Special Measures Regime
John Bercow Excerpts(10 years ago)
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Mr Speaker
I am very keen to accommodate the interest of colleagues who are still waiting to question the Secretary of State. I should just remind the House that we have quite a substantial load of business today, and I know that the main debate is very heavily subscribed, so if I am to accommodate all remaining colleagues, there is a premium upon brevity—a seminar in which I think can most appropriately be conducted by a member of the Procedure Committee. I call Mr David Nuttall.
Mr David Nuttall (Bury North) (Con)
The families of elderly people in care are often those best placed to spot the early warning signs of poor care. To what extent will reports from families be used to determine and prioritise where inspections take place?
Oral Answers to Questions
John Bercow Excerpts(10 years ago)
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Mr Hunt
My hon. Friend has made a very good point. We have learnt from the big efforts to improve standards of care in hospitals—of which I think everyone in the House should be proud—that the best way in which to improve those standards is to be transparent about how well people are doing. What the new chief inspector of hospitals has done is identify not just the failing hospitals that have been put into special measures, but the good and outstanding hospitals, so that they know what they should and can aspire to. I think that we shall hear shortly how the chief inspector of general practice intends to implement the same regime in general practice.
Mr Speaker
Order. If the right hon. Gentleman would face the House, it would greatly avail us. I understand the natural temptation to look backwards—[Laughter.]—as in, behind him! But he must face the House.
Mr Jamie Reed (Copeland) (Lab)
On 20 June, I wrote to the Secretary of State informing him of the claims of doctors in Cumbria that unless drastic action were taken to reduce the pressures on GPs’ work loads, patients could die. I have not even received a response. Why, having being given such a stark warning, is the Secretary of State sitting on his hands? There are fewer GPs today than there were during Labour’s last year in office. How can standards in general practice be improved when surgeries are dealing with a recruitment crisis?
Mr Hunt
I should clarify for my right hon. Friend that the Prime Minister’s challenge was a successor to the national dementia strategy. The Prime Minister’s challenge finishes at the end of this Parliament and that is why we are having discussions about what should succeed it, because we all have an interest in ensuring that we maintain the tremendous momentum of the past few years.
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)
16. What assessment he has made of the adherence by NHS trusts and clinical commissioning groups to the healthy child programme (a) in general and (b) in respect of the provision of perinatal mental health services.
The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)
My hon. Friend is right to highlight the importance of the Chavasse report. Its focus on improving care for veterans is warmly welcomed. There is a lot that we can work with to deliver better care and build on the specialist care centres already in place for veterans who have lost limbs and need prosthetic services and to provide additional support for veterans with mental health problems.
Mr Jim Cunningham (Coventry South) (Lab)
May I remind the Secretary of State that it takes seven years to train a doctor and most of the doctors he boasts about were trained under a Labour Government? What is he doing about the disparity between GPs surgeries and the service that they offer? Some months ago I made some visits in Coventry and I was amazed by the difference in the levels of service.
Patient Safety
John Bercow Excerpts(10 years ago)
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Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Mr Speaker
Order. For the benefit of the public—it is important that they find our proceedings intelligible—I should say that these exchanges are taking place because an urgent question was submitted and because I granted it. That is the beginning and the end of the matter.
George Freeman (Mid Norfolk) (Con)
After the shocking events at Mid Staffs under the last Government, I would like to congratulate the Secretary of State on his crusade for accountability and transparency as the best disinfectant, as shown by his support for whistleblowers and for 4,000 additional nurses. Does he agree that the collection, monitoring and day-to-day use of data on health outcomes is absolutely key? I welcome his Minister’s support for measures in my ten-minute rule Bill, now adopted and sponsored by me and my hon. Friend the Member for Stafford (Jeremy Lefroy).
Mr Speaker
Ah! I keep my eye on the hon. Member for Reading East (Mr Wilson), because he does bob up and down, but he tends to do so only intermittently. It is a good thing that I have noticed him. Let us hear from the fellow.
Mr Rob Wilson (Reading East) (Con)
I was saving my energy, Mr Speaker.
I welcome my right hon. Friend the Secretary of State’s changes, which have made improving patient care and raising standards such a central part of the NHS mission. It is important to shine a light on poor performance, which is why I also welcome today’s CQC report on Royal Berkshire hospital, which highlights a number of important challenges that confront my local hospital. Does he agree that only by being open and transparent about problems can we tackle them and fix them for the long term?
Oral Answers to Questions
John Bercow Excerpts(10 years, 1 month ago)
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Mr Speaker
If the Secretary of State needs encouragement I am happy to give it to him.
Mr Hunt
I am most grateful for any encouragement I can get.
The NHS needs to change its culture to be much more open to whistleblowers. That is why we have banned gagging orders in contracts and funded a whistleblowing helpline and website, and why we are working with brave whistleblowers, such as Helene Donnelly from Mid Staffs, to reform the training of NHS clinicians to make it easier.
Dr Poulter
I am afraid that the distance between the real world out there for patients and the Labour Government’s record is very clear. Under the Labour Government’s record on general practice, 20% of patients were routinely unable to get a GP appointment within 48 hours, and a quarter of patients who wanted to book an appointment more than 48 hours in advance could not get one. That was what happened under Labour; that is Labour’s commitment to general practice and GP patients. Under this Government, we are making sure that there is equality of finance per patient according to patient need, and that is how health care decisions should be made.
Mr Speaker
Order. I encourage the Minister to learn to provide more succinct answers. They are always too long.
Stuart Andrew (Pudsey) (Con)
12. What the planned timetable is for his Department’s congenital heart disease review.
Mr Nigel Evans (Ribble Valley) (Con)
T3. The fears of the people of the Ribble valley that the old Clitheroe hospital would be closed and not replaced were allayed when the new hospital was built. It recently opened with 32 in-patient beds, radiology, diagnostics and other facilities. Will the Secretary of State come to Clitheroe to have a look at this brand-spanking-new hospital, which is being welcomed by the local community, and to say thank you to the staff there for all they do? If he does so, I promise to take him for a pint of healthy real ale afterwards in the Campaign for Real Ale pub of the year in Pendleton in the Ribble valley, to celebrate the opening of the new hospital.
Mr Hunt
Well, I must say that that sounds like a pretty irresistible offer, and I will give it careful consideration. Local community hospitals have an important role to play in our NHS because of the high standard of compassionate care that they deliver, and because they are easy for relatives to get to. I am delighted to see my hon. Friend campaigning for his local hospital, and delighted that it is doing so well.
Mr Speaker
Order. We are very pressed for time, but I want to accommodate a couple of remaining colleagues.
Barry Gardiner (Brent North) (Lab)
I am grateful, Mr Speaker. In Brent we have the highest incidence of TB and of type 2 diabetes in the country. We have just received a cut of £450 million in the money allocated to the CCG. The Secretary of State says that this is fair, but my constituents want to know whether it is in accordance with need.
Jane Ellison
The hon. Gentleman is right to draw attention to the problem of TB in London. As a London Member myself, I know what he is talking about. I encourage him to participate in the current consultation on Public Health England’s comprehensive TB strategy. It is a very important document which marks a step change in the way we confront the problem. That will help us to allocate resources to need and to address serious problems.
Kevin Barron (Rother Valley) (Lab)
Will the Minister give us an update on the proposed licensing of e-cigarettes by the Medicines and Healthcare Products Regulatory Agency? Does her Department believe that e-cigarettes could be used in smoking cessation programmes?
Health
John Bercow Excerpts(10 years, 1 month ago)
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Mike Gapes
On a point of order, Mr Speaker. The Secretary of State knows very well the issue I am trying to raise, because I raised it during the business statement last week. I want him to respond to an important fact. A leaflet was circulated in my borough on 20 May, two days before polling day. It was quoted in the local papers, and it related to the A and E department at King George hospital in my constituency. I simply want to ask him to confirm whether the announcement from the Secretary of State for Health referred to in the leaflet was made with his authority, or by him, during the week before polling day.
Mr Speaker
The hon. Gentleman is an ingenious and indefatigable Member. He probably knows that I can best describe that as an attempted point of order, because it is not a matter for the Chair. That said—[Interruption.] Order. That said, the hon. Gentleman has made his point forcefully, and it would certainly not be in any way disorderly for the Secretary of State to respond to it if he wished to do so.
Mr Hunt
I am most happy to respond to what—I agree with you, Mr Speaker—is a thinly disguised point of order. I will happily say this: what I said was completely in order because I was simply restating information publicly available on the trust’s website.
I want to go back to talk about Basildon hospital, because of the remarkable turnaround there. Chief executive, Clare Panniker, and her team deserve huge credit for the changes that they have made, which will truly turn a corner for patients who depend on their services.
Mr Speaker
Order. I ask the hon. Gentleman to calm himself for a moment. I accept the great importance of these matters, but I hope that this is a point of order rather than of frustration.
Mr Speaker
The hon. Gentleman is nodding with great vigour and intensity. Let us hear the attempted point of order.
Mike Gapes
I want to be clear about what the Secretary of State just said. He said, “What I said was”. I seek your advice, Mr Speaker. How can I get clarification from the Secretary of State about whether he made an announcement during the purdah period in the days just before the election or whether it was a previous statement rehashed and reissued from weeks before?
Mr Speaker
The short answer to the hon. Gentleman is that he must use his best devices, both in this debate, where he might have an opportunity to catch the eye of the Chair later, and in Health questions, which, if memory serves me right, are coming up very soon—
Mr Speaker
As I said, they are coming up very soon, and I am grateful to the hon. Member for Weston-super-Mare (John Penrose) for concurring with my suggestion that “very soon” does indeed include tomorrow. There will also be opportunities at all times for the hon. Member for Ilford South (Mike Gapes) to table questions with the advice of the Table Office. I have known him for 20 years and more, and he is not very readily put off his stride. I have no doubt that he will continue to gnaw at the bone until he achieves an outcome that he regards as satisfactory. Meanwhile, we must continue with the debate and the oration of the Secretary of State.
Mr Hunt
The decision to place 11 trusts into special measures last summer was not taken lightly, but we can see today that it was the right decision. Across the whole NHS, the number of people who think they would be safe in an NHS hospital is as high as it has ever been, the number of people who think that people are treated with dignity and respect has risen by six percentage points over the year and the number of people who think that people are treated with compassion has gone up by eight percentage points. This Government have introduced new chief inspectors of hospitals, general practice and adult social care to oversee the toughest, most transparent and most independent rating system of any country anywhere. We have improved accountability with a statutory duty of candour, and we are supporting staff by publishing ward-level nurse staffing levels for every trust.
Mr Speaker
Order. There is now a kind of institutionalised rowdiness about this debate, epitomised by the hon. Member for Swansea West (Geraint Davies) on the third row. It would be seemly if he would calm himself. I do not refer to people outside this place, but this debate is being keenly attended by a large number of citizens, who would expect Members to behave in as seemly a fashion as I feel sure they do on a day-to-day basis.
Mr Hunt
Despite the amount of work that has been done in the past year, there is still much to do to improve safety and care. According to a study based on case note reviews, around 5% of hospital deaths are avoidable. That equates to 12,000 avoidable deaths in our NHS every year, or a jumbo jet crashing out of the sky every fortnight. On top of that, every two weeks, the wrong prosthesis is put on to a patient somewhere in the NHS. Every week, there is an operation on the wrong part of someone’s body. Twice a week, a foreign object is left in someone’s body. Last spring, at one hospital, a woman’s fallopian tube was removed instead of her appendix. Last summer, the wrong toes were amputated from a patient. This spring, a vasectomy was given to the wrong man. To tackle such issues, we need to make it much easier for NHS staff to speak out when they have concerns. We need to back staff who want to do the right thing, and we are currently looking at what further measures may be necessary to achieve that.
Today, this Government vow never to turn back the clock on the Francis reforms, and I urge the shadow Health Secretary to do likewise when he stands up. Another vital set of reforms that we need to make if we are to prepare the NHS for the future involves the total transformation of out-of-hospital care. We know that prevention is better than cure and that growing numbers of older people, especially those with challenging conditions such as dementia, could be better supported and looked after at home in a way that would reduce their need for much avoidable and expensive care. This year, three important steps have been taken towards that vital goal. First, the new GP contract brought back named GPs for the over-75s—something that was so shamefully abolished by Labour in 2004. Older people often have chronic conditions that make continuity of care particularly important. However, Labour scrapped named doctors, and we are bringing them back.
We are also acting to break down the silos between the health and social care systems with an ambitious £3.8 billion merger between the two systems. The better care programme is, for the first time, seeing joint commissioning of health and social care by the NHS and local authorities, seven-day working across both systems and electronic record sharing, so that patients do not have to repeat their story time after time and medication errors are avoided.
Mr Hunt
Perhaps I can reassure the hon. Lady on those matters. First, the better care fund is the first serious attempt by any Government to integrate the health and social care systems and eliminate the waste caused by the duplication of people operating in different silos. The Government require all trusts to publish nurse-staffing ratios on a website that will go live this month. It is an important, radical change, and we are encouraging trusts to do exactly what she says is happening in Salford. It is important to say that, where other Governments have talked about integration, we are delivering it. We are doing one more important reform: we are taking the first steps to turn the 211 clinical commissioning groups into accountable care organisations with responsibility for building care around individual patients and not just buying care by volume.
From next year, CCGs will have the ability to co-commission primary care alongside the secondary and community care they already commission. When combined with the joint commissioning of social care through the better care fund, we will have, for the first time in this country, one local organisation responsible for commissioning nearly all care, following best practice seen in other parts of the world, whether Ribera Salud Grupo in Spain, or Kaiser Permanente and Group Health in the US—[Interruption.]
Mr Speaker
Order. I say to the hon. Member for Rhondda (Chris Bryant), who has just published an extremely cerebral tome on the history of Parliament, that he should not be yelling and exhorting from a sedentary position as though he is trying to encourage a horse to gallop faster. It is not an appropriate way to behave.
Andrew George (St Ives) (LD)
The Secretary of State mentioned the importance of integrating secondary and primary care. He will be aware that the chief executive of NHS England recently addressed the large number of community hospitals with a sword of Damocles hanging over them and whether or not they will continue to exist. He said that that issue should be revisited and, indeed, has argued that community hospitals should be developed and that we should protect that area of care. Does the Secretary of State believe that the chief executive of NHS England is calling for the retention and reopening of community hospitals?
Mr Speaker
Interventions should be brief—the hon. Gentleman is experienced enough to know that.
Mr Hunt
I agree with the new chief executive of NHS England. There is an incredibly important role for community hospitals and, indeed, for smaller hospitals. He was making the point that it is not always the largest hospitals that have the highest standards. One reason why the public like smaller hospitals is that they are more personal, and very often the doctors and nurses know people’s names, which makes a difference. They are also closer to people’s homes and easier to get to for relatives wishing to visit people in hospital.
Mr Speaker
Order. The shadow Secretary of State is clearly not going to give way at the moment.
Andy Burnham
The Prime Minister set his own test for his reorganisation: its effect on waiting times. This month, waiting times hit a six-year high. Almost 3 million people are now on the waiting list for treatment, up by half a million since 2010, but that is not all.
David T. C. Davies
On a point of order, Mr Speaker. The shadow Health Secretary does not seem to want to give way to anybody from Wales. Is there any reason for that, and could it be a case of discrimination of some sort?
Mr Speaker
I am always interested in the ingenious interventions of the hon. Gentleman, but that is not a matter for the Chair and I will not speculate on it or in response to the hon. Member for Swansea West (Geraint Davies). We will return to the shadow Secretary of State.
Andy Burnham
I just gave way to somebody from Wales. What is the hon. Gentleman on about?
That is not all. As I said before, the NHS is now missing its standard to ensure that cancer patients start their treatment within 62 days. That will cause huge distress to thousands of families up and down this country.
Another way in which the NHS has got worse, and every patient knows this to be true, is that it is becoming harder and harder to get a GP appointment. It is a common experience for people to ring their surgery early in the morning only to be told that there is nothing available for days. A survey has found that almost half of GPs predict that the average waiting time will exceed two weeks by next year.
The clearest measure of growing problems in the NHS is what has been happening in A and E, which is the barometer of the whole health and care system. Problems or blockages anywhere in the health and care system will manifest, in the end, as pressure in A and E. If A and E is the barometer, what is it telling us? It is warning of severe storms ahead. Hospital A and E units have now missed the Government’s target for 46 weeks running. For the last four weeks, the NHS overall has missed the Government’s target, suggesting that the winter crisis has now been followed by a summer crisis.
Why is that happening? The fact is that cuts have been made to general practice, social care and mental health, which are pushing more and more people towards the acute hospital and placing it under intolerable pressure. Today, many hospitals are operating way beyond safe bed occupancy levels, and not surprisingly this is taking a toll on A and E staff. Today, we reveal that three times as many A and E consultants left the NHS in 2013, raising the worrying prospect of A and E now being trapped in a downward spiral.
Alun Cairns
On a point of order, Mr Speaker. I seek your advice. I am trying to raise a relevant point with the shadow Secretary of State. I want to point out that A and E waiting times in Wales have not been hit since 2009—
Mr Speaker
Order. The hon. Gentleman must not use an attempted point of order to try to make a point that he would make in the debate if he got the chance to contribute. He said that he wanted my advice. My advice to him is that persistence pays and he should keep at it, as I am sure he will.
Andy Burnham
I will give way to the hon. Gentleman before the end of my speech, but not now; I will do so when I am ready, because I want to develop my point, which is this: a successful NHS was thrown into chaos by reorganisation. Four years after Lansley’s big bang, the dust has still not settled. People out there are struggling to make sense of the 440 NHS organisations that have replaced the 163 that the Government inherited. They cannot make it all fit together and so are still sweeping up the mess. It was always nonsense to commission local GP services from a national level. To correct that, NHS England is now suggesting a new round of structural changes. This is the reorganisation that never ends. It is now rumbling into the fifth year of this Parliament. In fixing one problem, I fear the Government are going to create another—a local conflict of interest with GPs commissioning GPs. The truth that they do not like to face is that the former Health Secretary presented a defective and confused plan, and they now know, in their heart of hearts, that instead of pausing it, as they did, they should have stopped it altogether. They did not, and however much they tinker it will never make sense.
That is why the only Bill in the Gracious Speech with any link to health is the one that tries to clear up the mess of reorganisation. The small business, enterprise and employment Bill restricts redundancy payments to public officials. If ever there were a Bill that locked the stable door after the horse had bolted, this is surely it. When the Health and Social Care Act 2012 went through the House, there were repeated warnings from Labour Members, including my hon. Friend the Member for Leicester West (Liz Kendall), that the reorganisation would result in primary care trust staff being made redundant and then rehired, with, as a result, a huge waste of NHS resources. In June 2011, the Leader of the Opposition challenged the Prime Minister in this House on precisely that point. The Prime Minister failed to act on the warning. As a result—these are shocking figures; Government Members should listen to them—over 4,000 people have subsequently been made redundant and then rehired within the NHS. In the first three years of the reorganisation, there have been over 32,000 exit packages, averaging £43,500, and 2,300 six-figure pay-offs, 330 of which were worth more than £200,000. The total bill is £1.4 billion and counting. What a scandalous waste of NHS resources when people are waiting longer for cancer care.
We always know when this Government are on the ropes: it is when they furiously try to blame the previous Government. This time, they cite employment contracts, but that excuse will not wash. Given that they were explicitly warned about this when their health Bill was going through the House before the reorganisation took place, people will ask why on earth they did not bring forward the measures on redundancy in this Queen’s Speech before the NHS reorganisation, not after it. It all adds up to mismanagement of the country’s most cherished asset on a spectacular scale.
Care Homes
John Bercow Excerpts(10 years, 2 months ago)
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Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Norman Lamb
The hon. Gentleman makes a fair point. The difference in the providers that pay people properly is clear. Incidentally, domiciliary care is another area where there are concerns. My right hon. Friend the Member for Sutton and Cheam (Paul Burstow) visited Wiltshire recently, which has moved away from the old style of paying people a pittance and now gives care workers a salary. When that happens, the whole culture starts to change completely.
We must ensure that there is compliance with the minimum wage, as well as advocating wages that are better than the minimum. Her Majesty’s Revenue and Customs has done a lot of work in the sector to address the abuse of the minimum wage regulations, which is far too widespread. It is completely intolerable for any care provider not to meet its statutory obligations. As the shadow Minister said, we have to ensure that when they commission care, councils cannot be complicit in an arrangement that they know will end up with people not receiving proper pay.
Mr Speaker
Nobody could accuse the fastidious Minister of excluding from the answers any consideration that he thinks might in any way be material. If he can combine that with reasonable economy, the House will be even more grateful to him than it is.
Mr Mark Harper (Forest of Dean) (Con)
On the Minister’s last point, I am pleased that Gloucestershire county council, notwithstanding the financial pressures on it, has prioritised spending on adult social care for elderly people and those with learning disabilities. From his conversations with the CQC, is he confident that its culture is not just that of a tick-box regulator, but that of an organisation that sees itself as the champion of those who are receiving care and their families, such that if it sees the sort of abuse that was highlighted on television last night, it will act to ensure that it comes to an end and that the perpetrators are dealt with swiftly?
Tobacco Products (Standardised Packaging)
John Bercow Excerpts(10 years, 3 months ago)
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Dame Angela Watkinson (Hornchurch and Upminster) (Con)
I support my hon. Friend’s measures to reduce the number of young people smoking, but she will not be surprised to hear that I do not support this measure. Only 5% of under-15s smoke, which is the lowest level for a generation. The Government’s anti-smoking measures that are already in place are clearly working. There are smoking cessation classes and posters in the streets and in every publication we pick up; there are television adverts warning people constantly about the health risks of smoking. Nobody in this country smokes in ignorance. The people who smoke make a deliberate choice to do so—they deliberately ignore all the warnings that are made available to them. We also must not forget parental responsibility in this, because parents are responsible for their children’s habits and for how much money they have to spend unsupervised—
Jane Ellison
I welcome my hon. Friend’s support for measures that can be effective in preventing children taking up smoking and urge her to read the detail of Sir Cyril’s report, which addresses directly some of the points she raises. She is right to draw attention to the fact that all these measures are taken in the round as part of a wider package of anti-tobacco measures. We are considering standardised packaging against the backdrop of some important steps taken in recent months, not least Parliament voting overwhelmingly for a ban on smoking in cars with children, and we have also brought forward measures to prevent proxy purchasing of tobacco by adults for children.
Mr Speaker
Order. I do not wish to be unkind to the House, but so far it is not obvious to me that we have had questions; we have had what might be described as lengthy volleys of words, which are not quite the same thing. If we can have short questions and short answers, we might have a reasonable chance of making effective progress towards subsequent business. Let us be led in that important mission by Valerie Vaz.
Valerie Vaz (Walsall South) (Lab)
I obviously welcome the Minister’s statement, but given the evidence from Sir Cyril, from Australia and Canada and from the Health Committee, will she update the House on a possible time frame? “Before 2015” is too vague.
Jane Ellison
My hon. Friend draws attention to the Scottish regime, which has regulatory differences to our regime. It is a matter that I consider and that we keep under review. Indeed, where measures have proved to be effective in any jurisdiction, we take great interest in that.
Oral Answers to Questions
John Bercow Excerpts(10 years, 3 months ago)
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The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)
The hon. Lady will be aware, of course, that it was the right hon. Member for Leigh (Andy Burnham) who had the most to do with introducing the private sector and agreeing ambulance service contracts in the Greater Manchester area. I think that Opposition Members need to remember their record on private sector involvement. If she has concerns, we will of course look into them.
Mr Speaker
The Minister’s answers are too long. He really has to get that into his head. I do not know how hard I have to try. I try to help the hon. Gentleman, but he is not very good at helping himself.
David Tredinnick (Bosworth) (Con)
In his travels to the People’s Republic of China, what has my right hon. Friend the Secretary of State learned about the integration of western medicine with traditional Chinese medicine?
Care Bill [Lords]
John Bercow Excerpts(10 years, 4 months ago)
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Mr Speaker
I remind the House that with this we are discussing the following:
Amendment (a) to Government new clause 34, in subsection (3), after ‘of’, insert ‘improving’.
Amendment (b) to Government new clause 34, in subsection (3), after ‘adult social care’, insert
‘; and if it has satisfied itself that the recipient is competent to handle the data in compliance with all statutory duties and to respect and promote the privacy of recipients of health services and adult social care.”.’.
New clause 25—Misuse of data provided by the Health and Social Care Information Centre: offence—
‘(1) A person or entity commits an offence if they misuse, or negligently allow the misuse of information they have requested and received from the Health and Social Care Information Centre.
(2) “Misuse” means—
(a) using information in a way that violates the agreement with the Health and Social Care Information Centre;
(b) using information in a way that does not violate the agreement with the Health and Social Care Information Centre, but that gives rise to use that is outside the agreed limits of use; or
(c) using information supplied by the Health and Social Care Information Centre in such a way as to allow or enable individual patients to be identified by a third party.
(3) A person who is guilty of an offence under subsection (1) is liable—
(a) on summary conviction, to an unlimited fine;
(b) on conviction on indictment, to imprisonment for not more than two years or a fine, or both.
(4) An entity who is guilty of an offence under subsection (1)—
(a) is liable to an unlimited fine; and
(b) must disclose the conviction on all future applications to access data from the Health and Social Care Information Centre.’.
Government amendment 8.
Amendment 29, in clause 116, page 100, line 29, after ‘Authority’, insert
‘and the Secretary of State’.
Government amendments 17, 18, 15 and 16.
Dr Sarah Wollaston (Totnes) (Con)
I love medical data. They have undoubtedly saved my life and the lives of almost everybody in the House. Medical data, particularly big data, allow us to identify which drugs and procedures work and which do not work. They enable us to pick up the rare side effects of medications that have recently been released on to the market before they can wreak the kind of havoc that we have seen in the past. They enable us to identify which are the good hospitals and which are the failing hospitals. They allow us to identify which clinicians need serious retraining and from which clinicians the public need protection.
I would argue that evidence-based medicine is one of the greatest advances of our age. Evidence-based medicine works a lot better if we have access to big data. I state for the record that I do not intend to opt out. I hope that the Government will use the six months that we have to mount a clear campaign to the public that sets out just what the possibilities are.
I also feel that some of the concerns about releasing big data to pharmaceutical companies are misplaced. We need our pharmaceutical companies to be able to access those data, and there is a virtuous circle. We know that if we attract more research to the UK, not only will that benefit our universities, it will create more employment.
Mr Speaker
It is very good of the right hon. Member for Charnwood (Mr Dorrell) to drop in on us. I know he was here yesterday and we must now hear from the Chair of the Health Committee.
Mr Stephen Dorrell (Charnwood) (Con)
Mr Speaker, I take your rap across the knuckles in the spirit in which it was intended. I apologise to the House for being late today, due to a diary conflict. I hope I can claim that I do not arrive, speak and then disappear very often. My practice is to be here for a debate and to contribute and listen to it, and I apologise to the House for not matching that standard in this debate.
I am, however, grateful for the opportunity to speak in this debate, because a discussion about the way in which the health service handles data and introduces a culture that allows a freer exchange of data around the health and care system is fundamental to the delivery of more joined-up services—ultimately between the NHS and the social care sector—which is an objective that is espoused widely, and regularly repeated, in this House.
The Select Committee had a session at which NHS England gave evidence about the position it got to with care.data and the delay that was announced two or three weeks ago. Although there is a widespread view within the Select Committee that it is important to get better at handling data in order to allow the delivery of improved services, we also had a sense that NHS England, in its handling of the care.data programme, had not respected sufficiently the sensitivities both of individual GPs, as the hon. Member for Easington (Grahame M. Morris) was saying, and—more importantly, ultimately—of individual patients about the safeguards that apply to their data and the uses to which those data can be put.
I agree with the hon. Gentleman that it is important that the six months of additional breathing space NHS England has given itself is used to address those concerns, both within the service and among patient groups, about security of data and the safeguards in respect of which data are used as a result of a more open—in the correct sense of that word—use of data around the system.
Mr Speaker
Order. I was going to call the hon. Member for Totnes (Dr Wollaston), as she had applied to speak in the Third Reading debate, but if she does not wish to speak, I will call the right hon. Member for Charnwood (Mr Dorrell) instead. Does the hon. Lady wish to catch my eye?
Mr Speaker
Order. Hon. Members will, I know, be sympathetic to each other. Everyone will try to help other colleagues, I feel sure.
Care Bill [Lords]
John Bercow Excerpts(10 years, 4 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
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.
The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)
I beg to move, That the clause be read a Second time.
Mr Speaker
With this it will be convenient to discuss the following:
Amendment (a) to Government new clause 34, in subsection (3), after ‘of’, insert ‘improving’.
Amendment (b) to Government new clause 34, in subsection (3), after ‘adult social care’, insert
‘; and if it has satisfied itself that the recipient is competent to handle the data in compliance with all statutory duties and to respect and promote the privacy of recipients of health services and adult social care.”.’.
New clause 25—Misuse of data provided by the Health and Social Care Information Centre: offence—
‘(1) A person or entity commits an offence if they misuse, or negligently allow the misuse of information they have requested and received from the Health and Social Care Information Centre.
(2) “Misuse” means—
(a) using information in a way that violates the agreement with the Health and Social Care Information Centre;
(b) using information in a way that does not violate the agreement with the Health and Social Care Information Centre, but that gives rise to use that is outside the agreed limits of use; or
(c) using information supplied by the Health and Social Care Information Centre in such a way as to allow or enable individual patients to be identified by a third party.
(3) A person who is guilty of an offence under subsection (1) is liable—
(a) on summary conviction, to an unlimited fine;
(b) on conviction on indictment, to imprisonment for not more than two years or a fine, or both.
(4) An entity who is guilty of an offence under subsection (1)—
(a) is liable to an unlimited fine; and
(b) must disclose the conviction on all future applications to access data from the Health and Social Care Information Centre.’.
Government amendment 8.
Amendment 29, in clause 116, page 100, line 29, after ‘Authority’, insert
‘and the Secretary of State’.
Government amendments 17, 18, 15 and 16.
Dr Poulter
The Government are fully committed to the care.data programme and to the core principles that underpin its use, which are to present and promote transparency in the quality of health and care services to patients and the public, while protecting their privacy and confidentiality; to promote health and care research to help us to understand how to fight disease, cure illness and improve care; and to better integrate health and care services by using the data and information to understand what good, joined-up and integrated care looks like.
Barbara Keeley
On a point of order, Mr Speaker. I understood that this debate was scrutiny of the remaining stages of an important Bill. The Minister seems to be reading his speech into the record, which for me does not stack up as a debate on the remaining stages of a very important Bill, and an aspect of it—care data—that is crucial to every NHS patient in the country.
Mr Speaker
The Minister is certainly in order and there is a continuation of Report stage tomorrow. I am sure he will want to be sensitive to the fact that other Members wish to contribute.
Dr Poulter
Indeed, Mr Speaker, and I hope that other Members will also be sensitive to that. The more interventions I take, the less opportunities there are for Members to speak. I have been very generous. I have taken interventions on a number of occasions from those on the shadow Front Bench, and from the hon. Member for Worsley and Eccles South (Barbara Keeley) and others. I have been generous with my time, but I want to preserve time for other Members to contribute to the debate, as I see you are keen for me to do, Mr Speaker.
Although the HRA amendments are important in ensuring that its remit is clearly and accurately defined, it will be able to work with those with an interest in children’s social care research when research crosses boundaries, to seek consistency in standards and to avoid unnecessary duplication.
Government amendments 15 and 16 are minor and technical. Amendment 15 is consequential to the addition of provisions on the better care fund—part 4—in Committee. It ensures that provisions on commencement cover the better care fund. Amendment 16 removes the privilege amendment inserted in the other place in accordance with the Commons’ sole privilege to deal with monetary matters.
The Government’s proposals ensure that we correct the difficulties we inherited from the previous Government in preserving confidential patient data. They ensure that we have in place a system in which NHS and care data must be used for the benefit of the health and care system and for public health purposes. They put us in a much better place to ensure that we enhance transparency and better use information to benefit patients. They ensure that we have a better basis on which to understand the basis of disease. If in the first place we had had the Health and Social Care Information Centre and the benefits we know will come from care.data, we would have been able to deal with and better combat many diseases while protecting patient confidentiality. We would have understood much more quickly the dangers of thalidomide and other drugs that were harmful to babies in utero. We would have been in a much better place to expose those examples of poor care, such as Mid Staffs; to develop national frameworks for treating diseases such as chronic obstructive pulmonary disease and heart disease; and to understand what good care looks like in the treatment of those conditions by collecting data in a fundamentally better and joined-up way.
The Health and Social Care Information Centre will, for the first time, provide us with a repository for joined-up, integrated data across health and care. Hon. Members often rightly talk of integrated care, and of the benefits of joining up health and care. Unless we have the data collected to understand what good integrated care looks like, and unless we understand what measures of integration are right, we will not be able properly to inform the debate on delivering integrated care or break down the silos that have sometimes existed to the detriment of patients across the health and care system. I hope hon. Members on both sides of the House can support that. I hope they decently recognise that this Government have put in place not just a patient opt-out if they do not want their data to be shared, but strong safeguards—much stronger safeguards than the previous Government —to protect patient confidentiality.
Mr Speaker
Order. One might have thought the intervention of the hon. Member for Copeland (Mr Reed) was exquisitely timed.
Bill to be further considered tomorrow.