Health and Social Care Bill

---

The Committee consisted of the following Members:

Chairmen: Derek Conway, † Mr. Jim Hood

† Bradshaw, Mr. Ben (Minister of State, Department of Health )

† Browning, Angela (Tiverton and Honiton) (Con)

† Burden, Richard (Birmingham, Northfield) (Lab)

† Cooper, Rosie (West Lancashire) (Lab)

† Crabb, Mr. Stephen (Preseli Pembrokeshire) (Con)

† Gidley, Sandra (Romsey) (LD)

† Hesford, Stephen (Wirral, West) (Lab)

† Hopkins, Kelvin (Luton, North) (Lab)

† Jenkins, Mr. Brian (Tamworth) (Lab)

† Kumar, Dr. Ashok (Middlesbrough, South and East Cleveland) (Lab)

† McCabe, Steve (Lord Commissioner of Her Majesty's Treasury)

† Mallaber, Judy (Amber Valley) (Lab)

† Milton, Anne (Guildford) (Con)

† Moffatt, Laura (Crawley) (Lab)

† Mulholland, Greg (Leeds, North-West) (LD)

† O'Brien, Mr. Stephen (Eddisbury) (Con)

† Wright, Jeremy (Rugby and Kenilworth) (Con)

John Benger, Celia Blacklock, Committee Clerks

† attended the Committee

Column number: 289

Public Bill Committee

Thursday 17 January 2008

(Afternoon)

[Mr. Jim Hood in the Chair]

Health and Social Care Bill

Clause 35

Bodies required to be notified of certain matters

1 pm

Greg Mulholland (Leeds, North-West) (LD): I beg to move amendment No. 233, in clause 35, page 17, line 38, at end insert—

‘(ba) to the relevant professional regulatory body’.

We are making reasonable progress, but I will try to be brief because we are all keen to get as far as possible next week. Amendment No. 27 introduced an important point of principle, but amendment No. 233 raises an important point of practicality. I hope that the Minister will not use the same arguments against the amendment, unless, of course, he decides to accept it, because it is not about being prescriptive—an issue on which he has commented on various occasions.

The amendment is important in a practical way for two reasons. In layman’s terms—an always useful method of explaining the impact of a Bill—one major effect would be a new, clearer regulatory system for health and social care, with some redefined and refocused responsibilities. Clearly, an important part of that is professional regulatory bodies, most of which support the new and refocused role that they will have. If we are to have a new, joined-up framework, which makes sense for the reasons stated earlier, surely we must include the professional regulatory bodies when a commission issues a notice—be that a notice of decisions or proposals, a warning notice or a notice of procedure for suspension. I appreciate the Minister’s comments about not wanting to be prescriptive, but professional regulatory bodies should be among the organisations that must be informed of such notices if this is to be a genuinely joined-up and effective system. We all know from other areas—from the Shipman case—that when we do not have properly joined-up systems and effective sharing of information, that can lead to issues and problems.

The second reason concerns a potential loophole that I would like the Minister’s views on. Is there not a danger that when an individual who has been issued with a suspension notice moves to a different area, they could slip through the net if the professional regulatory body with an important role in that area is not involved?

Sandra Gidley (Romsey) (LD): I am reminded of a number of practical examples, including one in my constituency whereby a nursing home owner sacked a

Column number: 290

nurse because of abuse. He took the matter seriously, but we can envisage a case in which an inspector might highlight problems of abuse needing some sort of investigation. In the case to which I refer, the nurse was allowed to enrol with various agencies and work in the next county, and there was absolutely no way of tracking what she was doing. She was later, quite rightly, removed from the professional register.

The Chairman: Order. I remind the hon. Lady that this is an intervention.

Greg Mulholland: My hon. Friend makes a useful point demonstrating a potential practical example, which is what I am trying to get across. I hope that the Minister understands that practical point and the need for a properly joined-up framework. We would be delighted if he accepted the amendment. One could say that it is absolutely belt and braces, but given that there are still concerns about the regulatory framework for health and for social care, as the Minister has acknowledged, surely it would make sense to include the professional regulatory organisations in this part of the Bill. I look forward to the Minister’s comments.

Mr. Stephen O'Brien (Eddisbury) (Con): I consider the proposal perfectly sensible and I look forward to the Minister’s reply.

The Minister of State, Department of Health (Mr. Ben Bradshaw): The reason why we must resist the amendment is not that it is prescriptive; rather, it is a question of degree. As members of the Committee will have noticed, the commission is required to give notice of action to any people whom it considers appropriate. We would expect that in most circumstances, that would include the relevant regulatory body, but we believe that it is better for that to depend on the particular circumstances, rather than there being a blanket requirement. For example, if a registered manager had received a warning notice for a minor breach that had then been properly corrected, the commission might consider it appropriate, or disproportionate, to have to inform the manager’s regulatory body.

Sandra Gidley: I take the Minister’s point about a minor breach about which it may not seem necessary to inform the regulatory body. However, there are cases where a series of minor breaches might flag up a problem, and surely the professional regulatory body is the ideal place to collate that information. People do not know where to complain when there is a problem. Shipman was a classic example—there were different areas in which concerns had been raised. There needs to be some way of bringing that information together in one place.

Mr. Bradshaw: I accept that, but I still think it best that the Care Quality Commission be left to use its judgment. If there were a succession of breaches, that would clearly ring alarm bells. If we are talking about a relatively minor breach of a registration requirement that had been quickly addressed, it seems unnecessary to put the Care Quality Commission under an

Column number: 291

obligation. Indeed, there may be some people—care home managers, for example—for whom there is no professional regulatory body. Putting that requirement in the Bill is probably not the best way to achieve the end that I think we all share: that the professional regulatory bodies, where they exist, be informed when they need to be.

Greg Mulholland: I appreciate that the Minister did at least come back with different arguments in resisting the amendment. I have a couple of brief points to make. Following those comments I am going to withdraw the amendment, but this is an important issue, which the Minister acknowledged. We should be mindful of this issue during the Bill’s passage and when the new regulatory framework comes into force, and we may need to revisit it in future, with the input of the Care Quality Commission and the professional regulatory bodies. It is better to be safe than sorry, and that is a clear principle, even if that means that minor incidents should be reported. My hon. Friend the Member for Romsey made a valuable point: where there is a series of minor incidents that might be missed, the amendment would increase the clarity of the framework, which is essential to the Bill. It would also provide a safeguard, which is why we tabled it. However, I appreciate the fact that the Minister has listened, and I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 35 ordered to stand part of the Bill.

Clause 36

Periodic returns

Question proposed, That the clause stand part of the Bill.

Mr. O'Brien: How often does the Minister expects the returns set out in the clause to be made? That question goes to the heart of the burden of bureaucracy.

Mr. Bradshaw: I am afraid that I cannot give that information at the moment; I apologise. The hon. Gentleman asked the same question this morning, I think, and I will endeavour to get back to him on it within the next few minutes.

Question put and agreed to.

Clause 36 ordered to stand part of the Bill.

Clause 37

Liquidators etc.

Question proposed, That the clause stand part of the Bill.

Mr. O'Brien: Another matter on which the Minister can help the Committee, whether now or in a few moments’ time, is that of liquidators. I suspect that he would be the first to agree that it would be helpful if the failure regime currently employed by Monitor was in front of both Houses when we consider the Bill and

Column number: 292

any regulations that may arise from it, particularly given that such regulations are subject to a negative resolution. I hope that he will be equally happy to make that failure regime available to the Committee.

Mr. Bradshaw: The hon. Gentleman is aware that the failure regime is still a matter for discussion; therefore, I am not in a position to provide him with it. However, I can tell him that the time frame he asked about is annual.

Question put and agreed to.

Clause 37 ordered to stand part of the Bill.

Clause 38

Death of registered person

Question proposed, That the clause stand part of the Bill.

Mr. O'Brien: What is the length of time envisaged to allow a surrogate to take on the responsibility of registration in the case of the death of a registered person, and will that surrogate be liable in the same terms as the original registrant?

Mr. Bradshaw: I am afraid that I will have to come back to the hon. Gentleman on that one, as well.

Angela Browning (Tiverton and Honiton) (Con): I had not expected to speak to this clause, but a case with which I have been dealing this morning has prompted me to ask the Minister to consider a particular set of circumstances.

That case—perhaps I should have tabled an amendment as a result of it—involves a learning-disabled woman aged 65 who has been in some form of care or residential care all her life, and who was in residential care in my constituency when the care home closed because of the owner’s age. No one else would take the care home on, so I negotiated with social services and they agreed to move the woman to Hampshire, so that she could live nearer to her only remaining relatives—they did not take on caring for her, although they obviously took an interest. Unfortunately, her carer died in her sleep quite unexpectedly in November, and as an interim measure she went to live with her brother and sister-in-law, who are older than her. Now that she is living with them, the Devon authority paying for her care says that that is where she should stay.

Obviously, I will fight this case through the county council. Is there any way in which we can, in the unfortunate and unexpected circumstance of the sudden death of a named carer, ensure that such an event does not trigger a change to the underlying entitlement to service that the service user had before? Perhaps that is an unfortunate case and I will get a good resolution, but I ask the Minister to consider the context of it. Clearly, Devon county council now sees the death of the carer as an opportunity to reduce its commitment to a lady whom it is paying for out of area.

Column number: 293

Mr. Bradshaw: As a fellow Devon MP, I fear that I am well acquainted with the shortcomings of Devon county council, as is the hon. Lady. I am not in a position now to answer for the exact legality of the situation that she describes, but I will endeavour to do so in some other form. It would be for the Care Quality Commission to decide how long a surrogate would have responsibility for registration, rather than for it to be set in stone in legislation.

Question put and agreed to.

Clause 38 ordered to stand part of the Bill.

---

Prepared 18 January 2008