Schedule 6 - CSCI: supplementary

Health and Social Care (Community Health and Standards) Bill – in a Public Bill Committee at 2:45 pm on 4th June 2003.

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Photo of Paul Burstow Paul Burstow Shadow Secretary of State for Health, Shadow Spokesperson (Health) 2:45 pm, 4th June 2003

I beg to move amendment No. 433, in

schedule 6, page 114, line 17, at end insert—

'(4) The CSCI must adopt the Articles of the United Nations Convention on the Rights of the Child as the principles upon which actions taken or decisions made by or on behalf of CSCI which affect the rights and welfare of any child receiving service regulated under Parts II, III and VIII of the Care Standards Act 2000 must be based in all situations not specifically covered by primary legislation, Regulations or National Minimum Standards.'.

The amendment probes Government thinking on the applicability of the UN convention on the rights of the child to CSCI's discharging its responsibilities, both in dealing with regulated services and in inspecting social services authorities. I draw to the Committee's attention the fact that the National Care Standards Commission recently chose to adopt the articles of the UN convention in its board proceedings so that, when taking decisions or actions not directly informed by or governed by regulations, national minimum standards or statutory provisions, it had regard—as it should—in discharging its responsibilities to the promotion of the welfare of children and the safeguarding of their interests.

I hope that the Under-Secretary will not, as I suspect, tell me that the Government wish to maintain as much flexibility as possible for CSCI and therefore do not wish the amendment to be made, but that he will—as an advocate of children's rights—encourage that new body to give due regard to what its predecessor did.

I have a few questions for the Under-Secretary on that subject, particularly about the role of the children's rights director in the new social care inspection framework. In the National Care

Standards Commission the director has responsibility for all regulated services that deal with children. Will the children's rights director have responsibility for all services—in so far as they deal with children—that are covered by the new body? The responsibilities for regulated services are being transferred directly from the existing legislation; what I want to know is whether the children's rights director will have a locus in the new responsibilities to inspect social services and social services providers not regulated by the Care Standards Act 2000. The Bill is not entirely clear on that, so it would be helpful to establish how far the writ of the director will run and whether changes to the regulations will be required.

This probing amendment is intended to secure the Government's support for the principle that a body with the promotion and safeguarding of children's rights at its heart should—wherever practical and possible—follow the UN convention and be guided by it.

Photo of David Lammy David Lammy Parliamentary Under-Secretary (Department of Health)

First, I commend the principle behind the amendment: that CSCI decisions about children receiving social services should be based on the convention—that is admirable. I am sure that the hon. Gentleman is aware that the UK is a signatory to that treaty—as are most other countries. I have no doubt that the management of CSCI, as experts in children's services, will be well aware of the principles of the treaty and that their day-to-day decisions will be informed by that.

The UN convention on the rights of the child is an international treaty that was signed between national Governments. Therefore, it would be totally inappropriate to give a public body the role of interpreting it—as the amendment would do. That is a matter for the Government of the day alone. If the National Care Standards Commission has decided to adopt the convention, that is its right, and is admirable. There is no reason why the new social services inspectorate could not do the same, but that could be done without legislation.

The hon. Gentleman asked about the children's rights director. He will continue with his functions, which are set out in current regulations, and the future role of that position will be decided by the chair and the board as part of their broader functions. We will be informed of their views and consequently we may amend regulations as necessary.

For the reasons that I have given, I shall urge right hon. and hon. Members to vote against the amendment if the hon. Gentleman presses it to a Division.

Photo of Paul Burstow Paul Burstow Shadow Secretary of State for Health, Shadow Spokesperson (Health)

I expected the Under-Secretary to do no less. As I said at the outset, the probing amendment was intended to secure at least an indication that the Under-Secretary agrees that the adoption of the convention by the National Care Standards Commission was a worthy decision. I believe that it was more than worthy: the convention is a practical and useful aid to its decision-making processes. I encourage the CSCI to adopt the convention, and I hope that the Government will do the same when they

come to give it further guidance. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Amendment made: No. 341, in

schedule 6, page 115, line 12, leave out from 'CSCI' to end of line 13.—[Mr. Lammy.]

Photo of Paul Burstow Paul Burstow Shadow Secretary of State for Health, Shadow Spokesperson (Health)

I beg to move amendment No. 432, in

schedule 6, page 115, line 15, at end insert—

'(2A) The CSCI must also appoint a Vulnerable Adults Rights Director who is to be an employee of CSCI and is to have such functions as may be prescribed.'.

Photo of Peter Atkinson Peter Atkinson Conservative, Hexham

With this it will be convenient to discuss the following:

Amendment No. 389, in

clause 72, page 28, line 14, at end insert—

'(ee) the need to safeguard and promote the rights and welfare of vulnerable adults;'.

Amendment No. 390, in

clause 72, page 28, line 16, leave out

'purpose specified in paragraph (e)'

and insert

'purposes specified in paragraphs (e) and (ee)'.

Amendment No. 376, in

clause 101, page 40, line 41, at end insert

'and the need to safeguard and promote the rights and welfare of vulnerable adults.'.

Photo of Paul Burstow Paul Burstow Shadow Secretary of State for Health, Shadow Spokesperson (Health)

The amendments deal with the rights of vulnerable people, particularly vulnerable adults. They would create a similar duty to safeguard and promote the rights of vulnerable adults as that for children under the Bill as drafted. Liberal Democrat Members believe that that is a glaring omission, which should be dealt with—by accepting the amendment or by tabling a similar one—in order to ensure that CSCI and the Commission for Healthcare Audit and Inspection have a clear focus on the need to safeguard and promote the welfare of vulnerable adults.

There is a view that to do so for the rights of vulnerable children is necessary and proper but that there is no need to give similar priority to vulnerable adults. That will cause problems in operational work, so I encourage the Government to give serious thought to trying to ensure that, in the work of both commissions, adult services and adult service users rights are to the fore. Having a children's rights director on a statutory basis and backed up by regulations will be of great benefit. It will enable that office-holder to do things and push issues unlike any other present office-holder in CSCI or the National Care Standards Commission. The amendments would establish a specific office in CSCI for a director for the rights of vulnerable adults, and stipulate requirements on safeguarding and promoting the welfare of vulnerable adults.

Will the Under-Secretary explain whether he feels that the amendments will in some way fetter the discretion of either commission? Why is it perfectly acceptable to fetter their discretion in discharging

responsibilities on the rights of children, but not right to do so when it comes to safeguarding the rights of vulnerable adults? What distinction are the Government drawing? What is the philosophical difference that results in different approaches? I hope that the Under-Secretary can explain that to the Committee and I look forward to his response.

Photo of Chris Grayling Chris Grayling Shadow Minister (Education)

No one could dispute or disagree with the aspirations of the hon. Member for Sutton and Cheam in wanting to ensure that all vulnerable people in our society receive the support that they need. I am sure that I am pre-empting the Under-Secretary's comments—I offer my support for them in advance—by saying that if we wrote vulnerable adults into the Bill along with vulnerable children, we would either have to go to the extreme of listing every group in society that could be looked after by the bodies, or everybody would have to become a priority. That is the job that those organisations are there to do.

Photo of Paul Burstow Paul Burstow Shadow Secretary of State for Health, Shadow Spokesperson (Health)

I understand that argument, which was last paraded when we made the point during the passage of the Care Standards Bill a few years ago. Is the hon. Gentleman arguing that there should not be equity in the treatment of vulnerable adults and children in securing the very highest standards of care and treatment?

Photo of Chris Grayling Chris Grayling Shadow Minister (Education) 3:00 pm, 4th June 2003

My argument is simply that that is the job of those organisations. If we bracket vulnerable children and vulnerable adults, that equals everyone in our society who is vulnerable. The job of those organisations is, in the case of CHAI, to look after patients, and in the case of CSCI, to look after the vulnerable. Incidentally, I am a bit confused as to whether it is pronounced ''sea-sky'', which sounds like a motto for the Fleet Air Arm, or ''Ciskei'', which is a province in South Africa. CSCI's job is to look after all vulnerable people, and I am not persuaded that we need to amend the Bill or make it more complicated to reflect that.

Photo of Andrew Murrison Andrew Murrison Conservative, Westbury

My hon. Friend may have received some correspondence from Help the Aged, as I did today, that deals with that specific point. Its concern is that it has noted the special treatment that the Bill gives to children, and is wondering what is in it for elderly people. One could go on and on. I entirely agree with my hon. Friend. He is right to point out that the NHS is there for everyone and if we start balkanising it in the way that some suggest, we will have real problems.

Photo of Chris Grayling Chris Grayling Shadow Minister (Education)

I am grateful to my hon. Friend for that comment. There is a particular issue relating to children. Society as a whole wants to ensure that children who are not in a position to fight their own corner, as they do not have age or experience, are adequately protected. None the less I agree, as I too have regular dealings in my constituency with people who have learning disabilities and those who have mental health problems. I want to see this organisation do the job for them.

I do not disagree with the aspirations of the hon. Member for Sutton and Cheam. In order to keep the

Bill simple, however, it is the Committee's message to those who are going to work for CSCI—and the intention of the whole House—that we expect them to ensure that they look after the interests of those vulnerable people. I am not persuaded that we need to add to the Bill to achieve that.

Photo of David Lammy David Lammy Parliamentary Under-Secretary (Department of Health)

The hon. Member for Epsom and Ewell (Chris Grayling) makes the point incredibly well. There is not much to add. The amendment would place an obligation on the new inspectorate to appoint a director of rights for vulnerable adults, and would provide an additional duty to have a regard for and to safeguard and protect the rights of vulnerable adults. I am sure that those motives are laudable, but they must be resisted for two reasons.

There is nothing to prevent CHAI or CSCI from having a director responsible for vulnerable adults but we do not see the need for legislation in that area. The original reasons for the role of a director of children's rights were very clear. Children in care who are looked after in boarding schools away from home are especially vulnerable and there is public consensus about that. There is not, however, public consensus about vulnerable adults, and it is unclear how we would define vulnerable adults, when social services are in the business of providing care standards services for vulnerable people.

The hon. Gentleman has a point, philosophically, but technically, we do not see the need to put this issue in the Bill. I would gently make the case that there is a view—as articulated so well by the hon. Member for Epsom and Ewell—that the rights of the child are well established. Vulnerable adults are a much larger group, and there is a point of view that having a director for vulnerable adults might mean that the case for vulnerable people achieving their rights might be undermined. After all, they are adults, and people might look to the director, not to themselves. For that reason, I resist the amendment.

Photo of Paul Burstow Paul Burstow Shadow Secretary of State for Health, Shadow Spokesperson (Health)

I am grateful to the hon. Member for Epsom and Ewell and to the Under-Secretary for clearly setting out the Government's position. [Interruption.] I deliberately conflated that. I just want to pick up on a couple of points that the Under-Secretary made. He talked about how one would go about defining a vulnerable adult. I simply draw his attention to section 86 of the Care Standards Act 2000. The Government seemed to have no difficulty in coming up with what was presumably then conceived by parliamentary counsel as a working definition. In respect of children's services there is now a means to ensure that the interests of the child are central to the work of the commission, which is, after all, under pressure from the providers—the subject of regulation in many respects. My concern is that there is a buttress, through regulations and statute, for the rights of children, but there is no similar buttress in respect of the rights of adults.

The hon. Member for Epsom and Ewell rightly asked what groups of people we were talking about. He went on to talk about people with learning disabilities. I would add to that people who lack mental capacity. The Government have, for some years, been contemplating introducing mental

incapacity legislation. They have not yet done so. Such legislation is long overdue and would go some way to allay some of my anxieties about the absence of something within CSCI to deal with the issues. It is clear that we will not make progress on the matter today. This is a missed opportunity to establish parity of esteem and treatment in relation to the rights of adults who are vulnerable and lack capacity to make decisions for themselves and those of children, who the Minister is rightly concerned about and who similarly lack the ability to articulate their needs as clearly as we would wish. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Schedule 6, as amended, agreed to.

Clause 38 ordered to stand part of the Bill.