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Health and Social Care Bill

moved Amendment No. 59: 59: Clause 26, page 14, line 7, at end insert— ““( ) In deciding whether or not to make the order, the justice must take into account, in particular, the extent to which the Commission had paid regard to the duties set out in section 2(3)(c) and (d).”” The noble Baroness said: The clause refers to the urgent procedure involved when an application has to be made to a Justice of the Peace to cancel a registration. It requires the justice to take into account the extent to which the commission has paid regard to the duties set out in Section 2(3)(c) and (d) of the Mental Health Act 1983, which refer to the commission’s activities being proportionate to the risks and the need to safeguard and promote the rights and welfare of children and vulnerable adults. In effect, we are seeking to ensure that the JP is reminded that the decision is proportionate to the risks involved; that it is the last resort; and that it is essential to close the nursing or residential home, ward, clinic or hospital without further investigation. Closing an establishment is a draconian measure and affects not only the resident or patient at risk but all the other residents or patients who share the facility and who may not be at risk. I do not doubt that this measure is necessary. I know that CSCI has used it only nine times in the past year and, knowing the integrity of that organisation, I have no doubt that it was used appropriately. However, this vast new regulator, the Care Quality Commission, will have to have a depth of administration; we know that large organisations are much more difficult to manage and we do not know what level or quality of person will be involved in making these decisions. For 12 years I was a JP and I remember being called in on a Saturday morning or late in the evening to sit alone and make immediate decisions on some very difficult cases. I was reliant on the information given to me by the police or other authority. The cases were presented as having no alternative. Later, reflecting on a case, I used to wonder whether other possible avenues had been explored. I would have welcomed a prompt to consider the wider issues or, in our context, for the clerk to remind me that I should be sure that a decision was proportionate and that action had been taken to accommodate the other residents or patients. When I chaired the Brighton health authority we had a case of legionnaires’ disease in a ward which was part of a 20-storey block. It was a vast building with numerous wards and theatres, and an accident and emergency department. The chief executive telephoned me and suggested that we evacuate the 20 storeys as they shared the same air-conditioning system. I counselled that we should not panic and resisted the closure. Fortunately, it was contained within a single ward. This amendment is designed to resist the temptation to panic and to give a prompt to a JP sitting alone to ensure that a decision to deregister takes into account all the implications of an immediate closure. I was delighted to learn that, when the shadow chairman of the CQC was questioned before the Health Select Committee last week on the closure of hospitals or hospital wards, she said that she could envisage situations where licences could be suspended or withdrawn as a very last resort. She said that it was important to remain proportionate, not to regulate blind, and to consider the consequences of such an action. She noted that she currently regulated Sellafield; closing it down might not be the best regulatory approach, but there were firm sanctions that could be taken against management to improve performance. I hope that the noble Baroness, Lady Young of Old Scone, will take a personal interest in making the decision to go to court for an immediate closure. I beg to move.