Clause 14 - Code of practice: effects on existing functions of Commission for Healthcare Audit and Inspection

Health Bill – in a Public Bill Committee at 9:45 am on 20th December 2005.

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Question proposed, That the clause stand part of the Bill.

Photo of Andrew Murrison Andrew Murrison Shadow Minister (Health)

Clause 14 is an innocuous clause, but it is nevertheless important. I should therefore be grateful if the Minister answered a few questions on it, before we signify that we are content.

The clause essentially deals with the role of the Commission for Healthcare Audit and Inspection in respect of the code of practice. In that context, we must refer back to the Health and Social Care (Community Health and Standards) Act 2003, with which many of us are very familiar. Some of us spent many hours considering it in the same way as we are considering this Bill.

Clause 14 sets out the effects of the code of practice on the existing functions of the CHAI; those effects are quite marked. What extra resources will be allocated to the Healthcare Commission in relation to those functions? That is an important matter, and will incur an opportunity cost. The Healthcare Commission is spread reasonably thinly as it is, and works very hard. If it is to be given more responsibilities, the resources necessary to discharge those responsibilities need to be found from somewhere. It would therefore be good to know what assessment the Minister has made of the costs and where the resources to meet those costs will be found.

The 2003 Act requires the Healthcare Commission to conduct an annual review of each NHS body. It must publish the criteria that it has devised, and those must be approved by the Secretary of State in accordance with the Act. The criteria must reflect standards set up by the Secretary of State in accordance with clause 46 of the Act.

On Thursday, I moved a raft of amendments to give teeth to the code of practice; those amendments were discussed during our debate on clause 13. In comparing the Bill before us with the 2003 Act, I am delighted to see that those amendments may yet see the light of day, because it is for the Minister to set standards from which the Healthcare Commission will devise the criteria against which it will judge NHS bodies when it inspects and reports on them. Those standards will presumably be things such as minimum cleanliness standards, infection control, nurse requirements, and minimum standards for the   cleaning of bed spaces, each of which were the subject of amendments that I and my hon. Friends tabled as part of the debate on clause 13.

The purpose of my contribution to the clause stand part debate is to ask the Minister whether my view of that matter is correct, and whether many of the concerns that I raised as part of our debate on clause 13 may be addressed via a circuitous route. I am, of course, disappointed that those matters will not form part of the code. However, I am pleased to hear that the Minister will spend her Christmas break deliberating on the code, and perhaps coming up with suggestions on how it might be improved, which she will send us electronically over the public holiday. That is very good, but I may be able to save her a little time and effort. It seems to me that she already has the power to set the standards that the Healthcare Commission will use to determine its criteria. The Bill hands the commission responsibility for judging NHS bodies on their cleanliness and their provision for addressing health care-associated infection, so all may be well. It would be good to hear the Minister’s views on that thesis; does she think that there is any truth in it?

Basically, what I am suggesting to the Minister is that if the 2003 Act and the Health Bill are taken together, the concerns that I outlined in debate on clause 13 may be addressed. The fact that the Minister is to set standards may sort out the issues that I raised in speaking to my amendments to that clause. I should be grateful if the Minister commented on that.

Photo of Jane Kennedy Jane Kennedy Minister of State, Department of Health

We will come shortly to the new power to issue improvement notices that we will give the Healthcare Commission. The clause gives the commission the duty to take account of the code, precisely as the hon. Gentleman suggests, when conducting any review or investigation of health care under the powers of the Health and Social Care (Community Health and Standards) Act 2003.

Observance of the good practice set out in the code will clearly be critical to achieving a real improvement in infection prevention and control. If NHS bodies are trying and failing to achieve what the code requires of them, it is essential that that is known, and the body that will know it is the Healthcare Commission. When failings occur, it can inform the trust and—we will discuss this shortly—where necessary, the Secretary of State.

The clause requires the Healthcare Commission to take into account observance of the code when awarding performance ratings for NHS bodies. That puts infection prevention and control at the heart of this important measure. The power to advise the Secretary of State is a sensible and necessary measure. It ensures that the Healthcare Commission will review the observance of the code at the front line; it can use its knowledge of how the code of practice is being observed to advise on how the code itself can be improved. The power will provide an additional   mechanism to help bring about improvements in the code and, through that, improvement in the quality of infection prevention and control.

I am assured by the Healthcare Commission that it will be able to make reviewing the observance of the code part of the assessment process that it already conducts. That means that the additional burden on the commission about which the hon. Gentleman is concerned should be kept to a minimum. He will have seen that the regulatory impact assessment that accompanies the Bill included a broad estimate based on information supplied by the Healthcare Commission. As with all publicly funded bodies, the Healthcare Commission is under a duty to perform its functions as efficiently as possible. I am satisfied that it has the resources that it needs to undertake the extra work that we are asking it to do, although we expect that costs will initially be at the higher end of the range given in the regulatory impact assessment.

Obviously, it will take time for the best practice outlined in the code to become firmly embedded throughout the NHS. There will be early costs, but they will be minimal. I am confident that the Healthcare Commission has the resources that it needs. On that basis, I hope that the Committee will agree that clause 14 should stand part of the Bill.

Question put and agreed to.

Clause 14 ordered to stand part of the Bill.