---

Health and Social Care Bill

This group of amendments focuses on the role of the new commission in ensuring that providers handle complaints effectively. I applaud the intention behind these amendments, which is to ensure that providers learn from complaints, because that is exactly what we are seeking to achieve. I welcome the opportunity to reinforce that. Amendment No. 18, tabled on behalf of the Joint Committee on Human Rights, would require the commission to have regard to the level of satisfaction with complaints handling. The noble Baroness, Lady Meacher, and my noble friend Lady Jones have taken a different approach. Amendments Nos. 50 and 53B build on existing provisions in Clause 16 to make it explicit that registration requirements could cover the steps which registered providers should take to act on any recommendations resulting from complaints. Amendment No. 53B also addresses a different point, specifying that registration requirements could, in particular, cover the handling of complaints made by those service users who do not currently have recourse to a second-stage complaints process. Finally, Amendments Nos. 58 and 58A would enable the commission to issue warning notices where providers are failing to implement recommendations of the Health Service Ombudsman and Local Government Ombudsman. I hope Members of the Committee would all agree that the onus must be on care providers, wherever possible, to resolve complaints themselves. I reassure the Committee that the Bill provides mechanisms to help achieve that. Clause 16 enables the Secretary of State for Health to set, in regulations, the essential registration requirements that providers will need to meet in order to become, and remain, registered with the Care Quality Commission. Clause 16 already enables regulations to make provision for the handling of complaints and disputes. Members of the Committee will be aware that we are consulting on key areas which these crucial registration requirements need to cover in order to provide proper assurances of safety and quality of care to patients and service users. Requirement 10 of the draft registration requirements proposes that there should be a requirement on registered providers and managers to have effective systems in place for handling complaints, and that they should learn from complaints. Indeed, this proposed requirement has been agreed by both the Parliamentary and Health Service Ombudsman and the Local Government Ombudsman, and sets out that providers should: "““Ensure that people and their relatives and carers are aware of and can use, with support where needed, and without prejudice to their care and treatment, simple and clear arrangements for handling comments and complaints. Ensure that complaints about failures to ensure people’s health, safety and welfare are investigated and resolved promptly and effectively. Learning from complaints is reflected in risk management, quality assurance, clinical governance and training and development arrangements””." I therefore do not believe that it is necessary to amend the provisions to make regulations ensuring that the commission takes into account not just how the provider handles complaints but also how the provider learns from those complaints. Furthermore, because the registration requirements will apply across both publicly and privately funded care, this should help to improve the situation for those people that Amendment No. 53B seeks to help. We recognise that there is an issue about the fairness of current arrangements for people who either choose to seek care independently or who do not qualify for state support and feel that their complaints have been inadequately addressed. The Government are actively considering ways in which some form of independent resolution may be achieved for those groups; I very much hope to have some answers in due course. We are also looking at options for ensuring that local complaints arrangements are as consistent as possible, whether they relate to publicly or privately funded services. So, to the extent that the final registration requirements—currently the subject of our consultation—cover this issue, the commission will already have the powers it needs to ensure that registered care providers are handling complaints properly, whatever the arrangements may be to provide that care. Let us remind ourselves that where registered care providers fail to meet registration requirements, the commission will be able to use the full range of its enforcement powers, not just issuing a warning notice as proposed by Amendments Nos. 58 and 58A. The emphasis in the new system we are putting in place for resolving complaints locally will also assist organisations to identify their mistakes, to learn lessons from them and to ensure that similar mistakes are not repeated. The noble Baroness raised the capacity of the ombudsman to deal with some of these complaints. I quote from a letter from Ann Abraham, the Parliamentary Ombudsman for the UK and Health Service Ombudsman for England: "““Clearly I recognise that, in the short term, the changes will result in an increase in the number of enquiries made to my Office and the number of investigations I undertake. I do not, however, expect to receive the same number of complaints for investigation as the Healthcare Commission has done. As evidence, I note that when the Scottish health system moved to a similar two-stage model at the time of the introduction of the Healthcare Commission in England, the number of investigations increased, but not unmanageably so … I have recently restructured my Office and I am confident that we will be able to meet the forecast increases in my workload, and will be able to provide an efficient and effective response to demand””." I have tried to answer some concerns of the Members of the Committee. I take the point about the care provided for those who may not qualify for state support, and am more than happy to look into that further. With the assurances I have given Members of the Committee today, I hope that they can, at least at this stage, consider withdrawing their amendments.