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Baroness Pitkeathley: My Lords, in welcoming these amendments, I declare an interest as chair of the General Social Care Council Advisory Group. I am convinced that the proposed amendments will be of great importance to the staff, about whom we are talking. While on my feet, perhaps I may pay tribute to the openness with which the proposed changes have

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been greeted by all the staff with whom I have had contact. The commitment to the changes which are being introduced is impressive. None the less, I know that they will be reassured by the assurances offered by the Government in these amendments.

On Question, amendment agreed to.

Clause 40 [Power to extend the application of Part II]:

Lord Hunt of Kings Heath moved Amendment No. 51:

    Page 18, line 37, at end insert ("or by Health Authorities, Special Health Authorities, NHS trusts or Primary Care Trusts").

On Question, amendment agreed to.

Lord Weatherill moved Amendment No. 52:

    After Clause 40, insert the following new clause--


(" .--(1) The Secretary of State shall grant exemption from the operation of the provisions of this Part of this Act in respect of any establishment or agency which provides nursing or personal care and which he is satisfied is being, or will be, carried on or managed in accordance with the practice and principles of the body known as the Church of Christ, Scientist.
(2) It shall be a condition of any exemption granted under this section that the establishment or agency in question shall adopt and use the name of Christian Science house and the agency in question shall adopt and use the name of Christian Science visiting nurse service.
(3) An exemption granted under this section may at any time be withdrawn by the Secretary of State if it appears to him that the establishment in question is no longer being carried on or managed in accordance with the said practice and principles.").

The noble Lord said: My Lords, in moving this amendment perhaps I should declare a personal interest. Although "orthodoxy" is my doxi--and 1662 at that--my wife is a Christian Scientist, and during the 51 years of our happy marriage I have come to have a regard and a respect for Christian Science teaching and healing. Christian Scientists believe that healing is best achieved through prayer. Indeed, the weekly and monthly publications, Christian Science Journal and Christian Science Sentinel, contain in every issue accounts of contemporary healing through prayer from around the world. Many of them are difficult cases, previously abandoned by the medical profession as hopeless.

A Christian Scientist proactively adopts prayer in sickness and also in health as the most effective means of improving the human condition in all departments of life, without medical intervention. Of course, not every healing is instantaneous and there may be occasions when individuals may need the practical support and care of Christian Science nursing.

There are two Christian Science nursing homes, or houses, in the United Kingdom. I have visited one of them, Charton Manor in Kent, and have seen for myself the high level of facilities and the care of Christian Science trained nurses. Those who enter Charton Manor for Christian Science healing do so voluntarily. They do not have to remain if they subsequently decide that they need medical attention.

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In more than 70 years of exemplary operation, there can be no suggestion that the conduct of Christian Science houses or of domicilary care by Christian Science trained nurses has warranted any increase in the level of government supervision or interference. Indeed, as the Minister well knows, they were specifically exempted from the Nursing Homes Act 1928 and, most recently, from the Registered Homes Act 1984.

I should like to thank the Minister and his officials for the meetings that we have had with them and with representatives of the Christian Science Church. I have been present at one or two of those meetings. I pay tribute to the Minister for his understanding attitude and for the verbal assurances that he has given us at those meetings. The purpose of my new clause is to give the Minister an opportunity to reaffirm those assurances.

Briefly stated, they are, first, that, having particular regard to the Human Rights Act 1998 and Article 9 of the convention, the fundamental religious right of a Christian Scientist, however serious or acute their illness or injury may be, to choose a type of care which is entirely free from all medical diagnosis or intervention is acknowledged and will be preserved; secondly, that no regulations will be applied to Christian Science houses or Christian Science visiting nurse services which would have the effect of preventing Christian Science nursing services being provided in accordance with the practices and principles of the Church of Christ, Scientist, as they have traditionally been; thirdly, that those administering Christian Science establishments or agencies, or their staff members, will not be required to undergo any medical training, including training in first aid, identification or recording of symptoms, diagnosis, or physical therapy, or to attend any prescribed educational programme or in-service training pertaining to patient care, as opposed, for example, to building safety codes and other regulations of a similar kind; and, finally, that it is not the Government's intention that the powers contained in Clause 19 of the Bill shall be exercisable in respect of a Christian Science house or visiting nurse service, where the perceived violation of Clause 19 arises solely by virtue of the patient's intention to rely exclusively on Christian Science treatment for healing. I beg to move.

9 p.m.

Lord Hunt of Kings Heath: My Lords, I am most grateful to the noble Lord, Lord Weatherill, for allowing me to, I hope, reassure him in relation to the position of Christian Science houses. The effect of the noble Lord's amendment would be to exempt Christian Science houses and nursing homes from the requirement to register with the commission. Perhaps I may say right at the start that the Government have no intention of preventing or discouraging people from being cared for in accordance with the principles and practices of the Church of Christ, Scientist. The Care Standards Bill will not mean that Christian Science houses or their visiting nurse services will have

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to give medical treatment to their patients, or do anything else which would go against their religious principles.

I shall deal first with Christian Science establishments. Establishments which fall within the definition of a "care home" and are carried on or managed in accordance with the principles of the Church of Christ, Scientist, will have to register with the commission as a care home. But that does not mean that Christian Science houses would be compelled to comply with regulations or standards which would offend, or be incompatible with, the practices and beliefs of the Church of Christ, Scientist.

I recognise that the type of care and treatment provided by Christian Science houses is non-medical and based on healing through prayer. This is very clearly different from the kind of NHS-style care which other nursing homes provide. The Bill allows for care homes to register as providing different categories of care. The categories will be described in regulations. Applications to register with the commission as a care home will need to state the category of care that the care home intends to provide. It is in this way that the commission will differentiate, for example, between care homes which provide nursing care and those which provide only residential care. It is the Government's intention to provide in regulations for a category of "Christian Science home".

I would not expect many of the regulations or national minimum standards concerning care homes to cause the church any difficulties because I am aware of the very high standards which are apparent in those homes. However, it has to be accepted that there may be a few regulations and standards, such as those regarding the administration of medication, which would not be appropriate. The Department of Health will consult and work with the Church of Christ, Scientist, to ensure that regulation by the commission is compatible with the church's principles and practices.

On the issue of regulating Christian Science visiting nurse services, which the amendment would exempt from regulation, it has not been the intention that the commission would regulate nurses agencies and so, under the Bill, they would be exempted from the definition of a "domiciliary care agency" through regulations made under Clause 4(5).

While recognising that there are differences in the type of nursing provided, it is our view that Christian Science visiting nurse services are akin to nurses agencies. Our intent will be to ensure that they are also exempted from the definition of a "domiciliary care agency" and from the requirement to be regulated by the commission.

I have every sympathy with the intent behind the noble Lord's amendment. I hope that these assurances will satisfy his concerns.

Lord Weatherill: My Lords, I thank the Minister for what he has said and for reaffirming what he said to us in our private conversations. The Christian Science movement is in favour of the Bill itself but is concerned

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that its own practices should not be interfered with in any way. Having been given those assurances, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

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