A and E and Ambulance Services

Debate between Paul Burstow and John Bercow

Thursday 18th December 2014 Commons Chamber

[Paul Burstow (Sutton and Cheam) (LD)]

rose—

[Mr Speaker]

An absolutely delicious intellectual beauty parade. Mr Martin Horwood.

Oral Answers to Questions

Debate between Paul Burstow and John Bercow

Wednesday 9th April 2014 Commons Chamber

[Mr Speaker]

Order. There are a lot of noisy private conversations taking place, notably at this stage on the Opposition Benches, but I want to hear both the questions and the right hon. Lady’s answers, so let us have a seemly atmosphere in deference to Mr Paul Burstow.

[Paul Burstow (Sutton and Cheam) (LD)]

6. What steps her Department is taking to support developing countries in tackling the effects of dementia.

Care Bill [Lords]

Debate between Paul Burstow and John Bercow

Monday 10th March 2014 Commons Chamber

[Paul Burstow (Sutton and Cheam) (LD)]

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

[Mr Speaker]

With this it will be convenient to discuss the following:

New clause 2—Review of the case for establishing a commissioner for older people in England

‘(1) The Secretary of State shall establish an independent review of the case for establishing a statutory office of Commissioner for Older People in England.

(2) The review will consider the—

(a) increasing diversity of the older population in England;

(b) UN Principles for Older Persons in 1991 (UN 1991) and other relevant developments in international policy on ageing;

(c) lessons from the establishment of such offices in Wales and Northern Ireland;

(d) balance of advocacy, investigatory and enforcement duties and powers to be granted to the office in statute;

(e) jurisdiction of the office in relation to other public bodies;

(f) relationship of the office to Ministers;

(g) accountability of the office to Parliament;

(h) appointment of the office holder;

(i) human and financial resources necessary to support the office; and

(j) any other matters the Secretary of State sets out in the terms of reference of the review.

(3) The review will report and make recommendations to the Prime Minister, Deputy Prime Minister, Chancellor of the Exchequer and the Secretary of State by December 2014.’.

New clause 3—Duty to identify carers

‘Each NHS body in a local authority’s area, as defined in section 6(8), shall co-operate with the local authority to ensure that effective procedures exist to identify patients who are or are about to become carers and make arrangements for carers to receive appropriate information and advice.’.

New clause 4—Local authority duty to make reasonable charges

‘Where a local authority that meets an individual’s needs under sections 18 to 20 of Part 1 of this Act is satisfied that the individual’s means are insufficient for it to be reasonably practicable for the individual to pay the amount which would otherwise be charged, the authority shall not require the individual to pay more for it than it appears to them that it is reasonably practicable to be paid.’.

New clause 5—Portability of care

‘(1) The Secretary of State must prepare a report containing an assessment of what primary or secondary legislation would be required to ensure people in receipt of care and support in the community in the UK receive continuity of such care and support if they change their place of residence, with particular reference to moves between countries of the United Kingdom.

(2) The report under subsection (1) must be laid before each House of Parliament six months after this Bill receives Royal Assent.’.

New clause 7—Independent review of future demand for social care and healthcare

‘(1) The Secretary of State shall make arrangements for an independent review of, and report on, the likely demand for adult social care, public health and healthcare services in England over the next twenty years.

(2) The objective of the review mentioned in subsection (1) shall be to identify the key factors determining the financial and other resources required to ensure that social care and health functions as a cost effective, high quality, equitable, integrated and sustainable single system which—

(a) promotes individual well-being (as defined in Part 1 of this Act),

(b) enables access to be determined on the basis of need, and

(c) can meet forecast demand.

(3) The arrangements for the conduct of review shall include provision for a fully integrated modeling and analysis of health and social care including examination of—

(a) the technological, demographic and health status trends over the next two decades that may inform or affect demand for adult social care and health services;

(b) the inter-dependencies between adult social care, public health and healthcare and the appropriate balance between different types of intervention, in particular between:—

(i) health and social care,

(ii) primary and secondary care,

(iii) physical and mental health, and

(iv) treatment and prevention; and

(c) any other matter that the Secretary of State sets out in the review‘s terms of reference.

(4) The Secretary of State shall lay before each House of Parliament a copy of an interim report on emerging themes and trends identified by the first such review by the end of November 2014 and make arrangements for a consultation process to be undertaken in relation to those interim findings.

(5) The Secretary of State shall lay before each House of Parliament a copy of the final report by the end of July 2015.

(6) At no more than five year intervals, the Secretary of State shall make arrangements for the updating of the report of the review mentioned in subsection (1) with the same objective and approach as mentioned in subsections (2) and (3), and including such matters as are provided for in paragraph (3)(c), and shall prepare and lay before each House of Parliament a report on the outcomes.

(7) The Secretary of State shall prepare and lay before each House of Parliament, as appropriate, a statement on the extent to which the reports mentioned in subsections (1) and (6) inform the Government‘s wider fiscal and economic strategy and decisions in each public spending review.’.

New clause 9—Reporting on the funding for new costs arising from the Care Act

‘(1) The Joint Care and Support Reform Programme Board must inform the Secretary of State by an annual written report that it is satisfied whether sufficient funding is in place to ensure that social care is adequately funded and that the provisions in the Act can be implemented satisfactorily.

(2) In subsection (1), the “Joint Care and Support Reform Programme Board” means the board of that name consisting of representatives of (but not limited to): the Local Government Association, the Association of Directors of Adult Social Services and the Department of Health.

(3) The report mentioned in subsection (1) should include a statement of the satisfaction of the Joint Care and Support Reform Programme Board with (but not limited to)—

(a) adequacy of the funding of the provisions in this Act,

(b) on-going costs of implementation,

(c) an additional five yearly review of the short and medium term cost of setting the eligibility criteria at the level set out in regulations.’.

New clause 11—Provision of certain care and support services to be public function

‘(1) A person (“P”) who provides regulated social care for an individual under arrangements made with P by a public authority, or paid for by a public authority, is to be taken for the purposes of subsection (3)(b) of section 6 of the Human Rights Act 1998 (acts of public authorities) to be exercising a function of a public nature in doing so.

(2) This section applies to persons providing services regulated by the Care Quality Commission.

(3) In this section “social care” has the same meaning as in the Health and Social Care Act 2008.’.

New clause 13—Deferred payment data

‘The Health and Social Care Information Centre shall make arrangements to collect and publish data including, but not limited to—

(a) the number of individuals entering into a deferred payment arrangement,

(b) the proportion of those individuals who received—

(i) regulated financial advice,

(ii) other forms of advice, and

(iii) no advice

before entering into a deferred payment arrangement,

(c) the average length of time a deferred payment arrangement is held,

(d) the numbers of individuals holding such arrangements broken down by different periods of time held, and

(e) the amount of money deferred under such arrangement.’.

New clause 15—National framework for local authority fees for care providers

‘(1) The Secretary of State shall establish an indicative national formula with which local authorities shall determine the costs of care provision in their area.

(2) In having regard to the matters mentioned in section 5(2)(b), a local authority must derive fee levels for independent providers of care and support services from the formula mentioned in subsection (1).

(3) The Secretary of State shall make arrangements for the audit of local authority fee levels to determine their compliance with the duty mentioned in subsection (2) and the extent to which this contributes to the effective delivery of the requirements of section 5(2), with particular reference to paragraphs (b), (d), (e) and (f).

(4) The formula in subsection (1) shall be made by regulations laid in pursuance of section 123(4) of this Act.’.

New clause 17—Duty to review economic, financial and other factors affecting provision of care services

‘(1) The Secretary of State shall make arrangements for—

(a) a review of the economic and financial factors affecting the employment (including recruitment, training and development, effective deployment and retention) of care workers and the extent to which current policies, mechanisms and relevant compliance by regulated providers of care services make it more or less likely that the objectives of this Act will be realised; and

(b) a public consultation on the conclusions and recommendations of the review.

(2) The Secretary of State shall lay a report of the review and public consultation before each House of Parliament by 1 September 2014.’.

New clause 18—Impact of working conditions on quality of care

‘(1) In exercising their functions under Part 1 local authorities must assess and consider how working conditions for people employed in care and support services impact on the fulfilment of local authority duties under Part 1 of this Act.

(2) “Care and support services” means—

(a) services provided by a local authority; and

(b) services commissioned by a local authority.

(3) Regulations may specify particular matters local authorities must have regard to in relation to subsection (1).’.

New clause 19—Promoting health of carers

‘(1) In exercising their functions health bodies shall—

(a) promote and safeguard the health and well-being of carers;

(b) ensure that effective procedures exist to identify patients who are or are about to become carers;

(c) ensure that appropriate systems exist to ensure that carers receive appropriate information and advice; and

(d) ensure that systems are in place to ensure that the relevant general medical services are rendered to their patients who are carers.’.

New clause 20—Local authorities: duties with respect to young carers

‘(1) A local authority must ensure that it takes all reasonable steps to ensure that in relation to—

(a) any school within its area and under its control; and

(b) any functions it discharges in pursuance of its responsibilities as a children’s services authority, there is in place a policy that both identifies young carers and makes arrangement for the provision of support for pupils who are young carers.

(2) In discharging its duty under subsection (1), a local authority must have regard to any guidance given from time to time by the Secretary of State.’.

New clause 21—Further and higher education: duties with respect of student carers

‘(1) The responsible body of an institution to which this section applies must identify or make arrangements to identify student carers and have a policy in place on providing support for student carers.

(2) This section applies to—

(a) a university;

(b) any other institution within the higher education sector; and

(c) an institution within the further education sector.

(3) A responsible body is—

(a) in the case of an institution in subsection (2)(a) or (b), the governing body;

(b) in the case of a college of further education under the management of a board of management, the board of management; and

(c) in the case of any other college of further education, any board of governors of the college or any person responsible for the management of the college, whether or not formally constituted as a governing body or board of governors.’.

New clause 22—Duty for Financial Services Consumer Panel

‘(1) The Financial Services Consumer Panel at the Financial Conduct Authority shall have a duty to review the availability, quality, adequacy and effectiveness of financial advice being provided to care users and their families on the implications of the relevant provisions of this Act, and make an annual report thereon to the Secretary of State containing recommendations for steps to take to remedy any deficiencies identified by the Panel.

(2) The Secretary of State shall lay a copy of the report mentioned in subsection (1) before each House of Parliament. The first such report must be so laid within 12 months of this Act receiving Royal Assent.’.

New clause 23—Financial advice for care users: qualification to provide

‘(1) The Financial Conduct Authority shall prepare and conduct a review of the implications of the relevant provisions of this Act for—

(a) training and development; and

(b) the level of the required qualifications

for advisers seeking licences to provide financial advice to care users and their families.

(2) The Authority shall submit a report of the findings of the review mentioned in subsection (1) to the Secretary of State, along with recommendations.

(3) The Secretary of State shall lay a copy of the report mentioned in subsection (2) before each House of Parliament. The first such report must be so laid within 12 months of this Act receiving Royal Assent.’.

New clause 24—Public awareness

‘(1) Local authorities shall have a duty to prepare, publish, consult on and implement a plan for raising and maintaining awareness amongst the residents of their areas of the arrangements for social care, and in particular of any changes to such arrangements brought about by Part 1 of this Act.

(2) The Secretary of State shall prepare and lay before each House of Parliament an annual report on the level of public awareness and understanding of the arrangements for social care, in particular—

(a) awareness and understanding of the changes brought about by the provisions of this Act; and

(b) the effectiveness of local authorities’ implementation of their plans for raising public awareness in their areas.’.

New clause 26—Declassification of a police station as a place of safety for the purposes of section 136 of the Mental Health Act 1983

‘(1) The definition of a place of safety in section 135(6) of the Mental Health Act 1983 shall no longer be read to include a police station for the purposes of section 136 of that Act.

(2) With regard to persons removed to a place of safety under section 136(1) of the Mental Health Act 1983, subsection (1) above shall have effect from—

(a) 1 April 2015, where such a person is aged 18 years or under; and

(b) 1 April 2017, where such a person is aged over 18 years.

(3) By 31 March 2015 the Secretary of State shall prepare and lay before each House of Parliament a report setting out the progress made by that date towards fulfilling the objective set out in subsection (1) above.’.

New clause 31—Register of persons who provide regulated social care

‘(1) Health Education England must make arrangements for the compilation, publication and maintenance of a register of persons as set out in section [Provision of certain care and support services to be public functions] who provide regulated social care for an individual under arrangements paid for by a public authority that have undertaken education and training in accordance with the duty set out in section 95.

(2) This duty may be delegated by HEE to Local Education and Training Boards established under section 101.’.

New clause 32—Funding and remuneration of home care workers

‘(1) The Secretary of State shall establish an independent review of the funding and remuneration of home care workers with a view to a report making recommendations regarding—

(a) hourly salary,

(b) remuneration of travel time,

(c) remuneration of travel costs,

(d) minimum time required properly to fulfil each of the care tasks and duties to be performed,

(e) establishment of an efficient means of recording arrival and departure times at residential settings, and

(f) the charging basis of the agency employing the care worker with a view to ensuring that all the costs of providing for (a) to (e) above are adequately met.

(2) The Secretary of State shall lay a copy of the report of the review mentioned in subsection (1) before each House of Parliament.’.

Amendment 26, in clause 1, page 2, line 5, at end insert—

(j) the right to living independently and being included in the community.’.

Amendment 21, in clause 5, page 6, line 2, leave out from ‘must’ to end of line 4, and insert—

‘(a) have regard to the need to ensure that sufficient services are available for meeting the needs for care and support of adults in its area and the needs for support of carers in its area; and

(b) ensure that the fee levels provided to independent providers for the delivery of care and support services are derived from a national formula which determines the accurate cost of care in each local authority area, the result of which will mean that the provisions of paragraphs (2)(b), (d), (e) and (f) can be delivered effectively.’.

Amendment 20, in clause 12, page 11, line 31, at end insert—

‘(aa) require the local authority, when carrying out the assessment, to capture an individual’s main and other disabling conditions.’.

Government amendments 1 and 2.

Amendment 31, in clause 24, page 22, line 39, at end insert—

‘(3A) The Secretary of State shall, after suitable consultation, establish by regulation a specified timeframe for the conclusion of the steps required of local authorities by virtue of this section.’.

Government amendment 3.

Amendment 32, in clause 27, page 25, line 8, leave out ‘keep under review generally’ and insert ‘review regularly’.

Amendment 33, page 25, line 42, at end insert—

‘(5A) The Secretary of State shall, after suitable consultation, establish by regulation appropriate arrangements and timetable for the regular review of care and support plans and of support plans by local authorities provided for in subsection (a).’.

Government amendments 4 and 5.

Amendment 27, in clause 42, page 38, line 24, at end insert—

‘(2A) There are different types of abuse, as defined in guidance.’.

Amendment 28, page 38, line 29, at end add—

‘(4) A relevant partner, as defined in section 6(7) has a duty, where it has reasonable cause to suspect a person is an adult at risk of abuse or neglect, and the adult appears to be within the local authority’s area, to inform the local authority of that fact.’.

Government amendments 6 and 14.

Amendment 22, in clause 76, page 69, line 33, after ‘adults’, insert ‘and children’.

Amendment 23, page 69, line 37, after ‘adults’, insert ‘and children’.

Amendment 24, page 69, line 42, after ‘adults’, insert ‘and children’.

Amendment 25, page 69, line 44, after ‘adults’, insert ‘or child’.

Government amendment 7.

[Paul Burstow]

I hope that the House will forgive my having a number of new clauses to explain in the time available to discuss part 1 of the Bill. I will try to crack on as quickly as possible to explain the thinking behind each of them. I will do so not in numerical order, but in order of importance, starting with the new clauses on which I particularly want to hear the Minister’s response.

First, I wish to discuss new clause 11, which deals with the Human Rights Act 1998 and its application to social care. The Act has enormous potential to improve the lives of those most vulnerable to human rights abuses in social care settings. People who are being provided care in their own homes or in care homes face risks in respect of their privacy, their family life, being safe and not suffering degrading treatment. Such matters are all very much at the heart of how we ensure that we provide dignified care.

I am sure that the Minister knows, as do other hon. Members, that a loophole has opened up in our law as a consequence of a judgment made by the courts some years ago. It arose in 2007 following the decision by the House of Lords in the YL v. Birmingham city council case. The Law Lords held that a private care home providing residential care services under contract to a local authority was not performing a “public function”, so its residents were excluded from the protections of the Human Rights Act. In practice, that means that domiciliary care users, or their families or carers, can complain to the care company, depending on the terms of their contract, but in many cases they will not be able to take their complaint any further. Contractual terms and conditions are important, but they can often fail to give the protection that we would want to see, and residents in care homes have no security of tenure and are often afraid to complain because of fear of eviction. Many people with care needs face additional challenges asserting their contractual rights, particularly if they lack the capacity to do so because of dementia or learning disabilities.

The decision that private and third sector care home providers were not directly bound by the Human Rights Act meant that thousands of service users had no direct legal remedy to hold their providers to account for abuse, neglect and undignified treatment, even though the public body commissioning those services remains bound in law by the Human Rights Act. There is need for change in this area. The loophole was partly closed by the previous Government, with cross-party support, through section 145 of the Health and Social Care Act 2008, which covers residential care services. However, under changes that this Bill will introduce, it will need to be reinstated by order, but there is a far better and more elegant way in which that could be done—by implementing new clause 11.

New clause 11 seeks to clarify the law so that all providers of publicly arranged or paid-for care are within the scope of the Human Rights Act. Service users who experience serious human rights abuses will then have direct means of legal redress. However, this is not just about going to law; it is about what goes on in the hearts and minds of those organisations and the attitude they take towards how they provide services, so the Human Rights Act has a part to play in culture change as well. For example, the Act has been successfully invoked in an argument about a local authority’s refusal to place a married couple in the same nursing home.

The Government have accepted that there is a loophole, and we very much welcome that. We raised the matter during consultation on and scrutiny of the draft Bill, and we offered up a suggestion, which their lordships adopted. In response to the Joint Committee, the Minister told us that organisations that were not covered by the Act should none the less consider themselves bound by it. Lord Hope, the recently retired Deputy President of the Supreme Court had this to say about that:

“Comments of the kind that were made, that people should consider themselves bound by a convention right, however well intentioned, do not have the force of the law”.—[Official Report, House of Lords, 16 October 2013; Vol. 748, c. 549.]

That is why we need to give it the force of law, which is what new clause 11 attempts to do. It puts back the law to where Members of all parties expect it to be, and ensures that a poor judgment by the court is corrected.

New clause 1 deals with the issue of power of access. Last week, I handed in a letter to the Prime Minister, setting out the case for the measure. It was signed by 602 organisations and individuals, including Age UK, Mencap, the National Autistic Society and many others with expertise in the area of adult safeguarding. They all share a common concern that there is a gap in the law when it comes to protecting vulnerable people who have the ability to make decisions for themselves but who are living in a home with someone else who is abusing them or neglecting them and who is denying them, because of their ability to exert their authority over that person, the ability to get the protection that they need. The Law Commission took that view in its review of mental capacity legislation, and the Equality and Human Rights Commission also took that view in its analysis of the legislation.

In our debates in Committee, my hon. Friend the Minister of State said that when officials were asked to provide the evidence behind their advice that the new power was unnecessary, there was an opaqueness surrounding the issue. There was not the necessary level of clarity to understand what powers could be used and in what scenario. I must say to the Minister that the scenarios that have been offered up to justify the position that there is no need for legislation do not address the circumstance that I and my new clause 1 seek to address. I am talking about someone who legally has capacity but who is under duress and unable therefore to exercise their individual right to seek protection. As a consequence of that, we need this power.

Changes to Health Services in London

Debate between Paul Burstow and John Bercow

Wednesday 30th October 2013 Commons Chamber

[Mr Speaker]

Order. I should just say to the House, almost as a courtesy, that I am prioritising London Members. However, non-London Members should take heart. If they exercise their knee muscles they may have an opportunity in due course.

[Paul Burstow (Sutton and Cheam) (LD)]

The hon. Member for Hackney North and Stoke Newington (Ms Abbott) was absolutely spot on in her question to the Secretary of State, not least with regard to variability and accessibility of GP services. A few months ago, I asked him whether he would make it a requirement for plans to expand out-of-hospital care to be in place before hospital changes occur. Can I take it from his statement that it is his intention that, when recommendations from the Independent Reconfiguration Panel are before him, he will require plans to build capability for community health services and primary care services to be in place before they go ahead?

Investing in Britain’s Future

Debate between Paul Burstow and John Bercow

Thursday 27th June 2013 Commons Chamber

[Mr Speaker]

My sense is that there is nothing unparliamentary about the use of the word “curmudgeon”. It is very much a matter of taste.

[Paul Burstow (Sutton and Cheam) (LD)]

I congratulate the Government on the announcements about social care spending and the health service. I draw my right hon. Friend’s attention to a capital project that will serve my constituency: the commitment to an investment of £219 million in St Helier hospital. However, that project has been stuck in the mud for the past three years because local NHS managers have been blocking its progress. Will he intervene with Ministers at the Department of Health to unblock that project and provide the much-needed investment?

Oral Answers to Questions

Debate between Paul Burstow and John Bercow

Tuesday 17th July 2012 Commons Chamber

[Paul Burstow]

Of course what the hon. Gentleman omits to mention in seeking to give an impression is this: the implication is that social services are not coping with delayed discharges and are the principal cause of them, but the figures do not bear that proposition out. [Interruption.] Indeed, the extra investment the Government are making in reablement services means that discharges in this area are being assisted and improving—[Interruption.]

[Mr Speaker]

Order. The question has been asked, and the Minister is giving his answer. Members may like it or dislike it, but they have a duty to listen to it with courtesy. While I am about it, let me emphasise that there is far too much sedentary noise coming from both Front-Bench teams. I think that the Minister has finished his answer; we are grateful to him.

Mental Health Unit (Burton)

Debate between Paul Burstow and John Bercow

Monday 19th December 2011 Commons Chamber

[Paul Burstow]

I will certainly give some further consideration to that. I am not sure that I am in a position to give my hon. Friend the undertaking he wants tonight, but if new issues arise it is in the public interest to make sure they are properly understood. My hon. Friend has rehearsed a number of the key issues this evening, and although he is right that consideration is being given to extending the consultation period, that is not for quite as long, as he suggested. I believe the PCT has decided to extend it by three to four weeks. It must do that, as the public and my hon. Friend must have confidence in the process. I am sure that he will understand that in responding tonight what I cannot, will not and must not do is come down on one side or the other on the options being canvassed in the consultation or express a preference as to its outcome. As he will know, there are clear requirements in law in respect of significant service changes that ultimately allow for reference to the Secretary of State, and I must avoid fettering the discretion the Secretary of State might in due course have to exercise.

Staffordshire Local Involvement Network—the LINk—is overseeing this consultation, and it has facilitated sessions after the presentations at public meetings. It has not involved anyone from either the PCT or South Staffordshire and Shropshire Healthcare NHS Foundation Trust. The LINk will also oversee the analysis of the consultation, to ensure its results are presented objectively. There is an independent element, therefore. I hope that goes some way towards reassuring my hon. Friends who have spoken tonight.

Travel has been mentioned in passing, and it is an important issue. When PCTs and service providers consult on service reconfigurations of this sort they must properly consider travel times, distances and journeys. I am pleased to note that, certainly in terms of the environmental impact assessment, those matters have been brought into play, although I await to see from the outcome of the consultation whether they have been sufficiently brought into play.

The local NHS would say that the consultation is about the future direction of in-patient services in the area and further strengthening community services. We must remember that this consultation is not only relevant to mental health in-patient services in Burton, but that it covers Tamworth and Stafford as well.

Although the concerns raised tonight have rightly focused on the Margaret Stanhope Centre, the important wider issue of improving community mental health services must be kept in mind. That is why I come back to the concern about the impact of reducing the number of beds available in the area. There is a dispute between the NHS locally and my hon. Friend about whether that will retard local services’ ability to meet legitimate needs, or whether more investment in community services will meet those needs.

This has been an important debate because it has allowed my hon. Friend to set out clearly and cogently his concerns. The consultation is not yet concluded and there will now be some additional weeks in which further views can be gathered. Clearly, the campaign being run by the Burton Mail, with the support of many of my hon. Friend’s constituents, will be a factor that the PCT will need to take into account when making its decisions. I am sure that the health overview and scrutiny committee will also want to be satisfied when it draws its conclusions about whether the results of the consultation are safe and sound, and whether it supports a model that does posit the notion that there are many mental health circumstances where the mental health needs are better and more appropriately met in the community, although there is also a need to ensure that there is always a robust in-patient response where that is necessary.

With that, may I take the opportunity to wish you and others in this Chamber the compliments of the season, Mr Speaker? I thank my hon. Friend for raising these matters and I will come back to him on any details that I have not addressed this evening.

[Mr Speaker]

I thank the Minister for his good wishes, and they are warmly reciprocated.

Question put and agreed to.

Oral Answers to Questions

Debate between Paul Burstow and John Bercow

Tuesday 18th October 2011 Commons Chamber

[David Tredinnick (Bosworth) (Con)]

Does my hon. Friend agree that many patients look to NHS Choices for accurate and unbiased information? Is he aware that its site on homeopathy is both biased and inaccurate? As the Department has had a long-standing review that has not reported, will he—

[Mr Speaker]

Order. I call the Minister.

[Paul Burstow]

If the hon. Gentleman would care to write to me setting out where he believes there are inaccuracies, we will examine them.

Health and Social Care (Re-committed) Bill

Debate between Paul Burstow and John Bercow

Wednesday 7th September 2011 Commons Chamber

[The Minister of State, Department of Health (Paul Burstow)]

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

[Mr Speaker]

With this it will be convenient to discuss the following:

New clause 10—Requirements as to transparency—

‘(1) Regulations may impose requirements on the National Health Service Commissioning Board and clinical commissioning groups for the purpose of ensuring that they are open and transparent in their decisions in commissioning health services for the purpose of the NHS.

(2) Regulations under this section may in particular impose requirements relating to—

(a) the imposition of minimum waiting times for patients,

(b) the imposition of clinical thresholds that a patient must reach before being eligible for treatment.

(3) The regulations may provide for the requirements imposed, or such of them as are prescribed, not to apply in relation to arrangements of a prescribed description.’.

New clause 11—Financial duties on clinical commissioning groups: administrative costs—

‘After section 223K of the National Health Service Act 2006 insert—

“223L Financial duties on clinical commissioning groups: administrative costs

(1) The Board must direct clinical commissioning groups to ensure that their expenditure on administrative costs does not exceed a prescribed percentage of their resource.

(2) The Board must ensure that the total national limit on clinical commissioning groups expenditure on administrative costs in any year from April 2014 does not exceed 55 per cent. of the total spent on administrative costs by primary care trusts in the financial year 2009-10.”’.

New clause 12—Secretary of State’s duty as to education and training—

‘After section 1F of the National Health Service Act 2006 insert—

“1G Secretary of State’s duty as to education and training

For the purposes of improving the quality of patient care, the Secretary of State has a duty to maintain a comprehensive, multi-professional education and training system for health professionals and to ensure the continued professional development of all staff delivering NHS services.”’.

New clause 13—Providers’ duty as to education and training—

‘For the purposes of improving the quality of patient care, all providers of services for the purposes of the health service have a duty to contribute towards the maintenance of a comprehensive, multi-professional education and training system for health professionals and to ensure the continued professional development of all their staff delivering health services.’.

New clause 14—Duties of clinical commissioning groups as to persons for whom they are responsible—

‘After section 3B of the National Health Service Act 2006 insert—

“3C Duties of clinical commissioning groups as to persons for whom they are responsible

(1) A clinical commissioning group has responsibility for persons who usually reside in the clinical commissioning group’s area.

(2) Regulations may provide that for the purposes of this section a clinical commissioning group also has responsibility (whether generally or in relation to a prescribed service or facility) for persons who—

(a) were provided with primary medical services by a person who is or was a member of the clinical commissioning group,

(b) have a prescribed connection with the clinical commissioning group’s area, or

(c) are provided with primary medical services by a member of the clinical commissioning group.

(3) The power conferred by section 3(1B)(b) must be exercised so as to provide that, in relation to the provision of services or facilities for emergency care, a clinical commissioning group has responsibility for every person present in its area.

(4) Regulations may provide that section 3(1A) does not apply—

(a) in relation to persons of a prescribed description (which may include a description framed by reference to the primary medical services with which the persons are provided);

(b) in prescribed circumstances.

(5) The duty in subsection (1) does not apply in relation to a service or facility if the Board has a duty to arrange for its provision.”.’.

New clause 16—Distribution of health service functions—

‘(1) The Secretary of State may direct the NHS Commissioning Board, or a clinical commissioning group, to exercise any of his functions relating to the health service which are specified in the directions.

(2) The functions which may be specified in directions include functions under enactments relating to mental health and care homes.’.

New clause 17—Secretary of State’s directions to health service bodies—

‘(1) The Secretary of State may give directions to any of the bodies mentioned in subsection (2) about its exercise of any functions.

(2) The bodies are—

(a) the NHS Commissioning Board; and

(b) clinical commissioning groups.

(3) Nothing in provisions made by or under this or any other Act affects the generality of subsection (1).’.

New clause 18—Care Quality Commission: duty as regards stability of existing NHS services—

‘The Care Quality Commission, in exercising its functions, must have regard to the need to avoid existing NHS services, including but not restricted to, emergency care, intensive care, chronic and complex care, teaching, training and research or case-load, becoming viable or unstable due to an unplanned reduction in income or caseload.’.

New clause 20—Clinical commissioning group commissioning work: public function—

‘The Secretary of State must issue directions to clinical commissioning groups which will ensure that commissioning work is predominantly retained as a function by staff directly employed by the clinical commissioning group.’.

New clause 23—Chief environmental health officer for England—

‘(1) The Secretary of State shall appoint a Chief Environmental Health Officer for England.

(2) The Chief Environmental Health Officer for England shall give advice to and report to the Chief Medical Officer for England on all such aspects of environmental and public health as are relevant to the public health functions referred to in section 2A of the National Health Service 2006 Act and the duties referred to in section 2B of that Act.

(3) The Secretary of State shall report to Parliament annually on the work of the Chief Environmental Health Officer for England.’.

Amendment 1222, in clause 1, page 2, line 2, leave out ‘promote’ and insert ‘provide or secure a’.

Amendment 1223, page 2, line 3, leave out from ‘must’ to ‘improvement’ in line 4 and insert ‘provide or secure a comprehensive Health Service designed to promote’.

Amendment 1239, page 2, line 4, after ‘improvement’, insert ‘and to ensure improvement’.

Amendment 1176, page 2, line 7, leave out subsection (2) and insert—

‘(2) The Secretary of State must for that purpose provide or secure the provision of services in accordance with this Act.’.

Amendment 1224, page 2, line 8, leave out ‘secure that services are provided’ and insert ‘provide or secure, either directly or indirectly, services’.

Amendment 48, page 2, Leave out lines 10 to 12 and insert—

‘(3) The services so provided must be free of charge.’.

Amendment 1174, page 2, line 10, after ‘services’, insert ‘so’.

Amendment 1175, page 2, line 10, leave out ‘as part of the health service in England’.

Amendment 1177, page 2, line 12, at end insert—

‘(4) For the purposes of this Act “the health service in England” is defined as those services provided under section 3 of this Act.’.

Amendment 1240, in clause 2, page 2, line 17, leave out ‘with a view to securing’ and insert ‘so as to ensure’.

Amendment 1241, page 2, line 23, leave out ‘with a view to securing’ and insert ‘so as to ensure’.

Amendment 1212, page 2, line 33, at end insert—

‘(5) In discharging the duty under subsection (1) the Secretary of State retains the power to create a new NHS trust or provider organisation.’.

Amendment 1169, in clause 3, page 2, line 38, leave out from ‘State’ to end of line 40 and insert ‘, so far as is consistent with the interests of the health service, must exercise the functions conferred by this Act so as to secure—

(a) that inequalities between the people of England with respect to the benefits that they can obtain from the Health service are reduced, and

(b) a continuous reduction of inequalities between the people of England with respect to the outcomes achieved for them.

‘(2) The Secretary of State must publish and lay before Parliament an annual report detailing the progress which has been achieved in discharging this duty, and the means by which the Secretary of State intends to fulfil this function in the following year.’.

Amendment 1183, page 2, line 38, leave out ‘have regard to the need to reduce’ and insert ‘act with a view to reducing’.

Amendment 1197, page 3, line 1, leave out Clause 4.

Amendment 1194, in clause 5, page 3, line 16, leave out ‘have regard to the need to’.

Amendment 1242, in clause 9, page 5, line 32, at end insert—

‘(h) promoting co-operation between each of the authority’s relevant partners.’.

Amendment 1243, page 5, line 35, at end insert—

‘(4A) For the purposes of this section each of the following is a relevant partner of a local authority—

(a) where the authority is a county council for an area for which there is also a district council, the district council;

(b) the police authority and the chief officer of police for a police area any part of which falls within the area of the local authority;

(c) a local probation board for an area any part of which falls within the area of the local authority;

(d) a youth offending team for an area any part of which falls within the area of the local authority;

(e) a clinical commissioning group for an area any part of which falls within the area of the local authority.

(4B) The relevant partners of a local authority must co-operate with the local authority in the making of arrangements under this section.’.

Amendment 5, page 5, line 43, leave out Clause 10.

Amendment 1178, in clause 11, page 7, line 15, leave out from ‘Subsections’ to ‘apply’ and insert ‘(1), (3) and (4) of section 3C’.

Government amendment 49.

Amendment 1172,  in clause 14, page 9, line 35, after ‘blood’, insert ‘, haematopoietic stem cells’.

Amendment 1173, page 9, line 37, after ‘tissue’, insert ‘, haematopoietic stem cell’.

Government amendments 50, 51 and 54.

Amendment 42, in clause 20, page 16, line 34, at end insert—

13DA Duty of the Board as to commissioning of services

In carrying out its duties in respect of the commissioning of services the Board must in the exercise of its functions have regard to the interdependency of services and the impact that the arrangements for the provision for one service may have on the financial and clinical sustainability of other services.’.

Amendment 1198, page 17, leave out lines 12 to 19.

Amendment 1184, page 17, line 21, leave out ‘have regard to the need to reduce’ and insert ‘act with a view to’.

Amendment 1185, page 17, line 23, leave out ‘reduce’ and insert ‘reducing’.

Amendment 1186, page 17, line 25, leave out ‘reduce’ and insert ‘reducing’.

Amendment 1187, page 17, line 36, leave out ‘act with a view to enabling’ and insert ‘have regard to the need to enable’.

Amendment 1188, page 18, line 4, after ‘functions’, insert ‘have regard to the need to’.

Amendment 1195, page 18, line 17, leave out ‘have regard to the need to’.

Government amendment 60.

Amendment 1203, page 19, line 28, at end insert—

13OA Duty as regards stability of existing NHS services

The Board must not exercise its functions, in particular in respect of section 13I (Duty as to patient choice) or 13K (Duty to promote innovation) in a way which could lead to existing NHS services, including but not restricted to, emergency care, intensive care, chronic and complex care, teaching, training and research, becoming unviable or unstable due to an unplanned reduction in income or case-load.’.

Amendment 46, page 22, line 12, at end insert—

‘(1A) The Secretary of State must publish guidance to the Board, to which the Board must have regard, about the exercise of its powers under subsection (1).’.

Amendment 1167, page 24, line 16, at end insert—

‘Duty to reduce bureaucracy

132ZA Duty to reduce bureaucracy

‘(1) The Board must exercise its powers so as to reduce administrative costs in the NHS.

(2) For that purpose the Board must exercise its duties under 14A and 14C to ensure that at no time there exist more clinical commissioning groups than there were primary care trusts on 1 April 2011.’.

Government amendments 67 and 68.

Amendment 1206, page 26, line 41, at end insert—

223E1 Financial duties of the Board: needs-based allotments

(1) The Board must make allotments to clinical commissioning groups based solely on the need of the population served by each commissioning group.

(2) The Secretary of State may give directions as to how the needs set within subsection (1) are determined.’.

Amendment 1218, in clause 22, page 27, line 17, at end insert ‘provided that the members of a clinical commissioning group cannot consist entirely or mainly of persons who are providers of primary medical services under section 83(2).’.

Amendment 1211, page 27, line 22, at end insert—

‘(c) shall be co-terminus with the social services local authority, unless it is notified by the relevant health and wellbeing board, and the local authority, that they approve an area which is not co-terminus.’.

Government amendments 70 and 71.

Amendment 43, in clause 23, page 34, line 20, at end insert—

14PA Duty of clinical commissioning groups as to commissioning of services

In carrying out its duties in respect of the commissioning of services each clinical commissioning group must in the exercise of its functions have regard to the interdependency of services and the impact that the arrangements for the provision for one service may have on the financial and clinical sustainability of other services.’.

Amendment 1189, page 35, line 2, leave out ‘have regard to the need to reduce’ and insert ‘act with a view to’.

Amendment 1190, page 35, line 3, leave out ‘reduce’ and insert ‘reducing’.

Amendment 1191, page 35, line 5, leave out ‘reduce’ and insert ‘reducing’.

Amendment 1192, page 35, line 22, leave out ‘act with a view to enabling’ and insert ‘have regard to the need to enable’.

Amendment 1193, page 35, line 36, after ‘functions’, insert ‘have regard to the need to’.

Amendment 1196, in clause 20, page 36, line 3, leave out ‘have regard to the need to’.

Amendment 1230, in clause 23, page 36, line 7, leave out from ‘consortium’ to ‘that’ in line 8 and insert ‘has a duty to secure’.

Amendment 1231, page 36, line 16, leave out from ‘consortium’ to ‘that’ in line 17 and insert ‘has a duty to secure’.

Amendment 37, page 36, line 36, at end insert—

14YA Duty as to conflicts of interest

(1) Each clinical commissioning group must exercise its functions so as to ensure that any conflicts of interest, and personal and prejudicial interests are dealt with.

(2) The Secretary of State must issue guidance on how conflicts of interest and personal and prejudicial interests should be dealt with by clinical commissioning groups as part of their decision making.’.

Amendment 1204, page 36, line 36, at end insert—

14YA Duty as regards stability of existing NHS services

Each clinical commissioning group must not exercise its functions, in respect of section 14U (Duty as to patient choice) or 14W (Duty to promote innovation) in a way which could lead to existing NHS services, including but not restricted to, emergency care, intensive care, chronic and complex care, teaching, training and research, becoming unviable or unstable due to an unplanned reduction in income or case-load.’.

Amendment 41, page 36, line 43, leave out from second ‘are’ to end of line 44 and insert ‘fully consulted—’.

Amendment 45, page 38, line 22, at end insert—

‘(1A) The Secretary of State must publish guidance to commissioning consortia about its exercise of powers under subsection (1), to which each commissioning consortia must have regard.’.

Amendment 1181, page 38, line 26, at end insert—

‘(3) For the avoidance of doubt it is hereby declared that nothing in this section authorises a clinical commissioning group—

(a) to disregard any enactment or rule of law, including but not limited to section 1(3), or to override any person’s contractual or proprietary rights; or

(b) to charge for anything the group does in the exercise of its powers under this section which relates to any accommodation, service or facility of a type to which section 3(1) applies; or

(c) to charge for anything in relation to the exercise of its functions under section 3 or 3A.

(4) A clinical commissioning group shall exercise the powers specified in section 7(2)(f) only after consulting (to the extent that it appears to it to be practical) any person who appears to it to have an interest through its own previous research in the ideas or intellectual property in question as to whether it should exercise them and, if so, as to any financial arrangements.

(5) A clinical commissioning group shall demonstrate in its annual report under section 14Z3 how the exercise of its power conferred by subsection (1) has not interfered to a significant extent with the performance by the group of its functions.

(6) Income raised by a clinical commissioning group as a result of the exercise of powers under this section shall be specified in its annual accounts, referred to in its annual report under section 14Z13, and paid annually to the Secretary of State.’.

Amendment 1250, page 41, line 38, at end insert—

‘(6A) If the opinion of a Health and Wellbeing Board given to the clinical commissioning group under subsection (5) is that the Health and Wellbeing Board does not consider that the draft takes proper account of each joint health and wellbeing strategy referred to in that subsection, and if the clinical commissioning group does not so consider it, the group shall inform the Health and Wellbeing Board, whereupon it may report to the Secretary of State that it does not consider that such a plan takes proper account of any such strategy and the Secretary of State may require the clinical commissioning group to carry out such further consultation with the Health and Wellbeing Board as he considers appropriate, or may make a final decision on the plan and require the Commissioning Board or the clinical commissioning group to take such action, or desist from taking such action, as he may direct.’.

Amendment 1171, page 42, line 23, at end insert—

‘(3) If in the Board’s opinion, having considered any opinion submitted to it by a Health and Wellbeing Board under 14Z12(1)(a), the plan published by the clinical commissioning group does not take proper account of each joint health and wellbeing strategy published by the Health and Wellbeing Board which relates to the period (or any part of the period) to which the plan relates, the Board must instruct the clinical commissioning group to revise its plans under 14Z10(1).’.

Amendment 1202, page 42, line 23, at end insert—

14Z12A Power of Referral of Commissioning plans to the Secretary of State

(1) If the Health and Well-being Board is of the opinion under section 14Z12(1) that a plan published by the CCG under section 14Z9(6) or 14Z10(2) and which is submitted to it in accordance with section 14Z9(6) and 14Z10(3) or 14Z11(4) or (8), does not take proper account of any relevant joint health and wellbeing strategy it may refer the matter to the Secretary of State for a decision.

(2) Regulations under this section may provide for the mechanism by which such referrals are made.’.

Amendment 38, page 43, line 9, at end insert—

‘(ab) section 14YA’.

Amendment 1199, in clause 24, page 49, line 35, leave out from beginning to end of line 37 on page 50.

Amendment 1213, page 50, line 27, at end insert ‘and must consult with local Health and Wellbeing Boards prior to any decision on this matter with a view to securing their agreement.’.

Amendment 1255, in clause 27, page 53, line 5, leave out ‘the Secretary of State’ and insert ‘Public Health England’.

Amendment 1256, page 53, line 6, leave out ‘an’ and insert ‘a suitably qualified’.

Amendment 1257, page 53, line 20, after ‘authority’, insert ‘, reporting to the Chief Executive of that authority,’.

Amendment 1253, page 53, line 21, at end insert ‘, and will be accountable to—

(a) the local authority, and

(b) the Secretary of State for Health.’.

Amendment 1258, page 53, line 21, at end insert—

‘(2A) The individual so appointed is to be employed by Public Health England, which shall have responsibility for their professional qualification and development.’.

Amendment 1259, page 53, line 30, after ‘authority’, insert ‘or Public Health England’.

Amendment 1254, page 53, line 42, leave out ‘consult’ and insert ‘obtain the agreement of’.

Amendment 1260, page 53, line 42, leave out ‘the Secretary of State’ and insert ‘Public Health England’.

Amendment 7, in clause 29, page 54, line 30, at end insert—

‘(3) This section comes into force on a date to be specified by order by the Secretary of State.

(4) The time specified in subsection (3) must be after such time as the Secretary of State is satisfied that the workforce education and training functions of strategic health authorities are being fulfilled by another body.’.

Amendment 1237, page 256, line 31, leave out Clause 299.

Amendment 1238, page 257, line 29, leave out Clause 300.

Amendment 47, in clause 304, page 261, line 19, at end insert—

‘(1A) Section 29 comes into force in accordance with sections 29(3) and (4).’.

Amendment 1245, in schedule 2, page 269, line 21, leave out from ‘consortium’ to end of line 24.

Amendment 1244, page 269, leave out lines 25 to 29 and insert—

‘(3) The arrangement must include provision for the functions of the clinical commissioning group to be exercised by, and only by, its employees on its behalf.’.

Amendment 1249, page 269, leave out line 29.

Amendment 1234, page 269, line 29, at end insert—

‘(4) Nothing in paragraph (3) shall authorise the inclusion of any provision for any of such functions to be exercised by—

(a) any of the clinical commissioning group’s members who hold or benefit from contracts to provide primary medical services under section 83(2); or

(b) individuals who have been employees of such members; or

(c) by a governing body, committee or sub-committee which consists entirely or mainly of such members.’.

Government amendments 292 to 299.

Amendment 1170, in schedule 4, page 278, leave out lines 35 and 36 and insert—

‘(a) omit “Strategic Health Authorities” and insert after “(a)”— “the National Health Service Commissioning Board”, and

(b) omit “Primary Care Trusts” and insert after “(b)” — “Clinical Commissioning Groups”.’.

Amendment 1247, page 281, line 10, at end insert—

‘(2A) Regulations made under this section must specify that—

(a) direct payments can not be made in respect of the whole or part of a course of private health care or in respect of insurance premiums which have the purpose of providing healthcare, and

(b) direct payments can only be made in respect of services which NICE has specified are services that can be provided by the health service, having particular regard to safety, efficacy and cost-effectiveness.’.

Amendment 1248, page 281, line 23, at end insert—

11A In section 12C (Direct payments pilot schemes) omit subsection (8).’.

Amendment 31, in schedule 23, page 417, leave out lines 18 to 21.

Amendment 32, page 418, line 34, leave out lines 5 to 8.

Southern Cross Care Homes

Debate between Paul Burstow and John Bercow

Tuesday 12th July 2011 Commons Chamber

[Paul Burstow]

It really is not a question of financial assistance; it is about the co-ordination of the Association of Directors of Adult Social Services and the Department’s regional directors of social care, who are working with those colleagues at local authority level, and about making sure that they are co-ordinating their activity with the Care Quality Commission. All those things are happening, have been happening and will continue to happen to ensure that we do what the Government are committed to doing—ensuring continuity of care and that people can stay in the homes they are currently in with the knowledge that the Government really are committed to making sure that they have no doubt that they are not going to be thrown out on the streets as a consequence of this business’s restructuring.

[Mr Speaker]

I am grateful to the Minister of State and to colleagues.

Southern Cross Healthcare

Debate between Paul Burstow and John Bercow

Thursday 16th June 2011 Commons Chamber

[Paul Burstow]

rose—

[Mr Speaker]

Order. By my reckoning the hon. Lady posed three questions, but I know that there will be an immaculate and beautifully tailored single reply from the Minister.

[Paul Burstow]

Thank you very much, Mr Speaker.

I can assure the hon. Lady that, first and foremost, clear arrangements are in place to deal with a catastrophic failure, which I think is now increasingly unlikely. More importantly, we need to ensure that we learn lessons from past care home closures and take them into account in future. However, we can also be clear that the underlying viability of this business is very strong indeed. We need care homes, and that is why we now have a route towards a solvent restructuring of the business.

--- Later in debate ---

[Paul Burstow]

rose—

[Mr Speaker]

Order. I will of course ask the Minister to provide a brief reply, as I know he will be happy to do, but we must focus on the very specific question of Southern Cross. This is not a general debate, whatever the temptations experienced by the hon. Gentleman.

[Paul Burstow]

In the spirit in which the question was asked, if the hon. Gentleman were to write to me I would be only too happy to consider his request.

Oral Answers to Questions

Debate between Paul Burstow and John Bercow

Tuesday 7th June 2011 Commons Chamber

[Paul Burstow]

rose—

[Mr Speaker]

Order. The Minister will want to focus on GP commissioning of integrated cancer services.

[Paul Burstow]

I am grateful for that advice, Mr Speaker. The hon. Lady’s remark was one that she might have made from the Back Benches when the Labour party was in power, but which it never listened to when in government. On GP commissioning consortia, we believe that it is important that consortia have access to the right expertise to be able to commission effectively both clinicians from other parts of the health economy and other expertise from the voluntary sector. That should be possible and we think that it is how we can improve commissioning in the NHS.

Oral Answers to Questions

Debate between Paul Burstow and John Bercow

Tuesday 25th January 2011 Commons Chamber

[Mr Stephen Dorrell (Charnwood) (Con)]

Does my hon. Friend agree that improved co-ordination between health and social care is fundamental to the delivery of the efficiency challenge faced by the health service and social services? Does he further agree that the £1 billion provided by the health service to reinforce that relationship is an important step taken by the Government to reinforce that interface? Can he assure the House that, as we move into the new world, the existing arrangements for good practice across that interface will be preserved?

[Mr Speaker]

Order. I know that three questions will attract one answer from the Minister.

[Paul Burstow]

The answer to all those questions is yes. The right hon. Gentleman is right to draw attention to the additional money going into social care via the NHS. It is intended to kick-start the collaborative working that was often so absent under the previous Administration.