Private and Voluntary Health Care (England) and Care Home Regulations 2001

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Jacqui Smith: First, I spelled out what action the Department took in 2000 to attempt to make contact with representatives of the IPL industry. Because the industry was not regulated, it was necessary to try a range of different groups to make contact with them. I outlined the significant range of responses that we received in the formal consultation, most of which supported the Government's regulatory approach.

Lord Haskins passed representations from Aculight to the Department, which were used with other representations as part of the consultation. My understanding is that the Department made it clear to Aculight that that was the point. The difficulty may be that Lord Haskins did not receive a copy of that letter.

I showed that the Department rightly took considerable pains to consult the industry. It had already received a large number of representations suggesting that it was appropriate to regulate intense pulsed light as I described. I gave some reasons as to why that was appropriate. We are trying to put in place appropriate safeguards for the use of technologies that

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people believe may cause damage if used inappropriately. The Department acted correctly, and the policy objective is right.

Mr. Burns: First, is it right or wrong to say that the Department of Health has admitted that it failed adequately to consult the major companies supplying intense light machines for cosmetic hair removal? Secondly, is it right to say that officials at the Department belatedly attempted to consult them after the formal consultation process had finished? Thirdly, as a result of Lord Haskins's representations or passing on information to the Department, has it had the courtesy, through Ministers, to respond to Aculight?

Jacqui Smith: I answered the last point. [Interruption.] I did answer it. If I am wrong, I will certainly correct myself.

I think that I also responded to the first two points. I made it clear that we received quite a lot of responses in the formal consultation. I understand that officials in the Department sought to meet the manufacturers as a result of their comments, which was appropriate. Today's debate and the extent of the contact suggest that there was significant consultation. Some providers may not like the results of the consultation, but for the reasons I outlined, it is appropriate that the Government have acted as we have to safeguard users of intense pulsed light.

If I do not manage to cover particular points that were raised, I shall write to hon. Members, but as I said, many issues are covered in the standards. It is appropriate that they are laid down in the standards.

The hon. Member for Oxford, West and Abingdon asked about regulation, particularly of walk-in centres. Those establishments regulated as independent clinics are private establishments only, so to the extent that they are private walk-in centres, they are regulated. Those clinics that provide NHS services, whether wholly or partially, will not be independent clinics for the purpose of the regulations. On regulation 3(4), the hon. Gentleman is right: the issues to which he referred are exempted in this case. The procedures are not covered by the legislation. Given the overall objectives of the regulations, this would not have been the appropriate place to deal with issues such as body piercing.

The hon. Gentleman also made a point about anaesthetists. The problem is the responsibility of the Competition Commission and the Office of Fair Trading, as I believe he suggested. Other issues that the hon. Gentleman raised—the presentation of bills, the process of gaining consent and the provision of information—are covered in the standards that underpin the regulations. We must have consistent standards, and inspection of establishments will be done on the basis of ensuring that standards are met.

The hon. Gentleman made a point about the Race Relations (Amendment) Act 2000; I shall write to him about that. The regulations emphasise the responsibilities of establishments as employers. Rightly, they will have to follow employment legislation on race discrimination.

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The hon. Member for Worthing, West raised a point about terminations. Not only is monitoring of terminations not a good use of regulations, but it is not appropriate in the legislation. I believe that the hon. Gentleman made the point, taken up by my hon. Friend the Member for Stourbridge (Ms Shipley), that we need action to ensure that the number of terminations is minimised. The Government's teenage pregnancy strategy, the guidance to schools on sex and relationship education and the expansion of access to contraceptives and contraception advice are more important than monitoring in reducing the number of terminations.

Peter Bottomley: I shall not challenge the Minister, but she may wish to reflect on the requirements for notifying the chief medical officer of each termination. I believe that that is a requirement on national health service hospitals. I hope that she will give further consideration to my suggestion.

Jacqui Smith: I certainly undertake to consider it.

On the hon. Gentleman's point about staff, they will be covered by health and safety regulations, as he suggested. The issue of disqualification also relates to doctors from abroad, who must register with the General Medical Council. Through the regulations, we will be able to ensure that providers and employers check references and carry out the sort of recruitment practices that we expect.

I was not completely clear about the hon. Gentleman's comments on medication. I believe that he was concerned about the extent to which medication for patients in the community might be enforced.

Peter Bottomley: Or in an independent clinic, which was a way of getting it into the discussion.

Jacqui Smith: The hon. Gentleman is very honest. It would probably be more appropriate to consider the issue in a discussion of the Government's commitment to introducing new mental health legislation, particularly for modernising compulsion for treatment in the community. However, the hon. Gentleman managed to ask the question, and I managed to respond.

I think that I have responded to the points made by the hon. Member for Lichfield.

Dr. Harris: I listened carefully to the Minister's reply to my questions, but she did not respond to the following points: first, she said that the regulations would not deal with tattooing and body piercing, but she did not say whether the Department had a plan to deal with the issue; secondly, I want to know if she thinks that paragraph 17 on audit is adequate; thirdly, and most importantly, can she assure me that resident surgical and medical officers will not be expected to work longer shifts than those of junior hospital doctors with the same experience in the NHS, which are required to be limited?

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Jacqui Smith: I did not answer the hon. Gentleman's specific questions, but I shall write to him. Several of the issues he raised are covered in the standards that underpin the regulations.

Dr. Harris: Will the Minister clarify what she said? Is there a published standard that specifies, for example, that resident surgical officers and resident medical officers will not be required as part of their contract of employment to work long shifts in excess of the standards in the national health service that apply to junior hospital doctors of the same experience?

Jacqui Smith: There is not a standard that explicitly states that. As I said, the standards underpin the type of employment practices and the expertise that would be expected in different clinics, and service-specific standards are being developed in respect of each of those. I explained the status of those standards; in relation to the particular points, I shall write to the hon. Gentleman about the extent to which they are covered in the standards. They are the basis on which the regulations are interpreted when private and voluntary health care establishments are inspected.

I return to our objective: the regulations provide a far better way of ensuring that we monitor and regulate the appropriateness of premises or numbers of staff. They enable us to put the needs of patients, the importance of clinical standards and the extent to which we will be able to regulate and improve them at the heart of the regulation of private and voluntary health care providers. The measure should be welcomed as part of the Government's overall improvement and modernisation of regulation.

Question put and agreed to.


    That the Committee has considered the Private and Voluntary Health Care (England) Regulations 2001.


5.49 pm

Mr. Burns: I beg to move,

    That the Committee has considered the Care Homes Regulations 2001 (S.I. 2001, No. 3965).

Given the nature of the proposal, I am slightly surprised that it should have been bracketed with the earlier measure. Fortunately, we can redress the balance by having a proper debate on what the Committee will agree is an important measure, considering what has happened in the past in care homes.

The Opposition welcome all improvements in standards of care, and the enhancements to the standards of protection that that entails for those who are resident in a care home, regardless of whether they are young adults—as is the case under these regulations—or a more elderly client group.

In that respect, we are at one with the Government. We share their goal of raising standards in the care home system throughout the country. However, that does not preclude us from having concerns about the

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details of certain matters, and from seeking an explanation and guidance from the Minister about them. I shall try to do that without unduly detaining the Committee.

This is a lengthy document that addresses many requirements, and the way that it is drafted occasionally causes confusion about its intentions. I am also concerned about certain provisions in which the Government appear to resort to their natural tendency to seek to over-regulate, and to nanny the system along. With regard to some of the regulations, it is not necessary for them to be so heavy handed.

Regulation 19 addresses the fitness of workers. That is an important issue. Regulation 19(1) states that a person shall not be employed at a care home unless schedule 2 has been complied with—and, in particular, paragraph 7 of that schedule, which requires the criminal records bureau to carry out a criminal records check on people working in care homes.

In principle, that is an excellent provision, because it is essential that people with criminal records should not be employed in such a sensitive area. That is especially the case with regard to certain kinds of criminality that would have a devastating impact on clients, and on the smooth running of a care home.

However, there is a flaw in the way those regulations will be introduced. They will come into effect on 1 April 2002, and the criminal records bureau will start operating at the end of March. Therefore, they will be introduced almost simultaneously. How will care homes be able to meet the requirements of the regulations from 1 April? The time scale is too tight.

I also understand that criminal records checks are expected to take from two to three weeks. That might be an optimistic forecast. It is not plausible to expect potential members of staff to wait that long, as they might be able to find employment elsewhere on the very day that they begin looking for work. I also wish the Government to clarify whether the criminal records checks will also be carried out on care staff in the national health service.

A criminal records check will cost £12 a person. The care homes' administration costs must be added to that. That is another cost that independent sector providers will have to bear. It would be better to wait a week, obviously with the member of staff being closely supervised and presumably other references having been taken up with a former employer or other referee. We should allow a saving-grace time scale. An individual could decide after a few days and before the check had come through that that was not the job for him or her—with the employers still having to pay the fee for the criminal check because they would have had to put in motion the procedures for a criminal record check. However important the checks, it seems unfair to employers, given the cost involved, that criminal records must be checked from day one so that checks are run on people who may decide, long before the information comes back, that they do not want to work in the sector.

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