We have heard contributions from Scottish MPs this afternoon, and I will dwell briefly on Scotland and other devolved Administrations. Scotland is punching well above its weight within the UK, demonstrating its strong science and research base. It receives about 11% of the total pot of research council, Innovate UK and higher education research capital funding, compared with its share in our population of about 8%. I was in Glasgow last week and was delighted to inaugurate the construction of a new £68 million imaging centre of excellence, to which the Government are contributing £16 million as part of the precision medicine catapult. The hub of that catapult is in Cambridge, but an

4 Nov 2015 : Column 368WH

important spoke in the operation is in Glasgow. I have had dengue myself, so I was pleased to hear about the good work on the treatment of that unpleasant disease being funded up in Glasgow.

I can give many other examples of good scientific activity in Scotland that are in receipt of significant public support, but I also want to mention Northern Ireland, as we have had contributions from some of its Members. We want to do more to help Northern Ireland secure support and be more competitive when applying for grants.

Danny Kinahan (South Antrim) (UUP): I apologise for not having been present to speak earlier, but I want to mention the numerous cuts in Northern Ireland as a result of the overall cuts. Will the Minister look at something similar to what we have in shared education, which is a £500 million loan facility? It could work with businesses and with how we do things in Northern Ireland, but be solely for science. In that way we could turn back the cuts that have happened, from primary schools right the way through to universities, which are still doing wonderful things.

Joseph Johnson: We want to help parts of the country that are receiving less than their share of science spend to be more competitive in the allocations of restricted funding. We have recently announced a process of science and innovation audits to enable areas to assess their potential fields of expertise, competence and excellence, so that they may focus on where they have a chance of being world-leading, globally excellent and more competitive. We look forward to helping consortia from Northern Ireland and other parts of the country—including universities, local enterprise partnerships and local authorities—to come together to assess where they can build on existing centres of excellence and become more competitive.

Government and Treasury investment in science goes much further than simply what the Department for Business, Innovation and Skills and its partner bodies do. Research and development tax credits have been mentioned a number of times, and they are extremely valuable and fast-expanding support for business investment. R and D tax credits are now worth £1.75 billion in relief to more than 18,200 companies, supporting more than £14.3 billion of innovative investment, as has been mentioned. In that context, I want to mention the patent box, a key initiative in making the UK tax regime competitive for innovative high-tech companies. It helps to drive growth and investment in the UK, creating high-value jobs in innovative industries. Some 639 companies have received benefits totalling £335 million since the relief was introduced in 2013.

UK science investments must be seen in perspective. We must look at the outputs of, as well as the inputs to, our science base. What I have described thus far is serious, substantial and robust investment, which has been delivering real results. We are the most productive science base in the G7, and our scientific impact on the world is out of proportion to our size as a nation and our level of investment. For every £1 spent by the Government on R and D, private sector productivity rises by 20p a year in perpetuity.

Government funding for science is only part of that story. Research and development in the UK also benefits from the private sector spending that the Government

4 Nov 2015 : Column 369WH

help crowd in. Business spending on R and D has risen by 8% to £18.4 billion. In a recent Westminster Hall debate secured by my hon. Friend the Member for Pudsey (Stuart Andrew), we heard about the important role of medical research charities, such as the British Heart Foundation. Charities receive additional support from the Treasury through gift aid on donations. On top of that, last year we spent £198 million from the charity research support fund.

Last year, Cancer Research UK reported gift aid income of more than £34 million. Overall in the past financial year, UK charities received £1.2 billion in tax repayments on gift aid donations. We have to look at direct Government spending through BIS and its partner bodies in the context of the bigger ecosystem that it creates. When we look at the bigger picture, we see that the UK’s overall spending on R and D reached £28.9 billion in the last year for which we have full data—up 7% on the previous year. That is an important context for us to bear in mind.

I will wrap up, so that the hon. Member for Penistone and Stocksbridge can conclude the debate. Debates such as this help to highlight the issues and choices involved in our responsibility to fund science. The UK science base is extraordinary; our cutting-edge research base is world-leading; our universities are world-class; we develop and attract the world’s brightest minds; and we have earned 14 Nobel prizes in the sciences over the past 12 years as a result. Science is one of our clear comparative advantages in the global race. BIS Ministers are working hard on making the strongest possible case to the Treasury. Our case will of course be balanced against priorities across Government, but we are hopeful that we have made the strongest possible case on behalf of science.

3.57 pm

Angela Smith: I thank the shadow Minister and the Minister for their responses. I particularly thank the Minister for pronouncing my constituency properly, because few people do. I also welcome the debate we

4 Nov 2015 : Column 370WH

have had and the strong consensus on the issue throughout the House, across all political parties. We have had some excellent speeches.

I go back to my big point, which is about how deeply embedded science is in our society and our everyday lives. Some of our most important innovations have become such a part of our everyday lives that we take them for granted. Stainless steel, for example, forms not only our cutlery, saucepans, washing machine drums and microwave oven liners, but hot water tanks and equipment for such activities as catering, brewing, distilling, food processing, and water and sewage treatment. Every part of our lives is affected by technologies such as the one that produces stainless steel. The key question, therefore, is whether as a nation we want to continue to play a leading role globally in scientific innovations that will shape the world of tomorrow, in the same way as our innovations in the past have shaped the world of tomorrow.

The Minister’s response acknowledged the Government’s role in underpinning our science base. He also made it clear that a capital commitment is already in place. The Campaign for Science and Engineering has made the point that if the cash ring fence is maintained, the loss in real funding will rise to more than £3.1 billion by the 2020 election. That amount would pay for four research institutes equivalent to the £700 million Francis Crick Institute being built in London—one for the north of England and one for each of the devolved regions. That point is well made.

According to the Minister, the Treasury has funded the science base well in difficult times. I acknowledge that, but the commitment to revenue to match the capital commitment made by the Government is important. The £400 million ISIS neutron source at Harwell will run for only about 120 days this year, instead of an optimal 180 days, because of the lack of revenue funding. That underlines the fundamental point of the debate. We did not quite get the commitments that we were looking for, but the Minister acknowledged our case implicitly. He has told us that he is arguing and fighting hard for science funding. We thank him for that—

Motion lapsed (Standing Order No. 10(6)).

4 Nov 2015 : Column 371WH

Wanless Review and the Dickens File

[Valerie Vaz in the Chair]

4 pm

John Mann (Bassetlaw) (Lab): I beg to move,

That this House has considered the Wanless Review and the Dickens file.

Valerie Vaz (in the Chair): Before the hon. Gentleman begins, I advise him and other hon. Members that, in line with the House’s sub judice resolution, no direct reference should be made to the substance of criminal or civil legal proceedings that are current—that is, those on which a judgment has not yet been issued or on which appellate proceedings are active. Clearly there are still police investigations current that relate to the matters that he intends to raise and I am sure that he is aware that the House would not want him to prejudice those investigations by anything he might say here today.

John Mann: Thank you, Ms Vaz. I assure you that I have no intention of prejudicing any investigations. I am keen to challenge those commentators who say that there is some big conspiracy to hunt out and name people who are innocent, and that everything has been overstated when it comes to historic child abuse. Some have got quite a track record in saying that. I would say to them: Rolf Harris, Stuart Hall, Max Clifford and the former Bishop of Lewes; 1,400 children in Rotherham, children in Derby, in Northampton, in Halifax, in Newcastle, in Oxford, in Telford, in Peterborough, in North Yorkshire and in Wrexham; bishops in Belgium, Norway and Austria—all over the world, there has been a spate of arrests and huge numbers of convictions of people involved in child abuse from the past, so those who say that this has somehow been dreamt up are factually wrong.

My involvement began in 1988 when, looking at corruption in the London Borough of Lambeth, I was told that when boys left children’s homes—boys over 16, therefore—they were being cajoled into prostitution. That was being done through various bars in the borough. There were suggestions about how and where, and that was all given to the police. I was told of a place that I had never heard of called Dolphin Square, which was one of the places where those boys were going to parties that involved Members of Parliament. I will refrain from giving the detail I was given. It was given to the police at the time and it has been given many times since. The police told me about a year into that investigation that somebody on high had curtailed the investigation—stopped it. I know; I was there. That is what happened.

Then, several years later, in 1994, Inspector Clive Driscoll, who was looking at a different, possibly related sex abuse scandal in the same borough came to see me. He was taken off his investigations and told to stop investigating. It now transpires that at Coronation Buildings in Lambeth in 1980 another police investigation was curtailed. In that case, special branch moved in to stop it. Therefore, we know that three separate investigations mysteriously disappeared and, in one case, I was there when that happened.

I have no intention of naming names, not because of the advice given, but because that is not appropriate. I do not know who is guilty. That is not my job. It is not

4 Nov 2015 : Column 372WH

the job of any MP and I have never done that. Let me therefore correct the record. One newspaper,

The Mail on Sunday

, suggested that I had named a Member of Parliament. That is factually inaccurate; it is not true. The story was fabricated. It was taken—I think as a spoiler—from a newspaper called

The Sun

, which said that two MPs had made various allegations. Not true. There are not two MPs and I am not an MP involved in doing that. If I was, I would not have named anyone; I would have given the evidence to the police and kept my mouth shut. It is fair to say that I have given information—evidence in some cases—to various police forces and some of that involved prominent people. I am not naming those people, I have not done that and I will not, because it is for the police to investigate and make a case for prosecution in the courts if they feel that is appropriate. My criticism and complaint is about where that does not happen. It is important that those matters are clarified immediately.

Look at the scale of what is going on. I believe there was a further arrest just this afternoon, but so far in north Wales a whole series of people have been arrested and jailed. That is also the case in other parts of the country. According to Simon Bailey, the chief constable of Norfolk constabulary, there are at the moment 89 national or local politicians, 145 radio, TV and film persons, 38 music industry persons and 15 people from the world of sport under investigation, as well as 2,016 others, including people from religious institutions, teachers and careworkers. That is what the police said to the Society of Editors on 19 October this year. Operation Pallial in north Wales has made over 40 arrests. In Lambeth, people have been jailed—in other words, they were successfully prosecuted. The idea that this stuff is in some way fanciful or made up is again not proven by the facts. The commentators who suggest that are wrong—very sadly wrong.

Let me talk about Nottinghamshire. A gentleman came to see me; he flew in from Canada for a 20-minute meeting—he had not been in this country for 30 years—about an allegation in relation to the Ashley House children’s home in my constituency, which he and I knew could not be prosecuted. It was not possible. For a 20-minute meeting—he flew in and flew out just to tell me that. He was not making it up.

The woman who claims to have been abused at Skegby Hall near my constituency and at various other locations is not making it up. The dozens of children at Beechwood in Nottingham who made detailed allegations are not making it up. Those who have come to me in relation to schools and churches or family abuse, including rape as young children, are not making it up. People do not go to their own MP and make this kind of thing up.

The man who came to me alleging that he, aged 11, was forced to work in a foundry full time, and before that, from the age of eight, was forced to work in a field, gave precise locations and precise names. He has a full file of precise records. He is not making it up; he is telling the truth about what happened. The whole issue of children being sold on to farms as slave labour is a scandal yet to emerge in this country. It is a part of this big, historic problem and more will emerge from that.

That is not the conspiracy. The conspiracy was the conspiracy of silence at the time—the conspiracy of connivance, the conspiracy of cover-up. That is the conspiracy. Do you know what the man who was enslaved

4 Nov 2015 : Column 373WH

wants more than anything? Strangely, because he never went to school, he cannot read and write, so he wants literacy lessons. This is my battle at the moment. I have a letter on it that arrived in the last hour from a county council that has given him five literacy lessons, questioning whether he needs more, when he was not allowed to go to school because he was enslaved. That is the cost of child abuse in this country.

This debate is about people like that man, who are living with this stuff today. There are people whose lives have been diverted, with many going abroad. Some have channelled it into great success, by being single-minded about their goals in life, but others are very damaged, and many lives have been totally destroyed. These campaigners are not going to go away, because they know what happened. I am fortunate. I was never beaten as a kid; I was not sold or raped as a child, but I have met lots of people who were. Some of the names are jaw-dropping. They are not going to go public, for lots of good reasons, and that is their choice, but the numbers coming forward and who have confided in me are extraordinary. They are not asking for anything to be done; they are supporting the campaign. They do not want to relive their trauma. The scale of the problem is absolutely phenomenal. I know there will be some sceptics about what I am going to say, and all I can say to them is, “Open your eyes and ears. See and hear what is going on.” What is under the surface will always be far bigger than what has emerged.

My approach is to give absolutely everything to the police. Material I have seen recently relating to the Dickens dossier incorporates stuff relevant to North Wales police and to other forces. I will not go into details, because that would prejudice those investigations, but there are dozens of documents that are hugely important.

There were two Dickens files. I have met someone who has not come forward because of the Official Secrets Act but who saw the first Dickens file. There were approximately 16 names in it; they were cross-party and not all were well known, but some of them were. That was the result of research done by Geoffrey Dickens. I do not know whether it is true or not, but I do not know that he gave the file to Leon Brittan in November 1983.

On 18 January 1984, a second person gave a second file to Geoffrey Dickens. I have a copy of that file, which I call the second Dickens dossier, and so do the police. The information in it was provided by two former Conservative MPs, Sir Victor Raikes, the former Member for Liverpool Garston, and Commander Anthony Courtney, a former British Navy intelligence officer and former Member for Harrow East. There was an internal battle going on within the Conservative party, specifically within the Monday club—they were both key figures in that—with a new organisation, the Young Monday club. They were part of that factional battle, and the second file emerged because of it. I do not think that they thought that what they described in the file as paedophilia was of particular importance other than for doing the other side in.

What is significant is the details, the allegations that were made and the fact that those allegations were not investigated. The file is unambiguous. I have an original. I have met, spoken to and got a copy from the person who personally handed it to Geoffrey Dickens, who in

4 Nov 2015 : Column 374WH

turn then personally gave it to Leon Brittan. In the first line, it says, “GK Young heads up a Powellite faction known as Tory Action.” George Kennedy Young, now long dead, was deputy director of MI6. The allegation is that he manipulated a group of people, and that, within that, there were paedophile rings. The file goes into detail about who it is alleged was involved and where. I will not give all the locations because I think some would be sensitive and might identify people, but London is one, Greater Manchester another, and North Yorkshire is a third. I should stress to any journalists listening, that Mr Leon Brittan is obviously not in that file, or indeed the other Dickens file. Geoffrey Dickens was not stupid. He did not give Leon Brittan a file that named Leon Brittan, but there are lots of other names in there.

The file is intriguing, to say the least. Information and allegations in it include allegations of sex with children, names of people alleged to be involved, and suggestions both of locations, including one precise location, and of a third-party organisation that was directly involved. I will not name that organisation. It will all come out—there is no reason why it should not—but it would not help the police if it came out today. It would be a pretty straightforward investigation for the police to look into the precise location that is in the file, but there was no investigation. The question is, why not?

It is worth saying one other thing about George Kennedy Young. He was involved in many dubious activities; he tried to get some kind of private army called “Unison” going. I have seen a range of background documents that would be of interest to anyone campaigning on the Shrewsbury pickets and on infiltration of the miners’ strike, with names that correlate. There are a lot of allegations about him attempting to undermine both the Heath and the Wilson Governments. He was clearly a manipulator, and is key to what was going on. I do not know why he is so prominent or why the Society for Individual Freedom, which he set up, is named in this, but he is a significant figure and that may give some sort of reason for why things then disappeared.

After the review by Mr Wanless and Mr Whittam, the Prime Minister said that their report meant that

“people who’ve been looking for conspiracy theories will have to look elsewhere.”

I am not looking for a conspiracy theory. To me, this stuff is fairly simple. There are always simple explanations. But we do not need to look elsewhere any more. I have here a copy of part of what I call Dickens dossier No. 2. It went to Leon Brittan at the time. We need to know why it then disappeared, what happened to it and where the Home Office investigation into it went. Why did the file disappear when such serious allegations are made within it? It is incongruous that there could be no investigation, given the information in here. It is not possible that this dossier would not raise all sorts of issues.

I could reveal more from other documents I have seen, from the same person, that suggest that quite a lot of people were aware of the issues, but it would be inappropriate. I am certain that some people who are named in the file were on the periphery—not involved in anything that could be described as child abuse, but a bit too close for comfort in terms of embarrassment—and they knew some of the sorts of things that might have been going on and had suspicions. I think those people are guilty of nothing other than a loose connection—being

4 Nov 2015 : Column 375WH

at various events or venues—but they know things. It is clear from correspondence I have seen that some of them must know things.

Part of the problem is that when we talk about paedophilia, most people think we mean under-16s. But at the time the term could be used in relation to 16 to 21-year-old men. With Dolphin Square and Lambeth, the issue is the allegations about Members of Parliament paying for sex with boys over 16 who had been procured from Lambeth children’s homes after they had left them. I would call that major sleaze, but at the time, it was illegal. The file also alleges things involving children younger than that. I do not know—I have not got a clue —whether any of it is true, or what bits are true, but there is sufficient information for a major police investigation.

That is why it is absolutely critical that the lid is lifted. We need to know where the file went, why it disappeared and what is going to happen now. The original is with the police. Why did the Home Office and the whole of Government fail to come up with that document, when it had been given to Leon Brittan in 1984? I think the answer to that question will unlock part of the cover-up of the time, explain it and help the police. It is imperative that the Government now reopen the Wanless and Whittam investigation to see why they were not given the file at the time by someone in the Home Office, and why civil servants at the time did not co-operate.

4.19 pm

The Parliamentary Under-Secretary of State for the Home Department (Karen Bradley): It is a pleasure to serve under your chairmanship for the first time, Ms Vaz. I congratulate the hon. Member for Bassetlaw (John Mann) on securing the debate and on the points he raised. He has been a tenacious and very determined campaigner on this matter.

Before dealing with the specifics of the Wanless review and the Dickens file, it is important to highlight that tackling child sexual abuse is a top priority for this Government. Victims should, and increasingly do, feel able to come forward to report abuse to the police and get the support they need. We have been consistently clear that when an allegation of child sexual abuse is made, whether it occurred now or in the past, it must be thoroughly investigated by the police, so that the facts can be established. Let me be clear: the Government are determined that forces should do everything they can to bring perpetrators of child sexual abuse to justice. Child sexual abuse now has the status of a national threat in the strategic policing requirement, meaning that forces are able to maximise specialist skills and expertise in both preventing and investigating allegations of offending. Police forces and police and crime commissioners must have the capabilities they need to protect children from sexual abuse.

It is sadly only too true that in the past, these horrific crimes were not always given the priority they should have had. We are appalled that abuse was allowed to proliferate in the very institutions where children should have been most protected: schools, hospitals and care homes. Child sexual abuse is now rightly centre stage as an issue that we must confront. I want to be clear—the hon. Gentleman alluded to this—that it is incredibly important that victims feel they can come forward, and will be listened to and believed.

4 Nov 2015 : Column 376WH

Tackling this issue is a shared effort. The “Tackling Child Sexual Exploitation” report, published in March, sets out the national policy response to the failures seen in towns such as Rotherham, Manchester and Oxford. Collectively, the actions in that report will: strengthen accountability and leadership in professions and local government; address the culture of inaction and denial that led to victims being dismissed and ignored; improve joint working and information sharing, so that agencies intervene early; strengthen the protection of children who are at risk; reinforce law enforcement efforts to stop offenders; and provide greater support for victims and survivors. It is a wide-reaching and ambitious programme of work, driven forward at pace by an inter-ministerial group chaired by my right hon. Friend the Home Secretary, who shares my deep personal commitment to this important work. I am sure that that broad range of activity will confirm to the hon. Member for Bassetlaw that this Government are absolutely committed to learning from the failures of the past and ensuring they do not recur.

In that context, I turn to the so-called Dickens dossier and the Wanless and Whittam review, which the hon. Gentleman spoke about. It may be helpful if I set out the circumstances and findings of that review. In July 2014, my right hon. Friend the Home Secretary and the Home Office permanent secretary approached Peter Wanless, chief executive officer of the National Society for the Prevention of Cruelty to Children, and Richard Whittam, QC, to ask them to conduct a review of two independent investigations in respect of information the Home Office received about child sexual abuse between 1979 and 1999. Peter Wanless and Richard Whittam, QC, were chosen as esteemed, highly experienced and knowledgeable individuals in the field. Their review and findings were published last November.

The Wanless and Whittam review focused in part on how the Home Office responded to information relating to the Dickens file, as well as how the police acted on any information passed to them at the time. As referenced in their report, Peter Wanless and Richard Whittam, QC, were given free access to the Home Office’s filing system. They also undertook wider searches in other Departments and agencies, and their requests were complied with. Among their conclusions was the following statement:

“It is very difficult to prove anything definitive based on imperfectly operated paper records system at 30 years remove.

Whilst a sophisticated cover up would be unlikely to leave papers in the general registry system of a major Government Department, extensive searches of paper records for the period, well beyond the Home Office itself, have not uncovered any evidence of organised attempts by the Home Office to conceal child abuse, either in specific documents retained by them or others, or through an obvious pattern of destroyed files.”

Their work shows that the original reviews did not cover anything up, and it neither proves nor disproves that the Home Office acted inappropriately. Likewise, they do not prove or disprove that public money ever found its way to the Paedophile Information Exchange, but they make clear that they saw

“no evidence to suggest PIE was ever funded by the Home Office because of sympathy for its aims.”

Wanless and Whittam made three sets of recommendations for the Home Office, all of which related to how the Department dealt with sensitive allegations, how officials passed such information on to the police, and how the details of those allegations were

4 Nov 2015 : Column 377WH

properly recorded. The permanent secretary accepted all three sets of recommendations, and the Home Office has undertaken considerable work to implement them in the year since the report was published.

I congratulate the hon. Member for Bassetlaw on locating material that he believes constitutes the so-called Dickens dossier. I am unable to offer an explanation as to why he has apparently been able to locate those documents when the Home Office has not. I can only refer to the outcome of the diligent work by Mr Wanless and Mr Whittam, who met with the hon. Gentleman during their review. I reiterate that neither they nor the previous independent reviewer were able to identify a Dickens dossier within the Department’s holdings.

I am grateful to the hon. Gentleman for passing whatever information he has to the Metropolitan Police Service. It is not for the Home Office, or for me in my role as Minister with responsibility for preventing abuse and exploitation, to comment on or intervene in individual ongoing investigations. As such, I will not comment or speculate on what might be in those papers. It is right and proper that any material relevant to the matter or any allegation of child sexual abuse be passed to the police so that it can be properly investigated. I congratulate the hon. Gentleman on doing just that. I understand the police are reviewing the documents passed to them, and I look forward to hearing the outcome.

As I said, it is vital that victims and survivors report the abuse they have suffered so that it can be investigated and the truth can be established. The Government are determined that no stone shall be left unturned in pursuit of that aim. That is why my right hon. Friend the Home Secretary has established an independent

4 Nov 2015 : Column 378WH

statutory inquiry on child sexual abuse. The inquiry will challenge institutions and individuals without fear or favour, and will get to the truth. Justice Goddard is leading the inquiry’s important work, and is grasping this once-in-a-generation opportunity to expose what has gone wrong in the past and learn lessons for the future. The right place for further consideration of the Home Office’s or other institutions’ handling of the so-called Dickens dossier and other non-recent abuse allegations is the inquiry, which is free to consider evidence from any point in the past without restrictions and has the power to compel witnesses and call for evidence.

We are committed to the inquiry having the full co-operation of Government and access to all relevant information, including secret information where appropriate. Although it would not be appropriate to give a blanket undertaking that people who have signed the Official Secrets Act will not be prosecuted for reporting information relating to possible child sex abuse offences, the Attorney General gave an undertaking on 15 June that no document or evidence provided to the inquiry would result in, or be used in, any prosecution under the Official Secrets Act, or any prosecution for unlawful possession of the evidence in question.

Finally—I cannot emphasise this point enough—the Home Secretary has been clear that it is vital that the whole Government fully co-operate with the inquiry on its important work. All Departments must and will ensure that they have the systems and processes in place to do so. I assure the hon. Member for Bassetlaw that the Government are determined to uncover the truth. We must all work together to ensure that the inquiry is able to do so.

Question put and agreed to.

4 Nov 2015 : Column 379WH

Care Homes (Regulation)

4.30 pm

Peter Heaton-Jones (North Devon) (Con): I beg to move,

That this House has considered regulation of care homes.

It is a pleasure to serve under your chairmanship this afternoon, Ms Vaz. The purpose of today’s debate is to highlight what I believe to be serious shortfalls in the current system for the regulation, inspection and investigation of private care homes and nursing homes. At the moment, I believe, quite simply, that we are letting people down—the people who are least able to speak up for themselves. They are the estimated 300,000 older people who currently live in around 17,000 registered care homes in England. Their average age is 85 and a significant proportion suffer from dementia. They are people largely without a voice and that, I believe, needs to change.

Two and a half years ago, some time before being elected to this place, I was contacted by a constituent in North Devon. He told me the very moving story of his mother, a former resident at a private care home, who had died in 2009. Her son believed then, and still believes to this day, that there are serious questions about the care that she received in the final months and weeks of her life.

In the following years, my constituent has pursued all the avenues open to him to have his mother’s case fully investigated. Invariably, though, he hit a brick wall, so he began to look beyond his individual case at the more general question of how care homes are regulated and complaints investigated. He came to the conclusion that the current system is simply not fit for purpose. It is a conclusion that I share, which is why I sought today’s debate.

Let me stress that this debate is not about my constituent’s individual, specific case. I do not seek to reopen it nor to raise any questions about the standard of care in that establishment today, six years on. Indeed, last night, I spoke to a senior director at the home’s parent company to give her that assurance, which she accepted. However, my constituent’s individual case is the starting point. That is how it must be, because at the heart of this issue are people, and we must always remember that when we talk about systems, institutions and processes. It is the people who matter, and at the moment, I believe that we are letting them down.

To seek evidence for that, we have to look no further than the website of the Care Quality Commission, the body that currently has responsibility for the regulation and inspection of care homes. Today, that website tells us that of the 700 care homes most recently inspected by the CQC, a staggering 44% have been rated as either “Requires improvement” or “Inadequate”. There is no reason to believe that those figures are unrepresentative of the sector as a whole, so that means that four in 10 of all establishments are not currently reaching the required standard. Surely the purpose of any system of inspection and regulation must be to drive up standards. Those figures alone, therefore, suggest that currently the system is simply not working.

Let us look at that system, because it has undergone some significant changes in the recent past, and indeed it still is undergoing change, even as we speak today. It seems to be a process, however, that in its fluidity is

4 Nov 2015 : Column 380WH

encountering considerable difficulty. We are in a flexible mode, I think it is fair to say, as far as the CQC’s arrangements are concerned.

In June 2013, the CQC issued a consultation called “A new start”, which proposed a whole new approach to inspection across all sectors, including care homes. That approach was confirmed in October two years ago, and the new provider handbook for residential care came into effect from 9 October last year. In April this year, the CQC introduced a special measures regime, as it was called, for failing services. However, it is clear that there are problems in the implementation of some of those new processes.

The CQC’s most recent publication, which was published as recently as 28 October, is called “Building on strong foundations”—I have a copy here, hot off the press. It sets out

“some of the choices it faces in responding to changes to how health and social care is delivered”.

Well, it must face some pretty tough choices, because it is pretty clear that what it seeks to do in changing its processes is not fully working.

Let me quote an article from The Guardian, which I admit is not one of my usual media choices. The columnist, Michele Hanson, wrote on 28 September this year:

“Do you fancy being a CQC inspector? You can. Anyone can. You don’t have to be a social care expert, just have a six-week induction course. And luckily, once you start inspecting, you don’t have to inspect everything. You can just inspect a couple of the Key Lines of Enquiry (KLOE), because they’re not all mandatory.”

The article goes on to say:

“You can leave out management of medication, or quality of life, or complaints, and you can inspect different KLOEs in different homes, which means you can’t compare”

what is good and what is not good. She concludes:

“Which is perhaps why our local care home, rated ‘excellent’ by CQC”

was exposed on the television a short time afterwards

“over the fearful abuse of one resident”.

Clearly, something is wrong with the system. What is the cause of that? It seems, as I said, that the CQC has encountered particular problems recruiting sufficient expert inspectors. In July this year, the National Audit Office found that just 9% of care homes have so far been assessed, because of a shortfall of 160 inspectors. Indeed, the February 2016 deadline to complete the work has now been pushed back to next October.

I have a great deal of respect for the many hard-working staff at care homes and at the CQC. Those at care homes in particular receive low wages for a job that I would never want to do. I also have some sympathy for the many care home providers who are having to cope with the ever-changing regulation regime. The goalposts are constantly moving, and it is costly for those care home providers to comply with the system. Care homes have to pay to be registered by the CQC, and, depending on how many residents they have, the cost can be anything from £276 to more than £13,000 a year. It is fairly obvious where those costs are going to be passed on to.

Let us make no mistake. In cases where something goes wrong, it is the care homes and the people who own and manage them who bear the ultimate responsibility for getting things right, but the regulatory framework

4 Nov 2015 : Column 381WH

that we—the state—impose has to help them, encourage them, and yes, force them to improve. At the moment, it does not.

Julian Knight (Solihull) (Con): My hon. Friend is making a powerful case and is clearly a strong advocate for fairness and transparency in the care home sector. On whether providers are being managed in the right way by the CQC, is not the point that they have said to Department for Business, Innovation and Skills that they feel that they are being asked to provide paperwork and not care, and that there is sometimes duplication between the local authority and the CQC in how the sector is regulated?

Peter Heaton-Jones: My hon. Friend makes an extremely good point. This must be about the elderly people who are in the care homes. They must be the entire focus of those who work in, manage and own those care homes, not the bureaucracy and the paperwork.

Andrew Percy (Brigg and Goole) (Con): I congratulate my hon. Friend on securing the debate, and it is a pleasure to serve under your chairmanship, Ms Vaz. You will remember that we looked at this issue in the Select Committee on Health in the last Session, as will the shadow Minister. We welcomed the new inspection regime, but I seem to remember that one criticism we had in discussions in the Committee related to the fact that we are dealing with often very elderly, very frail people who cannot speak for themselves, and one thing that the CQC could perhaps do better is engagement with families. That is not just after an inspection, when everything is all right. It needs to ensure that family members of those in care homes understand what the inspection regime is and how they can engage with it before, after and during the process. Although some of the changes have been positive and there is now perhaps better regulation in England, the people whom we ask to give feedback are often not able to speak for themselves, so we need to engage families much better.

Peter Heaton-Jones: My hon. Friend makes an extremely pertinent point, and I will talk about some challenges in the entire system when it comes to engaging with people. As he rightly says, people have difficulty in understanding the best way to engage with the system.

When things go wrong and a member of the public needs to raise a complaint against a care home, I am afraid the system becomes even less satisfactory. The CQC’s website says that it

“is unable to investigate individual complaints”

against providers. So how does someone complain if something goes wrong and they are worried about the care that is being given to an elderly relative in a care home? It is difficult. What can someone do if they fear that an elderly relative is being neglected, mistreated or not given the right healthcare, or if they fear that their relative’s life might even be in danger and the care home provider has dismissed the complaint or will not listen to it? The CQC has that said it will not handle individual complaints, so should they go the Parliamentary and Health Service Ombudsman? No, because the ombudsman says:

“By law, the Ombudsman cannot look into complaints about privately funded healthcare.”

4 Nov 2015 : Column 382WH

If someone tries to go to the ombudsman they reach a brick wall. The CQC will not handle individual complaints and the ombudsman does not accept them. There is one possibility: an organisation called the Independent Healthcare Sector Complaints Adjudication Service. The ombudsman’s website states that “you may”—I stress “may”—

“have the option of going to the Independent Sector Complaints Adjudication Service…which represents some independent healthcare providers.”

If someone’s healthcare provider is not one of them, they are stuck.

The system is bewildering. It lacks accountability and transparency, and would leave most people confused and frustrated. How are people in care homes supposed to deal with that bewildering system? They may be vulnerable, old and frail and perhaps suffering from dementia. Their loved ones might put all their time and energy into caring for them, but how are they supposed to navigate the system? It needs to change.

What changes am I proposing to try to put right some of the issues I have highlighted? Despite the best efforts of the CQC—I say again that this is not a criticism of individuals at the CQC, much less those who work in care homes—I am afraid that, as currently manifested, it is simply not fit for purpose when it comes to the regulation, inspection and investigation of standards in care homes. Its focus recently has rightly been on NHS hospitals and providers. In light of the Mid Staffordshire scandal and the findings of the Francis report, that is hardly surprising—indeed, it is right—but the unintended consequence has been insufficient focus on the private care home sector.

In the short term, we must hold the CQC to account and insist on significant improvements now, because the situation needs to be addressed immediately. In the long term, it seems to me that the solution is to create a new, single, dedicated body whose sole responsibility is the registration, regulation and inspection of private care homes. Crucially, that body should also be the first point of contact for anyone wanting to raise a complaint about a specific establishment or the care of an individual patient. It would have the responsibility and necessary powers and resources to investigate those complaints thoroughly and rigorously, and in real time.

At the moment, if someone has an immediate concern about the care being given to an elderly relative and the care home either disagrees or denies that there is a problem, there is nothing to be done and nowhere to turn. That could be a matter of life and death. It needs to change, and it needs to change urgently. When things need to be taken further, we need a complaints system that is easier for the public to access and more transparent, and whose findings are accountable to Parliament in individual cases. The current complaints infrastructure is bewildering and is just not working.

My constituent to whom I referred at the start of my speech has lived with the problem for the past six years. Over that time, he has invested a great deal of work, research and thought in it. It has been his life, and it has undoubtedly been part of the grieving process for his mother. He has produced a document that is the product of a lot of work, and I have it here. It contains 24 very detailed points, questions, proposals and recommendations. He is frustrated that despite his best efforts and with a

4 Nov 2015 : Column 383WH

few notable exceptions, the issue has been largely ignored by the media and not given sufficient focus by politicians. That is something I want to put right today.

In the many hours my constituent and I have spent discussing the issue, we keep coming back to one thing. It is not about processes, systems or organisations, it is about people—people who do not have a voice in a system in which, let us remember, four in 10 care homes currently fail to reach a satisfactory standard on the CQC’s own measures. That means that people—vulnerable, sick and elderly people—are not being properly cared for. That cannot be right. We must do something about it. I believe we have a moral duty to do something about it, and that we must act now.

4.46 pm

Jim Shannon (Strangford) (DUP): Thank you for calling me, Ms Vaz. I congratulate the hon. Member for North Devon (Peter Heaton-Jones) on bringing this topic to Westminster Hall, setting the scene and explaining its importance from his personal experience and knowledge.

Care homes should and must provide care and services to some of the most vulnerable in society. I believe and the House believes that those who have worked hard and have contributed to society and the economy all their lives deserve appropriate care and dignity in their old age. We have the opportunity to be a voice for those who cannot be a voice for themselves. That is the issue the hon. Gentleman has brought to the House today. The people involved are often at the fringes of society and are of all ages. Many people in care homes do not have immediate family and that is another concern. We read stories in the press and we may be suspicious of them, but they illustrate the problem. There is no smoke without fire, so if there is a story in the press there must be at least some truth in the story.

Some people may be physically unable to look after themselves, including those who are elderly or have learning difficulties, dementia or Alzheimer’s. They deserve the very best care in care homes and their families need the assurance that they are well looked after. If someone has dementia, Alzheimer’s or a physical disability, they deserve the same treatment and care as others to ensure that their meals are correct and that they are given a wee bit of time, compassion and understanding, as the hon. Gentleman said. It is imperative to do all we can to protect those in care homes and to ensure that they receive the care and dignity they deserve.

I welcome the opportunity to question how the Government intend to improve regulation of the industry so that the people who are cared for are protected. I am always a bit suspicious of statistics—as the saying goes, there are lies, damned lies and statistics—but they are clear. Only 64% of care service providers in England are registered with the Care Quality Commission, so there is a question to be answered. I have great respect for the Minister’s understanding and I think the world of him, so I am sure that in his response we will hear the compassionate understanding that he feels personally and as a Minister. I look forward to that.

The Care Quality Commission monitors and regulates care organisations to ensure that they are continuing to meet national standards, and herein we encounter the first issue about regulating care homes. We need to press for much higher levels of registration if we are even to think about improving regulation. We cannot improve

4 Nov 2015 : Column 384WH

regulation if we do not have registration. I hope that we can make higher levels of registration a key part not just of this debate, but of the Government response. We cannot improve regulation if 36% of care service providers are not registered with the main body for monitoring and regulating the industry. Indeed, we should express immediate concern about whether those unregistered care providers are up to the national standard. I am not saying that they are not, but Government observation and monitoring is needed to ensure that they are.

Last year, following years of scandals, the Care Quality Commission announced that it would reinspect all care services and then rate them individually. We do not want to go into too much detail about the most horrible stories and incidents, but they do resonate with all of us as elected representatives. Care homes judged to be inadequate would be shut down and their directors banned from working in such positions again.

Andrew Percy: The hon. Gentleman is making a very important speech. He references the examples of abuse, mainly involving physical abuse, that we have heard about. Does he share my concern that in other care homes the problem is not physical abuse, but people not receiving proper nutrition? It is a national scandal that £13 billion of NHS money is spent every year dealing with poor nutrition, much of it in the elderly population. There are no doubt some very good nursing homes and care homes, but the quality of the food in homes often contributes to the decline of residents, and the CQC needs to get a handle on that as well.

Jim Shannon: I thank the hon. Gentleman for his intervention; he is right. I tried to make the point earlier about the food that residents eat and its nutritional value, and about the time that may need to be spent looking after someone and feeding them. I thank the hon. Gentleman for highlighting another very important issue.

The National Audit Office found that just 9% of services had been assessed as of July this year, despite the deadline for inspections being February next year—a deadline that has been pushed back. Obviously, the February deadline cannot now be met, because 91% of homes cannot be inspected in that time, but perhaps when the Minister responds we can get an idea of a new deadline in relation to the inspection regime.

However well intended the Care Quality Commission system is, there are clear failings in the current way of doing things, and today’s debate gives us the opportunity to discuss the way ahead in terms of improving the poor rate of inspection. The right hon. and hon. Members who are here will illustrate that very clearly. Concerns have been raised across the political spectrum, both in newspapers and by political representatives, and I hope that the solution to those concerns can also be found on a cross-party, bipartisan basis. After all, this matter concerns us all. It is not a matter of scoring points—it is never that with me anyway, but it certainly is not with anyone in this debate, because we all have the same focus and commitment to delivery of the same level of care and to ensuring that all homes reach a certain level.

We have had many issues in the past in Northern Ireland. I know that this is a devolved matter and the responsibility of someone else, but having the appropriate protection and regulation is so important to ensuring

4 Nov 2015 : Column 385WH

that abuses are not happening. The historical and the up-to-date abuse cases that we see in the papers need to become a thing of the past.

We can come together from both sides of the House, set the right course, address the issues and hopefully, through the Minister and the shadow Minister, the hon. Member for Worsley and Eccles South (Barbara Keeley), provide some direction in relation to the solutions. I hope that my contribution and the issues I raised have been noted by the Minister—indeed, I know that they have been—and that they will prove useful to eliciting a strategy and a response from Government to ensure that this matter is addressed correctly as a matter of urgency, as the hon. Member for North Devon said, and to the best of our ability.

Several hon. Members rose

Valerie Vaz (in the Chair): Order. I intend to start the winding-up speeches at 10 past 5.

4.54 pm

Anne Marie Morris (Newton Abbot) (Con): Thank you, Ms Vaz. I shall endeavour to speed through my comments. First, I commend my hon. Friend the Member for North Devon (Peter Heaton-Jones). We are both MPs from the south-west, and our constituencies have a significant number of elderly residents and therefore of care homes and nursing homes. The issue he raises is crucial, but perhaps I can take the opportunity to broaden the debate, because I believe that the problem is not as simple as just the CQC. Many of his points about the CQC were well put, but this is a broader challenge.

I shall start by explaining that nine statutory bodies—all independent and all accountable to Parliament—are overseen by the Professional Standards Authority for Health and Social Care, so it is a question of looking not just at the CQC, but at all those bodies together. You can appreciate, Ms Vaz, that nine bodies will inevitably have various sets of regulations, which will not necessarily be consistent and work well together. Indeed, the Professional Standards Authority report in 2015 made it clear that the regulatory framework was unfit for purpose.

However, this is not just about the regulatory framework; it is broader than that, too. Rules and regulations do not make people good. Regulation is about trying to ensure best practice and that those who default are made to sort the situation out. As my hon. Friend said, too much bureaucracy takes the care out of caring, and this is really about care. It should not be about bureaucracy —box-ticking. It should be about ensuring that elderly residents are properly respected and cared for.

The Professional Standards Authority has concluded—unsurprisingly, given its oversight of nine authorities—that less is actually more. It suggests that we need a new framework and that we should look at sharing objectives across all the regulators and sharing the theories of what works so that there is a consistent approach. Most importantly, we should rebuild the trust among the professionals, the public and the regulator, because at the moment there is an awful lot of mudslinging among the three and that is not helpful. What we need is a good system that works for our society. We also need proper risk assessment models to ensure that we are looking at the things that really matter and actually put residents at risk.

4 Nov 2015 : Column 386WH

There are, inevitably and tragically, many cases that none of us want to be repeated. It almost goes without saying—my hon. Friend has already made it clear—that there are plenty of examples. Indeed, the statistics demonstrate that there is clearly something wrong. The report “The state of health care and adult social care in England 2014/15” showed that 60% of providers found to be inadequate were not improving, so there is clearly something not quite right. In Bedfordshire the Old Village School home managed to go from “good” to closure within six months; previously it had been excellent. There is clearly something at the root of this that is not just about regulation and bureaucracy, but is more fundamental.

Before I move to that broad picture, I have a couple more thoughts on the Care Quality Commission itself. I have met Andrea Sutcliffe on a number of occasions and I believe that she is cognisant of and takes seriously the concerns raised by my hon. Friend. However, there is a challenge, which is that the remit of the CQC was expanded to cover so much that in reality it is almost inconceivable that it could do the job properly, to the right standards, given how stretched it is. Indeed, in its own survey in 2014, 40% of CQC staff felt that they were not adequately trained. There is clearly a challenge—about regulation, about structure and about asking an organisation to do more than realistically it is capable of doing. If that is the case, we should not be surprised when things fall apart.

There was an interesting comment, however, from the National Audit Office. It said that the CQC does not know whether its model for predicting staff numbers is accurate enough. That, for me, goes to the heart of the matter. We can have as much regulation as we like, but if we do not have staffing right—if we do not have the right numbers or the budget to pay for them—inevitably, there will be huge problems.

I have looked at the care home reports for Teignbridge District Council in my constituency. The new regime and the five new tests came into play April this year, and the new tests are absolutely on point: the home must be safe, efficient, caring, responsive and well led. That is absolutely right. Twenty-one of the 70 care homes in the area have been inspected and 10 have been found to be good. I share my colleague’s concerns about the homes that were not found to be good, but I took to reading the reports to find out what they actually said. Although the reports covered 10 or 15 different areas, if I dug down to the root causes I found that they were really about staff and the adequacy of both numbers and training.

I meet people from my care homes regularly, every three months, and they tell me that if hon. Members do as I did, they will reach a similar conclusion—that it is a real challenge to find the managers needed to run the homes. Without those managers, the homes are found wanting but they have no ability to resolve the problem. There is a similar challenge in the shortage of nurses. Being a nurse in the care home sector is much more challenging, I think, than being a nurse in the NHS. Care home nurses often work on their own at night, whereas a nurse in an NHS hospital will be surrounded by lots of colleagues. In the care home sector, nurses often work with difficult individuals who have complex problems, often including dementia, with all its attendant behavioural complexities.

4 Nov 2015 : Column 387WH

The feedback from those responsible for care homes in my constituency conveys much frustration. They understand the role of the CQC, but they feel deeply frustrated that they cannot always put right the things that are found to be wrong. That must be incredibly frustrating. They feel that there needs to be a new balance between scrutiny and support. Although they feel it is right that they are properly scrutinised, they also feel that there is a lack of support. I had the pleasure of talking to the Minister only yesterday, and he was at pains to tell me that the CQC was indeed endeavouring to provide such support. I said to him then, and I will repeat it today, “They don’t see it and they don’t feel it.”

In the old days, under the CQC’s predecessor, care homes received guidance as well as criticism. Because of the desire to separate the two, which I can understand conceptually, they now feel as though they are left on their own. I am proud of our Devon homes, because we have produced our own kitemark for dementia care, as a result of which the homes work together, peer review each other and provide their own training schemes. I think that that is a good way forward.

For me, the big question is: are we looking at everything that impacts the system that endeavours to provide care in care homes and nursing homes? I do not think that we are. There is a big piece missing—the commissioning. At the moment, we review and scrutinise the provision of care, but we do not scrutinise the commissioning done by local authorities and unitaries. If they do not get the commissioning right and ensure that the right providers are providing what is needed, the system will fall down. I have, for example, seen individuals placed in care homes who should be in nursing homes because they have needs that are well beyond the capabilities of a non-nursing care home. That is something that must be critically and urgently addressed.

I am also concerned that we should look in a fair and balanced way at what we are paying our providers. At the moment, commissioners are not in any way held to account for what they pay providers. There is no standard review of the pricing across the country. If pricing is worked out on an ad hoc basis, the amount of money that local authorities pay their providers will vary across the country. At the end of the day, however, although there will be minimal differences in some staffing costs, by and large the costs will not be as diverse as the pricing structure indicates. There needs to be a proper analysis of the prices paid and what we are getting for the money. Are we getting tin tacks, or are we getting platinum? Is the situation as diverse as I fear it is? As a civilised society, we need to determine what we should be giving our citizens, and we need to ensure that that is delivered consistently across the country. The failure to do so will give rise to safeguarding issues.

My final point on commissioning is that we should separate commissioning and provision. At the moment, a local authority can do both, so there is a potential conflict of interest. I am conscious of the fact that time is not in my favour and you would like me to move on, Ms Vaz. I have made most of the points that I wanted to make, so I will just say that dealing with that is a key issue. Regulation is only part of the problem. As the sun slowly comes out, we need to start to fix the roof, and this has to be a key part of that process. We need a proper system of care, not merely compliance. It needs to be properly funded, and staff need to be properly trained.

4 Nov 2015 : Column 388WH

5.5 pm

Andrew Percy (Brigg and Goole) (Con): I will be very brief, because I have already made the points I wanted to make about nutrition, and about family involvement and engagement in the inspection process. I congratulate my hon. Friend the Member for North Devon (Peter Heaton-Jones) on securing this debate on a subject that has always bothered me in my other role, which members of the Health Committee have heard a lot about, as a volunteer first responder with the ambulance service in Yorkshire. In that role, I have spent a lot of time in care homes, and there is a real mix of standards.

There are two things worth raising with the Minister that bother me and that, I hope, broadly come within the scope of this debate. One is the quality and dignity of care for elderly patients in care homes. When they need to be taken to hospital, they are often, sadly, taken on their own. I remember watching a very elderly lady who was having a suspected stroke on a hospital trolley at Scunthorpe hospital. She was alone and obviously very distressed. The ambulance crew were doing the best that they could, but they were booking her in and all the rest of it. I remember looking at her and thinking, “I would not want that to happen to my grandma.” That happens too often.

The second point is about the need for an understanding of palliative and end-of-life care in care homes. That is an issue of training and standards. I have been called to care homes where I have had to try to resuscitate people who are clearly at the end of life in a very unpleasant situation. We must get better at that, because we know what inevitably happens to many people in care homes before they even get to nursing homes, so proper training must be given. In that respect, proper standards of care and the quality of training of people working in care homes are in desperate need of improvement. In some areas and some care homes, those things are very good. I have a wonderful care home in my constituency, which has a cinema and a hairdresser, and it is lovely to go into. It does not have some of the problems found in other care homes. People have to pay for that, however, and only those who can afford to do so get it. Too many people cannot afford that, so they do not access the same quality of care or staff training. I hope that the Minister can respond to those two brief points.

5.8 pm

Natalie McGarry (Glasgow East) (SNP): It is an honour to serve under your chairmanship, Ms Vaz. I congratulate the hon. Member for North Devon (Peter Heaton-Jones) on securing this important debate. Ensuring that our older people, and those of a younger demographic who have complex needs, have access to high-quality care is a vital role and duty of any Government, and I am pleased to have the opportunity to contribute to the debate. Across the political divide, and in all parts of the UK, our older people deserve comfort, dignity and decent care. Many important points have been raised, and I think we all agree that strong regulation must be in place to ensure that care facilities that provide vital support meet the highest possible standards. With an increasingly ageing population, that is a necessary consideration that transcends party politics. It is not for me—a Scottish National party MP for a Scottish constituency and a spokesperson for the party—to dictate English policy on a matter that is devolved to Scotland,

4 Nov 2015 : Column 389WH

but I hope that by sharing the approach we have taken in Scotland, I can help to inform the debate and show some examples of best practice.

Members have contributed thoughts and experiences from their constituencies. The hon. Member for North Devon made the important point that we are talking about people, not merely systems and processes. He was a powerful advocate for our agreeing to ensure quality care for everyone. The hon. Member for Strangford (Jim Shannon) constructively articulated the need for cross-party consensus and argued for compassion and care. The hon. Member for Brigg and Goole (Andrew Percy) made a pertinent point about nutrition and standards, and spoke of the requirement to engage families in the care process. He brought his own experience to the debate. The hon. Member for Newton Abbot (Anne Marie Morris) successfully broadened the debate beyond the regulatory framework and the CQC, and raised a key concern about pay in the sector.

The debate has underlined the need to get things right for people in care everywhere. That was the key point of emphasis in our approach in Scotland, where Scottish Ministers have developed national care standards to ensure that everyone in Scotland receives the same high quality of care, no matter where they live. By articulating clear standards underpinned by the principles of dignity, privacy, choice, safety, realising potential, and equality and diversity, we are able to explain what someone can expect from any care service they use. The standards are written from the point of view of the person using the service, and help people to raise concerns or complaints.

Although the national care standards have served Scotland well, and ensured that we have a clear and robust regulation regime, the Scottish Government have committed to undertaking a review and are consulting the public on updating those standards. The SNP believes that the rights of our older people to decent care and dignity in care homes are human rights, and that is at the heart of the Scottish Government’s consultation. The Care Inspectorate and Healthcare Improvement Scotland are asking everyone with an interest and involvement in health or social care—personal or professional—to take part in the consultation, which will help the standards evolve to meet the needs, rights and choices of people across Scotland. I especially urge anybody with experience of care homes to give their input to the process in Scotland, as the consultation closes on 10 December.

Standards of safety were addressed in Scotland’s care homes following the tragic fire at Rosepark care home in Uddingston in 2011. In March 2014, the Scottish Government put revised guidelines in place to ensure the utmost standards of safety and care, and they continue to progress their improvement agenda. Improving safety, care and regulatory standards in care homes is a key priority for Members of all parties. The Rosepark case and the Scottish Government’s response underscore the importance of learning lessons from failings.

We need an open and inclusive debate on standards in care homes that involves all parties and, most importantly, members of the public who use the services—a debate that carefully considers how we can improve the care experience for all. In the past 45 minutes, we have made at least some contribution to the wider debate. I thank

4 Nov 2015 : Column 390WH

the hon. Member for North Devon for securing the debate, and I look forward to what I am sure will be a proactive and constructive response from the Minister.

5.13 pm

Barbara Keeley (Worsley and Eccles South) (Lab): It is a pleasure to speak in this debate with you as our chair, Ms Vaz. I congratulate the hon. Member for North Devon (Peter Heaton-Jones) on securing this debate on an extremely important issue. I have read the document he referred to, which was sent to me by his constituent. I sympathise with his constituent and others who have lost their loved ones in similar circumstances; those are tormenting times for people. If any patient is failed by the NHS or a care provider, we must ask them serious questions about what went wrong. We must try to ensure that no patient or family member has to go through a similar situation. Often, what family members want is for nobody else to have to suffer in the way that they have.

The regulation of care and nursing homes is extremely important, particularly as more people are likely to rely on those homes given our growing elderly population. The hon. Gentleman mentioned the CQC and its recent reports and developments. It said in its “State of Care” report that

“there is room for improvement across the whole of the adult social care sector.”

That is a very damning conclusion for it to come to, having moved into social care and nursing care inspection. The hon. Gentleman referred to the statistics. Only around two thirds of social care provision was rated good or outstanding, and 7% of services were rated inadequate. It is of even more concern that fewer than half of nursing homes were rated good or outstanding; 10% received the lowest rating of inadequate. Out of 1,275 nursing homes that the CQC inspected, 127 homes were rated inadequate. That is very serious if we think about how many people are in those homes. Would any of us accept that standard for our grandparents, mothers, fathers, wives or husbands? Of course we would not. We would demand the highest standards for our family members, as the hon. Member for Strangford (Jim Shannon) mentioned.

The CQC found examples of extremely bad practice, including a nursing home with an overpowering smell of urine and with mould on the walls, and a care home that did not administer medication properly. Recent evidence to the Public Accounts Committee showed that improvements were needed to the CQC’s regulatory regime. However, the CQC now appears to be having to manage with fewer resources. I understand that it plans to pioneer a new approach of “co-regulation”, with providers sending in

“self-assessments of how they think they’re doing”,

which the CQC would then verify. When less than 50% of nursing homes are judged to be good or outstanding and 10% are rated inadequate, I find that very concerning. This is not the time to move to a system of self-assessment—a move that seems to be driven by a projected cut to the CQC’s resources. As the hon. Member for North Devon said, it already has serious staffing issues, with one third of its inspection positions vacant.

More needs to be done. We covered that well during the debate. I agree that more needs to be done to help families to raise cases of bad practice, so that lessons

4 Nov 2015 : Column 391WH

can be learned—a point that the hon. Member for Brigg and Goole (Andrew Percy) touched on when he talked about the CQC working better with families. Complaints about health and social care are dealt with by different services, which follow local complaints processes. The Parliamentary and Health Service Ombudsman looks at complaints about the NHS, the independent Health and Social Care Advisory Service undertakes investigations, and the Local Government Ombudsman investigates issues regarding local authorities and adult social care. It is clear that care is changing, but care in nursing homes always spanned all those areas.

Vulnerable older people being cared for in nursing homes can rely on a variety of health and social care professionals. In nursing homes, older people often have a number of medical and care needs, which are dealt with by different people, including care assistants, nurses, GPs, and through hospital treatment and care. We need to ensure that the regulation of the sector takes that into account. When there are failures by multiple organisations, all those involved must be held to account. That very thing—the changeover—makes it difficult. How can the regulatory framework for nursing homes be improved to deal with that overlap? We are now talking about the integration of health and social care in Greater Manchester and other areas of the country, but we need a regulatory and complaints system that works with what we have. We should be striving for a health and social care system in which all older people receive the care that they need. If that does not happen, we need clear procedures enabling people to have their issues investigated. It is not clear where family members can go if they become alarmed that care is not being provided adequately.

The social care system helps some of the most vulnerable people in our society. When they do not have a voice, we must ensure that they are heard. In this debate we have heard some worrying statistics about care not being provided as it should have been. We need to improve our regulatory and complaints system, so that we learn from cases such as that of the constituent of the hon. Member for North Devon. I am glad that there has been quite a bit of consensus in the debate about the need to improve standards of care and regulation. We look to the Minister to tell us how that improvement might happen.

5.19 pm

The Minister for Community and Social Care (Alistair Burt): It is a great pleasure to serve under your chairmanship, Ms Vaz. You will not find a lack of consensus here today; I am glad to start off in that way.

I congratulate my hon. Friend the Member for North Devon (Peter Heaton-Jones) on securing this debate, which has been really good. Colleagues have made some very moving and pertinent points. I find myself in the position that Ministers find themselves in; understandably, I have responsibility for an inspection and regulatory regime that we are all working hard to ensure does its job of protecting people in the manner that we all described. Inevitably, however, the issues that arise are always the things that go wrong. The question is how to strike the balance between, on the one hand, giving an assurance about the chief inspector of the Care Quality Commission, and the assurance that our degree of concern about what happens in care homes is

4 Nov 2015 : Column 392WH

absolutely appropriate, and, on the other hand, in no way being complacent about the issues that colleagues spoke about, and about where the problems are. That is what I hope to address.

I am really appreciative of the contributions made. I will come to the contribution of my hon. Friend the Member for North Devon in a moment. The hon. Member for Strangford (Jim Shannon) spoke with his usual decency and compassion. He wants speedier action, and he recognised our non-partisan sense of interest in those who require care. My hon. Friend the Member for Newton Abbot (Anne Marie Morris) made a number of interesting points, including about managers in care homes. When I have spoken to CQC officials and others, I have found that issue to be vital. If there is good management, it will be a good care home; if there is not, it will not be. The lack of registered managers is a genuine problem, and we are on to that. The issue of commissioning is also underplayed.

My hon. Friend the Member for Brigg and Goole (Andrew Percy) spoke movingly about the issue of loneliness and isolation. He talked about someone who was taken from a home in an emergency, needing urgent care, who found themselves on their own. That raises questions about the extent of care delivered to individuals in those circumstances, and I hope that anyone who heard that would question their procedures to ensure that it did not happen to anyone they were looking after.

This morning, I met Unison officials in the office and we had a word about training standards. We have to be absolutely certain that training is available for all who are active in care homes. As we know, there is the skills care certificate. However, I am led to believe that we cannot be sure that everyone is getting the training they need, and as a result of this conversation, I am really interested in finding out what more we can do to ensure that training is available for all.

Andrew Percy: One area of training where we really could help to take the pressure off the ambulance service is in relation to falls, which place a huge demand on our local health services. Paramedics often say to me that they feel those falls could be dealt with more appropriately by care home staff—or even avoided—if staff were trained properly.

Alistair Burt: I take my hon. Friend’s point, which confirms what I was saying about the need for training, and for appropriate treatment and rehabilitation to be available after falls. The role of occupational therapists should not be minimised after such incidents.

I am all too willing to hear from the hon. Member for Glasgow East (Natalie McGarry). The fact that this matter is devolved is of no interest; what is important is that we share best practice and best standards of care. I very much appreciate her contribution. The hon. Member for Worsley and Eccles South (Barbara Keeley) again challenged me on what we are doing, and really that is the meat of the remarks I prepared to give in response to the comments of my hon. Friend the Member for North Devon; I am grateful to him for sharing those with us before the debate.

Let me put one or two things on the record. The Government are committed to improving the quality of adult social care, and to ensuring that people receive high-quality and compassionate care. We have taken a number of firm steps in that regard, and that is partly

4 Nov 2015 : Column 393WH

because of the sort of issues raised today. However, we are in a relatively early phase of the use of the new powers given to the CQC, and in a sense this debate reflects the sort of baseline from which we all have to work.

My hon. Friend referred to the experiences of his constituent, whose mother died in a local care home, and he spoke powerfully about the frustration that his constituent experienced in raising concerns with the care home provider and other bodies, such as the CQC and the local clinical commissioning group. We offer our condolences to my hon. Friend’s constituent, and I share his frustration that the experiences of service users and their families have not always been central to the provision of care or the oversight of regulation. I know that my hon. Friend’s constituent has met senior staff at the CQC on more than one occasion, and I hope that those meetings were helpful to him. However, I appreciate that this debate is not an opportunity to reopen this case, which I know the CQC has investigated extremely thoroughly.

Picking up on some of the concerns expressed today, I want to reassure my hon. Friend that we have come a long way; we have made real improvements in the regulation of adult social care in quite a short time, but of course there is more to do. Our reforms to the CQC have been central to those improvements. The regulation of adult social care has three key roles: first, to identify poor practice and take action to protect service users from the risk of harm; secondly, to encourage improvement by identifying areas of weakness; and, thirdly, to highlight and share good practice and success. All these roles are built on the foundations of effective use of data and rigorous inspection. In that respect, the CQC has been transformed in recent years, not least by having been given new powers in 2014, which is obviously not all that long ago. Those powers need to be built on.

The CQC has put in place specialist inspection teams under the leadership of the chief inspector of adult social care. These teams include “experts by experience”—people who have personal experience of care—and inspections now take particular account of the views and experiences of the users of services and their families.

The great majority of CQC inspections are unannounced. In a very small number of cases, when there are good practical reasons for doing so, notice may be given, but in the vast majority of cases services are not tipped off or warned that an inspection team is on its way. Providers registered with the CQC are required to meet a new set of fundamental standards that govern the quality and safety of services. These standards only came into force on 1 April, but they are the standards of safety and quality that providers must always meet. The CQC has a range of enforcement powers that it can use against providers that breach these fundamental standards. These powers vary from issuing warning notices and fines and imposing conditions on a provider’s registration, to cancelling registration, which withdraws a service’s permission to operate, thus closing it.

The new fundamental standards include two important new registration requirements. The first—the duty of candour—requires providers to be open with service users about all aspects of their care, and to inform them

4 Nov 2015 : Column 394WH

when there are failures in their care. The second—a “fit and proper person” requirement for directors—ensures that accountability for poor care can be traced all the way to the boardroom if necessary.

The CQC’s model does not just assess whether providers are meeting the fundamental standards. The CQC asks five key questions of each service: is it safe? Is it caring? Is it effective? Is it responsive? Is it well led? All inspections deliver a rating for each of these five key questions on a scale running from “inadequate”, through “requires improvement” and “good”, to “outstanding”. Inspections also result in an overall rating for each location.

There was much talk about what has been found so far in relation to those ratings, with a small number of providers deemed to be “outstanding” and more providers deemed to be “good”. However, a number of providers were deemed to “require improvement” or be “inadequate”. In starting its inspection process, the CQC looked first at those providers that might have more difficulties than others. The CQC is aware of what is going on, and it started its inspections at the end of the scale where it expected to find difficulties. That was designed not to force closures, but to recognise where improvement and support, which my hon. Friend the Member for Newton Abbot mentioned, is so important. In 40% of those cases, improvement has been made; on a subsequent inspection, things were found to have improved. However, that still leaves a percentage of those providers having not improved, and I think it is those providers that have been highlighted today.

Having met Andrea Sutcliffe, I am quite confident that her determination is exactly the same as that of everyone in this room. However, it is clear that there are so many places to cover that we have to be certain of ensuring that the standards that we have spoken of, and that the CQC is working to, will be delivered by all providers. Those are standards in training, management and ensuring effective monitoring.

My hon. Friend the Member for North Devon used the phrase, “There’s nowhere to go”, in relation to someone having concern about an individual. I would not want that to be the message; I would not want anyone to feel that they had nowhere to go if they felt that someone was at risk of being, or was being, ill-treated in a care home. That is not the case. The truth is that if someone has such a fear, they can contact the CQC, which will act if it agrees that a person’s safety or wellbeing is at risk, and if need be the CQC will contact the police. I would not want anyone to think that if they knew of someone in a care home being ill-treated, there was nothing they could do as of this moment. They can and should do something.

However, it is also clear from the nature of the debate that if the CQC’s most recent report has set a baseline, there are things that we need to do and improve. The sort of information available to us through our constituents, and the sort of interest that specialists such as those here have taken, will give me good guidance on how to ensure those improvements are seen through.

5.30 pm

Motion lapsed, and sitting adjourned without Question put (Standing Order No.10(14)).