Health and Social Care (Safety and Quality) Bill

Debate between Baroness Laing of Elderslie and William Cash

Friday 9th January 2015 Commons Chamber

[Sir William Cash (Stone) (Con)]

I beg to move, That the clause be read a Second time.

[Madam Deputy Speaker (Mrs Eleanor Laing)]

With this it will be convenient to consider:

New clause 3—Care and Quality Commission annual State of Care Report—

‘(1) Section 83 of the Health and Social Care Act 2008 (health and adult social services: reports for each financial year etc.) is amended as follows.

(2) After subsection (2) insert—

“(2AA) The reports under subsection 1(b), (c), and (d) must, in particular, cover the safety of health and adult social care services in England.”’

[Sir William Cash]

Before I make my remarks on the proposals, I pay tribute to my hon. Friend the Member for Stafford (Jeremy Lefroy), my neighbour, with whom I have worked for the past five years with great enthusiasm, because he has dedicated himself to all matters in his constituency, but specifically to dealing with the problems that came out of the Mid Staffordshire public inquiry—I campaigned vigorously to get that public inquiry. I also pay tribute to Ken Lownds, whom I regard as a hero of that inquiry in many respects. I pay tribute to his work on zero harm and the Bill. I do not in any way want to leave the Minister out of the tributes because he has done a great job, as has the Secretary of State for Health. I wanted to put that on the record. We are reaching the climax of the Bill and this is the moment to pay tribute to those who so richly deserve it.

The object of new clause 2 is to amend section 46 of the Health and Social Care Act 2008. The section deals with health and adult social care services reviews and performance assessments. It comes under the rubric of reviews and investigations under chapter 3 of the Act on health care standards.

Section 46, “Periodic reviews”, provides that:

“In respect of each Primary Care Trust the Commission”—

the Care Quality Commission—

“must…conduct reviews of the provision of health care provided or commissioned by the Trust…assess the Trust’s performance following each such review, and…publish a report of its assessment.”

It also makes special provision with respect to each English national health service provider. Subsection (3) states:

“In respect of each English local authority the Commission must…conduct reviews of the provision of adult social services provided or commissioned by the authority…assess the authority’s performance following each such review, and…publish a report of its assessment.”

In the light of experience, and to improve the 2008 Act, particularly section 46, the new clause would substitute for subsection (3) the following:

“The assessment of the performance of a registered service provider is to be by reference to whatever indicators of quality the Commission devises, but must include indicators of the safety of health and social care services.”

The purpose of that is to require the CQC to ensure that the indicators used to assess ratings cover the safety of care, which goes back to the question of harm-free provision. Basically, the argument goes like this: the object is to stress that the CQC can be an effective regulator only if it is free of undue influence from Ministers. The measure is a good indicator of whether the Government are prepared to say that they want the CQC to be able to exert influence and carry out its functions irrespective of undue influence from Ministers. In other words, are they prepared to step back and allow the CQC to do its job properly?

The CQC has decided to make safety one of the key indicators for the assessment of provider ratings. As a result, safety is a critical component of the CQC’s new inspection regime. On many occasions, I have discussed with Ken Lownds over dinner and otherwise the origins of much of his thinking on the subject, some of which I had difficulty understanding—apparently some of it comes from aviation safety, but I will leave that to the experts.

Under the leadership of the three chief inspectors, the CQC has put in place specialist inspection teams able to scrutinise the quality and safety of care more rigorously. Inspections no longer simply consider whether providers are meeting the registration requirements, but provide a judgment about the quality of care on a scale running from outstanding to inadequate, offering providers, commissioners and local people fuller information about the quality of care.

The CQC’s tougher, people-centred, expert-led and more rigorous inspections are seeing some outstanding care, and the CQC has already rated many good services. That new approach has also exposed poor care and variations in care, making the level of quality transparent in a way it has never been before.

I have to say that my experience of what happened after Mid Staffordshire—this was before my hon. Friend the Member for Stafford came into the House, and I pay tribute to what he has done to help me since—was itself a matter of the gravest concern. Having witnessed what went on there, I then had to engage in a campaign, and I tried, unsuccessfully, to push the Government of the time into having a public inquiry, but Ministers, including two Secretaries of State, refused point-blank to hold one.

Furthermore, I had to nudge—if I can use that word—those on my own party’s Front Bench quite vigorously. I think that would be the appropriate description. That included our then shadow Secretary of State and the now Prime Minister, who responded magnificently, making an inquiry a manifesto commitment. One of the very first things the Government did when they came into power under the present Prime Minister was to say, “We will have this Mid Staffordshire public inquiry under the Inquiries Act 2005.” As a result of that and of the work of Ken Lownds, my hon. Friend and others of us who have been involved in this issue, including the sponsors of the Bill—I should also refer to them—we now have this new Bill in my hon. Friend’s name, which will make quality transparent in a way it never has been.

We are already confident of the great strides the CQC is making to be an effective regulator of health and social care providers. I hope that the Minister will accept that new clause 2 is exploratory, but I tabled it in the fervent belief that he will respond satisfactorily to my request, because this is a matter of grave concern.

If it is convenient, Madam Deputy Speaker, I will move on to the next new clause, unless my hon. Friend the Member for Stafford would like to respond to my points now. Would that be appropriate?

[Madam Deputy Speaker (Mrs Eleanor Laing)]

At this point, we are considering new clause 2 and new clause 3, so it would be appropriate for the hon. Gentleman to address new clause 3, if he so wishes.

[Sir William Cash]

That is very good. I just wondered whether my hon. Friend wanted to respond on new clause 2 before I move on to new clause 3.

New clause 3 proposes to amend section 83 of the 2008 Act, which deals with health and adult social services and with reports for each financial year. The new clause would insert proposed new subsection (2AA), which says:

“The reports under subsection 1(b), (c), and (d) must, in particular, cover the safety of health and adult social care services in England.”

To put that into ordinary language, the purpose is to require the Care Quality Commission to cover safety of care in the annual state of care report. That is hugely important, because it is the narrative to which people will be able to refer in identifying progress on these incredibly important provisions.

Armed Forces (Prevention of Discrimination) Bill

Debate between Baroness Laing of Elderslie and William Cash

Friday 24th January 2014 Commons Chamber

[Mr Cash]

On a point of order, Madam Deputy Speaker. Would it be possible for the Leader of the House to be called to the House to explain the circumstances in which, as I understand it from the House of Lords, the European Union (Referendum) Bill is now, in effect, a dead parrot?

[Madam Deputy Speaker (Mrs Eleanor Laing)]

I appreciate that the hon. Gentleman wishes to bring this news to the House and is using the mechanism of a point of order so to do, but this House has not, as yet, been informed of anything that has happened in the other place this morning. I am sure that the House will be informed in due course in the proper manner, and that when the news from the other end of the Palace reaches this end of the Palace, the necessary steps will be taken by the Ministers responsible.

European Union (Approvals) Bill [Lords]

Debate between Baroness Laing of Elderslie and William Cash

Monday 13th January 2014 Commons Chamber

[Mr Cash]

I am extremely interested in that because I recall that a serious dispute arose only a few days ago, when the distinguished Secretary of State for Education made remarks regarding the manner in which world war one was being addressed. The debate ultimately turned on the question of whether or not it was Germany that started the first world war, and I have no doubt at all, and nor did A. J. P. Taylor.

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. The hon. Gentleman rightly said earlier that the Chair would be keeping a watchful eye to ensure that this debate sticks to the purpose of discussing this very short Bill. At the moment the hon. Gentleman is just within the bounds of discussing Europe for citizens. He may be straying somewhat, however, and I am sure he will bring his remarks back to the subject under discussion.

[Mr Cash]

I certainly will, and precisely because of that reference to world war one. I took part in the debate on the Floor of the House about the idea of our helping to commemorate world war one, and I believe we can do it, as my hon. Friend the Member for North Thanet (Sir Roger Gale) said, on our terms without European money. It is about remembrance, and that is most emphatically in this Bill, as I am sure all Members of this House will recognise, so when I referred to the question of world war one, I was referring to the remembrance aspect of this strand of the programme. I would like to make it clear that I am very much in favour of that and in no way would want to prevent substantial remembrance events from taking place. Indeed, I shall be going to Normandy next year, where my father was killed in the second world war, and won the military cross, at Maltot near Caen. I shall be going there to commemorate all the brave men and women who died in the second world war and also to pay tribute to those who took part in the first world war. I am not against the principle of this, therefore, and I am very much in favour of moneys being provided for it, although I think we can do it on our own terms and we do not need this Bill to do it.

There is one final point I wish to make. I think the entire debate that we have had in the last few days about whether or not there should be vetoes and whether or not there should be disapplication of legislation is very important. For the reasons I have given, and because of the way in which the money, which is our money, is being spent by the European Union on projects that are not consistent with the voters’ wishes in general, this is not the kind of thing I would want to support. Furthermore, that is why I shall be voting against this Bill. I am also extremely surprised because I do not think the Minister is in any way disagreeing with my general proposition that, for the reasons set out clearly in the programme itself, this money is going to be made available to those who promote the political objectives of the European Union and the citizenship that goes with it and will provide substantial grants for that purpose.

All of these points are reasons why we should exercise a veto. Indeed, this proposal would provide a perfect example under my parliamentary sovereignty Bill, which I introduced a few months ago. If 100 Members were to decide they did not want something like this, I hope that would lead to its being vetoed.

In summary, I do not approve of this approvals Bill. This is all about democratic decision making. Let us bear in mind that the draft regulation is indeed a regulation, which is of a higher order even than a directive. We have to comply with every aspect of a regulation. I have great affection for the Minister, and I have heard what he has said. I greatly approve of almost everything he does, but not this measure. This should be a European Union disapprovals Bill.

Housing Benefit

Debate between Baroness Laing of Elderslie and William Cash

Tuesday 12th November 2013 Commons Chamber

[Mr William Cash (Stone) (Con)]

On a point of order, Madam Deputy Speaker. This afternoon in the High Court, there has been a ruling that the charter of fundamental rights is part of domestic law, irrespective of the European Union (Amendment) Act 2008 and despite what was said at the time. What can be done to stop this coach and horses going through Acts of Parliament, invading our supremacy, and what can you and Mr Speaker do to defend this Parliament?

[Madam Deputy Speaker (Mrs Eleanor Laing)]

The hon. Gentleman makes his point very well, as ever. However, as he knows, that is not a matter for the Chair.

High Speed Rail (Preparation) Bill

Debate between Baroness Laing of Elderslie and William Cash

Thursday 31st October 2013 Commons Chamber

[Mr Cash]

On a point of order, Madam Deputy Speaker.

[Madam Deputy Speaker (Mrs Eleanor Laing)]

We will hear the point of order after 4 o’clock.

[Lilian Greenwood]

The Government’s hopelessly ambitious timetable to pass the hybrid Bill for phase 1 by the middle of 2015 makes it even more important that we introduce stringent reporting standards. Even Ministers acknowledge that that plan is challenging, and that is putting it mildly. It appears to be certain that spending will continue under the authority of the preparation Bill beyond the general election. If it does, there must be proper reporting requirements in place. In fact, we submitted a similar amendment in Committee, and I am sorry it was deemed unnecessary at the time. I am glad the Government have been persuaded to think again and have accepted our amendment. It will make for a tougher Bill that makes Ministers accountable for bearing down on costs, and it will deliver better value for public investment.

[Mr Cash]

On a point of order, Madam Deputy Speaker. We have not reached the last group of amendments, which are vital to all the people in my constituency and throughout the country who are affected by the Bill. This point of order is about the travesty of proceedings in relation to the programme motion and all that goes with it.

[Madam Deputy Speaker (Mrs Eleanor Laing)]

The hon. Gentleman, as ever, makes his point, but as he and the House know, that is not a point of order. The timetabling of discussions on this Bill is a matter for the House.

Fixed-term Parliaments Bill

Debate between Baroness Laing of Elderslie and William Cash

Monday 13th September 2010 Commons Chamber

[Mrs Eleanor Laing (Epping Forest) (Con)]

We last debated this matter in the House on 16 May 2008. Contrary to what the right hon. Member for Blackburn (Mr Straw) said earlier this evening, on that occasion the Conservative Opposition did not oppose the Bill. I know that because I was speaking for the Opposition on that day. We said the matter was worthy of exploration and discussion and that we did not oppose the principle of fixed-term Parliaments.

I am sorry to have to quote myself, but I have checked exactly what I said:

“A cross-party organisation called Fixed Term was set up in October 2007…and has published the results of a poll conducted in October 2007. It found that 25 per cent. of Conservative MPs, 41 per cent. of Labour MPs and 88 per cent. of Liberal Democrat MPs support fixed-term Parliaments. If anything was to convince me to be against any Bill it would be the fact that 88 per cent. of Liberal Democrats…are in favour of it.”—[Official Report, 16 May 2008; Vol. 475, c. 1714.]

Well, times change—[Interruption.] Don’t they just. I do not know what the percentages are today, but there are good reasons for the Bill and I am happy to support it. However, that does not mean I shall not criticise it.

When the Deputy Prime Minister introduced the proposals some months ago, he said that the Bill was intended to strengthen the power of the House. I do not believe that it does so. At the moment, the House can bring about Dissolution by a simple majority, but the Bill will require in most cases a two-thirds majority. I do not believe that the Bill takes power away from the Executive and gives it to the House. That does not mean the Bill is fatally flawed; it just means that we ought to look at what it really does and not pretend that it gives more power to Parliament.

I draw the attention of the Parliamentary Secretary, Cabinet Office, my hon. Friend the Member for Forest of Dean (Mr Harper), to the concern we debated earlier and which was raised by the Clerk of the House before the Select Committee. I am honoured to be a member of the Committee and I endorse what its Chairman said earlier in the debate. Despite what the Deputy Prime Minister said earlier, it is possible that the Bill could bring about judicial review of events that occur and decisions that are taken in the House. I do not want to see that happen, not just as a matter of principle but because it disturbs the stability of the constitution and of the House. I sincerely hope that the Deputy Prime Minister and my hon. Friend have taken into consideration the concerns expressed by the House today and by the Select Committee and that we will return to these matters in Committee.

The evidence put before the House today is not conclusive. It is one legal opinion against another legal opinion, and the integrity of the House and what happens here should not be left in the balance between one legal opinion and another. I sincerely hope that the Minister will consider that point in Committee.

[Mr Cash]

Does my hon. Friend accept that it is possible that the very fact that the Clerk of the House of Commons has taken one view and that other lawyers have taken another view—albeit in a strange sequence—could be a reason why a court would be more than concerned to issue a judgment in its jurisdiction?

[Mrs Laing]

Yes. As ever, my hon. Friend makes an important legal point and we must not lose sight of it. We must remember that at one level we can have party political banter and House of Commons arguments, but at another level we must respect the stability of our constitution. It is not just a matter of legal opinion but of consulting the law properly. I am sure that what my hon. Friend has just said will be taken into consideration by Ministers.

We have to put the Bill in its true context. It is rare for me to find myself in agreement with the hon. Member for Great Grimsby (Austin Mitchell).