Pharmacy First

Jeremy Quin Excerpts

Wednesday 31st January 2024 Commons Chamber

[Dame Andrea Leadsom]

The hon. Gentleman raises a good point. Of course, pharmacists will be prescribing for seven common conditions. Plenty of referrals will be made to GPs, and from GPs to pharmacists, to give patients the accessibility and the appropriate level of assessment for their needs.

[Sir Jeremy Quin (Horsham) (Con)]

Pharmacies in Horsham have asked for such a scheme, so they will very much welcome it, as do I. However, as the Minister is aware from our one-on-one discussions, for which I am grateful, there are currently issues of access to pharmacies in Horsham. Will she ensure that the sector is appropriately resourced and has the right training in order to ensure that the scheme is the great success that it deserves to be?

[Dame Andrea Leadsom]

Absolutely, and I am always happy to discuss that further with my right hon. Friend.

Oral Answers to Questions

Jeremy Quin Excerpts

Tuesday 23rd January 2024 Commons Chamber

[Mr Speaker]

I look forward to seeing that in Chorley.

[Sir Jeremy Quin (Horsham) (Con)]

I warmly welcome what my right hon. Friend said last week about encouraging research on lobular breast cancer, and I look forward to meeting the Under-Secretary of State for Health and Social Care, the hon. Member for Lewes (Maria Caulfield), shortly to work out how we can operationalise what is her clear ambition.

[Victoria Atkins]

I thank my right hon. Friend and my hon. Friend the Member for Bishop Auckland (Dehenna Davison) for bringing two amazing women to talk to me about the impact of lobular cancer. For the benefit of Members on both sides of the House, last week we sent out a “Dear colleague” letter and graphics about the women’s health strategy so that we can all help our constituents to understand what this Conservative Government are doing to ensure that the healthcare of women is faster, simpler and fairer.

Oral Answers to Questions

Jeremy Quin Excerpts

Tuesday 5th December 2023 Commons Chamber

[Maria Caulfield]

As I said in an earlier response, there is a global shortage of ADHD medication. As we set out in our response to her written question, we expect that to be resolved shortly.

[Jeremy Quin (Horsham) (Con)]

Lobular breast cancer treatment must be improved. Will the Minister meet my constituent and me to discuss how?

[Andrew Stephenson]

Yes.

Mental Health Units (Use of Force) Bill

Jeremy Quin Excerpts

3rd reading: House of Commons
Friday 6th July 2018 Commons Chamber

[Jeremy Quin (Horsham) (Con)]

I congratulate the hon. Member for Croydon North (Mr Reed) on this Bill, which I support. I have two concerns that I raised on Report, one of which relates to training, which was touched on by my hon. Friend the Member for Croydon South (Chris Philp). The promoter of the Bill dealt with those admirably on Report, as he has throughout the progress of the Bill, and that certainly settled my concerns.

Of course, we will have other concerns. We all know that legislating in this place is one thing, but ensuring the enforcement of that legislation is another. There are areas—social care and others—where we all have questions to ask ourselves about enforcement of stuff that gets through this House. However, I know that this Bill is sound, and it puts this country in the best place in the world for legislation on this area. I congratulate the hon. Member for Croydon North on what he has been doing. I know that he will be as doughty on ensuring that we have proper enforcement as he has been in promoting the Bill.

I echo the words of the hon. Member for Liverpool, Wavertree (Luciana Berger): this is a fantastic example of where a truly dreadful, appalling incident in an hon. Member’s constituency has provoked questions and led to an investigation, to thought, and ultimately to legislation. That is the purpose of private Members’ Bills, which, if properly scrutinised and if proper time is given, can really have a positive impact for our constituents. A dreadful incident has hopefully produced, via the work of the hon. Gentleman, a lasting legacy. I congratulate him once again on this Bill. I wish Seni’s law, as I hope it will soon become, Godspeed in its remaining stages.

ME: Treatment and Research

Jeremy Quin Excerpts

Thursday 21st June 2018 Westminster Hall

[Carol Monaghan]

I will come on to interactions with the Department for Work and Pensions. ME patients report that energy levels vary. Sometimes, going to such an appointment can wipe out someone for many weeks afterwards. If that person were to attend the appointment the following day, their condition would be very different.

[Jeremy Quin (Horsham) (Con)]

I am delighted that the hon. Lady has secured this debate. She referred to the seriousness of ME and how many people are affected. Does she agree that for it to be taken seriously and proportionately to its scale and impact, that needs to be reflected in every area, including the amount of medical research that is devoted to ME? It is certainly a point that my constituents are concerned should be raised in this debate.

[Carol Monaghan]

ME receives practically no biomedical research funding, which I will come back to. Because of the misunderstanding of the condition, the treatments available are often more damaging to the person than no treatment at all.

Merryn Crofts was just 15 when she experienced hives and swelling in her joints after a family holiday in Majorca. Tests revealed that she had contracted glandular fever. Despite dozens of medical appointments, Merryn’s condition deteriorated; she suffered breathing problems, exhaustion and excruciating hypersensitivity to touch, light and sound. She was eventually diagnosed with ME. This once bright young woman was forced to wear an eye mask and suffered from severe migraines, brain fog, slurred speech and persistent infections. Stomach problems and difficulties swallowing meant that her weight plummeted to just 5½ stone. Merryn was eventually fitted with an intravenous nutrition line but was given a terminal diagnosis in 2016. Merryn wrote in her blog:

“Having severe ME, is like being trapped in your own body every single day. There is no rest, you are bedbound all day every day. It snatches the most simple things away from you like being able to wash yourself, even in bed. Being cared for in every way possible. In terrible pain, from everything. Not being able to talk on the phone or have visitors, and feeling worse about saying no every time someone asks again. Months and months in hospital. Severe infections. Breathing problems. Low immunity. Problems anywhere and everywhere in the body. Paralysis. Severe hypersensitivity. The list is endless, and if I was physically able to type I would carry on. Spread awareness and remember all of us and all of those who have lost their lives.”

Merryn died on 23 May 2017, just days after her 21st birthday.

Why is the treatment for people with ME so poor? The lack of understanding shown by some healthcare professionals of a person’s suffering is one of the greatest frustrations to the ME community. Much of that stemmed from the publication of the controversial PACE trial. The treatments investigated in the PACE trial were based on the hypothesis that ME patients harbour “unhelpful” convictions about having a disease and that the continuation of their symptoms is the result of deconditioning.

The PACE trial compared different treatments, including cognitive behaviour therapy—CBT—and graded exercise therapy, or GET. The results that were published in The Lancet in 2011 seemed to show that GET and CBT could bring about some improvements in a person with ME. Although that may seem positive, if we dig a little deeper we discover that the parameters for recovery were changed midway through the trial and the results depended on self-reporting. Patients have told me that they were pressurised to describe improvements they really did not feel. One participant in the original trial said:

“After repeatedly being asked how severe...my symptoms were. ..I started to feel like I had to put a...positive spin on my...answers. I could not be honest about just how bad it was, as that would...tell the doctors I wasn’t trying and I wasn’t being positive enough.”

Mental Health Units (Use of Force) Bill

Jeremy Quin Excerpts

Report stage: House of Commons
Friday 15th June 2018 Commons Chamber

[Mr Reed]

Thank you, Mr Speaker. I have sympathy for what the hon. Member for Shipley (Philip Davies) said, but I hope that during today’s debate we will find ways of achieving the objectives of his constructive amendments.

The Bill is known as Seni’s law after Seni Lewis, a young man from Thornton Heath in my constituency who died in 2010 after a period of severe and prolonged face-down restraint. Seni is one of too many people who have suffered unnecessary and avoidable deaths in our mental health services, and that comes alongside any number of unnecessary and avoidable injuries. Following the inquest into Seni’s death, the coroner’s verdict was clear that, without change, what happened to Seni will happen again, and it has already happened to others. That change is this Bill, and I am grateful for support from Members on both sides of the House, the Minister and every single professional and patient advocacy group working in the sector.

New clause 1 is probing. It arises from the fact that Seni Lewis’s parents, having suffered the trauma of the loss of their child in completely avoidable circumstances in 2010, had to fight the state for seven years simply to obtain an inquest to find out how their previously healthy 21-year-old son ended up dead on the floor in hospital. The coroner pointed to severe failings by the mental health trust, the police and the Crown Prosecution Service that led to delays in that inquest opening. The root cause of the problem was the insufficiently independent investigation conducted by the mental health trust into its own failings. The answer is to ensure that any death in such circumstances automatically triggers a fully independent investigation into the circumstances and causes of that death, with legal aid provided to the families of the deceased persons so that there is a level playing field for all parties taking part in the inquest.

Currently there is a huge disparity between how investigations are conducted for deaths in mental health units and those in other forms of state detention. When somebody dies in police custody, an external investigation by an independent national body happens automatically, but the same does not happen in a mental health setting. If a patient dies, the trust or private provider investigates itself or appoints another trust or individual to do so. That lack of accountability means that reports can be delayed or kept quiet, and can lack the necessary independence and rigour.

[Jeremy Quin (Horsham) (Con)]

I congratulate the hon. Gentleman on the progress of the Bill, which I hasten to say that I support, but I have a concern about new clause 1. I appreciate that he has tried to address it in subsection (7), which aims to avoid conflict with the coroners, and he may have dealt with my concern, but I was worried about the interaction between the new independent report, the coroner’s work and the work of the police, if that is relevant. The hon. Gentleman referred to the external reports produced in other custodial circumstances, so is he able to reassure the House that, were this proposal to go ahead, there would be no conflict between the different authorities: the coroner, the police and the author of the independent report that goes to the Secretary of State?

--- Later in debate ---

[Mr Reed]

I hear what the hon. Gentleman is saying, but the point remains: if we take measures to deal with only physical restraint but not chemical restraint, we may simply push the services to use chemical restraint, such as rapid tranquilisation, more frequently and we would not wish to see that as an unintended consequence of amending the Bill further.

On the nature of the use of force, the hon. Member for Shipley has tabled amendments 44 to 78, which would replace the word “force” with the term “ restraint” throughout the Bill. I do not wish to pre-empt his reasons for doing that, and I suspect he will explain himself well later this morning, but let me say that we used the term “restraint” rather than “force” during an earlier draft of the Bill, so I agree with the general intention behind these amendments. I was persuaded, however, that the current wording ensures greater consistency with other legislation and therefore that the Bill does not run the risk of adding confusion into how the professionals interpret the language used.

The right hon. Member for North Norfolk has tabled a number of amendments dealing with the information provided to patients. Amendment 38 would include in the information given to patients details of their right to independent advocacy, which would help the patient to make the right decisions about their care and involve, where appropriate, carers and families. I certainly agree on the need to give more power to service users, so I would gently encourage the Minister to set out how those objectives might be achieved.

The Bill, as amended in Committee, says that information does not need to be provided where it would “cause the patient distress”. I understand that the hon. Member for Christchurch also has concerns about that, which is why both he and the right hon. Gentleman have tabled amendments to remove that potential loophole. I agree on this, and following discussions with the Minister, I am happy to accept Government amendments 1 to 3, which remove this “distress” loophole.

On staff training, the hon. Member for Shipley has tabled amendments 11 and 12, which seek to strengthen the Bill by adding usefully to the list of training topics. I know that he has discussed the Bill with his local care trust, and I welcome that spirit of engagement and representation. Amendment 11 would require training to be given on “roles, responsibilities and procedure” if the police are called to a mental health unit, as happened in the case of Seni Lewis and in many others. That strikes me as a sensible addition to the Bill, ensuring a more joined-up approach between police officers and staff in mental health units. Amendment 12 would also strengthen the Bill. It would add

“awareness of acute behavioural disturbance”

to the list of training topics. That is clearly a valuable thing for staff to be aware of in terms of how restraint may affect someone displaying behavioural disturbance. I support amendments 11 and 12, but before accepting them, it is important to hear whether the Government intend to deal with them through guidance.

There are, however, amendments that I am not happy to accept. Amendment 9 would remove the need for training on diversity, but that is a crucial part of the improved training and it goes to the heart of the Bill’s purpose in ensuring equal treatment for everybody by identifying those areas where treatment is not being delivered equally to everybody, whether because of ethnicity, type of disability or gender. If we do not capture that data, we cannot see the problem, and if we do not recognise the problem, we cannot put in place the measures to deal with it. Therefore, I cannot support that amendment.

[Jeremy Quin]

I wonder whether the hon. Gentleman has any thoughts on amendment 113, which I do not think will be debated. It was tabled by my hon. Friend the Member for Witney (Robert Courts) and it seeks to define what “regular intervals” are and whether there should be annual training. At the moment, the training is to be given at “regular intervals”, so does the hon. Gentleman have any thoughts on how regular those intervals should be and whether there should be an annual stipulation?

[Mr Reed]

I agree with the sentiment, but I do not think that the Bill should be too prescriptive. It is for the Government, working with professionals in the field, to determine the appropriate period within which refresher training should take place. However, it should definitely take place, because training done several years previously can easily be forgotten or the circumstances can change. There is always a need to keep professional practice absolutely up to date.

Research shows that there are real fears about unconscious bias in our mental health services. The Angiolini review, published by the Government last year, shows how a disproportionate number of people from black, Asian and minority ethnic communities have died after the use of force in custody. Black people are four times more likely to be sectioned than white people. Training must reflect those challenges and consideration must be given to the effects of that kind of unconscious bias.

There are also concerns, as shown in amendment 13, proposed by the hon. Member for Shipley, about the frequency with which staff receive training—indeed that point has just been made in this debate. The principle of refresher training is important and the Bill deliberately does not specify how often it is provided, as that needs to be up to the Government, in consultation with professionals. I welcome and accept Government amendment 4, which ensures that training need not be undertaken by a member of staff if they have recently been trained to an equivalent standard.

Turning to the recording of data, the Bill sets out what should be recorded by mental health units when using force, and this is how trusts will be held accountable for the types and frequency of restraint used, as well as which patients they use it on. A number of amendments have been tabled on this issue, and I will deal with a few of them. I appreciate that there is concern about the provision in clause 7(2), which provides that the use of “negligible” force does not have to be recorded; amendments 102, 103 and 39 seek to remove the subsection. I shared similar concerns at an earlier stage of the Bill because I, too, feared that this might be a loophole. The reason this provision is in the Bill is that we want to avoid unnecessary burdens on staff, who might feel otherwise that they have to record every physical contact, such as guiding a patient through a door by the elbow. Such recording would be unnecessary and it is important that the Bill does not set up such circumstances.

I welcome the Minister’s assurance that the definition of “negligible” will be very tightly defined in the guidance, and I hope that gives the proposers of those amendments reassurance on the point that was behind them. The Minister has shown real commitment to building consensus on this Bill as it is has developed and I am sure she will do the same on the guidance. I hope that that encourages those Members not to press those amendments to a vote.

On what data should be recorded and why, I note that the hon. Member for Shipley proposes that the characteristics of staff who carry out restrain should also be recorded. That makes sense to me in principle, and the point has been made to me by people who work in the sector. There are real concerns about pre-existing prejudice against people with mental ill health, which might lead to inappropriate behaviour by some staff if it is not identified and corrected. However, up to this stage in the Bill’s development, there has been no engagement with the sector on this point, and the opinions and experience of those who work in the sector must be taken into account before we legislate. I look forward to hearing the Minister’s views on that, but my preference is for the issue to be considered through consultation, after legislation, and to be dealt with through guidance, if necessary.

Breast Cancer Screening

Jeremy Quin Excerpts

Wednesday 2nd May 2018 Commons Chamber

[Mr Hunt]

Absolutely. That will be one of the most important things that the review does.

[Jeremy Quin (Horsham) (Con)]

Tragically, it seems that the flaws were of long standing—I think the Secretary of State referred to a decade or more. Notwithstanding the length of time that has passed, will he assure the House that lessons will be learned that relate back to the procurement and design decisions that were made at the outset?

[Mr Hunt]

Absolutely. There are basically two parts to this process. One is what the problem was with the original procurement, and the other is the problem with the assurance of the project over the time period.

Mental Health Services: Children and Young People

Jeremy Quin Excerpts

Thursday 8th March 2018 Commons Chamber

[Steve Brine]

We always look at the actions being taken in Scotland and in all the devolved Administrations. The hon. Gentleman is right to touch on prevention, which was the first point he made. The proposals in the Green Paper are focused on providing significant support for schools to develop the work they already do on prevention and early intervention. Today’s report talks about the many good things that are going on and, as I said, some of the things we have already taken forward with the Green Paper. While we are kicking this about, let us just remember in these exchanges that this is about the health of young people in England, whom we all represent.

[Jeremy Quin (Horsham) (Con)]

The CQC has recommended that Ofsted should be charged with looking at what schools are doing to support mental health. Will the Minister take that up with his ministerial colleagues in the Department for Education?

[Steve Brine]

I am sure my colleague the Under-Secretary of State for Health, the hon. Member for Thurrock (Jackie Doyle-Price), who is responsible for mental health, will be taking that up as she considers responses to the Green Paper. My hon. Friend the Member for Horsham (Jeremy Quin) is absolutely right to raise that issue and I thank him for doing so.

Social Care

Jeremy Quin Excerpts

Thursday 7th December 2017 Commons Chamber

[Jackie Doyle-Price]

I know that the hon. Gentleman cares deeply about this issue and he has rightly raised it with me before. I reassure him that the Government are now acting, and we are in close contact with providers to address those issues. It is important to ensure that employers uphold their obligations under minimum wage legislation, and we must not put at risk anybody who is dependent on long-term care—I am satisfied that no one is at risk. We are working in detail with providers to ensure that we get them through this.

[Jeremy Quin (Horsham) (Con)]

West Sussex has some specific social care issues currently under investigation, and it would be inappropriate for the Minister to comment on those at present. However, I warmly welcome the expert panel. Will the Minister please ensure that it is fully acquainted with the lessons learned on financing from previous scandals, such as that at Orchid View in my constituency?

[Jackie Doyle-Price]

Absolutely. My hon. Friend mentions the expert panel, and it is important that we take the advice of those who have front-end experience of the sector. As he says, this is not just about money; it is about quality and getting the right blend of packages of support and help. We really need to think about achieving the best possible care for individuals, as well as how that care is paid for.

Care Homes for Older People

Jeremy Quin Excerpts

Thursday 3rd November 2016 Commons Chamber

[Peter Heaton-Jones]

Members on both sides of the House know that social care provision is one of the biggest challenges that we face, but that debate must be for another day. My debate is about something very specific: the way in which privately run care homes for elderly people are inspected and regulated, and the process that exists to raise complaints when relatives believe that something is going wrong. This is vital for two reasons. First, we are talking about nothing less than the welfare of vulnerable elderly people. Secondly, I believe it is possible to make significant improvements at relatively little cost, and I hope in the next 15 minutes or so to set out why.

Before I do so, I will provide a little background. Why have I taken up this cause? Three years ago, while I was still a mere parliamentary candidate, a local resident in North Devon told me a very moving story. John Barrass’s mother, Vera, a former resident at a private care home, died in 2009. Mr Barrass had serious concerns about the care she received in the final weeks of her life, and believed that a poor system of inspection, regulation and complaint handling was a significant factor. Specifically, he believed that a mechanism did not exist to allow him satisfactorily to raise his concerns about shortcomings in his mother’s care.

I do not seek to reopen that case, and neither does my constituent. In the years since his mother died, Mr Barrass pursued all avenues available to him to have her case fully investigated. He invariably hit a brick wall, so he began to look beyond his individual circumstances to examine instead the more general question of how care homes are inspected and regulated, and how complaints are dealt with. He came to the conclusion that the system was simply not fit for purpose, and he met me to explain why. That was the birth of a long campaign, which reaches another milestone with this debate.

Tomorrow marks the first anniversary of my raising this matter in Westminster Hall on 4 November 2015. Since then, I believe we have made some progress, but much of what I said at the time still stands today. What I have to say is based largely on a report produced by Mr Barrass, which I have here, called “Care means care, Justice in care”. The report was created in memory of his late mother Vera who, in Mr Barrass’s words,

“spent a nightmare in care,”

which led him to spend seven years producing this document.

I have helped Mr Barrass to take this to the very top. The previous Prime Minister, my right hon. Friend the former Member for Witney, received a copy and arranged a meeting with the former Minister, my right hon. Friend the Member for North East Bedfordshire (Alistair Burt). I am delighted to see him in the Chamber and pay tribute to him for the work that he did in this area, and for his sincere engagement with me and this campaign. Recently, the document was sent to the current Prime Minister. I quote Mr Barrass’s letter to her:

“I cannot bring my mother back or stop what I have agonisingly had to witness and go through, but I can try to stop this happening to others”.

I agree. An estimated 300,000 older people currently live in some 15,000 registered care homes in England. The average age of those people is 85, and a significant proportion suffer from dementia. They are largely without a voice, and that needs to change.

[Jeremy Quin (Horsham) (Con)]

I congratulate my hon. Friend on his campaign and his persistence with it. The matter affects many of us in this House; my constituents are still concerned about Orchid View care home and the issues that arose out of that. Does he agree that we have to learn from the mistakes of the past? We should have proper inquiries and proper investigations, and we should learn from those mistakes.

[Peter Heaton-Jones]

I thank my hon. Friend; I am sure that the Minister will have heard his comments. We need to move forward, and when things go wrong, we need to put them right.

The body responsible for the regulation and inspection of care homes is the Care Quality Commission, with which I have worked closely since launching this campaign. I believe that it is listening, but there is still considerable room for improvement. Today, the CQC’s website tells us that of the 448 care homes it has inspected most recently, a staggering 200—45%—have been rated as “requires improvement” or “inadequate”. There is no reason to believe that those figures are unrepresentative of the sector as a whole, which means that more than four in 10 of all establishments are not reaching the required standard. Surely the purpose of any system of inspection and regulation must be to drive up standards. The figures alone suggest that the current system simply is not working.

In June 2013, the CQC issued a consultation called, “A new start”, which proposed a whole new approach to inspection across all sectors, including care homes. That approach was confirmed in October 2013, and the new inspection regime was introduced. I broadly welcome it, but there are still huge question marks over its implementation. The original deadline for carrying out an initial inspection of all care homes was February 2016. However, in July 2015, the National Audit Office found that just 9% of care homes had been assessed because of a shortfall of about 160 inspectors. Not surprisingly, the original February 2016 deadline to complete the work was not going to be met, so it was pushed back to this October—last month. Yesterday, when my office asked the CQC for an update, it told us that it is

“committed to completing the first phase of the comprehensive inspection programme by March 2017”.

In other words, this new deadline—the third—is more than a year later than the original target.

I absolutely recognise that the CQC faces many challenges. The managers and inspectors are working hard, but my point is that we would not accept a delay of more than a year in the inspection of NHS services, so we should not accept it just because we are dealing with private sector care homes. We are still talking about vulnerable people who might well be suffering. We need to get a grip on this problem and to challenge the CQC to undertake its inspection programme in as timely a way as possible. I seek to be helpful when I say, “Let us, as a Government, work with the CQC to ensure that it delivers what seems to me to be such an important inspection programme without further delays.”

That brings me to another major area of concern: the CQC’s role in handling complaints, and indeed the role of myriad organisations and authorities involved in this area. What can someone do if they fear that an elderly relative is being neglected or mistreated, or is not being given the right healthcare? What can they do if they fear that their relative’s life might even be in danger, and the care home provider has dismissed the complaint or will not even listen to it?

When things go wrong, and a member of the public needs to make a complaint against a care home, they are faced with a bewildering labyrinth, and that needs to change. The website of the CQC, the body responsible for the regulation, says that the CQC

“is unable to investigate individual complaints”

against providers. To many people, that will seem odd.

Many people are in care homes commissioned by their local authority, so that offers another route for making a complaint. However, the complaints procedures in many local authorities—I speak as a former councillor in a unitary borough—consist of several layers, shall we say, and such a system does not lend itself to a speedy resolution. Not all people in care homes are in places paid for by local authorities, but even if they were, their complaint may fail to get through those many layers.

Should such an individual go to the Parliamentary and Health Service Ombudsman? Again, no, because that is another brick wall. The ombudsman says:

“By law the Ombudsman cannot look into complaints about privately funded healthcare.”

There is another possibility, which is an organisation called the Independent Healthcare Sector Complaints Adjudication Service. The ombudsman’s website states that people “may”—I stress that word—“have the option” of going to that organisation, which covers some independent healthcare providers, but if the healthcare provider of the person concerned is not one of them, they are stuck.

In a nutshell, the system is bewildering. It lacks accountability and transparency, and would leave most people confused and frustrated. People simply do not know who to turn to when they are worried that something is not right. Given that level of confusion, let us imagine what the situation is like for people whose elderly relative is in a care home. They are worried and in an emotional state, yet still have to deal with an incredibly complex complaints procedure.

I believe we could solve this quickly and cheaply, simply by requiring every care home to display a standard notice clearly setting out the complaints procedure with the relevant contact details. It seems incredible—I use the word in its literal sense—that that is not already mandatory. I ask the Minister to investigate with the CQC the possibility of producing such a notice. Something that simple really could make a huge difference.

As for the longer term, in the document I referred to earlier, my constituent John Barrass is convinced that we need one body only to investigate, regulate and handle complaints about care homes, with that being its one and only purpose. That suggestion deserves serious consideration.

A further problem thrown up by this entire process has been highlighted effectively by an organisation in Devon—not in my constituency, as it happens, but elsewhere in the county—called Your Voice Matters. I pay tribute to its founder and director, Jenny Moore, who has done very good work in this area. I have met her a number of times, most recently yesterday, in preparation for this debate. The issue in question is the growing number of cases where relatives are banned from care homes simply for complaining. This can take the form of a complete ban or of restricted visits; in some cases, it has even been known to lead to the eviction of the elderly person from the home.

Your Voice Matters has launched a good campaign called “Rights 2 Speak Up 4 Care”. It has identified the issue succinctly. In a nutshell, it is that private care homes are defined in law as ultimate landlords. Quite simply, they can decide who goes on the premises and who does not. Families who raise concerns are threatened or banned. As I have said, sometimes residents are evicted, and a private paying resident is not protected under any legislation—not the Health and Social Care Act 2012 nor the Human Rights Act 1998, for example. A private care home also has the power to prevent health professionals from visiting the home. Let us think about that for a moment: a care home has the power to stop doctors and nurses going into it to visit its clients.

Something has to change. Recommendations from Your Voice Matters include legislation to close those loopholes and to give protection to all residents and their families, a review of the relevant legislation and an independent panel to offer a fair hearing should a private care home want to place restrictions on a family member or a resident. Your Voice Matters has been working on this for some time, and literally yesterday—just yesterday—there was something of a breakthrough. In the run-up to this debate, there has been a flurry of media activity, with TV and radio programmes covering the issue. Yesterday, the CQC published new guidelines on its website. Care homes will now be required to keep a register of any occasions when relatives are banned or people are evicted. I am not convinced that that goes far enough, but it is a start, and I will keep working with Your Voice Matters to ensure that we go further.

That campaign group has made a number of other recommendations that I will mention briefly, as they have considerable merit. It suggests there should be better protection for whistleblowers who wish to highlight shortcomings in homes, as well as better training, with a mandatory training course for all those who work in or manage care homes.

I have referred several times to my constituent Mr John Barrass. He has carried out an investigation lasting seven years but, as he says, he is only one of the 65 million little people in the UK—those are his words—who are very rarely listened to but whose experiences, and what they have witnessed and suffered, should not be ignored any more. He says:

“I just wish we had been raising these issues before mum had this serious stroke, and helped to change the care system. Maybe, just maybe, my mother would not have had to go through what she did and my father and I would not have gone through 11 years of suffering.”

I want to leave enough time for us to hear from the Minister, but let me be clear about one further thing before I conclude. Many fantastic caring professionals work in care homes. They do their jobs on low wages and care brilliantly for many people. The owners and managers of many care homes are committed to providing the best possible service. They face all the pressures of running a small business and the costs that that entails. There are good managers, investigators and staff at the CQC. I do not wish to criticise those who are doing well, but I do seek to call out those who need to do better.

I should briefly mention the many organisations and individuals who contacted me in advance of the debate. I am unable to name them all, but I have received good representations from the British Medical Association, Independent Age, Hootvox, which is an organisation looking at ways to measure the success or otherwise of care homes, and many other individuals and constituents.

I end with this thought. The problem is that we have a growing number of cases in which care homes are simply not coming up to scratch. I have spent many days, weeks and months on this, discussing it with my constituent John Barrass and the Your Voice Matters campaign group in Devon. Whenever we discuss it, we keep coming back to one thing. I said exactly this a year ago in Westminster Hall and I say it again now: this is not about processes, systems or organisations, but about people—people who do not have a voice in a system in which, let us remember, four in 10 care homes fail to reach a satisfactory standard on the CQC’s measures. That means that some vulnerable, sick and elderly people are not being properly cared for. That cannot be right. I look forward to hearing from the Minister. We have to do something and we have to act now.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Nicola Blackwood)]

I thank my hon. Friend the Member for North Devon (Peter Heaton-Jones) for securing this important debate. He is a doughty campaigner. As he said, it is almost a year to the day since he last raised the issue in the House and he has taken much action since. I pay tribute to my predecessor, my right hon. Friend the Member for North East Bedfordshire (Alistair Burt), for his work. He has laid great foundations for the work we are doing now. As he said, care homes play a vital role in our society, but the decision to move into a care setting or place a family member there can be exceedingly stressful. It is essential that the public have confidence in the quality of care that they seek. Poor care, abuse and neglect are completely unacceptable at all times, whatever the cause, and we are determined to stamp them out.

My hon. Friend the Member for Horsham (Jeremy Quin) is right that we must learn from the mistakes of the past. That is why in October 2014 we introduced a tougher CQC inspection regime based on the five important questions that matter most to people: are services safe, caring, effective, well led and responsive to people’s needs? It is why we brought in a new criminal offence of ill treatment and wilful neglect, and why a fit and proper person test has been introduced to ensure that providers do not recruit directors who are known to have been responsible for unacceptable standards of care.

The CQC can and does take robust action against providers that breach regulations and standards, from issuing warning notices and fines, through imposing conditions on a provider’s registration, to cancelling that registration altogether. During 2015-16, the CQC took 901 enforcement actions in adult social care, ranging from warning notices to prosecuting providers.

The CQC now has specialist inspection teams, which under the leadership of the chief inspector of adult social care include people who have personal experience of care. Inspections are required to take into account the views of service users and their families. Furthermore, the great majority of its adult social care inspections are now unannounced. The timing of inspections is based on assessment of provider risk, but their frequency in usual circumstances can be expected to be at least every 24 months.

The CQC’s fundamental standards that registered providers are required to meet include two very important registration requirements. The first is the duty of candour, which requires providers to be open with service users about all aspects of their care and to inform service users where their failures are in their care. The second is, as I have said, a fit and proper person requirement for directors that ensures that accountability for poor care can be traced all the way to the boardroom if necessary. These standards now give the CQC an effective power to prosecute providers in cases where a failure to meet standards results in avoidable harm or a significant risk of such harm.

[Jeremy Quin]

Will my hon. Friend or one of her ministerial colleagues kindly meet me and my hon. Friend the Member for Crawley (Henry Smith) specifically on that point in relation to Orchid View? We would be most grateful if that was possible.