Clause 29

Health and Social Care Bill – in a Public Bill Committee at 10:00 am on 17th January 2008.

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

I beg to move amendment No. 199, in clause 29, page 15, line 37, leave out from ‘offence’ to end of line 38.

Photo of Derek Conway Derek Conway Conservative, Old Bexley and Sidcup

With this it will be convenient to discuss the following amendments:

No. 200, in clause 29, page 15, line 38, at end insert—

‘(2) A person guilty of an offence under subsection (1) is liable—

(a) on summary conviction, to a fine not exceeding £50,000, or to imprisonment for a term not exceeding 12 months, or to both;

(b) on conviction on indictment, to a fine, or to imprisonment for a term not exceeding 12 months, or both.

(3) In relation to an offence committed before the commencement of section 154(1) of the Criminal Justice Act 2003 (c.44), the reference in subsection (2)(a) to 12 months is to be read as a reference to 6 months.’.

No. 201, in clause 30, page 16, line 13, leave out from ‘liable’ to end of line 14 and add—

‘(a) on summary conviction, to a fine not exceeding £50,000, or to imprisonment for a term not exceeding 12 months, or both;

(b) on conviction on indictment, to a fine, or to imprisonment for a term not exceeding 12 months, or to both.

(5) In relation to an offence committed before the the commencement of section 154(1) of the Criminal Justice Act 2003 (c.44), the reference in subsection (4)(a) to 12 months is to be read as a reference to 6 months.’.

No. 202, in clause 31, page 16, leave out lines 18 to 22 and insert—

‘(2) Subject to subsections (3) to (5), those regulations may not provide for an offence to be triable on indictment or to be punishable with imprisonment or with a fine exceeding level 4 on the standard scale.

(3) Subject to subsection (4), in the case of regulations under section 16, those regulations may provide for an offence to be triable summarily only or either summarily or on indictment and for an offence to be punishable with a fine or imprisonment or both.

(4) In case referred to in subsection (3), those regulations may not provide for an offence to be punishable with—

(a) imprisonment for a term exceeding 12 months, or

(b) in the case of summary conviction, a fine exceeding £50,000.

(5) In relation to summary conviction for an offence committed before the commencement of section 154(1) of the Criminal Justice Act 2003 (c. 44) the reference in subsection (4)(a) to 12 months is to be read as a reference to six months.’.

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

The amendments would empower the CQC to seek stronger sanctions against providers who commit offences. Amendments Nos. 201 and 202 would amend clauses 30 and 31 respectively. They arise from Anna Walker’s comments when giving oral evidence. She said that

“at the end of a process like that, there is often considerable public anger and concern about what has gone on and I wonder whether some of the penalty issues need to be recognised in that context. The maximum fine allowed under the new legislation would be £50,000. There is an issue about public concern which that measure does not meet”.——[Official Report, Health and Social Care Public Bill Committee, 8 January 2008; c. 25, Q36.]

The point was also made that not only is a wider spectrum of sanctions needed; it will be important to have sanctions suitable for the body in question, given the range of providers that the CQC will register—from small care homes to giant hospitals. The Minister alluded to that point in his response to the last clause stand part debate. There is a world of a difference between what might need to be done in relation to an accident and emergency hospital facility, compared with a small care home.

The amendments would ensure that there is potential for more serious offences to be tried in the Crown court, rather than receiving a maximum fine of £50,000 from magistrates. I therefore ask the Minister, why is the Crown court not available in the pursuit of sanctions? Does he agree with Anna Walker that stronger sanctions need to be available to the CQC? How will these sanctions compare with the current sanctions?

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

With your indulgence, Mr. Conway, I will respond briefly to a question that was asked earlier by the hon. Gentleman, to save time and to avoid the danger that I may forget to do so. In fact, he asked two specific questions: first, why this particular tribunal? The Care Standards Tribunal currently hears cases under the Care Standards Act 2000, so we are using that for continuity purposes. Secondly, he asked for the specific figures on outstanding complaints with the Healthcare Commission. In July 2006, the number of open cases was 5,180. In July 2007 it had gone down to 2,298, and I understand that the commission is now meeting its service level agreement targets on complaints. I hope that is helpful to the hon. Gentleman.

On sanctions, I was slightly puzzled by that bit of Anna Walker’s evidence. On the one hand, she seemed to imply that the new enforcement powers were not needed; then, in the quotation given by the hon. Gentleman, there was also an implication that the fines were not heavy enough. I am not clear on the matter, but I hope to discuss it informally with her, which might enable me to reach a better understanding.

The £50,000 figure is a ten-fold increase on the status quo, and it is for a single offence, so there is the potential for multiples of £50,000. It is not that the maximum fine that could be levied against a hospital is £50,000—if there is more than one breach of the regulations, that figure could multiply. As was acknowledged earlier, the Healthcare Commission is not the only organisation that has a locus in monitoring patient safety; there is also the Health and Safety Executive and the criminal law. The hon. Gentleman was right to remind us that criminal investigations are still going on in relation to the Maidstone and Tunbridge Wells incident. That does not mean that hospitals or managers will never be liable for much more serious offences. However, we think that we have come up with a tougher but proportionate suite of penalties and sanctions that suit the role of the Healthcare Commission, that are flexible and that the commission is not forced to use. That should also act as a useful deterrent, because of the damage to reputation that would be incurred by one of those fines or penalties. In light of those assurances, I hope that the hon. Gentleman will withdraw his amendment.

Photo of Stephen O'Brien Stephen O'Brien Shadow Minister (Health) 10:15 am, 17th January 2008

This is an area in which it is possible to gain a better understanding of the thrust of what Anna Walker at the Healthcare Commission was seeking to achieve, not least in the light of informal discussions that the Minister may have with her. I ask that if those informal discussions result in any proposals, the Minister discuss them with us first, before consideration on Report, so that we can see whether we can find a common view. The sanctions, coupled with the enforcement powers, will be vital to ensuring that we can provide the teeth that we all wish to see bear down on bad practice, and to encouraging best practice. With that proviso, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 29 ordered to stand part of the Bill.