Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2025

Lord Kamall Excerpts

Monday 10th February 2025 Grand Committee

[Lord Scriven (LD)]

My Lords, again I thank the Minister for clearly and aptly outlining what the statutory instrument is for. I am not going to go over the reasons for this but, broadly, these Benches support what is happening and understand why the streamlining is required. However, like all streamlining where common sense seems to take the central point, it is worth testing just how common and sensical the requirements are, and whether the Government have thought through some of the consequences—or unintended consequences—of what may happen. Although the intention to maintain regulatory oversight and uphold care standards is obviously commendable, several points warrant further investigation and probing. I hope that the Minister will answer in her normal way; she is usually quite thorough and detailed.

The Explanatory Memorandum notes that a post-implementation review conducted in July 2022 had limited responses, providing insufficient evidence to suggest that the 2014 regulations did not meet their original objectives. Could the Minister elaborate on the steps taken to engage stakeholders during this review? What measures will be implemented to ensure that, when statutory instruments are extended in future, more comprehensive stakeholder participation will be sought? The amendment mandates having a review every five years. Given the dynamic nature of health and social care, how will the Government ensure that the regulations are monitored and remain responsive to emerging challenges and innovations within the review period?

Removing the expiry date also extends the regulations indefinitely. Have the Government assessed the potential long-term impacts of this permanency on service providers and the CQC’s regulatory capacity? I think the noble Baroness knows why this question is being asked. Although I heard what she said about the operational issues that the CQC is undergoing at the moment, the regulatory changes that we are discussing may have some operational impact on the CQC.

In particular at the moment, when the CQC’s backlog is significant and its chief executive has said that it has no idea how it will deal with it—indeed, there are certain things stuck in the computer system that they do not know how to get out—how will the Government ensure in the interim that any application made to the CQC regarding this instrument is dealt with in a timely and safe manner?

Finally, on the policy areas that the Minister said were outwith these regulations due to further consultation and the sensitivity required, when will the statutory instrument be laid before Parliament? What is the timescale? Are any interim measures being put in place to ensure that any safety issues or regulatory issues with these sporting events are dealt with before the statutory instrument is laid before Parliament?

With those questions, we are, as I say, very supportive of this instrument in a broad sense, but the Minister’s normal detailed response would be welcome.

[Lord Kamall (Con)]

My Lords, I once again thank the Minister for the statutory instrument before us. We understand the reason for it: making sure, in particular, that this continues to be in effect after March this year, and setting the next review for 2028. Maybe that is where some of the questions arise—the noble Lord, Lord Scriven, alluded to some of these concerns.

We have just finished debating an SI on adapting for innovation—particularly in relation to speeding up clinical trials, which is to be welcomed. It showed that we need to be flexible with the emergence of new technology, knowledge and capabilities in health and social care. But, like the noble Lord, Lord Scriven, we wonder about a five-year review cycle, which may not allow for sufficient flexibility, given some of the fast-paced developments in healthcare. We have seen massive strides in digital health and mental health services. In our debate earlier in the Chamber, we asked about the use of AI in analysing data that the NHS already has. Will five years be too long to wait? Could it slow down the adoption or reviews, if you like, of some of these new technologies? Could the delay in reviewing regulations lead to some important issues being unaddressed for far too long? There may be new awareness of some emerging patient safety risks, for example. I just wonder: how do we get the right balance? I understand why the Government have extended this for five years, but we want to make sure that, within those five years, the Government, the NHS, the regulations and the CQC are flexible enough to take account of innovations.

The absence of interim mechanisms for addressing pressing issues during this review period could also foster a sense of regulatory stagnation. There may well be a case where providers and stakeholders feel that concerns are not being acted on quickly enough, especially as challenges arise before that next review. Although we understand the need for a stable framework, we want to understand how to get the balance between stability and responsiveness right. Could that delay necessary regulatory adjustments?

The other point here is extending the scope of the regulations to all patients being assessed or treated for a mental health disorder in a mental health unit. Obviously, this coincides with the debate that noble Lords are having on the Mental Health Bill. In this case, it extends beyond only those with learning disabilities and autism. This expansion is generally welcomed, but, once again, it raises questions—which were raised on the last SI—about resources and capacity. I know that the Minister has heard this a number of times, particularly during the passage of the Mental Health Bill. Will there be sufficient support for providers so that they can meet these expanded requirements? How will the Government monitor and address any challenges that may arise from this broader scope?

Fortunately, the Minister pre-empted one of the questions that I was going to ask about the regulations’ provisions on temporary healthcare settings, particularly at large sporting and cultural events. We understand the need to remove those regulations, but what thought has been given to the unintended consequences of doing so? I am generally supportive of removing regulations, but I understand why we need them: to make sure that enough account is taken of safety but also that someone is held responsible and there is some accountability when things go wrong.