Clause 14

Health and Social Care Bill – in a Public Bill Committee at 6:15 pm on 15th January 2008.

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Suspension of registration

Photo of Stephen O'Brien Stephen O'Brien Shadow Minister (Health)

I beg to move amendment No. 11, in clause 14, page 6, line 34, at end insert—

‘(c) documented reasonable grounds for taking action have been laid before the board of the Commission.’.

Our amendment proposes to tack new paragraph (c) on to subsection (2), which states:

“Except where the Commission gives notice under section 27, the power conferred by subsection (1) is exercisable only on” the outlined grounds. The amendment would establish a clear audit trail that could be interrogated in the case of appeals. I am sure that the Minister will be the first to accept that that is an absolutely appropriate best practice, which is what we have all been trying to put in place for many years in the public and private sector and within the professions. Those in the professions are being considered here because they are providing a service on behalf of others. I cannot understate the importance of such an amendment.

Photo of Sandra Gidley Sandra Gidley Shadow Minister, Health

It is not clear from the amendment whether the “documented reasonable grounds” would be publicly available in the first instance. I have a concern that if all is proved well, something will have been put in the public domain that could cast an adverse light on a body. There are vexatious complainants who have a habit of making complaints about various bodies. I wonder how we balance protecting the innocent on both sides of the equation when publishing information.

Photo of Stephen O'Brien Stephen O'Brien Shadow Minister (Health)

I am grateful for the intervention because the hon. Lady raises a very powerful and valid concern. We are often dealing with some pretty sensitive issues in relation to such matters. Clearly, the amendment states that the grounds have to be “documented”, which imposes an obligation to get things down in writing. That is often one of the first disciplines that is jettisoned by those who might have something to hide. The amendment also suggests that the grounds have to be “reasonable”—and that must be the right test for taking action—before they can be laid before the board of the commission. So, disclosure will be governed by where such requirements relate to board payments.

The point at which reasonable grounds are being considered will be an internal board matter. Patently, if a board makes decisions, all those matters are ultimately publicly discloseable—that is the very nature of what they are about. Therefore, given the sensitivity, I am sure that some protections are already in place. However, I need to be careful not to take the position of the Minister because this is his Bill and, ultimately, it has to be his drafting. The amendment makes clear that the process of getting the information documented, the test of reasonableness and the fact that it is presented to the board would mean that the controls that normally apply so that sensitivities within information can be contained before they are published would equally apply to the disclosure of board papers.

Photo of Sandra Gidley Sandra Gidley Shadow Minister, Health

I thank the hon. Gentleman for that explanation. My other concern is that such a suspension could be open-ended. Is he in favour of putting a time limit on the documentation being produced?

Photo of Stephen O'Brien Stephen O'Brien Shadow Minister (Health) 6:30 pm, 15th January 2008

That is an interesting point. With anything that involves a decision, the time limit of the documentation that we are calling for would have to ride with the timetable on decision making. There are obligations on the part of the commission operating through its board to make timely decisions, and there will be a process by which it is under some form of need to produce a determination on the particular expectation of outcome.

I am reluctant to impose a timetable that goes beyond the normal expectation of the board’s operation. However, I am grateful to be asked the question because it forces me to explain what we want to achieve. We want an audit trail. An audit inevitably comes after decision making. We want it documented and made available. It must demonstrate that a reasonableness test on reasonable grounds has been applied and considered by the board. That the test would have been timely and available to the board when it was deliberating important matters is what we want to achieve through an audit trail. After all, it would be a post-event matter rather than a pre-event matter or a contemporaneous event, so documentation is necessary to make sure that the board is behaving and advising itself properly.

I hope that the Minister will take the opportunity to satisfy the Committee that the Bill will generate an audit trail as matters stand or be willing to contemplate the intention behind the amendment. I expect him either to adopt it or to come back on Report with something that will govern expectations of the way in which the board and the commission will operate.

Photo of Ben Bradshaw Ben Bradshaw Minister of State (Regional Affairs) (South West), The Minister of State, Department of Health

As I said, we agree that it is important that there should be a proper procedure for the Care Quality Commission to follow when it makes certain decisions about registering, deregistering, suspending registration or amending the conditions of registration. We have set out that procedure under clauses 22, 23 and 24. In clause 22, in particular, we require the commission to give its reasons for such a decision in a written notice to the relevant registered managers or providers.

It is inconceivable that the new commission’s board would not want to ensure that it was content that the commission’s actions, particularly when serious, are reasonable and defensible. It will need to be accountable for the commission’s decisions and for them to be made appropriately. We do not think that it is for us, but for the organisation itself, to establish the organisational and board level processes that it needs best to carry out its statutory functions in such a way. For that reason, I ask the hon. Gentleman to withdraw his amendment.

Photo of Stephen O'Brien Stephen O'Brien Shadow Minister (Health)

I am somewhat reassured by what the Minister has said. It is not unreasonable. What will be placed on the record will be read by those who must undertake such duties and I hope, therefore, that they rise to the expectations that will be placed on them. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 14 ordered to stand part of the Bill.