Draft Health and Care Act 2022 (Consequential Amendments) Regulations 2025
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
I beg to move,
That the Committee has considered the draft Health and Care Act 2022 (Consequential Amendments) Regulations 2025.
It is a pleasure to serve under your chairmanship, Mr Twigg. A copy of the draft regulations was laid before the House on 21 October.
There are estimated to be around 47,000 people in the UK with Down’s syndrome. Despite existing legal duties and frameworks, those people face real challenges in accessing the care and support they need to live the lives they want to in their own communities. This Government are determined to set that right. Through the implementation of the Down Syndrome Act 2022, aligned with the overarching aims of our 10-year health plan for England, we are striving to improve the life outcomes for people with Down’s syndrome by improving their access to services, raising awareness and understanding of their needs, and breaking down the barriers to opportunity that they and other disabled people face. The draft regulations will make a technical but necessary amendment to the Down Syndrome Act to support its effective implementation, and it is right that they should be given full scrutiny in Committee.
I will begin by setting out what the Down Syndrome Act requires. Under the Act, the Secretary of State for Health and Social Care is required to give guidance to relevant authorities in health, social care, education and housing services on what they should be doing to meet the needs of people with Down’s syndrome. Relevant authorities must have due regard to the final statutory guidance, once published. This Government want disabled people’s access to, and experience of, healthcare services to be equitable and effective. The guidance under the Down Syndrome Act supports that aim by raising awareness of, and bringing together in one place, the practical steps that organisations should take to meet the needs of people with Down’s syndrome. It also helps to clarify the support and services that people with Down’s syndrome can expect to receive.
On 5 November, we launched a public consultation on draft guidance under the Down Syndrome Act. Work to develop the draft guidance has involved significant engagement with people with lived experience and, importantly, with the organisations that support them. The consultation presents a further opportunity for people with lived experience and their families to share their views. We expect the guidance to improve support for people with Down’s syndrome and for those with other, similar conditions. In order for the guidance to deliver improvements for those people, it needs to be implemented effectively across the range of communities that it serves.
On 9 May 2023, NHS England published statutory guidance stating that every integrated care board should identify a member of its board to lead on supporting that ICB to perform its functions effectively in the interests of people with Down’s syndrome. The NHS England guidance also states that ICBs should have a lead for learning disability and autism, and a lead for children and young people with special educational needs and disabilities. It will be important for ICB leads to work collaboratively across the integrated care system, with local authority, public health, education and wider partners. The consultation on the draft guidance will help us to understand whether the guidance is clear, informative and useful to relevant authorities in carrying out their legislative requirements in support of people with Down’s syndrome. We will use the feedback received to ensure the guidance is fit for purpose.
I now turn to what the draft regulations will do. Under the Down Syndrome Act, relevant authorities must have due regard to the final statutory guidance when exercising their relevant functions. The Act does not create any functions beyond that duty. The schedule to the Act specifies the relevant authorities that must have due regard to the guidance and the specific functions of those bodies to which the guidance applies. As drafted, the schedule does not include NHS England or ICBs. Rather, it refers to the National Health Service Commissioning Board, which was the former name of NHS England, and to clinical commissioning groups, which were the commissioning bodies in place at the time the Down Syndrome Act was passed.
These draft regulations seek to bring the legislation up to date by replacing references to CCGs with ICBs, and references to the National Health Service Commissioning Board with NHS England. The changes are required because the Health and Social Care Act 2022 made provision for the abolition of CCGs and replaced them with ICBs, and renamed the National Health Service Commissioning Board as NHS England. The purpose of that change is to bring ICBs and NHS England within scope of the Down Syndrome Act duty to have due regard to the guidance.
Final guidance issued under the Down Syndrome Act will not be published until these changes come into force. We intend to publish the guidance before the planned abolition of NHS England comes into effect. We understand that the ongoing reforms across Government affect the timing and content of the final guidance, and its content after publication. We will keep the final guidance under review, and it will be updated to reflect the latest policy and legislative frameworks as and when necessary.
The Down’s syndrome guidance will not be statutory for those not specified in the schedule to the Down Syndrome Act, which means that persons who are not relevant authorities are under no obligation to have due regard to the guidance. It is therefore important that we change the wording in the Down Syndrome Act now to ensure that the guidance will apply to current relevant authorities. The change will also ensure that the legislation is in alignment with NHS England’s statutory guidance on the ICB leads on Down’s syndrome. ICB leads are responsible for the implementation of the guidance under the Down Syndrome Act. It is therefore critical that they are referenced in the legislation itself.
The regulations will come into force on the day after the date on which they are made. The rationale is to ensure that the duty under the Down Syndrome Act to give guidance to relevant authorities applies to the correct authorities. The regulations will have no material effect until the final guidance is published. We therefore do not believe it necessary to engage with or notify the public further on these changes.
By making important updates to the Down Syndrome Act, these regulations will provide vital assurance that the guidance will be implemented effectively, ensuring that it can achieve the aim of improving the life outcomes of those with Down’s syndrome. I commend this statutory instrument to the Committee.
Stuart Andrew (Daventry) (Con)
It is a pleasure to serve under your chairmanship, Mr Twigg. I am sure it will delight the Committee to know that I do not intend to detain us for too long. [Interruption.] I always get a cheer when I say that. I would like to begin by saying that I do not see anything particularly contentious in this. The Minister rightly points out that these are technical changes that bring the Down Syndrome Act into line with the reforms introduced by the Health and Care Act 2022, in particular the replacement of CCGs with ICBs and the renaming of the NHS Commissioning Board as NHS England.
However, it is worth questioning the Government on the longer-term stability of these changes. As hon. Members will know, the Government have stated their intention to abolish NHS England by April 2027. That process has already been delayed, reportedly due to uncertainty over who will meet the redundancy costs for staff within those organisations. If that abolishment proceeds, a new health Bill will be required. At present, we do not know when that Bill will be brought forward or what it will contain. It is therefore entirely possible that the statutory references being updated today will need to be amended again in the near future.
I also note that there is no statutory review clause in this instrument. While that may be understandable given the technical nature of the changes, it adds to concerns that further legislative changes may not be properly anticipated or subject to adequate scrutiny in good time.
While I support these draft regulations, I urge the Minister to clarify what transitional arrangements are being considered for the functions currently held by NHS England and the integrated care boards. That is especially important, as he rightly pointed out, for the consistency of support that we all want to see in the context of the Down Syndrome Act. We must ensure that people with Down’s syndrome are not adversely affected by any ongoing organisational changes within the health system. The Minister mentioned some of the updates to the Down Syndrome Act. Perhaps he could update us further on any other actions that are ongoing. How many still need to be done?
In addition, I note that the Act seems to require the Secretary of State to publish guidance, on which the Government have just launched a consultation. One of the criticisms of the Act at the time was that it is specific to Down’s syndrome. Although I obviously welcome that focus, others face similar disabilities and challenges. How might the Government support them?
Finally, it looks like people can respond to the guidance only online. Can the Minister assure the Committee that he is confident that those who are digitally excluded will not be prevented from taking part in this important consultation?
Dr Ahmed
I am grateful to the right hon. Gentleman for showing the consensus on the Down Syndrome Act. It should be placed on record that the Act was a private Member’s Bill sponsored by Sir Liam Fox, then a Conservative Member. I am delighted to carry forward the draft regulations on the basis of that consensus.
The right hon. Gentleman asked what these statutory instruments will look like in relation to future iterations of NHS governance structures. As he said, NHS England will continue to undertake the statutory functions until parliamentary time allows for legislative changes. I am confident that the Down Syndrome Act and Acts like it will be components of the primary legislation that will be required to make those new arrangements, such that we will not require this type of Delegated Legislation Committee process again.
I will take back the question about digital access to the consultation process to my officials. The right hon. Gentleman raises a very important point on exclusion, of which I am also very cognisant. I am happy to write to him with a fuller answer.
Again, I am grateful for the consensus on both sides of the Committee. I commend the draft regulations to the Committee.
Question put and agreed to.