Extent, commencement and short title

Part of Mental Capacity (Amendment) Bill [Lords] – in a Public Bill Committee at 2:30 pm on 22nd January 2019.

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Photo of Alex Cunningham Alex Cunningham Labour, Stockton North 2:30 pm, 22nd January 2019

I very much commend the work of organisations from the grassroots right through to the national level. The reason I sat down with people from my local authority before the start of this Bill Committee was so that I could understand what was happening at the grassroots. That grassroots work that feeds all the way through the system informs us and it is important that we take account of it.

My hon. Friend the Member for Slough will know that, with the amount of written evidence submitted to the Committee, we could have stood here and made three-hour speeches ensuring that we raised the issues that they wanted raised. Some of us are a little more kindly and will be relatively brief.

This is not a matter to be pushed through with little consideration because the consequences of getting it wrong are significant. I ask the Minister to think carefully, not just about the comments made by hon. Members but about the evidence that has come from the sector. We raise that evidence out of concern that the Government might be making the wrong move. We need to tread carefully and understand the implications.

Amendment 53 seems sensible and proportionate. How can we possibly pass legislation that would have an undue impact on local authorities and other responsible bodies without giving them the resources to carry out the functions required? I have spoken in previous sittings about care home managers and the impact provisions in the Bill would have on them. Not only do I believe that they do not have the adequate skills to carry out assessments. I am also concerned that they have a severe conflict of interest if they are expected to be involved in the assessment of those who reside in their care.

On resources, we know that care homes and local authorities have tight budgets and that costs are rising. If the Government do not publish an updated impact assessment and a strategy for implementing the new system, the cared-for persons will lose out. I asked the Minister during the debate on a previous clause what assessment she had made of the potential cost that will fall on care homes for their extended role in the process. I also asked what data she had received from the sector on costs and whether she would publish it.

I am keen to understand who will pick up those costs. Will it be the person being detained, the CCG, the private hospital or the care home? I did not receive an answer then, so I hope the Minister can tell us now who will be responsible for the new costs in the system. Surely she should publish that assessment so that we can understand the additional financial burden being placed on the sector before the measures of the Bill come into force. As colleagues know—I have said it before—we have received a significant amount of written evidence, and many organisations and individuals share a concern over funding. The Leicestershire County Council DoLS service is concerned that there

“remains a huge potential…that we end up with another underfunded system that prevents responsible bodies from meeting their statutory duties to the detriment of citizens and their rights.”

My hon. Friend the Member for Worsley and Eccles South has gone into the resources and training in some detail. I agree with the Royal College of Nursing, which states:

“All health and care staff should be educated to understand the deprivation of liberty processes and the impact that this Bill will have on the patients they care for…Without adequate education, healthcare professionals cannot make provision for the best interests of the person in care.”

Does the Minister agree? The RCN is at the sharp end. If she agrees, will she ensure that care professionals have the resources to carry out this vital training?

The care sector is under-resourced—I will not repeat what I said last week. All jobs websites show dozens of adverts for care assistant jobs involving long hours and minimum pay. The Minister seems content to make it harder for bodies such as care homes to cope with the pressures. That is before we get onto the subject of local authority funding and pressures which, again, I will not repeat. Surely we must ensure that the provisions are not enacted until a full implementation strategy is published. I would ask the Minister: when are we going to see it?

On amendment 54, much of the detail debated during the Committee will be addressed in the code of practice. We have raised our concerns over and over again. Does the Minister agree that legislators, healthcare staff, assessors and advocates—the list goes on—should be fully informed and aware of the code of practice prior to the revisions in the Bill being implemented to give them a fighting chance to prepare? I am concerned that any code of practice will not be subject to the scrutiny of both Houses to provide other pieces of legislation, particularly as this Government do not have a good track record of welcoming scrutiny from other Members or from outsiders. Perhaps the absence of an oral evidence session demonstrates that. There is concern that the code of practice will contain significant flaws and gaps. This morning, the Minister was not even prepared to talk about it in general terms, and said that we would have to wait for the detail and the views of experts and further consultation. I accept that, but we could still have some sort of comment on the general terms of the code.