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Health and Social Care Bill

Yes, that is a consequence of the YL case. During a Liaison Committee sitting, I put that point to the former Prime Minister. He said that such a situation would be severely anomalous, and that people with publicly funded places in the private sector ought to be protected by the Act, as not protecting them would militate against contracting out and privatisation as ways to deliver public services. Our other concern about the broad amendment moved by my hon. Friend the Member for Luton, North to encompass self-funders in the health and social care sector is that it would do little to fix the problem for other vulnerable groups such as those that I have described, and might support the false impression that nothing further needs to be done to rectify the anomaly. New clause 1 proposes restoring, for the health and social care sector pure and simple, the Human Rights Act's original intention, which is that the Act should cover private-sector providers of publicly funded services, under arrangements made pursuant to statutory powers. I hope that the Minister will consider carefully the new clause and its purpose. I hope that he will accept it, but if he is unwilling to do so, I urge him to tell the House today that he will undertake to introduce his own amendments to achieve the same effect in the other place. The other new clauses and amendments that I have tabled are intended to implement the recommendations in our report, ““The Human Rights of Older People in Healthcare””, published last summer. We described how the use of human rights can be a powerful lever to improve the quality of services, as well as guaranteeing in their delivery basic concepts such as dignity and respect for the elderly in hospitals and care homes. As I said, the report gave graphic evidence of abuse and showed that many homes are not compliant with existing regulations. We said that the care standards regulations should require care homes to respect residents' human rights. The regulations governing the operation of health and social care providers, which deal with matters including staff training and the handling of complaints, require that the health, safety and welfare of service users be secured. We recommended that users' human rights should also be central to the operation of health and social care providers, and amendments Nos. 3 and 4 are designed to achieve that. We recommended that the new Care Quality Commission should adopt a human rights framework to underpin and inform its work and make it more effective in fulfilling its statutory duties. We were disappointed that the Government's reply to our report did not address that issue adequately. New clause 2 and amendments Nos. 5 to 7 would ensure that the protection and promotion of human rights are central to the new commission's performance of its functions. If the Minister cannot accept the amendments, I should be interested to hear why he thinks our proposals unnecessary. Help the Aged has said clearly that its main concern is the YL loophole. Notwithstanding that, it believes that the CQC can and should promote and protect human rights through its own work, saying:"““It is vital that the CQC takes a human rights-based approach””," and that"““this vital remit should be explicit in the legislation…CQC's work on human rights should go far beyond that of any normal public body. Respect for and promotion of human rights should be fundamental””." Help the Aged welcomes the amendments that I have tabled. The outgoing Commission for Social Care Inspection also supports our approach, saying:"““The new commission should place the rights of the people who use services and their carers at the heart of its work and they should have clear rights of access to it.””" Our report on the Bill published in February clearly recommended that the"““merged inspectorate…should adopt a human rights framework””," and we were disappointed by the Government's response, which said:"““The Department of Health will not be specifying the precise work programme of the new regulator, but will expect compliance…to form an important element of its work””." There are three problems with that. First, putting the human rights of health and social care users at the heart of the commission's work is not equivalent to specifying the precise work programme; it is more fundamental. Secondly, compliance with the Human Rights Act is a legal requirement, not simply something that the Government can expect to happen. Our concern is to ensure that human rights influence the work of the new commission across the board and are not seen simply as a tick-box compliance exercise. Finally, our report concluded that the Healthcare Commission should not view the 1998 Act as one of the large number of sets of regulations to which it is subject. We said that it should instead regard the framework created by the Act as overarching and fundamental to all its work. We regret that the Department of Health failed to address that point. It simply restated the current position—that the Act is seen as just another statute applicable to public bodies and demanding compliance, rather than as the culture change that we recommended in last summer's report on the human rights of the elderly. We have seen the point come through strongly in the evidence that we have been taking on access to services for adults with learning disabilities—an issue on which we hope to report in a few weeks' time. I am pleased that CSCI fully agrees with our conclusions. I hope that the Minister will reflect on that and agree with us that it is essential that the issue becomes an overarching part of the commission's work. Amendments Nos. 8 and 11 deal with the functions of the new commission. Amendment No.8 would require it to take into account the"““need to improve the range and quality of information provided by health care and social care services to users of those services about their rights””." That is crucial. Without clear and accessible information about how human rights apply in hospitals and care homes, service users will not be in a position to challenge how they are treated or to know how to seek redress. We have been particularly concerned about older people and people with learning disabilities, but accessible information is essential to secure the protection of the human rights of us all. We have all seen the signs in public buildings saying that staff are entitled to be treated with dignity and respect. However, we do not often see signs that say that service users, patients or relatives are entitled to be treated with dignity and respect by staff. That, however, should be part of the information process. A lot of hospitals, including those in my constituency, give leaflets to people as they arrive about how they can expect to be treated, but not about their rights in respect of how they will be treated. Such information is essential if people are to be able to enforce those rights. We also recommended that in undertaking its work, the new commission should take into account the provision of advocacy services. Amendment No. 11 deals with that issue. The Government share our view of the importance of advocacy for older people in health care as well as in other contexts. The important role that advocacy can play in supporting vulnerable people in health and social care will be reinforced by a statutory reference to advocacy in the Bill. New clause 4 relates to health and social care standards. The Bill does not require the Secretary of State to publish care standards or indicate what the content of those standards might be. We recommended that the CQC should apply a single set of standards for health and social care in relation to issues engaging the human rights of service users. New clause 4 is our suggestion of what a human rights standard might look like. It includes requirements in respect of: staff training on respecting the rights of service users; the publication of complaints procedures; a duty on people to report any failure to respect human rights that they see; discharge arrangements; and the publicising of the standards that apply. If the Minister sees a problem with those requirements, I would be grateful if he told me what it is. Finally, we recommended that a basic understanding of how the 1998 Act requires the protection of basic principles such as dignity, fairness, respect and equality should be included in the qualifications, accreditation and re-licensing of health professionals; amendments Nos. 14 to 18 seek to achieve that. Achieving effective human rights protection requires a combination of different measures operating in different ways to make human rights considerations more central to the decision-making processes of health and social care providers and the new regulator. I urge the Government to accept in principle that the Bill should be amended to reapply the 1998 Act to publicly funded residents of private sector care homes. I also urge him to consider seriously our other amendments, all of which are intended to protect the rights of extremely vulnerable people in the health and social care sectors.