Health and Care Bill

Baroness Henig Excerpts

Lords Hansard - Part 1 & Report stage
Monday 7th March 2022 Lords Chamber

Amendment 142 not moved.

[The Deputy Speaker (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Campbell of Surbiton, may be moving the next amendment on behalf of the noble Baroness, Lady Bull. The noble Baroness, Lady Campbell, is taking part remotely and I invite her to say whether she wishes to move the amendment.

Amendment 143

Tabled by

--- Later in debate ---

[Lord Hunt of Kings Heath (Lab)]

My Lords, there is a series of amendments in this group. My amendment does not really relate to the others in the group, but it is about an important issue.

In Committee, I raised the problem that a number of members of the public and the Relatives & Residents Association have brought to my attention: in a minority of care homes, if residents or relatives complain, the homes take retaliatory action in the form of making visits even more restrictive than they currently are and, in some cases, even evict, or threaten to evict, the person on whose behalf the complaint has been made. As I said, this is in a minority of homes— over the past few years I have been impressed by how many homes have continued to provide high-quality care in very difficult circumstances. None the less, this is an important issue.

In 2019, the Relatives & Residents Association was coming across at least one case a week of such intimidatory behaviour. We discussed this in Committee. The Minister said that she did not really think that the department had received much evidence of this, that in any case residents and their relatives and friends should complain to the home in the first instance, and that the Care Quality Commission would also pick up concerns.

This is a very confusing picture. If you go to the CQC’s website, you will see that it states:

“we do not settle individual complaints ourselves, but we still want you to tell us about your experiences of care.”

To most people, that is pretty confusing. If you are worried that a home is going to be intimidatory in its response to legitimate complaints raised, you are hardly likely to have confidence in its complaints system.

Up until about 2008, the CQC did take individual complaints but, due to a funding cut, it stopped doing so, even though, in Scotland, the equivalent body investigates specific complaints, and the predecessors of CQC investigated complaints. We know that there is huge pressure in care homes. We also know that some care homes are continuing extremely restrictive practices around relatives and friends being able to visit. This has become quite a serious problem in which, while they may not be in total lockdown, they come near to it, clearly more for the convenience of the home than for a public health reason. My amendment simply asks the CQC to go back to receiving and dealing with individual complaints in these cases. I hope that the Minister will perhaps be sympathetic to this. I beg to move.

[The Deputy Speaker (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Brinton, is taking part remotely; I invite her to speak.

[Baroness Brinton (LD) [V]]

My Lords, the noble Lord, Lord Hunt, introduced his Amendment 144B on complaints about care services very well. He is absolutely right: this is a muddle. Are people to go to the CQC or to a particular home when they wish to make a complaint? Any complaints system where the person making the complaint feels in a less strong position than the organisation to which they are complaining, or indeed—sometimes they might even put this strongly—which is wielding power over them is a complaints system that will not work. I hope that the Minister will understand this, and will respond and ensure, first, that there is a clear and understood system, and, secondly, that if some funding needs to be restored to the CQC to take us back to where we were, that will happen.

I want to speak particularly to two of the issues covered in this wide-ranging group of amendments: the licensing of cosmetic procedures and medical practitioners’ financial and non-pecuniary interests. I also have sympathy for the other two, on registration of social workers and hospital rehabilitation accommodation.

The amendments laid by the Minister, beginning with 153A, on the licensing of cosmetic procedures by local authorities and, indeed, Amendment 169 in the name of the noble Baroness, Lady Finlay, on cosmetic procedures, which I have signed, set out models for registration for those who work using devices that breach the skin and who are not covered by medical registration or, currently, by any effective regulation. I know that considerable discussions have taken place between Committee and Report, and it is welcome that the Government have felt that they can now lay their own amendments, signed by the noble Baroness, Lady Merron, and the noble Lord, Lord Lansley. I look forward to hearing the comments of the noble Baroness, Lady Finlay, on those amendments.

Amendment 184ZBB in the name of the noble Baroness, Lady Cumberlege, which I have signed, brings us back to the debate on medical practitioners’ financial and non-pecuniary interests. Our debate in Committee highlighted the problem that the financial and non-pecuniary interests arrangements do not match those that many others in the public sector have to make, where the registration body holds the information. The GMC has said once again that it does not particularly like the style of this amendment and would prefer the records to be held directly by the employer. However, I believe the argument that the registration body, which also has the power to take action, should be the place where these are kept.

I hope that, regardless of whether a vote is called, the Minister will take this away and look at it in more detail. We need an open, transparent and clear system of registration of financial and non-pecuniary interests.

[The Deputy Speaker (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Masham of Ilton, is taking part remotely; I invite her to speak.

[Baroness Masham of Ilton (CB) [V]]

My Lords, I will speak to Amendments 169 and 181. I have my name down for Amendment 169 on the licencing of cosmetic procedures. During the passage of this Bill, I have had my eyes opened to just how enormous this industry is and how a great many people are putting themselves at huge risk. I have heard of some disturbing cases in which procedures with collagen have gone wrong. At a conference about plastic surgery and cosmetic procedures, one-third of the attendees were from the plastic surgery field and two-thirds from cosmetic procedures, which shows how popular this is becoming.

All Members of your Lordships’ House taking part in these amendments share the desire that these procedures should be registered and safe. I am very pleased that the noble Lord, Lord Kamall, has accepted that this matter needs addressing and making safe. I thank him and his team for the hard work that they must have gone through in producing these amendments.

Amendment 181 is a very practical and important amendment, which I could not resist supporting and speaking to. It would reduce bed-blocking—a most unfortunate problem for a busy hospital that needs all its acute beds for ill patients, and frustrating for patients who still need rehabilitation but not in acute beds. These patients cannot go home because their accommodation is not suitable for their needs; for example, they might have to use a wheelchair and they need time to get organised. One of the problems is the time that it takes to get necessary adaptations completed. Housing authorities and social services need to work together with health authorities. If suitable rehabilitation accommodation is available, it can also be used for patients who need specialised treatment that is a long distance from their home. St James’s hospital in Leeds has a hotel for such patients, and incorporated into the hospital is a Marks & Spencer food shop; this is a very valuable service. I hope that the Minister will agree that these provisions should be available throughout the country.