The
Committee consisted of the following
Members:
Chair:
†Jim
Dobbin
†
Blenkinsop,
Tom (Middlesbrough South and East Cleveland)
(Lab)
†
Burns,
Mr Simon (Minister of State, Department of
Health)
†
Creagh,
Mary (Wakefield)
(Lab)
†
de
Bois, Nick (Enfield North)
(Con)
†
Dugher,
Michael (Barnsley East)
(Lab)
†
Johnson,
Diana R. (Kingston upon Hull North)
(Lab)
†
Jones,
Andrew (Harrogate and Knaresborough)
(Con)
†
Jones,
Mr Marcus (Nuneaton)
(Con)
†
Kawczynski,
Daniel (Shrewsbury and Atcham)
(Con)
†
Kelly,
Chris (Dudley South)
(Con)
†
Kirby,
Simon (Brighton, Kemptown)
(Con)
†
Munt,
Tessa (Wells)
(LD)
Shannon,
Jim (Strangford)
(DUP)
†
Smith,
Miss Chloe (Norwich North)
(Con)
†
Turner,
Karl (Kingston upon Hull East)
(Lab)
†
Twigg,
Stephen (Liverpool, West Derby)
(Lab/Co-op)
†
Whitehead,
Dr Alan (Southampton, Test)
(Lab)
†
Williams,
Roger (Brecon and Radnorshire)
(LD)
Annette Toft, Committee
Clerk
† attended the
Committee
Third
Delegated Legislation
Committee
Monday 26 July
2010
[Jim
Dobbin
in the
Chair]
Draft
Health and Social Care Act 2008 (Consequential Amendments No. 3)
Order
2010
4.30
pm
The
Minister of State, Department of Health (Mr Simon
Burns):
I beg to
move,
That
the Committee has considered the draft Health and Social Care Act 2008
(Consequential Amendments No. 3) Order
2010.
May
I begin, Mr Dobbin, by saying what a pleasure it is to serve under your
chairmanship? I have not had that privilege or pleasure previously, so
it is an added bonus for me.
The
Chair:
Thank
you.
Mr
Burns:
The draft order makes a consequential amendment to
the Water Industry Act 1991. That amendment is required as a result of
the implementation of a new registration system under the Health and
Social Care Act 2008. The 2008 Act set out a system of registration for
providers of health and adult social care, which the Care Quality
Commission operates. To manage the registration process, providers are
being brought into the new system in stages, the dates for which are
set out in the Health and Social Care Act 2008 (Regulated
Activities) Regulations 2010. As of 1 April, all NHS
providers were subject to the new system of registration, which will
cover private and voluntary health care and adult social care providers
from 1 October 2010. Those providers are currently
registered under the Care Standards Act 2000, so on 1
October, certain provisions in that Act will be repealed. One is the
definition of an independent hospital in England in section 2 of the
Act. A previous order, the Health and Social Care Act 2008
(Consequential Amendments No. 2) Order 2010, made some consequential
amendments to primary legislation using that definition. Unfortunately,
in that order the previous Government omitted an amendment to the Water
Industry Act 1991. That order was debated in the House in March 2010
prior to the general election, so this draft order, which makes that
amendment, will be issued free of charge. A further order, subject to
the negative parliamentary procedure, will make the necessary
amendments to secondary legislation. This second order has been laid
before the House
today.
Schedule
4A to the Water Industry Act 1991 contains a list of premises that
should not be disconnected for non-payment of water charges. Included
in that list is an independent hospital within the meaning of the Care
Standards Act 2000. Section 2 of the 2000 Act defines an independent
hospital as
“an
establishment”—
not being a health
service
hospital—
“the
main purpose of which is to provide medical or psychiatric treatment
for illness or mental disorder or palliative care; or…in which
any of the listed services are
provided.”
Those
listed services are set out in section 2 and include
“medical
treatment under anaesthesia…termination of
pregnancies”
and
certain cosmetic surgery.
An independent
hospital is also defined
as
“any
other establishment in which treatment or nursing (or both) are
provided for persons liable to be detained under the…Mental
Health Act
1983.”
As
the definition of independent hospital in the Care Standards Act 2000
will no longer be applicable in England, this draft order makes a
consequential amendment to the reference in the Water Industry Act
1991. It replaces the current cross-reference to the Care Standards Act
2000 and puts in place a new definition of independent hospital for
England. That new definition in effect replicates the detailed wording
that was included in the Care Standards Act 2000, as I have just set
out.
One
exception, which is one of the listed services previously mentioned in
the definition, is “prescribed techniques and
technologies”, which are currently prescribed under regulations,
but there will not be any separately prescribed techniques or
technologies under the new regulatory system. Most of the services that
would have been caught by “prescribed techniques and
technologies” will still be caught by the new provision, as
their main purpose is to provide medical treatment. The only services
that will not be caught are certain techniques used by beauticians for
cosmetic purposes. Those are not regulated activities under the new
registration system, and there is no reason to include establishments
that provide such services in the definition of “independent
hospital” as premises meriting protection from having their
water cut off for non-payment.
The amendment
will therefore ensure that the same kinds of premises that were
previously protected from having their water supply cut off continue to
be protected, but it does not rely on a cross-reference to the
definition in the 2000 Act; with effect from 1 October 2010, that
definition will not apply in England. The definition for Wales remains
unchanged. I commend the order to the
Committee.
The
Chair:
I remind Members that the debate should be
limited to the statutory instrument
itself.
4.35
pm
Diana
R. Johnson (Kingston upon Hull North) (Lab):
It is a
pleasure to serve under your chairmanship, Mr Dobbin. I do
not intend to detain the Committee for long as the Minister has set out
clearly the background to the order, but I have a few questions. Will
he confirm that the health care facilities mentioned in the order can
now have their water cut off for non-payment of bills? Has that
happened recently, and if so, how often and under what circumstances? I
also query the use of the term “independent hospital”,
which is not particularly helpful for the range of health care
facilities we are discussing. Could a different definition have been
used?
Mr
Burns:
The hon. Lady must bear it in mind that the only
reason we are discussing the order is that the previous Government
omitted that definition by mistake
in the original order, debated by the House in March 2000. If the
definition was suitable for the then Government in March 2000,
presumably, on grounds of logic and consistency, she should not be
upset by it now. I hope that that answer is of
assistance.
Diana
R. Johnson:
I thank the Minister for his response. I do
not want to engage in political ping-pong, as he and I have at heart a
concern for getting things right, and if a mistake was made we
obviously need to correct it. All I am saying is that the term
“independent hospital” does not serve us well when we are
discussing the range of services set out in the order, which include
cosmetic surgery and dental treatment. Perhaps it would be helpful to
consider whether that is the most suitable definition.
I seek
clarification on whether proposed new sub-paragraph 5, which sets out
the list of those providing health care, covers GPs’ surgeries,
care homes and nursing homes. Proposed new sub-paragraph (5)(a)
indicates that “medical treatment under anaesthesia” is
included, but dental treatment is included only when it is administered
under a general anaesthetic. Why are not all premises where dental
treatment is carried out included in the provision? Surely, dental
treatment cannot be carried out safely and effectively without access
to water.
Proposed new
sub-paragraph (5)(e) sets out that that protection is also to be given
to premises where cosmetic surgery is undertaken, except those premises
where procedures that do not count as medical treatments—ear and
body piercing, tattooing and so on—are carried out. I understand
the good public policy reasons for listing certain procedures that do
not count as medical treatments, but is that list exhaustive regarding
the practices that are excluded? A range of cosmetic procedures can now
be carried out—I am thinking of chemical peeling in
particular—that do not fit into any of the four categories set
out in proposed new sub-paragraph (5)(e). Might not one
expect cosmetic peels to be included in that list? Body-shaping is also
a cosmetic procedure, as I am sure the Minister is aware, in which a
local anaesthetic is used. Would that fall within the definition of
cosmetic surgery? I would be grateful for a response to those
questions.
4.39
pm
Mr
Burns:
May I begin by reiterating the definition of an
independent hospital? It is not a health service hospital; it is an
establishment
“the main purpose
of which is to provide medical or psychiatric treatment for illness or
mental disorder or palliative
care”,
or
it is an establishment in which certain listed services are provided.
Listed services include medical treatment under anaesthetic,
termination of pregnancies and certain cosmetic surgery. An independent
hospital is also defined as
any other
establishment…in which treatment or nursing (or both) are
provided for persons liable to be detained under the Mental Health Act
1983(4).”
The
hon. Lady asked whether the different types of medical establishments
were protected from having their water cut off by the Care Standards
Act 2000. In particular, she asked whether GP surgeries were covered.
If she looks at paragraph 5 of schedule 4A to the Water Industry Act
1991, she will find that the premises covered include
those
“used
for the provision of medical services by a registered medical
practitioner”.
She
also asked whether care homes and dental services were protected, and
the answer is yes. She further asked whether there were any services
that should have been protected but were not. The answer is that there
never was a question of how many had been cut off, because they were
all protected under the rules.
The hon. Lady
also asked about chemical peels. Let me assure her that they are not
included under cosmetic surgery as they are not a provision of
treatment for medical purposes, and the aim of the order is to maintain
the protection for those treatments that are for medical purposes. I
hope that that satisfies the hon. Lady, and that she and I have a
greater knowledge of some of the medical procedures that, I am ashamed
to say, I was unaware of before her incisive trail through
them.
Question
put and agreed
to.
4.42
pm
Committee
rose.
