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Local Government and Public Involvement in Health Bill

My Lords, I appreciate that the noble Earl has tried hard to address the issue which we raised in Committee of what LINks will do when they carry out their activities on premises. He has come up, ingeniously, with the words ““enquire into””. I am afraid that I shall have to disappoint him, but I hope that I will be able to reassure him at the same time. My understanding, which was confirmed by what the noble Earl said, is that the amendments are inspired by a concern that, when visiting premises, authorised representatives of LINks will not be able to ask staff, patients or patients’ families for their views on the level of service being provided. If that were the case, one would worry about it, because it would render the role of the LINks member essentially passive: they would become a fly on the wall or an observer. It would be a diminished role when compared with that of patients’ forums and leave them unable to judge how people really felt about their local care services. The noble Earl was right that we were unable to accept the word ““inspect””, but the power ““to enter and view”” means the same thing. The phrase was deliberately chosen to recognise the fact that LINk participants are not inspectors. ““Inspect”” applies to the professional regulatory bodies; those involved in LINks are lay people and, as such, are able to take a view from the patient and user perspective. I reiterate that LINks will have exactly the same powers as the patients’ forums to enter and view. Their members will be bound to have training and support that will equip them to do that job properly. I think that I can reassure the noble Earl by helping him to understand how Clauses 226 and 229 fit together. Clause 229(4) makes it clear that while an ““authorised representative”” of a LINk is conducting a visit, any viewing or observation should be carried out for the purposes of the carrying on of the arrangements set out in Clause 226. In other words, while LINks members carry out only the activities listed under Clause 226(2), one of those activities is precisely to obtain the views and experiences of people relating to local care services. That power will enable them to listen closely and ask questions of the people who experience services in situ. I hope that the noble Earl will therefore agree with me that ““to enquire into”” as a separate provision is unnecessary. We certainly see the ability of LINks members to be able to talk to staff, patients, users of care services, families and carers as an absolutely vital and integral part of their role. That will enable them to fulfil one of their core activities, obtaining the views and experiences of people about their local care services. Of course, the arrangements are very similar to those that currently exist under patients’ forums; they are certainly no less powerful. To ensure that this is something that LINks will not overlook, we shall reflect it in the LINks guidance to be published next year. This is the only opportunity that I have in the context of this short debate to tell the House what the Government have decided to do about the gatekeeper role and the unannounced inspections with regard to enter and view. We had a lively debate about that in Committee, where it was raised as a key concern. The main worry seemed to be that installing a gatekeeper would remove LINks’ ability to conduct spot checks and services, because they would have to give a period of notice for their visits to allow the regulator to respond with suggestions that would streamline visiting efforts. We listened hard because the voices around the Chamber were very strong. A few people disagreed, but the majority were strongly in favour of us changing this. Over the summer we secured cross-government clearance to change our policy and not require LINks to write to the relevant regulator to inform it of the intention to conduct a visit. This would have been included in the draft regulations. Consequently, as part of our consultation on the draft LINks regulations, we have publicly announced our decision to drop the gatekeeper role, which will allow LINks the freedom to visit appropriate premises at short notice and enhance their ability to highlight any concerns and raise them with the proper bodies. Given the extension into care, that is a really important provision. We shall ensure that more detail on how it would be considered reasonable and proportionate visiting practice will be included in LINks guidance to be published in the spring. We certainly endeavour to reassure Parliament that removing the gatekeeper role would not place a significant burden on health and social care providers—and I hope that that in part meets the anxieties that the noble Baroness, Lady Meacher, feels. As with what I said in response to the previous amendment in relation to ensuring that the visits were co-ordinated, we shall need to addressthat point in some shape and form, because it is important. I shall try to reassure the noble Earl on government Amendment No. 210. The amendment provides that the power to make regulations imposing a duty on services providers to allow authorised representatives of LINks to enter and view their premises may restrict authorised representatives’ access to certain premises and to the viewing of certain activities. The noble Earl asked why we needed more restrictions. I know that he would accept that it is important to prevent the invasion of privacy or possible risk of harm. It will mean, for example, that we will be able to restrict authorised representatives’ access to certain premises such as staff accommodation and premises providing only children’s social care. We feel that this amendment is an essential safeguard to protect people’s rights to privacy and dignity. I think that the noble Earl will find that that is acceptable; it is certainly not a way in which to reduce access to places and people that need to be covered. I hope that he accepts my explanation.