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Health and Social Care Bill

The amendments in this group all seek to establish a more general duty for the commission to involve people in its work. We discussed the proposal for the commission to have a children and adult rights director—touched on in Amendment No. 108—in our last session, so I will not repeat the arguments I made on that specific element. I have already referred today to the requirements set out in Clause 2 for the commission to have regard to the views expressed by and on behalf of members of the public, including patients and service users and those who represent them, such as LINks. I would expect the commission to cover these matters in its annual reports on how it has exercised its functions under Clause 79. But this is an area I will look at again when reviewing involvement as I undertook to do in the last group of amendments. I hope that the noble Baroness, Lady Barker, would therefore feel able to withdraw Amendment No. 15, which seeks to ensure that the commission will have mechanisms and channels for engaging with people who use health and adult social care services, and not move Amendment No. 108, which would require the commission to report on what it had done in this regard in its annual reports. Amendment No. 27 was tabled by the noble Baroness, Lady Meacher, and is supported by my noble friend Lord Patel. My noble friend Lord Campbell-Savours, too, led a powerful debate on the proposed new clause, which sets out in more detail how service users and the public should be involved. The proposed new clause proposes specific requirements for the commission to involve lay persons in its inspections and in special reviews. It also proposes a general requirement for the commission to provide information and to consult on how it exercises its functions, or to involve it in other ways. Amendment No. 104, which the noble Baroness, Lady Meacher, also tabled, specifically provides that the people authorised to carry out inspections will include lay people. The Bill already allows for lay involvement in inspections, and I fully expect the commission to use lay inspectors either in inspections that are carried out for registration purposes or in other site visits associated with service reviews. In this regard, the provisions in the Bill reflect existing legislation, under which the Commission for Social Care Inspection has developed its Experts by Experience scheme. The Healthcare Commission also uses lay representation in its visits. Similarly, the Mental Health Act Commission, as eloquently described by my noble friend Lord Patel, includes lay people with significant direct experience of mental health services, as well as professionals such as lawyers, doctors, nurses, social workers, psychologists and other specialists, in the 100 commissioners who carry out the commission’s visiting programmes. I certainly expect the Care Quality Commission to follow the excellent examples set by the current bodies in this regard. However, my understanding is that the current bodies do not support routinely involving lay representatives in every visit that they undertake. I am sure noble Lords will appreciate that there might be circumstances in which it might not be appropriate to do so. Indeed, we would not want the commission to have to wait until it could secure the services of a lay inspector where it needed to carry out an urgent inspection. It is therefore right that the commission can involve lay people in inspections as it deems appropriate.