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Lord Clement-Jones: I thank the Minister for that comprehensive reply. I appreciate the care taken in considering each of the amendments in turn. I appreciate also his individual replies. As he will understand, the amendments were put together by a consortium of a number of voluntary organisations; in

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fact, the key voluntary organisations concerned with children. Clearly, there are strong feelings that further safeguards are needed, particularly in the area of independent advocacy. I notice that the Minister referred to Article 12 of the UN convention. He recognised the work of the advocacy services and described excellently the way in which the Quality Protects programme is proceeding.

At the end of the day, the key point is whether such children have the right to advocacy. We can try to ensure that local authorities do things by circular; we can try to establish standards, programmes and so on, but in the end the UN convention requires the child to have the right to independent advocacy. I appreciate the Minister's attempt, within his parameters, to answer the matter in the most helpful way possible. But this is a major campaign that needs to be brought to fruition. That is strongly felt by the voluntary organisations, on these Benches, and elsewhere. We may want to return to the matter on Report.

I appreciate the Minister's reply on other matters. We have a great deal of food for thought, particularly in terms of Amendment No. 54. I appreciate his undertaking to look at the clause to see whether all the necessary powers are given to the commission in relation to children in hospices or private healthcare establishments and the undertaking to look at how all the standards applicable to children should be brought together in future. We shall read Hansard carefully in respect of that reply.

On Amendments Nos. 152 and 153, we had debates on the Health Act about the composition of various matters, such as PCGs, and so on. Of course, I appreciate the need to have a balance of expertise. Clearly, the Minister understands that it is important to have people who understand the issues. There is no question of trying to put a straitjacket on appointments to the commission. I believe that the answer lies in the way in which the department consults. The Minister commented, particularly in relation to Amendment No. 167, on the consultation regarding the powers and duties of the children's rights director. I see no reason why the department should not also consult, in relation to the members of the commission, with the same bodies as those with which it would consult on the way in which the children's rights director's duties will be exercised. I believe that that would be the sensible way forward. We look forward to that taking place. In the meantime, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendments Nos. 55 to 57 not moved.]

Earl Howe moved Amendment No. 58:

    Page 11, line 9, after first ("of") insert ("either--


The noble Earl said: In moving Amendment No. 58, I shall speak also to Amendment No. 59. The principle of subsection (2) of Clause 20 is difficult to argue against. Clearly, it is right, in the interests of public protection, that those who look after vulnerable

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people in a care home or other establishment are properly qualified for the purpose. Part of that qualification is that they should have proved themselves to be fit and proper persons to the appropriate registration authority.

Under Part IV of the Bill social care workers will need to register with either the English or Welsh council before they can call themselves by that name. In Clause 20 we find that a condition of being allowed to work in certain capacities at a care home or agency will be that an individual is registered with one or other of the councils.

The question posed by the amendment asks whether it will be necessary for a qualified nurse, who works in a care home and is registered with the UKCC, to take out a further registration with either the English or the Welsh council. I do not believe that it should be a requirement for that person to do so and I hope that the Minister will be able to give me some sort of reassurance on that.

The question branches out into wider territory when we consider the role of healthcare assistants. The Minister knows my views on healthcare assistants, which are that they should be regulated and that if and when they are so regulated, the registration authority should be the same authority that governs nurses. There are all manner of arguments to support that, on which, for the sake of brevity, I do not propose to expound. But one thing is clear. If somebody registers with the UKCC, or whatever body it is that succeeds it, the consequences of doing so will be a distinct kind of professional training and development. The training and development that will ensue from registering with the GSCC or the CCW will be of a different kind.

If my argument is sound that healthcare assistants should be able eventually to register on the nurses' register, because that is where their professional skills and disciplines most naturally lead them, then the Bill ought to allow for that rather than oblige them, as it appears to do now, to register with one or other of the councils. I beg to move.

7 p.m.

Lord Clement-Jones: The Minister was kind enough to write clarifying certain questions that I raised at Second Reading. One of those was that there would be no problems and that we knew what the status of healthcare workers would be--as to whether or not they would be able to register in the future under the nursing regime as opposed to the regime established by this Bill.

The Minister's letter said that the review concerning the need and scope of regulation of healthcare support workers is now under way and is due to report in April. He said that the GSCC and any new regulatory body that might emerge from the review would be complementary; that there would be no overlap as each body will be regulated as a separate workforce.

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We on these Benches are extremely keen to ensure that the Bill does not pre-empt the outcome of the above-mentioned review; that the possibility is retained of enabling the two registration systems to be designed so that healthcare assistants can register with the same body that regulates nursing. As I understand it, the RCN and others are having discussions with the Government on this issue, but we on these Benches seek the Minster's assurance that there will be the option of healthcare assistants being regulated by the body that regulates nursing, and that that option will not be closed off as a result of the Bill. We strongly support the amendments.

Lord Hunt of Kings Heath: I am grateful to the noble Earl for allowing me to clarify the position of nurses, and also to debate a matter that is close to my heart; that is, the potential regulation of healthcare assistants.

There is no intention that qualified nurses should have to register with the general social care council. The definition of social care work in Clause 51 as it stands will extend to nurses working in care homes and domiciliary care agencies; but Clause 51 also allows us to make regulations exempting persons from the requirement to be registered with the GSCC. I can assure the Committee that we will make regulations exempting nurses who are on a statutory authorised register of nurses.

I turn to healthcare workers more generally. I confirm the point made by the noble Lord, Lord Clement-Jones, that in December the Government announced that they had commissioned a review of the roles and responsibilities of support workers in healthcare settings. That review includes a wide-ranging consultation process. It will make recommendations on whether or not there should be some form of regulation of those staff to ensure public safety. It will take into account the Government's decisions about the regulation of unqualified staff in the social care sector. The outcome of that exercise is due in April.

My understanding is that there is no view yet on the outcome of the review. However, there is a clear consensus that healthcare workers should be regulated, though a great diversity on how it ought to be done. The review team is investigating the form that registration might take--registration, other models and costs. Of course, it is aware of the provisions contained in this Bill.

I fully understand the point made by noble Lords, that at the end of the day the last thing we want, as with nurses, is that if we regulate healthcare assistants in the future they will have to be registered under two regulatory bodies. We will, of course, ensure that if proposals are brought forward that will not happen.

Lord Clement-Jones: Does that mean that the Minister can confirm that nothing in this Bill pre-empts a decision that may be made in future?

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Lord Hunt of Kings Heath: Nothing in this Bill pre-empts a decision to be made in the future.

Earl Howe: Once again that is an extremely helpful and reassuring response from the Minister. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendments Nos. 59 to 66 not moved.]

Lord Rix moved Amendment No. 67:

    Page 11, line 50, at end insert ("and other residential provision for children living away from home").

The noble Lord said: In rising to move Amendment No. 67 I fear that some Members of your Lordships' Committee may have a sense of deja vu, for this amendment runs on naturally from the penultimate amendments moved by the noble Lord, Lord Clement-Jones; but I press on.

Disabled children are three times more likely than other children to live away from home. Where children are living away from home, whether on a longer or a shorter term basis, we want to ensure that there are consistent and safe child care practices, not only in children's homes but also in residential schools, family placements, respite units, NHS respite or longer-term units.

Those who work with "looked-after" children (if I may coin a phrase) should be afforded the best possible guidance and practice frameworks regardless of the location in which they are caring for the child. In view of the Minister's response to the amendments of the noble Lord, Lord Clement-Jones, I cannot believe that he will not accept my belt and braces addition to Clause 20, page 11, line 50. I beg to move.

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