Austerity: Life Expectancy

Nick Smith Excerpts

Wednesday 18th April 2018 Westminster Hall

[Chris Ruane]

I agree. All those issues are part of the mix as to why we are seeing a decrease in life expectancy. It is a complex issue that needs further inquiry.

[Nick Smith (Blaenau Gwent) (Lab)]

Will my hon. Friend give way?

[Chris Ruane]

I am afraid that I must move on, because I have been getting eyes from the Chair and I do not want to upset Mr Paisley.

The Government have said that the situation is a blip because of flu or the cold weather. The Department of Health has seemed to downplay fears about life expectancy, pointing out that smoking rates have gone down and cancer rates have gone down, but that is all the more reason to be worried. If those indicators are going down and life expectancy is going down, what is causing that? Those are good indicators, but there are some bad outcomes for certain people in certain areas.

A report by Professor Martin McKee, whom I had the pleasure of meeting yesterday, notes that the most recent period

“has seen one of the greatest slowdowns in the rate of improvement”

in life expectancy

“for both sexes since the 1890s”.

The relative data on life expectancy today is comparable to a time before workers’ rights, advancements in medicine and technology, and the welfare state. That slowdown, as reported by the Office for National Statistics last July, shows that the increases in the previous period, before 2010, meant that for every five years that a woman was living, she could expect to live one year extra. Now it is the case that for every 10 years that a woman is living, she can expect to live one year extra. The rate has been halved.

Let me add to those figures some of my own, which I received through parliamentary questions that I tabled in January. Between 2009-11 and 2014-16, 19.8% and 20.3% of local authorities reported a decline for females at birth and at 65-plus respectively. There are certain areas of the country, certain demographics and certain genders—women—who are feeling this the most. That is no surprise, because 80% of the austerity cuts made since 2010 have fallen on the shoulders of women. The link between life expectancy and cuts to social care budgets has already been highlighted.

The hon. Member for South West Bedfordshire mentioned Scotland. I do not want to stick up for the Scots: they can do a good job themselves, especially the hon. Member for Central Ayrshire (Dr Whitford), with her medical background. However, there are national and regional variations within the United Kingdom. If we look at local authorities in England, we see that 22% of them have seen a decrease in life expectancy.

Mental Health Services: Children and Young People

Nick Smith Excerpts

Thursday 8th March 2018 Commons Chamber

[Steve Brine]

I am very aware of the hon. Gentleman’s work on the Westminster Commission on Autism—he has a big event coming up in the next few weeks that I hope to go to. I completely agree with him, which is why it was so welcome that the CQC report highlighted Government proposals such as establishing dedicated mental health support teams in schools.

[Nick Smith (Blaenau Gwent) (Lab)]

Phase 1 on the CQC review noted that there were unacceptable variations in quality. How can quality be provided more consistently throughout the country?

[Steve Brine]

That is an excellent point. The NHS is very good at sharing best practice; the challenge comes in implementing it. The report rightly says that there are very good examples of good person-centred care throughout the country. The challenge is to make sure that is rolled out everywhere. I suppose the answer is to focus on the workforce and the investment, and to make sure that we have in place the agreed strategy to take the sector with us and do that.

Acute and Community Health

Nick Smith Excerpts

Thursday 8th February 2018 Commons Chamber

[Stephen Barclay]

I spoke to colleagues in the MOJ yesterday about the issue that my right hon. and learned Friend raised in the first part of his question. I agree with him that the standards of care for those in prison should be the same as those in the NHS more widely. As he will know, NHS England took over commissioning for healthcare services in prisons in 2013; that is one of the changes that have been made. He will also know that Dr Kirkup’s report drew attention to local factors, including a personal conflict of interests that goes to the heart of the relationship between the trust and the prison. However, he is absolutely right to allude to some wider issues from which we need to learn.

[Nick Smith (Blaenau Gwent) (Lab)]

How many members of the board failed to co-operate with this scathing review, and can the Minister name them?

Oral Answers to Questions

Nick Smith Excerpts

Tuesday 6th February 2018 Commons Chamber

[Jackie Doyle-Price]

My right hon. Friend the Secretary of State will be addressing that in a little while. The whole issue of reflective learning is important. We should not, through this case, prevent people from being honest about the experiences that they have had.

[Nick Smith (Blaenau Gwent) (Lab)]

20. Energy drinks packed with caffeine have been connected to problems with children’s health. Tesco, Asda and Aldi have banned the sale of these drinks to under-16s, so will the Government do the same?

[Jackie Doyle-Price]

We are becoming increasingly conscious of drinks with additional unnatural stimulants and their impact on people’s health generally, but obviously that becomes more acute with children’s health, so we will look more closely at it. I am glad that the hon. Gentleman has highlighted the initiatives that have been taken by individual retailers, because it is up to them to implement good practice.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

I have listened carefully to cancer charities, clinicians and patients on the importance of the cancer patient experience survey. I have been clear that, whatever form the CPES takes as a result of the changes to how confidential data is shared, we want the survey to continue with a methodology as close to that of the current survey as possible.

[Nick Smith (Blaenau Gwent) (Lab)]

T2. Last week at PMQs, the Prime Minister made an inaccurate statement about the emergency health services in Wales. The chair of the UK Statistics Authority concluded that the Prime Minister’s comparison was not valid. Comparisons on the performance of our NHS are important, so will Government Ministers check their partisan figures in future?

[The Minister of State, Department of Health and Social Care (Stephen Barclay)]

It is interesting, looking at the comparisons, to see that the NHS in Wales appears to have changed a number of them, to make it more difficult to compare performance between England and Wales. The more scrutiny there is of the performance in Wales—where clinicians say that the best performance often equates to the worst performance in England—the more we will see the need for serious changes in the way in which the NHS delivers its services in Wales.

Oral Answers to Questions

Nick Smith Excerpts

Tuesday 19th December 2017 Commons Chamber

[Nick Smith (Blaenau Gwent) (Lab)]

7. What recent assessment he has made of the adequacy of funding for social care.

[The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)]

Councils in England will receive an additional £2 billion for social care over the next three years, as announced in March 2017. The Government have given councils access to up to £9.25 billion more dedicated funding for social care over the next three years as a result of measures introduced since 2015. This means that, overall, councils are able to increase spending on adult social care in real terms in each of the next three years.

[Jackie Doyle-Price]

The entitlement to care is completely enshrined in the Care Act 2014, so if needs are not being met, there is a statutory obligation that can be enforced. On the long-term solutions, obviously, we have put in additional money to sort out the short-term funding pressures, but we need to have a long-term and more sustainable deal with which to meet our obligations for social care, which is why we are bringing forward a Green Paper next year. I hope that the hon. Gentleman will participate in that debate.

[Nick Smith]

Following Four Seasons’ temporary reprieve from administration, what plans are in place to help councils to deliver their statutory care duties in the event of the failure of this major provider?

[Jackie Doyle-Price]

I am grateful to the hon. Gentleman for raising this with me today, because I hope to reassure the House, and anxious people with loved ones in care with Four Seasons, that there is no immediate threat to continuity of care. I and my officials are keeping a very close eye on the situation, so that, with the Care Quality Commission, we ensure that there is a stable transition and that the commercial issues are dealt with in an appropriate way. That is leading to some very challenging conversations, but I can assure him that I and my officials are on it.

Social Care

Nick Smith Excerpts

Thursday 7th December 2017 Commons Chamber

[Jackie Doyle-Price]

My hon. Friend is right. I mentioned that local authorities are very keen for us to find a solution to this problem, but it is the Alzheimer’s lobby that is keener than anyone. At the moment, one in 10 people faces long-term care bills. Therefore, if we are looking at an individual’s risk, making financial provision is not necessarily something that they will do, so we do need a solution. The one in 10 people who face long-term care costs generally do face them as a consequence of dementia and the costs are very significant. That is exactly what we are trying to tackle by introducing a cap on the overall costs. That is why it is important that we all get involved and why the Alzheimer’s lobby is so keen that we establish cross-party consensus.

My hon. Friend raises an interesting point. The fact is that over the past 50 years, our lifestyles have changed significantly. Looking at my family, everybody lives within half a mile of each other, so as we get older it is very easy for the family to pick up caring responsibilities and share them about. I live 300 miles away from them. That is increasingly the pattern. Like her, when I knocked on doors during the election, I saw people in their late 80s whose families were living many miles away. That is something that we have failed to address over decades, and we need to address it now.

[Nick Smith (Blaenau Gwent) (Lab)]

Will the Minister update us on the financial stability of the Four Seasons group, which cares for over 17,000 vulnerable residents across the UK?

[Jackie Doyle-Price]

I am aware that there has been considerable press reporting on what is happening with Four Seasons. What I can say is that since Southern Cross, the CQC has been involved in market oversight and in stress testing exactly what is happening. We are satisfied that there is no risk to any of the people who currently experience care through Four Seasons. Beyond that, I cannot say very much because there are obviously commercial issues. However, the hon. Gentleman is right to raise the matter and I hope I can reassure him that the CQC is very close to what is happening there.

Contaminated Blood

Nick Smith Excerpts

Tuesday 11th July 2017 Commons Chamber

[Diana Johnson]

It is delightful to see you in your new place in the Chamber, Madam Deputy Speaker. I congratulate my hon. Friend the Member for Oxford East (Anneliese Dodds) on her maiden speech. That was an excellent start, and I am sure she will have a very long career in the House of Commons.

We have heard some really important and excellent contributions. I think we were all moved by the contribution from my hon. Friend the Member for Newport East (Jessica Morden) when she talked about Colin Smith—a little boy who received contaminated blood products when he was quite tiny, and who eventually died of AIDS and hepatitis C. That reminded us all that this is about boys and girls, husbands and wives, and brothers and sisters who have been affected by this scandal.

[Nick Smith (Blaenau Gwent) (Lab)]

Does my hon. Friend agree that these blood products should have been withdrawn as soon as the risks involved in their use became clear?

[Diana Johnson]

That is a good point, and I hope the inquiry will be able to get to grips with it.

I am really pleased we have had this announcement today from the Government, but I gently say to the Minister that we will not be going away on this: parliamentarians on both sides of the House will be following carefully how the consultation takes place and who is consulted, and making sure that there is a good, timely timetable, that there is legal support for those who need help with representation, and that there are regular updates to Parliament.

I want to finish with a quote from a person who has just emailed me and says that this is

“just the end of the beginning and still a long way to go before truth, justice and holding to account are achieved”.

We will now be watching very carefully what the Government do next.

Question put and agreed to.

Resolved,

That this House has considered the need for an independent public inquiry into the contaminated blood scandal.

Brain Tumours

Nick Smith Excerpts

Monday 18th April 2016 Westminster Hall

[Nick Smith (Blaenau Gwent) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Edward.

As my hon. Friend the Member for Warrington North (Helen Jones) said, brain tumours are the biggest cause of cancer death among children and adults under 40 in the UK. Surely, research into that disease should be a priority in the UK and around the world.

I will talk today about five-year-old Cian Case. My friend, Huw Irranca-Davies, who has now left this place after being the hon. Member for Ogmore, has been dealing with Cian and his family for some time, and he wanted me to pass on Cian’s story.

At the end of November 2015, Cian was admitted to the Royal Glamorgan hospital with acute stomach pain. A scan identified a tumour on his spine and he was rushed to the University Hospital of Wales in Cardiff, so that as much of the tumour as possible could be removed. The trauma left Cian completely paralysed from the waist down, with the neurologists sceptical about how much mobility he could recover.

Cian was diagnosed with an extremely rare and aggressive cancer that affects the central nervous system and that is mainly diagnosed in very young children. The survival outcomes are not favourable. The “seeds” of this cancer had already begun to spread to Cian’s brain. Fortunately, Cian responded well to that initial dose of chemotherapy and is now receiving intensive chemotherapy to his brain and spine.

[Mr Stewart Jackson (Peterborough) (Con)]

I pay warm tribute to Carole Hughes, the inspirational woman behind Peterborough-based Anna’s Hope. She is in the Gallery today. In view of the fact that cancer affects children in particular, does the hon. Gentleman agree that it is important that specialist neuro-rehabilitation therapy centres are set up to assist children in that position and to try to get them to fulfil their ultimate potential?

[Nick Smith]

I agree with the hon. Gentleman, who makes an important point.

I am pleased to report that Cian continues to make good progress and that his mobility is improving weekly, defying the original prognosis. Cian’s dad, Richard, is one of the more than 120,000 signatories to the petition we are discussing. He understands that cancers such as Cian’s are rare, and that that is why funding may not have been forthcoming enough. He believes, however, that more research can lead to longer and healthier lives for youngsters blighted so early by this disease. I am pleased that Cancer Research UK has committed to increasing spend on research into brain tumours, and we can all welcome that good news.

It is difficult standing here today relaying the story of one family’s brush with tragedy and the long road to recovery ahead, so I do not want our successors, years from now, to face the same questions, wringing their hands and saying, “Something should be done.” The community has rallied around Cian and his family—the school, the rugby club and the community drop-in centre have all organised different activities to raise awareness and funds, for which the family are incredibly grateful. The Noah’s Ark children’s hospital, LATCH and everyone in the health service has been fantastic on every step of Cian’s fight. They are all doing their bit; now it’s our turn.

Physical Inactivity (Public Health)

Nick Smith Excerpts

Tuesday 18th November 2014 Westminster Hall

[Nick Smith (Blaenau Gwent) (Lab)]

It is a pleasure both to serve under your chairmanship, Mr Weir, and to introduce today’s debate. I would like to put my thanks on the record to the Backbench Business Committee for allocating us this time, and I particularly thank the hon. Members for Chatham and Aylesford (Tracey Crouch) and for Canterbury (Mr Brazier), my right hon. Friend the Member for Rother Valley (Kevin Barron), my hon. Friend the Member for Bradford South (Mr Sutcliffe) and the right hon. and learned Member for North East Fife (Sir Menzies Campbell) for their support in applying for this debate. It is great to have cross-party interest, and I am looking forward to hearing colleagues’ contributions today on how we can best get Britain active.

I note that the hon. Member for Chatham and Aylesford has sent her apologies to us today; I understand that she is being kept busy in a bunker in Rochester and Stroud. Fair do’s—she is a tireless campaigner on public health and I pay tribute to the work that she has done in this area.

There is a physical inactivity epidemic and a growing obesity problem. If we want to make south Wales and the UK healthy again, we must help people to enjoy the simple activities that can save their lives. We need to walk, dance and play our way to well-being.

Tredegar in my constituency is the home of Nye Bevan and the NHS, and promoting physical activity is an issue that beats at the heart of our nation’s health. Although health is a devolved matter in Wales, I take an interest in the wider issues of public health, and during my time in the House I have spoken in favour of minimum pricing for alcohol and plain packaging for cigarettes, and taken an interest in the drivers of long-term conditions, such as diabetes, heart disease and obesity.

Britain, including Wales, is a great sporting nation. Governments of both colours have made huge efforts to showcase Britain as a home to sports. In recent years, we have celebrated the 2012 Olympics and this year’s Glasgow Commonwealth games, and next year there will be the rugby union world cup. However, for all that we are a successful sporting nation, we are not an active nation.

This debate is conveniently timed, as ukactive has just published its latest report into what it calls an “epidemic” of inactivity. Ukactive aims to get

“more people more active, more often”

and the stats that it has to show are really quite shocking.

Inactivity is the fourth largest cause of disease and disability in the UK, and physical inactivity directly contributes to one in every six deaths in the UK. That makes it as dangerous as smoking. Those who are completely inactive are at a much greater risk of a wide range of chronic diseases, such as diabetes, heart disease, cancers, obesity and mental health conditions, including dementia. Last week, the Welsh Minister for Health and Social Services reported that Wales is suffering from an “obesity epidemic”.

In the most recent Wales health survey, 58% of adults were classed as overweight, with 22% classed as obese. In my constituency of Blaenau Gwent that was higher, with 27% of adults being classified as obese. Meanwhile, Public Health England reports that obesity in adults has increased from 15% in 1993 to 25% in 2012. Obesity for children under 10 has increased to 13% and for 11 to 15-year-olds, it has increased to a shocking 18.7%. The answer to that is not just diet, of course, and it is certainly not to do nothing. We need to get Britain moving. How do we do that? I am careful at least to try and practise what I preach. Although I am often guilty of flopping down by the telly and watching sport instead of doing it, over the summer one of my tech-savvy daughters downloaded a pedometer app on to my phone for me. I now take care to get in my 10,000 steps a day, although sometimes it is a struggle. I am also a keen hiker; my part of the world, which includes the Brecon Beacons, is very good for that.

One of the key messages that we need to get across in this debate is that physical activity can be as simple as just going for a walk. This is not a debate on how to increase participation in sport, although sport is a cracking pastime for those who want to do it. Physical activity can be anything from taking the dog for a walk, to a Zumba class, to kids flying around on a skateboard. Not every kid in a class will be sporty, just as not every adult has fond memories of playing rugby in freezing cold PE lessons. We risk putting people off and making them think it is not for them if we make this solely a “sports” agenda, not a “get active” agenda. It is important that we make it easy, natural and normal for people to fit activity into their day.

In Blaenau Gwent in south Wales we have some fantastic, varied activity going on. There is a great tradition of bowling, with many teams from different valley villages and towns. That also helps address problems of loneliness and supports good mental health for older people. There are lots of dance groups, too. Places such as the Llanhilleth institute, built from the contributions of miners and steelworkers, positively bubbles with the sounds and energy of Zumba and body combat sessions. It is fantastic to see these places.

Having said that, in times of cutbacks to councils we need to promote more and more of such provision in deprived boroughs such as mine. I would like to see promotion of what I see as more accessible sports too, which require less space and less kit and caboodle, and which can be played indoors, such as table tennis and basketball.

Across Britain, the most deprived areas on average suffer more from inactivity and have higher rates of obesity than less deprived boroughs. There are practical concerns that we need to take into consideration. We can encourage somebody to take more exercise, but if we do, we need to make it easy, affordable and safe for them to do so. In order to make a meaningful difference, we need to be serious about reaching those hardest-to- reach groups.

The biggest health benefit is earned by getting someone to move from no activity to some activity. What are the Government doing specifically to encourage participation in physical activity in the most deprived areas? The next important factor is profile, and there is still lots to do to raise the profile of physical activity to improve public health. There have been some real success stories over the past year, of local government pushing this issue up the list of priorities. Ukactive found that over 70% of local authorities have increased spending on physical activity in the last year. In Wales, the Welsh Assembly Government have set the pace for leadership on this issue. Last year, Wales launched the Active Travel (Wales) Act 2013—Europe’s first piece of active travel legislation—which puts safe cycling and walking at the heart of Wales’s plans for the future.

We must not underestimate the achievements that there have been, but we must also not underestimate how far we still have left to travel. Despite the increases and the good work and good will that we have seen, spending on physical activity represents just 4% of the ring-fenced public health grant. We need all Governments, of all colours, to take leadership on the issues—just look at the national campaign on smoking, which has made such a huge difference. Before 1998, smoking levels were rising year on year, as inactivity and obesity levels are rising now, yet since 1998, 1.5 million people have quit smoking. The tide has turned. Important factors include the 10-year strategy, which has been long-term and, crucially, supported by all major parties across the aisle, so it is important that this issue is not politicised, and that is why it is great today that there is good cross- party debate. Pleasingly, the momentum has continued —and fair do’s, in 2011, the Government set specific targets to reduce smoking further by 2015. That needs to be applauded.

However, that leads me to a final but really key point. Action on smoking is about shifting the narrative to prevention rather than cure, and that is what we need to do now for physical inactivity. Individually, we all need to be concerned with physical activity for the sake of our personal health, and nationally, we all need to be concerned about physical inactivity for the sake of our national health service.

The new chief executive of NHS England put that in no uncertain terms last week, when he told the annual conference of Public Health England to get serious about obesity or bankrupt the NHS. We cannot afford to keep flooding our NHS with avoidable illness and disability. Diabetes UK estimates that type 2 diabetes already costs the NHS about £9 billion a year. If we are to protect our NHS and the excellent service that it gives us and our constituents, we need to prevent these problems from arising in the first place. The NHS is the national health service, not the national sickness service or the national pharmaceutical service. Prevention is better than cure. We need to start seriously looking at shifting to a service that promotes health and prevents illness wherever possible.

I am pleased that a future Labour Government would be committed to allowing GPs to give out exercise on prescription. That is a step that the medical profession is ready to take. A recent poll of GPs reported that 95% of GPs without access to exercise referral programmes said they would use one if it were available. The success of initiatives such as Let’s Get Moving, which encouraged more than 500 previously inactive patients to amass a total of 164 million steps—is that not brilliant?—shows how valuable GP surgery-led interventions can be.

This is an important debate and there are important questions to put to the Minister. First, how can the Government and others improve on what is being done? Secondly, where is the Olympic legacy for deprived areas such as Newham, which hosted the Olympics and is the least active borough in the country? Thirdly, what can be done to ensure that best practice is being shared, and that our efforts are being properly monitored so that we have data on what works, what is needed and, importantly, where?

Credit needs to be given where it is due. Some ships are moving in the right direction. For example, in England, the NHS’s “Five Year Forward View” makes a strong reference to this topic. We must applaud that, but the tide has not yet turned and inactivity is still set to rise.

Like smoking cessation, what can the Minister offer that will really make a difference in this regard? Labour has given a commitment to put physical activity at the heart of its future health plans, but the current Government and all future Governments, of any colour, need to do the same. I look forward to hearing from colleagues and to the Minister’s reply.

[Several hon. Members]

rose—

--- Later in debate ---

[Nick Smith]

I have little time to respond, so I unfortunately cannot comment on all the cracking contributions made in the debate, but I did particularly like the point raised by my hon. Friend the Member for Inverclyde (Mr McKenzie), who talked about our spending all day in front of a screen and then going home to spend our evening in front of a screen. We should all be mindful of that. I also laughed at his story about being a Zumba orphan, because that is where his mum spends all her time these days.

I want to highlight a few points that were made in today’s debate. It is important that we reduce obesity and improve health in areas of deprivation. The costs of being unhealthy are high, particularly for clinical conditions such as heart disease and diabetes. The financial costs of obesity are also high, and we need to promote physical activity. The NHS’s chief executive has spoken of the NHS being bankrupted by the high costs of physical inactivity.

I thank everybody for participating in today’s debate. We must place as much emphasis on promoting physical activity as we placed on reducing smoking in the past in order to see a successful campaign.

Care Homes

Nick Smith Excerpts

Thursday 1st May 2014 Commons Chamber

[Nick Smith (Blaenau Gwent) (Lab)]

(Urgent Question): To ask the Secretary of State for Health if he will make a statement on the Oban House care home and the Government’s policy for safeguarding residents in care homes.

[The Minister of State, Department of Health (Norman Lamb)]

The images that we saw on our screens last night were truly disgusting. No one deserves treatment like that. The family and loved ones of care home residents should not have to endure that. Poor care is completely unacceptable. Everyone should receive the highest standards of care delivered by well-trained and compassionate staff. We are committed to making that a reality and to preventing abuse and neglect. We are putting in place, through reform of the Care Quality Commission, a range of measures to improve the regulation of care homes, to hold to account providers that are responsible for unacceptable care, and to improve the quality of social care.

The chief inspector of social care at the CQC is putting in place new rigorous inspections carried out by specialist inspection teams. New fundamental standards of care are being introduced as requirements for registration with the CQC, which will allow the CQC to prosecute providers—and their directors—that are responsible for unacceptable care. We are introducing a new fit-and-proper-person test for directors of companies that provide care, which will allow the CQC to remove individual directors. The care certificate is on track to be introduced in March 2015 and is currently being piloted by employers. That certificate will include compulsory training. The CQC is being given the power to produce ratings of care providers that will provide a fuller picture of the quality of care than mere compliance with minimum standards.

A new statutory duty of candour on providers of care is being introduced, which will place a legal requirement on organisations to be open with patients about serious incidents. We are introducing a new offence of ill treatment and wilful neglect—one for an organisation and one for individuals. It will apply not just to those who do not have capacity, as is currently the case, but to all users of health and adult social care and all health and adult social care settings. A consultation on the new offence ended on 31 March, and we are now considering the responses. We aim to bring forward legislation at the earliest opportunity.

[Nick Smith]

I thank the Minister for his statement. The majority of residential care providers provide good, if not excellent, care. However, many of us across the country will have been sickened by the contemptible and callous treatment of elderly people in the Oban House and Old Deanery homes that we saw on “Panorama” last night. When we were shown the many calls for help from Yvonne Grant that were ignored, I, for one, railed against her so-called carers.

I acknowledge that the Care Bill will improve the safeguarding of elderly care home residents, but residents and their families need to know that their voices of concern are heard and acted upon when they feel that care is poor. The CQC needs to be up to the job. I met the CQC two days ago and felt that its engagement with residents and relatives could be much better. Can the Minister assure the House that the CQC will have the staff and expertise to carry out all the necessary inspections, including on the financial viability of care homes? Will he ensure that there is effective monitoring of care homes between inspections so that if there is high staff turnover, for example, that will be flagged up? Can he tell the House what training will be required for care homes staff? Will it be on the job and, if so, for how long?

Although it is right that care workers are held to account for their actions, senior managers should also shoulder their responsibilities. The Government failed to support my amendment to the Care Bill, which would have introduced an offence of corporate neglect. That would allow the prosecution of a care provider if the culture they set is a contributory factor in abuse or neglect. Police Operation Jasmine identified that sort of corporate neglect in south Wales. Will the Minister look again at the proposal in order to promote the care we all want for our loved ones in the place that they call home?

[Norman Lamb]

I thank the hon. Gentleman for his urgent question and his supplementary questions, which are absolutely legitimate and important. I agree that it is incredibly important that we recognise that there is a lot of great care out there, with incredibly dedicated care workers doing a very difficult job, often in difficult circumstances and without great pay. It would be awful if they were all tainted by the actions of a few.

I am pleased that the hon. Gentleman recognises that the Care Bill can make a difference and improve standards. It allows for the introduction of a care certificate so that everyone will be required, for the first time, to have compulsory training and meet a standard of competence before undertaking unsupervised care work. Part of that will be on the job, as I think is right for such work, but it is essential that people meet that standard.

The hon. Gentleman made the essential point that relatives, loved ones and the users of services themselves need to be heard. One thing we have done in that regard through NHS Choices is introduce the ability for anyone to comment on care services in a care home or in domiciliary care and to put their comments online, so that there is no hiding place for unacceptable standards of care. People’s comments and the judgments of the CQC will be available for everyone to see through the NHS Choices website.

I hope I can reassure the hon. Gentleman in relation to his amendment to the Care Bill. I totally agree with him about the importance of being able to prosecute for corporate neglect, which we will address, but in a different way. We are introducing fundamental standards of care that every care provider, and indeed every NHS hospital, must meet in order to be registered with the CQC. Where those standards are not met and there are serious failures, and where there is culpability because of corporate neglect of the sort he describes, the providers will be prosecuted. The CQC will have the power to prosecute not only the company or trust, but individual directors. This is the first time that that has been made possible. The existing regime is flawed, because the CQC must first serve a notice before anything can be done, and if the company complies with the notice it cannot be prosecuted, which is hopeless. We are removing that so that we can move straight to prosecution, as was the intention of his amendment.