Session 2010-11
Publications on the internet
General Committee Debates
Delegated Legislation Committee Debates

Draft Health and Social Care Act 2008 (Consequential Amendments no. 3)
Order 2010

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

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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”— 

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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

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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. 

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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.