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Baroness Young: Perhaps I may press the Minister on this important point. The example that he has given is of a person who presumably has been before the courts and subsequently convicted, in which case his name would have been known publicly. As I understand the point made in Amendment No. 25 and in the amendment of my noble friend Lord Howe, we are not talking about people like that, but about possible prospective foster parents, adoptive parents and possibly children.
I believe that the whole issue of confidentiality is extremely important. I have listened to the arguments and the Minister certainly has not satisfied me on how the power will work. A lot of people could be genuinely concerned that their names may become public knowledge. The more people who know about the people involved, the more likely it is that there will be a leak. These days we are all conscious of how difficult it is to keep anything confidential.
We need to have the matter spelled out carefully. I suggest that one needs to have, certainly before the next stage of the Bill, much more detailed examples than the one given to my noble friend Lady Knight. How do the Government consider that this will work? Who would have access to such information and in what circumstances may it be made public? We need answers to those questions which are not hypothetical.
Earl Howe: I am grateful to the Minister. I shall reflect carefully on what he has said as regards the confidentiality of foster and adoptive parents. However, I do not believe that he has covered the point I was seeking to make about children. I cannot think of any situation in which the identity of a child should be disclosed to the general public. Of course, there are circumstances when the name of a child needs to be mentioned in a report, but my amendments seek to ensure that only those few people with a need to know--and nobody else--should have access to that sensitive information. Between now and Report stage, I shall reflect on how to take this issue forward.
Lord Clement-Jones: I too thank the Minister for his reply. However, I am somewhat puzzled that he does not seem to have taken on board the points made during the course of this debate--a feeling expressed by other Members of the Committee who spoke. The Minister has not given satisfaction to those like myself who were seeking a more narrow amendment purely in terms of medical confidentiality; nor has he given satisfaction in relation to the broader range of amendments tabled by the noble Earl, Lord Howe.
The Minister seemed to be saying that the new commission will be subject to the new Data Protection Act and that that will solve everything. But I cannot see any reason why medical professionals--I proposed that this new commission should be on all fours with the Commission for Health Improvement which will also be subject to the new Data Protection Act--should not have the same protection for confidential information about their patients, and indeed for the patients to have that protection, as in the case of the commission. The rules of medical professional confidentiality were discussed at some length and were fully accepted by the Minister's predecessor, and I cannot see any reason why they should not be incorporated into this Bill.
I therefore urge the Minister, between now and Report stage, to look again not only at the narrower Amendment No. 25, but also at the broader anxieties relating to confidentiality raised in the debate. In the meantime, I beg leave to withdraw the amendment.
Members of the Committee will recall the Government's White Paper, Fit for the Future? In that White Paper the Government proposed that eight regional bodies should undertake the work of regulation and inspection of care facilities, which your Lordships have been discussing throughout this Committee stage. At the present time those functions are undertaken by 150 local authorities (more if we include Wales) and a large number of health authorities. There is therefore good reason for wanting to achieve a higher standard of consistency and greater uniformity of regulation and standard setting than can operate across such a large number of different organisations.
On the other hand, it is clear that in matters of this kind--the noble Baroness, Lady Masham, referred to this earlier--local intelligence is an important aspect of the work. Access to carers, to people who may have anxieties--members of staff and former members of staff--in relation to the standards being applied in homes or centres is essential. It is therefore important that there is good communication between the people charged with regulating facilities of this kind, which deal with some of the most vulnerable people in our community.
I assumed, when the Government recommended that eight regional bodies should undertake this work, they would follow the boundaries of the current regions of the National Health Service; and that the idea was to facilitate good communication across social and healthcare authorities where there is a responsibility to protect vulnerable people, and to ensure that those who have concerns have ready access to the regulatory body.
Since the White Paper was published the Government have come forward with the Bill before us. It does not recommend eight regional bodies; it recommends one care standards commission. As we have already said, this national commission will have an enormous range of responsibilities covering the whole age spectrum and most of the different aspects of social care needs that people experience in their lifetime. It is important that the way the work is undertaken commands the confidence not only of those who use the services and their carers, but also the wider community. The purpose of Amendment No. 27 is to secure an undertaking that if the Government intend to move away from providing eight local bodies, they ensure that the machinery is in place within the national body to facilitate that essential local contact.
Baroness Young: The point made by the noble Lord, Lord Laming, is extremely important. I do not support his Amendment No. 27 in relation to regional authorities. In some areas regions are quite clear but in others they are very unclear. I am not sure that the amendment would be helpful either administratively or in any other way. I therefore do not support it.
However, a real issue arises in relation to Clause 6 and I should like to make two points. As the noble Baroness, Lady Masham, said, it is one thing to inspect things that are obvious--matters of hygiene, standards in buildings and so forth--but when one is trying to identify members of staff who may be the wrong sort of person to be employed, it is much more difficult. The only ones who will have any idea what is going on are those on the spot. A national commission is unlikely to identify anybody.
This is a difficult but important issue. For that reason, the lower the level at which such inspections are undertaken, the more prospect there will be of identifying those who need to be identified. The same happens in the world with which I am much more familiar, that of education. People can only be identified at school level; it is difficult to identify them anywhere else. They are hardly likely to say who they are and outsiders are unlikely to know unless they are familiar with the circumstances of the organisation concerned. A real point is being made which needs to be addressed.
Baroness Pitkeathley: In a long working association I have rarely found myself in disagreement with the noble Lord, Lord Laming, but I am afraid I do tonight. I come from the same point of view as he, that of users and carers. But my experience and all the feedback that I have received tells me that users and carers want the establishment of a national commission in which standards can be applied across as wide an area as possible. The number of times people have asked me why things are different in Newcastle than in Plymouth leads me to say that.
That is where my disagreement with the noble Lord, Lord Laming, ceases because I agree with him that good communications and commanding confidence are essential for the commission. There is no doubt about it. Taking into account the points made by the noble Baroness, Lady Young, feedback from the local level, from the users and carers will be essential. But the establishment of standards is best done at national level so that everyone knows what they can expect.
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