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Health and Social Care Bill

moved Amendment No. 19: 19: Clause 2, page 2, line 16, at end insert— ““( ) 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,”” The noble Baroness said: I am grateful for the support from other noble Lords for these amendments, which are many and all relate in some way or another to putting human rights at the heart of the work of the Care Quality Commission. I will try to explain the perspective of the Joint Committee on Human Rights on this and why the Bill has such profound human rights significance. The human rights framework has considerable importance in structuring the ethos of public life in this country. In saying that, I build on much that has already been said this afternoon. The European Convention on Human Rights played that role for many years, but the framework was, as the Government say, brought home by the Human Rights Act 1998. That Act signalled a change and brought into being a framework within which the states’ actions towards individuals should be shaped. I refer here not only to areas in which the state takes powers to coerce someone or deprive them of their liberty, such as in counterterrorism and criminal justice or in the detention of patients under Mental Health Act powers. This is about how the state, and those through whom it works, deals with human beings. This view of human rights has led the Joint Committee on Human Rights to broaden its work and to undertake two major thematic inquiries: one into older people and healthcare, and one into the treatment of adults with learning difficulties. Both those inquiries were revelatory for committee members and brought us into contact with the meaning of human rights to a very broad range of people—those who are being cared for and those who work with those who are being cared for. I stress that the human rights framework is enormously important for those who care for people, because it enables them to see their work within an ethical framework through which they can articulate their values as caring professionals. It also enables them to stand up to anyone who tells them to cut corners and leave the old lady lying in a dirty bed, and to feel that they must blow the whistle when abuse needs to be exposed. The human rights framework is also part of each individual’s relationship with the state. It means that we can expect that our right to life will be protected, that we should not be subjected to inhuman or degrading treatment, that our right to family life shall be respected, and a number of other rights. By simply listing those three, however, I hope it is clear to the Committee that the work of the Care Quality Commission will have human rights work at its heart. I also resort to recounting a personal experience. Some years ago, I had an illness that kept me in hospital for quite a long time. I was in a wheelchair for six months. It was a profoundly educational experience. When I was recovering, I amused myself by writing about it. Articles appeared in the health pages of both the Times and the Guardian, if I remember rightly. My main thought was that my experience was parallel to that of my day job, in which I dealt with matters relating to prisons, prisoners and the protection of basic rights. Everyone needs the protection of those rights, and it became clear to me in hospital that I was one of those who needed them. First, there is huge potential for ill-treatment, neglect and abuse when one is a patient or someone who is being cared for. You are without power and you feel that you are without it. Your feeling of powerlessness is increased enormously by the potential humiliations that you can suffer through the invasion of personal privacy. If they do not have time to give you a shower, you cannot have a shower, so you feel dirty and smelly all day. You then wish that your visitors were not coming because you do not want them to see you in that state. It is very difficult to do anything about those things because you are completely dependent on your carers. If you try to do anything about it, what happens to you could get worse, rather than better. Those are classic human rights situations where protection is called for. They are the issues behind the whole conceptual framework of human rights. I know that the Government are not at all convinced by those arguments. They have said, as the Minister said in response to the report of the Joint Committee on Human Rights, that the application of Section 6 of the Human Rights Act 1998—the duty to act compatibly with convention rights—will mean that the Care Quality Commission will automatically take into account convention rights, and that there is no need to do any more about it. The Government say that the broad regulation-making power in Clause 16, "““already is sufficiently wide to enable regulations to be made in relation to the health and safety and welfare of service users and to secure their Convention rights””." Finally, the Government say that the inclusion of express reference to the Convention rights in Clause 16 could lead to uncertainty as the scope of an obligation to make regulations to secure rights would not be easy to determine. The Government do not wish the Care Quality Commission to become a quasi-judicial body. Perhaps I could ask the Minister whether the Government understand that Section 6 of the Human Rights Act 1998 requires the Care Quality Commission to act compatibly with convention rights—not merely to take them into account. Taking them into account is not the same thing as acting compatibly with them. Do the Government consider that the inclusion of obligations in respect of rights could create any greater uncertainty for the commission than the inclusion of obligations in relation to health and safety or welfare? Why would the inclusion of that obligation lead to the Care Quality Commission becoming quasi-judicial and why would that be so inappropriate? How would that differ from the role that the commission would play in relation to the protection of health and safety, and welfare? In our discussions and in the Government’s response to the Joint Committee, I feel that there has been a failure on the part of the Government to understand the profoundly important relationship between health and social care and human rights. I very much hope that the Government will be able to think again about their view on this and that maybe we shall make some progress. I beg to move.