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Health and Social Care Act 2008 (Registration of Regulated Activities) Regulations 2009

I shall tackle the different points raised by the noble Earl and the noble Baroness, Lady Barker. I thank both noble Lords, who have been helpful in the discussions we have had, which I, too, found very useful. The noble Earl raised the issue of the threshold. The regulations are underpinned by the revised code of practice for the NHS, which I referred to in my speech, on the control of healthcare-associated infections and the related guidance, which was published alongside the draft regulations under the powers given to the Secretary of State by Section 21 of the 2008 Act. This new code sets out the criteria that the Care Quality Commission will use to check that the NHS organisations are complying with the requirements on the prevention and control of HCAIs. As the noble Earl will appreciate, we take that issue seriously. We are not complacent; we are pleased that the numbers of MRSA and C. difficile cases are down, but I agree that the situation will not be satisfactory until they have all gone. The noble Earl raised the issue of how the CQC will act in assessing providers’ compliance and make decisions. It is doing so right now; it is making decisions on whether it will attach conditions to registration. I imagine that the noble Baroness, Lady Young, has her people hard at work on that right this minute. On the issue of safeguarding, the enforcement powers will remain those under the Care Standards Act until providers are transferred to the new registration system under the 2008 Act. On the powers to close down healthcare facilities and wards, that is one of the range of interventional powers. The commission will need to consider the risk to patients and others using services of stopping a service against leaving a substandard service open, and it can do that only by liaising with the relevant PCTs and authorities. That is what we would expect it to do. As I recall, the issue of what would happen to the fines was raised several times during the passage of the Bill. Where fines and penalties are incurred by NHS bodies as a result of a breach of safety requirements, we are working with HM Treasury to find a sensible way of returning the money collected to the local area where it can be reinvested into improving services. The noble Earl asked how often the register will be updated. The Act allows for it to be live and to be done on an ongoing basis. The noble Baroness, Lady Barker, asked about an offence being a breach of the registration requirements. Of course, issuing a penalty notice is only one of the CQC’s enforcement powers, so it would be for the CQC to choose the most appropriate action in any given situation. As for the independent sector coming under this in 2010 and what will happen if people decide to seek treatment abroad, the CQC’s remit applies only to care in England. I hope that I have covered all the points raised by noble Lords, but I shall look at what they have said and write to them if I need to provide a more satisfactory or full answer. I thank noble Lords for their comments on these regulations. Motion agreed.