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Health and Social Care Bill

I shall use precisely the same words as I used in my opening remarks on the previous group of amendments. I welcome—the Minister and the hon. Member for Romsey (Sandra Gidley) both seemed to miss my saying that—the majority of the amendments, which again pick up on points made by Conservatives in both Houses. It does not matter how much the Minister and the hon. Lady wish to deny that they were Conservative initiatives, they were indeed proposed by us in both Houses. I am pleased to say that some of them were supported by other Opposition parties. I am glad that the complaints function is addressed in regulations, although I fear that there are unresolved issues for patients, particularly for self-funders in social care. I am glad of greater scrutiny for prison and defence health care, although I retain some concerns about the powers of the Executive over that. I am glad of the amendments that limit the powers of the Secretary of State, but I am disappointed that no substantive amendments were achieved on malnutrition, given the powerful debates on that both in Committee and on Report. Amendments Nos. 6, 7, 9 and 11 are not controversial. Amendment No. 8, however, merits a bit of discussion. In addition to the handling of complaints and disputes, it enables regulations to make provision for the application of lessons learned from them. I am pleased to see the amendment on the amendment paper. It recognises that an effective complaints process includes a performance management output, so that mistakes are not repeated and loopholes are closed. I again pay tribute to my noble Friend Earl Howe for championing the amendment in another place, and I am pleased that the Government made the concession. However, it comes nowhere close to addressing the serious concerns that remain about the complaints arrangements both within registered providers and on a national scale through, inter alia, the parliamentary and health service ombudsman. I draw the House's attention to cross-party concern on that. The hon. Member for Luton, North (Kelvin Hopkins) made a number of powerful speeches on the subject in Committee, saying:"““A number of my hon. Friends, not necessarily members of the Committee, are concerned about changes in patient representation and procedures for patients making complaints in recent years.””—[Official Report, Health and Social Care Public Bill Committee, 17 January 2008; c. 346.]" He was supported by the hon. Member for Tamworth (Mr. Jenkins) in holding the Government to account for their failure in that respect. The amendment fails to address three issues—resourcing the ombudsman, monitoring trends, and supporting complaints by social care users. If you remember, Mr. Speaker, the Committee had three evidence-taking sessions before it considered the Bill in detail. In the ombudsman's written evidence, she said:"““I have already explored with the Treasury the additional funding I am likely to require””." However, no figure has been put on that. This is a serious issue, as the saving made by the Care Quality Commission will no doubt be reported as a gross saving by the Department, but could be a net loss to the taxpayer. I must remind the Minister that at column 348 of our Committee proceedings he promised to write to me with ““the exact figure””—a promise that his letter MS (H) 103035 failed to deliver on, dealing with the issue only in the broadest terms. It is disappointing that the Bill has reached its final stages, with this amendment, without that information coming before the House. I complained about that on Third Reading, but have had no response from the Minister. Looking at the complaints that the Healthcare Commission has received, the ombudsman faces a potential elevenfold increase in her work load. How much will that cost? We need to know whether the cost is admitted by the Treasury, or is it in denial of the costs of its very own legislation? Has the ombudsman been given the assurances and budgets requested and required? If not, why not? If the Minister does not know the answer, then after all this time, why not? If he does, but will not give it, surely we are right to place the question on the record.