Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2026

Debate between Lord Lansley and Baroness Harding of Winscombe

Wednesday 15th April 2026 Grand Committee

[Lord Lansley (Con)]

I shall speak briefly to this statutory instrument and ask a number of questions, if I may, to which I hope the Minister will be able to respond. I think that I understand the structure of what is proposed and the exclusion of first aid so that it is not covered, but when I look at the providers that are likely to be affected, I am trying to work out carefully which are the providers concerned. I am assisted by a friend who is part of the Faculty of Sport and Exercise Medicine and who said that it had undertaken a survey.

It seems to me that many of the people who responded to that as healthcare professionals may well be working in registered providers already, so they may be concerned about the need to register in relation to the services that they provide at events but in fact they do not need to register. However, the event organisers themselves may need to register if they bring healthcare professionals on site in order to provide services that go beyond first aid at their event. I am trying to understand how, when the department went out and identified 89, or whatever the number was, potential providers that were not already registered, it ended up with a figure of 36, which seems very low. It certainly bears no comparison to what those who are working in the sector believe would be the number of presently unregistered providers. We need to understand who these 36 are, the character of those providers that the department has identified and why there is such a discrepancy between that and what others have been saying. I would be grateful if the Minister would tell us much more about that.

As a practical example, are all football clubs, or the major football clubs in the Premier League, the Championship and so on, already registered with the CQC? Clearly, they, as organisations, provide continuing healthcare to their players. Do we not need to worry about any of that? Is an event like one of the big festivals that take place already registered, because it has put a team together in order to provide more than simply first aid? Perhaps we are worrying about a need for registration when actually we do not need to worry so much.

I have only one other question. An essential part of the follow-up to the Manchester Arena inquiry was the preparation of an event healthcare standard. Would the Minister be kind enough to update us on that process? Where does it stand and when might we see its publication for consultation?

[Baroness Harding of Winscombe (Con)]

My Lords, I will also ask a few questions. I declare my interests as the senior steward—namely, the chairman—of the Jockey Club and as the mother of an elite athlete.

I spent last weekend at two quite different sporting events, juggling my time between the Grand National and the Home Internationals lacrosse competition, as my daughter played for England for the first time— I did check with her that I was allowed to mention that in the Grand Committee. I mention them both because while one is really a grass-roots sporting event—it has a small crowd, but none the less there is an ambulance in attendance because it is a potentially dangerous sport—the other, the Grand National, is the second largest attended sport in the country and the second most watched sporting event on television. As I understand it, both are captured by the same changes being proposed today.

I express my condolences to everyone who was affected by the tragedy at Manchester Arena. In no way do I want to suggest that the questions I am posing negate the need to address the recommendations of the public inquiry. It is hugely important that we learn the lessons.

First, I took some time to speak to a former chief medical adviser of the British Horseracing Authority, Dr Jerry Hill, who told me that a clear standard of healthcare for events is an extremely positive move. I put on record that I wholeheartedly support the event healthcare standard. I understand that there has been good consultation on the draft and that, in Dr Hill’s view, it will help event medics fight their corner for resource. He told me that, at the moment, event medics often feel that they are behind Portaloos and security in priority at events. It is important that we recognise that we need that standard.

However, in moving from that standard being guidance to putting it on a statutory footing—I appreciate that this SI does not do that, but it sets us on that path—we need to evaluate formally whether the draft is effective. As I understand it, the DHSC was somewhat swamped by people wanting to participate in evaluating the draft, and that it was perhaps not following the more scientifically robust approach that a number of sports suggested—I think two focus groups were planned to evaluate the draft. Can the Minister assure us that that event healthcare standard will be evaluated to a scientifically robust standard rather than that of a more politically normal focus group? It is very important that we get it right.

Secondly, I also understood that, as my noble friend Lord Lansley says, the CQC’s initial impact assessment had claimed that only 36 healthcare providers would need to register. Horseracing alone thinks that we have 350 individual clinicians who would need to register, even allowing for the fact that each clinician tends to work in three different sports. Potentially, the Faculty of Sport and Exercise Medicine UK’s estimate of 23,000 is an overestimate. Even if it is one-third of that, it is still massively more than the CQC expected.

I also understand that, in November 2024, the CQC said that it had a maximum capacity to register new providers of 1,000 per year. If we are not very careful, with all the best intentions we will be setting up a bureaucratic quagmire, which will mean that events, big and small, will not be able to find suitably registered clinicians to support them. What assurances can the Minister give us that the CQC can cope with the workload? Has the CQC recruited, or does it intend to recruit, anyone from the sports or cultural events sector? In the past, the CQC has had, in maybe more traditional healthcare settings, a bad habit of sending non-specialist inspectors—my noble friend Lord Lansley is laughing at that, but it is serious business. The best example I have is of occupational therapists being sent to inspect ambulance services.

What assurance can the Minister give us that the CQC is going to recruit the suitable expertise to deliver on this important obligation? Where will it sit in the priorities of the CQC which, after all, has an awful lot of important work to do? It currently has an interim chief executive and a chairman who wants to leave, so I am nervous about quite so much going on to the CQC. I support others who have called for pragmatism in the implementation of these regulations to allow time, if the CQC is struggling to put the resource to them that they need.

Levelling-up and Regeneration Bill

Debate between Lord Lansley and Baroness Harding of Winscombe

Report stage
Monday 18th September 2023 Lords Chamber

[Baroness Harding of Winscombe (Con)]

My Lords, I will speak briefly in support of the amendments in the name of the noble Lord, Lord Mawson. I will reiterate two points very quickly, recognising the lateness of the hour.

The first point is that implementation is not the boring, straightforward part after the smart policy people have done their work. Too often in government, that is how it is viewed. Implementation is really hard. My world of digital has taught us that thinking of implementation as something that comes after is the wrong way to do it; instead, you should think of things as entirely iterative. In an agile way, you should continually be testing and learning in a cross-disciplinary, user-focused way. That is what the digital world does every day, but it is also what brilliant regeneration work does every day.

I hugely support the principles of these amendments, partly because of that first point and partly because I have also seen—in both the NHS and the Covid response—that it is only when we have all sectors of society working together on implementation that we get real change. We need the public, commercial, private and third sectors working collaboratively on the ground. The noble Lord, Lord Mawson, has been doing this for 30 years in Bromley-by-Bow, but we saw it on the ground across the whole country in our much-vaunted vaccination programme. What was truly brilliant about it was the genuine local, cross-societal engagement in reaching the people who were most vulnerable and most in need of getting those first jabs. That was implementation at its very best.

I have a simple question for my noble friend the Minister: if the Government will not accept these amendments, can she assure us that they really do appreciate how important implementation is? Also, if they do, how will she ensure that the good ideas in this Bill are not just passed on to someone else—that is, for someone else to think about how to do them—but are continually iterated so that we learn how they can best be implemented?

[Lord Lansley (Con)]

My Lords, I thoroughly agree with my noble friend Lady Harding of Winscombe about this. But this is not a fire-and-forget piece of legislation; in the levelling-up part, it has its own metrics. The metrics are all there in the White Paper.

I want to add two requests. The first is that this is not good enough: we are two general elections away from 2030, when it is intended that these metrics are reported. That is too far away. We need a sense of what is being done, how it is being achieved and the progress being made.

Secondly, we have talked a number of times about the advisory council on levelling up. We now know that it has a work plan and some of the subjects that it will address. Some will be very useful—for example, understanding precisely what the Government’s intentions are for investment zones would be useful to people in many parts of the country.

In place of Andy Haldane giving interviews in which he says, “It’s all a mixed bag”, we actually want some of these subjects to be reported by the advisory council, transparently and openly. It is important that Ministers engage with the advisory councils, but they should not be purely internal. As the noble Lord, Lord Mawson, rightly said, they should enable those charged with levelling up across the country to see what the Government are doing, why they are doing it and what progress is being achieved. I hope that my noble friend will say more about the transparency of the advisory council.