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Health and Social Care Bill

I am pleased to make a contribution to this important debate. I accept that, to an extent, the Bill focuses on the health sector and health care. However, I am a former social worker, a former teacher of social workers, and a one-time member of the Central Council for Education and Training in Social Work in Wales. I echo the words of the hon. Member for Blackpool, North and Fleetwood (Mrs. Humble): it is important that social care is not lost in the emphasis on health. The voice of the user must not be lost, either. That is one of the fundamental principles of social work and social care, and certainly something to which I attached great importance when I was teaching. Much of the Bill applies to England, but there are some points that are particularly relevant to Wales. I want to emphasise that there might be some cross-border issues and I seek reassurance from the Minister that they have been taken fully into consideration. The Welsh Affairs Committee is mindful of the implications of cross-border issues for health care in Wales and will conduct an inquiry early in the new year. There are particular arrangements in Wales. I would like reassurance that, for example, any implications of changes to the inspectoral arrangements in England have been taken into consideration. In Wales, we have our own body for regulating social workers: Cyngor Gofal Cymru, or the Care Council for Wales. It is separate from the General Social Care Council and operates on its own. Both bodies were set up under the Care Standards Act 2000. The Care Council is, like the General Teaching Council, a devolved body. However, the Care Council operates in the same area as the corresponding body in England and I am not wholly convinced that the operation of one will not have some influence on the operation of the other. The care quality commission in England will combine health and social care and inspection. As I have said, I am concerned about whether there will be implications for the inspectoral arrangements in Wales, particularly on a cross-border basis and when staff move from one employer to another across the border. The Care Council for Wales has a productive interface with health in Wales. There are regular meetings and training matters are discussed. However, it is important to realise that the work of the Care Council for Wales is not just focused on health. Its work also involves education, housing and community development matters. It works to a social model, not a health model. The care quality commission in England will combine health and social care inspection. Will the Minister let me know, either later or by means of a letter, what, if any, implications the Bill has for the inspectoral arrangements in Wales and the Care Council for Wales? Have there been discussions with the National Assembly Government and, if so, what were the conclusions? I have a particular example. Should the Care Council wish to change, vary or develop its work, I take it that that could be achieved through regulation, under clause 114. I note that clause 115 states that the standard of proof that is to be applied may not be varied in Wales, as compared to England. Will the Minister confirm that the power through regulation will be sufficient and that there will be no need to transfer legislative competence over the Care Council for Wales to the National Assembly? Will there be a need for legislative competence orders? They are already coming through and can take some time. Has he had any discussions with the National Assembly for Wales on the matter? I might be worrying unnecessarily, but I would value an assurance from the Minister. Clause 116 is on the training of mental health professionals. The regulation-making power for that lies with the Care Council for Wales. It is a Welsh matter, but again I hope that the Minister or his officials have had the opportunity to discuss it with the National Assembly. I am going into some detail, but I not seeking a place on the Committee. The Bill is largely concerned with matters in England. My second group of concerns is about the Welsh language and the implications under the Welsh Language Act 1993. The provision of services by a public body is subject to the Welsh Language Board and operates under a Welsh language scheme that has been approved by the Welsh Language Board. I am thinking in particular of developing needs in relation to mental health. When people are assessed for compulsory admission, a language choice is available. To some extent, that will be a matter of regulation for the Care Council for Wales. However, the Mental Health Act Commission is being merged under the Bill. I want to be reassured that Welsh language issues have been taken into consideration. I think great changes are going to be carried out in relation to mental health legislation in Wales. I mentioned compulsory admission. There is going to be a legislative competence order, which we hope will transfer to the National Assembly the right to legislate in this area. That is being proposed by a Conservative Member of the Assembly. The point is that the care quality commission will take on the duties of the Mental Health Act Commission in Wales and I want to be reassured that it will have a Welsh language scheme from day one. There was a discussion some time ago when the Children's Commissioner for England was set up and had some duties as far as children in Wales were concerned. I had a long session with the relevant Minister to try to persuade her to set up a Welsh language scheme from day one. After 13 questions, she agreed to write to me, and eventually we got a Welsh language scheme. However, that scheme needs to be there from day one. After all, patients will have concerns from day one, particularly on the difficult matter of mental health. There is considerable expertise in Wales on language matters, particularly in relation to social care and mental health. Looking at schedule 9, the principles of the Welsh Language Act should underpin provisions such as paragraph 2(e), which refers to standards of conduct, and paragraph (9), which imposes conditions for regulation. I looking to the Minister for reassurance that those particularly Welsh issues have been taken into account. Generally, I welcome the Bill, as other Members have.