Care Bill [HL]

Debate between Lord Low of Dalston and Lord Deben

Monday 21st October 2013 Lords Chamber

[Lord Low of Dalston (CB)]

My Lords, I shall speak briefly against Amendments 145, 146 and 149. As the noble Baroness, Lady Greengross, has just pointed out, these will take away the requirement that the CQC conduct periodic reviews of adult social care commissioning. These amendments seem perverse, coming hard on the heels of the latest care home scandal, revealed by the coroner’s finding that neglect contributed to the deaths of five residents at Orchid View care home in West Sussex.

Last week, the Close to Home report on human rights and home care by the Equality and Human Rights Commission concluded that some commissioning practices were likely to put at risk the human rights of older people receiving care. The Leonard Cheshire report, Ending 15-Minute Care, also points to problems with commissioning. It would therefore seem to make sense to leave Clause 83 unamended so that the CQC is empowered to oversee the practices of those commissioning adult social care and not just of those providing it.

[Lord Deben (Con)]

My Lords, in general terms, I support the government amendments. I am sure that my noble friend will want to answer the specific issue which the noble Baroness, Lady Greengross, raised. However, I support the Government with a slight caveat. Similar parts of the localism agenda of the Government have likewise seemed to have devolved in order to encourage people to take responsibility. I agree that there is a problem of prescription—if I may use that word in the context of the health service—because we all want to add in to any freedom the particular issues about which we have a special concern. I have real sympathy with those for whom dementia is one of those issues; it certainly is for me. However, we have to guard against that because, in the end, it may produce an artificial series of priorities. In this case, it is much better for the Care Quality Commission to make its own mind up, because it is going to be responsible. I take a rather different view about the recent scandals, in that the commission has to take responsibility for the claims that have been made. If it has to take responsibility, it must have as much control over its agenda as it possibly can.

My concern is simply that the Localism Act claimed to give localities all kinds of new controls over their futures. Yet, this week, we again find the Secretary of State for DCLG calling in a locally agreed solar decision, one supported by the local authority and by the inspector, but turned down—for reasons which are extremely difficult to see—by the centre. I want an assurance from my noble friend that this is real devolution; that the powers which have been given will not be circumvented by some other mechanism within this Bill or other Bills. The purpose of such devolution is to enhance responsibility. My concern is that, often, people who are given and who claim to have responsibility find that the structures are so prescriptive that they cannot take that responsibility seriously. If the amendments are an attempt to ensure that they can carry through their responsibilities in a way which enables the country to look to them to do the job they ought to be doing, that is fine and dandy. However, I hope that we can have reassurance that this is a real change, and not something that is going to be circumvented for the convenience of some Secretary of State by other bits of this or other Bills.

Enterprise and Regulatory Reform Bill

Debate between Lord Low of Dalston and Lord Deben

Wednesday 9th January 2013 Grand Committee

[Lord Low of Dalston]

My Lords, I have already expressed my concern about the signs of the Government rowing back from the equalities agenda. I do not intend to go over that ground again, though I share the suspicions of the noble Baroness, Lady Thornton, which she has just expressed in moving her amendment.

In support of the amendment, I shall make two brief points. Doing away with the equality impact assessments would be a retrograde step—or “calling time” on them in the Prime Minister’s words. There are two reasons for this. First, they force people to think about marginalised groups who are often overlooked. Far from being a burden, these assessments have often been welcomed by people with responsibility for running organisations and providing services as helping them at the end of the day to provide a better service. Secondly, it is essential for the proper evaluation of the implementation of policy and for accountability that we should continue to have these assessments.

If we think about the role of EIAs in government, it may be convenient for governments to be able to avoid scrutiny, but it is not a very intelligent way to go about the rational development of public policy. It is rather an obscurantist Government who seek to avoid systematic evaluation of the impact of their policies. It would be helpful and a good development if the requirement to conduct equality impact assessments were to be written into statute. I support the amendment.

[Lord Deben]

My Lords, I have a different view about this. I will try to express it in the way that one does as one tries to run a business and is concerned with public activities as well. There is a danger that these discussions become polarised. There are those who feel that unless you write all this down in a precise way you can easily mix and miss the necessary duty to ensure that what we do in the public and private sectors is properly balanced so that services and provision are accessible to all. I am one of those who think that one has to be particularly careful about disadvantaged groups and those who are most likely to be vulnerable. I lean very much in that direction.

However, there is also the other side of the argument; namely, that sometimes we have got ourselves into so prescriptive a situation that it is very hard for people to get on with the job. I want to give an example which is sufficiently far in the past for it not to be seen as party political. When I lived in Ealing, if you wanted an extension into your roof, which a lot of rather big houses in the area wanted, you could not get the decision from the planning authority until it had been discussed by the sexual orientation committee and the racial committee. Something which obviously had nothing to do with either of those committees had to go through the format to deliver. What worried me was that it was the cause of considerable aggravation for people who just wanted an extra couple of rooms for their family. It did no good for people’s views about either sexual orientation or racial equality.

I have taken that example because it is extreme but it actually happened. It caused real problems and was promoted by the then governing party in Ealing as a wonderful example of how good it was on precisely these issues. I thought that it was a terrible example of how to distort and upset the very careful balance that you have to have between practicality and the important ethical issues with which we are concerned.

Therefore, my concern about the proposed new clause is that it can so easily lead to a simple system of adding to bureaucracy without achieving any end. The important thing is that all of us in our public lives and in our private business lives—leave alone our private lives—should seek to carry through our duties, whatever they may be—familial, business or public—in a way which constantly encourages us to ask, “Is this proposal one which disadvantages sections of the community?”. You have to be pretty careful about how you define those sections because sometimes people get left out. If you are not careful, you get a whole lot of other people added in because someone says, “Oh, you have that list, but there is this lot and another group and another set who we might have missed out”. I am much more interested in framing the legislation in such a way as to encourage people to see their duties in whatever they do in this context.

It is equally difficult to argue that we should have a note in here saying that everyone should carry out their public duties remembering that they have to tell the truth, or should carry out their public duties in such a way that they do not waste money, because, if you say that, you are assuming that people do not think of those two things if they are appointed to public office. I think that most people doing these jobs already consider them in this way. I would much prefer to look for a solution that encourages people’s training and makes sure that they have sensible ways in which to remind themselves of these importances without having these detailed requirements, which very often will be used as a necessary factor in things which really have got nothing to do with the issues that we are talking about.

There is an in-between, a balance, between these two positions. We have to be careful of producing an answer which says, “If you don’t agree with this kind of detailed listing, somehow or other you are less enthusiastic about equality than those who do”. I am very enthusiastic about equality—I have a record of fighting for it all across the board—but I have to say that I also hate bureaucracy: it makes people who are on our side in the first place less on our side because of what they have to do when what they have to do is unnecessary.