission covers England only, but the MHAC
is, I am advised, covered in clause 48(3). Again, I shall perhaps add a
few lines on Welsh issues for members of the
Committee, although we have liaised closely with Ministers and
colleagues in the Welsh Assembly Government throughout the development
of policy on the Bill. They are happy with the provisions, and
so are we.
Anne
Milton (Guildford) (Con): Will the Minister give
us—he did not mention this—the figures on the loss of
staff? That came up during evidence sittings. It is a crucial matter in
the transition period and it is extremely important for the Committee
to hear how many staff have already been
lost.
Mr.
Bradshaw:
Yes. I am happy to do that.
Question put and agreed
to.
Schedule 2
agreed
to.
Clause
4
“Regulated
activity”
Question
proposed, That the clause stand part of the
Bill.
Mr.
O'Brien:
This is one of about five affirmative resolution
clauses in the Bill, and it concerns the regulated activity with which
we must now be concerned as we move on to consideration of
chapter 2. The Committee must effectively have another meta-debate on
this clause, if I can put it that way, given that the real meat will be
in the regulations. Clause 90 tells us that
“‘prescribed’ means
prescribed by
regulations”
made by the
Secretary of State. The clause also defines the geographical scope of
regulations—England, mainly.
While both the Commission for
Social Care Inspection and the Healthcare Commission cover England
alone, as the Minister has just mentioned, the Mental Health Act
Commission currently oversees the operation of the Mental Health Act
1983 in England and Wales. It was appropriate for us to raise the point
about Wales in the previous debate, because it was covered by schedule
2, but I noted—and it is relevant to the present matter
too—that the Minister has undertaken to return to some of the
points that were raised, both in writing, which is very helpful, and
when we come to debate further clauses and
amendments.
12.15
pm
The
Bill gives the functions of the MHAC pertaining to England to the CQC
and those pertaining to Wales to Welsh Ministers. Subsection (2)(a)
limits the scope of the CQC to England alone. The Minister has just
made a commitment that he will seek to help the Committee as much as he
can. What assessment has he made of the division of staff and
intellectual property arising from that split? I hope that, as he and
his officials are noting the process of these inquiries, the
intellectual property rights will also be given proper consideration.
They are an asset that is often overlooked but absolutely vital. Coming
from a commercial background, I can say that intellectual property
rights are often used most of the time in any transfer negotiation by
way of friendly or hostile purchase.
Subject to the following
provisions of clause 157, the Bill extends to both England and Wales. I
hope that the Minister will have checked by the time we reach that
clause that there is no conflict in the drafting. I put it no higher
than that, but it is certainly worth
checking.
Clause
4(2)(a) limits prescribed activities to those connected to health or
social care—the definition of which we will debate under clause
5—
“in, or in
relation to,
England”.
Can the
Minister tell the Committee the force of the phrase “in relation
to”? As an MP whose constituency has a Welsh border and much of
what is rather interestingly called “health tourism”
across that border, I am interested in what protection the clause gives
to my constituents who are treated and cared for in Wales—often
very well, I have to say. Obviously, for many of my constituents, being
treated in Wrexham Maelor hospital involves travelling a much shorter
distance than would be involved in travelling even to the Countess of
Chester hospital in the city of
Chester.
What right
of appeal, on behalf of my English constituents, does the clause give
me, as their representative in the House? I have frequently attempted
to ask the Secretary of State for Wales what happens if things go wrong
for my constituents in a health or social care setting in Wales. He has
immediately referred me to the First Minister of Wales, who has told me
that I have no standing with him and he has absolutely no obligation to
respond to me, and does not. Therefore, I have no way of representing
my constituents through the devolved powers, which in effect create a
form of devolved apartheid when it comes to
accountability.
What
impact will this provision have on NHS patients seeking health care
abroad—I am not now talking just about going across borders
within the United Kingdom—under the EU’s attempt to open
up the health care market? The Minister and all his colleagues will be
very conscious of the recent debate that has been had, mainly in the
press, because the EU was supposed to publish draft legislation on 20
December just gone, but has delayed it until early 2008, so we are in
live time. That is in the light of anger from, among others, our very
own British Ministers. We await that publication with bated breath. It
will be absolutely germane to this part of the Bill and the way in
which the Bill can
operate.
The
clause also, rightly, prevents the CQC from encroaching on the role of
Ofsted in the inspection of children’s services. Ofsted
inspects, among others things, children’s homes and residential
special schools. Can the Minister confirm that this provision will not
impact on the commission’s ability to report on children and
young people being treated on adult mental health wards? As he is well
aware, that is a scandal that continues to persist under this
Government. Given in particular the recent report on learning
difficulties services published by the Healthcare Commission, what will
he do to encourage close working between the two bodies in terms of
service users, providers and individual staff in the
sector?
I note the
Minister’s genuinely helpful alert to the Committee last
Thursday about joint working. He brought our attention to clause 64 and
schedule 4. However, my understanding of clause 64 is that it
requires the commission to promote co-ordination of reviews and
assessments, not of day-to-day processes. Schedule 4 comes closer to
supporting joint working in processes, although it does not require it
in the same terms as clause 64. Again, I hope that that provides
genuine food for thought for the Minister and his officials, because I
suspect that there will be time to think about it before we get
there. In relation to
clause 4(3), I hope that the Minister will give us an answer as to why
he has decided to enshrine these three aspects explicitly in the Bill.
It is not an exclusive definition of “connected with”,
but it seems to particularise when the rest is left to more generic
definition. What assessment has he made of the division of staff and
intellectual property arising from the division of the MHAC? Given that
the clause applies to England and Wales, should subsection (2)(a)
reflect that? What does “in relation to” mean? Will
Ofsted and the CQC work together? Why has he sought to define, although
not exclusively, “connected with” in the terms outlined?
Those are the questions that I hope he will seek to address as we
consider the clause.
Mr.
Bradshaw:
This may not be my job, but I slightly flinched
at the hon. Gentleman’s use of the term apartheid to describe
some of the complexities that have arisen from the democratic decisions
taken in this country to grant devolution to Wales, but I will leave
that issue with him. Apartheid, in my view, was a despicable,
racist-based policy, deliberately implemented by the nationalist
Government in South Africa. It is not an appropriate term to refer to
these
complexities.
Mr.
O'Brien:
I was born in east Africa, and therefore had to
live through and survive and challenge the whole of the apartheid
approach, but the Minister will be aware that the derivation of the
word has nothing to do with racism. It is to do with there being two
different sides of a similar issue and it was then hijacked to have a
meaning in political terms, which is what he might have described. He
is no better advocate than I am for being anti-apartheid in the sense
that the term was used in South Africa, but I was using the term here
in its genuine rather than ascribed
form.
Mr.
Bradshaw:
I take the hon. Gentleman’s point, but I
have noticed that a number of Conservative Members use the term
apartheid to describe the cross-border complexities caused by
devolution. I ask him to bear in mind how the use of that term would
come across to most South Africans.
The clause allows regulations
to be made to define the activities that need to be registered with the
Care Quality Commission. That will be carried out through regulations,
so the list of regulated activities can be revised as new models of
service provision evolve. This is particularly important, so I intend
to spend a little time outlining
it.
We want to
encourage flexible and innovative ways of delivering services to be
developed. I do not want the registration system to be a barrier to
that. Ofsted is responsible for regulating children’s social
care. To avoid the possibility of services currently registered with
Ofsted having to register twice, the clause specifically excludes any
services that are registered
with Ofsted from the definition of “regulated activity”,
but of course they will have to work closely together. We will be
consulting very soon on the activities that are to be regulated by the
Care Quality Commission. We expect that most service providers
currently regulated by the Healthcare Commission or the Commission for
Social Care Inspection will be required to register. These would
include independent sector health care providers and providers of adult
social care that are currently required to register. For the first
time, NHS trusts—including ambulance trusts—NHS
foundation trusts, and primary care community services will also need
to register. Under the current arrangements, because NHS care is
regulated and inspected differently from other services, it is not
always easy for patients to compare NHS services with those of other
providers. It also creates a barrier to joint working and means that
private providers providing some statutory services have to comply with
two regimes. Creating a unified system of regulation across health and
adult social care providers from all sectors will create a fairer
playing field. It will also assure the general public that whichever
provider they use, all services will be required to meet the same
national safety and quality requirements, and will be subject to the
same enforcement regime if they fail to do so.
In respect of the hon.
Gentleman’s question on assets, as I said in my answer to a
previous question, I will include whatever information we can give the
Committee on assets in writing.
On his question about
cross-border issues and the term “in relation to”, I
suspect—I will confirm this in writing—that this may
include examples in which the service is provided in Wales, although it
is commissioned in England. That may be an example where we would have
to use the phrase “in relation to English”, but I will
happily confirm that in writing.
Question put and agreed
to.
Clause 4
ordered to stand part of the Bill.
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