§ The Parliamentary Under-Secretary of State for Northern Ireland (Mr. Jeremy Hanley)
I beg to move,That the draft Registered Homes (Northern Ireland) Order 1992, which was laid before this House on 19th October, be approved.My noble Friend Lord Arran, who now has responsibility for health and personal social services in Northern Ireland, will introduce this order in another place, but it is my pleasure to introduce it to the House this evening. It covers a narrow and specific field—that of the regulation of standards of care in registered homes.
It strengthens, updates and replaces the existing Northern Ireland legislation on the registration and inspection of residential care homes and nursing homes in the private and voluntary sectors. Those homes provide accommodation and care for a wide range of people who are unable to continue living independently in their own homes because of old age and infirmity, illness or disabilities.
It may be helpful to the House if I take a few minutes to outline the background to the order and say a few words about those new provisions that will strengthen the powers of registering authorities in Northern Ireland—the four health and social services boards—to register and inspect private and voluntary homes.
In late 1988 and early 1989, the Department of Health and Social Services conducted a review of existing Northern Ireland legislation relating to the registration and inspection of private and voluntary sector homes. The review was prompted at the time by two main factors. The first of these was the very substantial increase in recent years in the number of such homes in Northern Ireland, which led to growing pressure on the boards to ensure that satisfactory standards of care were being maintained. The second main factor was the more up-to-date legislative provisions made in England and Wales through the Registered Homes Act 1984 and its associated subordinate legislation compared with the legislation in Northern Ireland dating from the early 1970s.
As part of that review, the Department issued a comprehensive consultative paper which invited comment from a wide range of interested statutory, voluntary and private sector organisations and individuals. About 100 responses were received. Although the responses revealed differences of opinion and emphasis on individual matters of detail, it was clear that there was widespread support for the view that the existing legislation needed to be strengthened and brought broadly into line with the 1984 Act.
The order includes a number of new provisions that strengthen the boards' ability to ensure that private and voluntary sector homes deliver satisfactory standards of care to their residents or patients. It provides for the registration of both the person or organisation in control of a home and, where different, the manager. It also enables the Department by regulation to require notice to be given during prolonged absence of the registered person or persons.
The order also provides for dual registration of a home as both a residential care home and a nursing home, so that, for example, elderly clients who become ill or more frail and therefore in need of nursing care do not have to 913 move out of what could be called their home. It introduces a procedure for the urgent cancellation of a registration in cases where a justice of the peace is satisfied that the residents are at serious risk. It also gives inspectors authorised by the Department a right of entry at all times to private and voluntary sector residential care and nursing homes.
The order enables the Department of Health and Social Services, for the first time, to prescribe by regulation registration fees and annual fees for residential care homes and annual fees for nursing homes. Current legislation provides only for the charging of registration fees for nursing homes. The introduction of fees will help, as far as is practicable, to make the boards' work of regulating the homes self-financing. The order also establishes a registered homes tribunal to hear appeals from proprietors of private and voluntary homes against decisions of the boards.
The order will, for the most part, bring Northern Ireland into line with the legislation on the regulation of similar homes in England and Wales—the Registered Homes Act 1984, to which I have already referred. It also takes account of the provisions of the Registered Homes (Amendment) Act 1991.
§ Rev. Ian Paisley (Antrim, North)
Will the Minister explain to the House the basic difference between the regulation before the House and those in the rest of the United Kingdom? Will he inform the House what all the talk concerning appointing a key worker for each individual in the homes is about? How much will it cost, and will the homes have to pay for it?
§ Mr. Hanley
I shall take advice on the matter and reply to the hon. Gentleman during the evening.
The equivalent provisions in the order are intended to provide the minimum controls necessary to prevent unsuitable people from operating small residential care homes for fewer than four people. Under existing legislation in Northern Ireland, such small homes have always had to be registered.
The provisions are designed to safeguard vulnerable people from any unscrupulous owners of small homes, without subjecting families who are participating in such worthwhile schemes as the stay-a-while scheme for elderly people and adult placement schemes for mentally handicapped people to the full rigours of registration applied to the owners of larger homes.
The order re-enacts the existing powers of the Department to make regulations in relation to the conduct of homes. Although the primary legislation provides, therefore, the legislative framework for the monitoring of standards of care and accommodation in private and voluntary sector residential care homes and nursing homes, it will nevertheless, like the 1984 Act, need to be underpinned by detailed regulations to be made by the Department on matters such as the records to be kept in homes, the registers, consultation with fire authorities, the provision of services and facilities, religious observance, the notification of death, serious accident or illness of residents or patients, complaints procedures and the frequency of inspections.
The order also provides a convenient vehicle for an amendment to the Health and Personal Social Services 914 (Northern Ireland) Order 1972 which is required to ensure that the Department and health and social services boards have unequivocal powers to contract for the provision of health and personal social services with private and voluntary sector providers.
This amendment is contained in paragraph 2(1) and (2) of schedule 1 to the order. Although this amendment can only be related loosely to the other provisions of the order, it is required as a matter of urgency following legal advice that the existing contractual powers in the 1972 order are open to challenge.
The proposal for a draft order was published for comment on 30 January 1992. There were only 13 replies. All welcomed the general content of the draft order, but there were some comments and suggestions about individual provisions.
§ Mr. Seamus Mallon (Newry and Armagh)
My point is not directly relevant to the order, but this debate is an opportunity to make a point about a nursing home in my constituency which does a tremendous job in serving many people. It is 300 yards from the main road, and for years the Department of the Environment has refused to salt the road from the main road to the entrance to the nursing home. Throughout the year, doctors have to call, ambulances have to call and nurses have to travel to the home at all times of the day and night, yet the Department has made this stupid decision. Will the Minister take that point on board in relation to all nursing homes and not only in relation to the one I have talked about?
§ Mr. Mallon
What is salt for the goose is salt for all ganders. The point is worth considering and this is an opportunity to enlist the Minister's help in dealing with it.
§ Mr. Hanley
I am grateful to the hon. Gentleman for his question. I assure him that, if he writes to me, I shall ensure that the matter is dealt with by my Lord Arran in its health and social services aspects and by the Minister of State, my hon. Friend the Member for South Ribble (Mr. Atkins), in its Department of the Environment aspects. If the hon. Gentleman writes to me, I shall ensure that answers are given to his questions.
I was saying that when the draft order was published for comment earlier this year, only 13 replies were received, which were generally supportive. I am most grateful to those who examined the proposals scrupulously in the interests of some of our most vulnerable citizens. I am grateful for those representations, because a few minor amendments were required as a result of the consultations. That has helped to improve the order.
It may seem surprising that the proposed legislation—
§ Mr. Taylor
It is interesting that the Minister agreed to make some amendments to the order as a result of representations from 13 parties. Is he prepared to make any changes to the order as a result of representations from elected Members this evening?
§ Mr. Hanley
Of the 13 representations we received on the order, not one came from a Member of this House.
§ Mr. Taylor
I must push the Minister to answer the people of Northern Ireland honestly because he has avoided answering the question. Will the Minister agree to 915 any amendments to the order expressed by any elected Member this evening, whether on the Conservative, Labour, Liberal Democrat, Democratic Unionist or Ulster Unionist Benches?
§ Mr. Hanley
I have given the right hon. Gentleman my answer. Representations have been made. The time scale for representations has now ended and the order is before the House tonight. The right hon. Gentleman knows the procedure of legislation, so he knows exactly what will happen tonight. If he wishes to press for a Division on an order that has been amended thanks to representations, I need say no more.
§ Mr. Eddie McGrady (South Down)
I do not want the Minister to be led into putting incorrect information on the record. I know that he has a problem because he is speaking today on behalf of a Minister in another place. I for one have made representations to the Department on many issues in the order.
§ Mr. Hanley
With respect, that is a different matter. The hon. Gentleman has a long record of being most constructive in his advice. His brother, the hon. Member for Newry and Armagh (Mr. Mallon), also has a long record of giving advice to the Department on these matters —I readily admit that. However, of the 13 representations that related solely to the order, not one came from an elected Member. If my information is wrong, I shall willingly apologise to the hon. Gentleman in writing.
§ Mr. Peter Robinson (Belfast, East)
I am not attempting to catch the Minister on the hop because I know that the matter is not his direct responsibility, although he answers in this House for it. My hon. Friend the Member for Antrim, North (Rev. Ian Paisley), the hon. Member for South Down (Mr. McGrady), as I understand it, and I wrote to the Department on the issue and asked for the Northern Ireland Care Homes Association to be permitted to have a meeting with the Minister in another place. All three of us wrote asking for such a meeting, but to this day Lord Arran has refused to give us a meeting.
§ Mr. Hanley
I am grateful to the hon. Gentleman for his comment. As he readily admitted, I am not aware of that set of circumstances. I can only inquire. Naturally, I apologise to the House. I do not have responsibility for health and personal social services in Northern Ireland, although I answer for those matters here. I shall use any provisions available to me to answer questions during the evening. I certainly need to seek advice from those who deal with these matters on a day-to-day basis.
§ Rev. Ian Paisley
When the Minister makes inquiries, will he ask Lord Arran to hand over to him the large file which I presented to him? Will Lord Arran hand over to the Minister the correspondence about that file? Will he hand over his reply to the Minister so that the Minister can study it and see how the people concerned have been treated?
I am sure that the Minister agrees that the order is intended to help all people who want to help the elderly and to run homes up to standard. I do not want to hear any Minister saying that we are pleading for special cases or that we are pleading that there should not be the right standards. That is not our business here tonight. We want 916 the highest possible standards, but we also want the people who have been engaged in the matter to be consulted and helped.
§ Mr. Hanley
I am grateful for the hon. Gentleman's comments and I should like to answer a question that he raised earlier. He wanted to know the main difference between the order and the Registered Homes Act 1984. The order attempts to put the registration and inspection of residential care homes and nursing homes on as much the same basis as possible. Unlike the 1984 Act, the order requires the manager of both types of home to be registered together with the persons who own or control the home.
The hon. Member for Antrim, North (Rev. Ian Paisley) wanted to know whether home owners would have to pay for the key workers required to be appointed by the board. Key workers will be appointed by boards under the new community care reforms from next April. They will be board employees who will have to keep under review the care needs of all vulnerable people, including those placed in homes. The hon. Member for Antrim, North was interested in the costs. The cost of case management and key worker provision will not be borne by proprietors of homes. I hope that that reassures the hon. Gentleman.
The hon. Member for Antrim, North also wanted to know why my noble Friend Lord Arran did not receive a delegation from the Northern Ireland Care Homes Association. The association's representations were riot about the registered homes proposal. They were about allegations of how boards were treating home proprietors at the moment. That is different from the subject that we are concentrating on tonight. I shall willingly look into the statements made by the hon. Member for Antrim, North and let him know about the other matter in due course.
§ Rev. Ian Paisley
There were representations on that very subject from 160 home owners controlling 3,600 beds. They were aware of the draft order but wanted their current problems to be addressed. Those homes have already been registered and the owners control 3,600 beds, but they cannot get to the Minister to make representations. That is the issue.
§ Mr. Hanley
Knowing how willing my noble Friend Lord Arran is to meet people throughout the Province, I am very surprised at the hon. Gentleman's statement. I shall readily take up the hon. Gentleman's point with my noble Friend and I am sure that we can arrange a meeting in due course. The representations that we received were not about the registered homes proposal, so they were not specific to the legislation that we are considering tonight.
§ Mr. Peter Robinson
Does the Minister accept that the Northern Ireland Care Homes Association is operating in the field covered by the order? It recognised deficiencies in the existing regime. It had some knowledge of the changes that were to be made and it wanted to make representations that would have affected the order. The association would like to address the Minister on many issues now and it would still like to meet the Minister. Many issues will be more dependent on the regulations that will ultimately appear as a result of the order. May lye have an undertaking that the Minister will meet the association, which represents 60 per cent. of the beds in their care in Northern Ireland?
§ Mr. Hanley
I shall certainly pass the comments of the hon. Members for Antrim, North and for Belfast, East (Mr. Robinson) to my noble Friend Lord Arran and suggest that he does what the hon. Member for Belfast, East asked. As I said, I am surprised that that meeting has not taken place. However, we must remember that the health boards also deserve a meeting with the Northern Ireland Care Homes Association. I hope that they will continue to talk to that association, because that is obviously the way to resolve grievances.
The order will make a significant contribution towards safeguarding the welfare of vulnerable people living in private and voluntary sector homes in Northern Ireland. I believe that the order should be welcomed and I commend it to the House.
§ Mr. William O'Brien (Normanton)
The order brings registered care homes in Northern Ireland into line with the legislation which applies throughout Great Britain. The Community Care (Residential Accommodation) Act 1992, which began its passage in the other place and which was considered in Standing Committee in this place in June, laid down future plans for community care throughout the United Kingdom. The Government intend the community care reforms to be implemented in full on the same day throughout the United Kingdom next April.
As the Minister said, private care homes have mushroomed throughout Northern Ireland as they have elsewhere in the United Kingdom. As the number of homes has increased, so have the problems. I want to refer to some of those problems and difficulties later.
As I have said, Standing Committee E considered the Community Care (Residential Accommodation) Bill in June and significant and important issues arose from those deliberations which apply to Northern Ireland through the order. They are important and significant because accountability in Northern Ireland in respect of registered homes is almost non-existent.
The need for more accountability is clear from the questions that were put to the Minister. There were references to requests for meetings and observations. The Minister applied the rules and regulations about the consultation period having passed. Therefore, it is a matter of this order or nothing. The Minister made it clear that our only alternative in the House tonight is to vote against the order if we do not accept its terms and conditions.
Paragraph 6 of the order states that the health boards must keep a register and specifies that it is the health boards' responsibility to maintain that register and keep it up to date. The local authorities in England and Wales are the registration authority for sheltered schemes.
Paragraph 29 refers to inspections. It is the health boards' duty to ensure that inspections are carried out and that standards are maintained and, where necessary, improved. In addition to registering and inspecting residential care homes, health boards are also responsible for ensuring that people who do not require medical treatment in hospitals are discharged into nursing homes or residential care homes or into their own homes.
The Minister said that the order also provides that people who can no longer maintain themselves in their own homes would be covered when they move into a registered home, whether in the voluntary sector or otherwise. Therefore, health boards have considerable 918 interest in the order. It is laid down in the order that health boards can also purchase residential care facilities on behalf of people whom they discharge from hospital.
Health boards have authority to close hospital beds, including geriatric beds, and to discharge patients into the community, some to be cared for by relatives or friends and others to be cared for in private or voluntary residential or nursing homes. The Minister explained that that is part of the function of health boards. It is accepted also by the Minister that health boards purchase care from residential and nursing homes and that they also accept residential and nursing homes for registration. Therefore, to a large extent health boards set the standards which apply in private and voluntary residential and nursing homes. Health boards are responsible for inspecting homes. The Minister pointed out that one of the responsibilities of health boards is to appoint inspectors to monitor conditions in registered homes and the way in which they operate.
§ Rev. Ian Paisley
I fully agree with what the hon. Gentleman is saying—the health board will be the boss —but what will happen when a health board objects to a care home employing a certain person? We have very strict employment regulations in Northern Ireland, but if a health board says, "You cannot employ that person," and refuses to tell the owner or manager the reasons for that, the manager will be liable if the applicant takes out a case against him under the fair employment legislation.
Does the hon. Gentleman agree that the board should take responsibility for refusing to allow the manager to employ a certain applicant? It should not be the responsibility of the home manager to face up to the fair employment legislation; it should be the responsibility of the board which refuses to allow him to employ that person.
§ Mr. O'Brien
The hon. Gentleman raises a matter to which I intend to refer, because employment in such homes is significant and important. I hope to reveal that health boards are accountable only to the Minister and will direct operations in registered homes. I am grateful to the hon. Gentleman for raising the issue.
The Minister mentioned inspections to be carried out by people who are appointed by health boards. Health boards will monitor the quality of services. That is part of their function. They will consider the state of a building and ask, "Is it clean, attractive and well heated?" Families will consider those issues when an elderly parent or a disabled relative seeks residential care. They will ask, "Is the building in a good state of repair? Is it decorated? Is it heated well? Are the rooms single or do people have to double up? Are private toilet facilities available in the bedrooms?" Many issues must be considered.
People will ask, "Are the staff qualified? Are the employment regulations written down and made clear?" I have personal experience of this. Unqualified staff are employed in some homes because lower rates of pay apply to them. There are problems because of the shortage of qualified staff, particularly at night when there is a greater need for the surveillance and care of elderly and chronically sick people.
Health boards are responsible for every aspect of registered homes. They create the need for private homes because they are closing hospital beds, particularly geriatric beds, and they then purchase care from those 919 homes. They are responsible for the registration and inspection of homes and for the standards of service in them. To a large extent, health boards are responsible for the charges that are set. Therefore, if a home closes because of substandard service or lack of staff, the health board could be responsible for taking care of the people who are discharged.
It is accepted by the Minister that, because of the circumstances in a registered home, a health board might have to take steps to close it down. If it does that, those who are discharged could become the responsibility of the health board. Therefore, health boards will ensure that homes remain open, regardless of the standard of service or the standard of the home. The reason for that is accountability.
In Northern Ireland there is no independent watchdog similar to the health councils in Great Britain, and no local authority committees exercise a watchdog role to supervise the provision of services and the condition of a home and to consider whether residents are happy there, whether they are receiving proper care and attention, and so on. Such accountability does not exist in the draft statutory instrument.
§ Mr. John D. Taylor
I welcome what the hon. Gentleman is saying. There is absolutely no accountability in Northern Ireland in respect of the control and administration of our nursing homes and residential homes. The health boards are, of course, quangos. The personnel are appointed by the Minister and are answerable to him only. In no way are they answerable to the people of Northern Ireland. We have no say whatever in the health boards or in the way in which they carry out their affairs. I was glad to hear the spokesman for the official Opposition pinpoint that deficiency in public life in Northern Ireland. Should there ever be a Labour Government, will he be prepared to restore to the people of Northern Ireland participation in health boards?
§ Mr. O'Brien
If the right hon. Gentleman reads the policies on which the Labour party campaigned earlier this year and at other elections, he will see that we believe that there should be accountability and that that accountability should be to the people who are employed in the service and to those who rely on the service. I refer to trade unions and to people who use the services. Accountability is very important if standards are to be maintained and if people are to have the care and protection that the homes should provide. When one authority is the agent for creating the homes, the agent for registering the homes, the agent for maintaining standards, the agent in many instances for setting the fees, and the agent for keeping the homes open, that is a serious problem which the Minister should address.
§ Mr. Hanley
It would be wrong if we did not recognise that each health and social services board, as part of its "People First" community care changes, has established the registration and inspection unit at arm's length. I must stress that the unit is at arm's length. Therefore, it is totally separated from the management of the board's own homes as well as from the board's contracting departments. There is a Chinese wall, as it were, between the arm's length inspection unit and any of the other departments in the health boards, just as we find in a local council in England. 920 It would be wrong for anyone to give the impression that the inspection unit will be somehow tainted because of the board's other interests.
There has been talk of there being no accountability. Health and social services councils are doing excellent work in the Province. No doubt they will take a deep interest, as they have traditionally over the years, in the activities of all sorts of home—board homes, voluntary homes and private homes. Therefore, the refusal of some people to recognise that health and social services councils exist and play a valuable role is less than fair.
§ Mr. O'Brien
I am grateful to the Minister for that intervention. Obviously questions arise from it. Who nominates the people in the arm's length organisation? Who nominates the people who sit on the care councils to which the Minister referred? How many are elected and how many are nominated? Will the Minister give some indication as to how the bodies are set up and to whom they are responsible?
§ Mr. Hanley
The hon. Gentleman puts a question which I believe I can answer because for the past six months I have been trying to find a way of devolving those responsibilities to the elected representatives within Northern Ireland. We are trying to devolve those responsibilities by agreement with all the parties in Northern Ireland. Until that time, we shall administer fairly the government of Northern Ireland.
§ Mr. O'Brien
The Minister is now admitting that for six months he has been trying to get representation on these boards—
§ Mr. John D. Taylor
I am sure that the spokesman For Her Majesty's Opposition, who is developing the theme in a way which will appeal to us in Northern Ireland, Will agree with me that not only are the health boards appointed by the Minister but that it is dishonest of the Minister to try to give the impression that the health and social services councils are distinct, independent and separate from his administration. Does the hon. Member for Normanton (Mr. O'Brien) agree that it is the Minister who appoints also all the members of the health and social services councils and that they are also quangos whose members are yes-men and not answerable to the people of Northern Ireland?
§ Mr. O'Brien
I will allow the Minister to answer that point in a moment. First, I want to put another question to him. Is it a fact that over the past few months some members of health boards and of the various councils have been removed because of their views on some issues? Perhaps the Minister will address that point in addition to the point made by the right hon. Member for Strangford (Mr. Taylor).
§ Mr. Hanley
The right hon. Member for Strangford (Mr. Taylor) said that all the members of the health and social services councils are yes-men. That is deeply insulting to the dedicated people, many of them district councillors, who work on the health and social services councils. It is extremely unfair to speak in that way of those who carry out that task.
921 In regard to inspection units, I am intervening to answer points now rather than leave them to the end when some hon. Members may have departed. Standards are governed by subordinate legislation and by guidelines prepared by responsible professional bodies. I am talking about guidelines such as "Home Life" and "Homes are for Living In", which have been published. In addition, the work of the arm's-length inspection units will be monitored. Indeed, they are being monitored by the Department's social services inspectorate and also by the nursing advisory group which I met not long ago. Also, each board has had to establish an advisory committee to provide a link between the units and the public interest.
It would be wrong to try to give the impression that somehow the inspection units are tainted. They are doing and will do valuable work. I should not like confidence in their work to be tainted by any deficiencies which may be commented on in the debate.
§ Mr. Deputy Speaker (Mr. Geoffrey Lofthouse)
Order. Interventions have been very long. I have allowed them to go on because I thought that it was helpful to the debate. However, I ask hon. Members to bear in mind that interventions are not supposed to be as long as those that we have heard.
§ Mr. John D. Taylor
On a point of order, Mr. Deputy Speaker. Can you confirm that we have a further five hours available for debate?
§ Mr. O'Brien
The significance of that must be that hon. Members have a great deal to contribute to the debate and that much will be said on the points made by the Minister, particularly about the arm's-length inspectorate. I assure the Minister that no hon. Member would seek to taint the work of the people who are employed by the inspectorate. We are concerned about their terms of reference and the fact that they are responsible to the Department or to the health boards. Obviously they have to work within the terms of reference set by the Department or by the health boards.
It is against that backcloth that I make the point that there should be more accountability and some local input into how the homes are supervised, maintained and inspected. However much the Minister intervenes and tries to explain how the quangos work, every road goes back to the Department or to the health boards. I should like to see that changed and more democracy and accountability introduced. I sense from the issues raised as a result of the Minister's interventions that hon. Members representing Northern Ireland want some accountability for the way in which the order is applied.
§ Rev. Ian Paisley (Antrim, North)
Will the hon. Gentleman take it from me, as an elected representative from Northern Ireland, that I am alarmed at what has happened to a delegation I met? If they raise matters with the board, they and their homes are harassed. One man, who was on the executive of the body, always had a clean bill of health. Immediately he took part in making representations to his Member of Parliament, the board came down on him. Inspectors were sent in and he was told that he was doing everything wrong. One person told me that he was taking no further part because it would place 922 his home and his livelihood in jeopardy, which demonstrates the massive power of the board. That power must be limited.
§ Mr. O'Brien
If trade unions representing people employed in homes and services provided by the health boards were allowed to give evidence and to make representations without the fears outlined by the hon. Member for Antrim, North (Rev. Ian Paisley), we would have a different picture of the case that the Minister has presented for supporting the order.
The Minister should widen the representations. There should be consultation and meetings. We were told that only 13 representations were made during the consultation period. This legislation is important and it will apply to all private and voluntary registered nursing homes in Northern Ireland. Yet when people were asked to make representations there was a lack of response. One reason is that people were afraid of the repercussions, because of their employment or their involvement with the various boards.
§ Mr. Hanley
I hesitate to intervene again, but I must make it clear that the new legislation will make it easier for home owners to appeal against decisions taken by boards' registration and inspection units, because it will set up a registered homes appeals tribunal, which will benefit from a panel of professional experts who will doubtless build up a body of useful case law. We are establishing a system which will be fairer to home owners.
Lastly—with your permission, Mr. Deputy Speaker—the hon. Gentleman mentioned 13 representations. There were 13 on the draft order, but there were more than 100 replies to the broad consultations carried out before the order was drafted. There have been wider consultations and responses.
§ Mr. O'Brien
What will be the make-up of the appeals tribunals? How will the panel be chosen and what will be the deciding factors? Will the Department or the health boards decide on the arrangements for setting up tribunals? Further accountability is necessary in all the matters that we have mentioned.
§ Mr. Roy Beggs (Antrim, East)
Does the hon. Gentleman accept that once an order is published in draft form, there is widespread recognition throughout Northern Ireland that any consultation is a farce and that no further meaningful changes will be made to it? That is why such a small number made further contributions.
§ Mr. O'Brien
I must bow to the experience and knowledge of local people, because they are nearer to the situation than I. There has been a lack of interest and of co-operation because the people of Northern Ireland fear that when an order is drafted and the purpose of the order is implemented, everything changes. The Minister has outlined certain principles, but it appears that there is a lack of spirit and principle in the Province. I shall allow the Minister to intervene to say that that is not correct. If it is, the Minister ought to join us to demand increased accountability.
The people of Northern Ireland are entitled to better facilities and services. The health boards are accountable to the Minister or to the Department of Health and Social Services, and if changes are to be made or there are any criticisms of the health boards, the Minister should be answerable.
923 Relatives and friends of people in the homes and the residents have little or no say or influence in services or in the way in which homes are run. In many cases, organisations have been set up within homes to try to improve services and to maintain facilities.
I should like to think that the greater involvement of relatives, friends and residents would result from the legislation. If the Minister believes that that is one way in which services should be provided, perhaps he will assure us that such a facility will be made available.
Hon. Members present in the Chamber who are worried by the lack of support and accountability want the Minister to say that he will take back the statutory instrument and write greater accountability into it.
§ Sir James Kilfedder (North Down)
As I have expressed hostility to the Eastern health and social services board in my area on many occasions, and although there has been a friction between me and the Earl of Arran—the Minister responsible for health in another place—I may speak with an independent voice. I would not ask the Minister to take the order back. He said that the elderly are among the most vulnerable in our community and I agree. Their welfare is paramount. If the statutory instrument in any way protects them from unscrupulous owners of residential care homes, I welcome it. It is an improvement on existing legislation. I have made many representations to the Department of Health and Social Services and to the board about homes. I am concerned about the standards imposed in some homes. The order is not perfect, but let us pass it, operate it and then try to get something more perfect still.
§ Mr. O'Brien
I have no reason to doubt the hon. Member's sincerity about maintaining care accommodation for the elderly and the mentally and physically disabled. If he thinks that the order will improve facilities, I hope that my contribution has pointed out the dangers inherent in the instrument—dangers which could result in a deterioration in facilities and services. Because we have the interests of the most vulnerable people at heart, I ask the Minister to look at the order in detail.
If the hon. Member for North Down (Sir James Kilfedder) has read the order, he will see that paragraph 29 gives almighty power to the health boards. I fear that tomorrow, together with other public expenditure bodies in Northern Ireland, the health boards will find that they have to trim their expenditure. If so, the order will do nothing to improve the services—and hence the lot—of the elderly, sick and disabled in Northern Ireland. If the hon. Gentleman believes otherwise, he is misled, but that is up to him.
§ Mr. Peter Robinson
I fully concur with the hon. Gentleman's remarks. I should make it abundantly clear that a corpus of law relating to the registration, carrying on and inspection of homes in Northern Ireland is already on the statute book. If we are to make changes, it is far better to get it right and to ensure that orders which we pass in the House have real meaning and effect and do not exacerbate the problems.
§ Mr. O'Brien
As the Minister said, the order will amend certain laws which now apply to inspections of and applications for homes and how homes are run. It brings Northern Ireland into line with the rest of the United Kingdom and the legislation passed in the House of Lords, 924 which has gone through the Committee stage of this House. We are now providing facilities for community care in Northern Ireland in line with those in the rest of the United Kingdom. However, the difference between Northern Ireland and the rest of the United Kingdom is that local authorities have an input into community care in the rest of the United Kingdom which they do not have in Northern Ireland. Against that background, I stress that there are dangers in what we are discussing tonight.
A group called Disability Action, which is an alliance of all the groups in Northern Ireland interested in promoting the rights of disabled people, whom the order covers, has published a commentary on a report drawn up by the policy, planning and research unit—an in-house Government research body set up by various Departments in 1988. Its first report on the prevalence of disability among adults in Northern Ireland says:The evidence now being published from this Study"—a study carried out by a body set up by the Government—commissioned by Government, is a landmark in the development of policies which will address the real issues faced by disabled people in Northern Ireland … The essential message is that the rate of disability among the adult population is 20 per cent. higher than in Britain, between one fifth and one sixth of adults are disabled and that by virtue of living in Northern Ireland a person has a 56 per cent. greater chance of being disabled than someone living in Britain. It argues that these facts put disability at the heart of social and economic policy debate in Northern Ireland. Disability is in a real sense, an essential measure of the state of Northern Irish Society and should be treated as such.I do not know whether Disability Action was on the list of those who contributed to the consultation procedure. If not, the document should be given careful consideration. It says:There is a very close link between disability and ageing; the older someone is, the more likely they are to be disabled." Therefore, the crux of what we are discussing today is covered by that document, published by a voluntary body which cares for disabled people in Northern Ireland. The fact that it cares for the disabled means that it also cares for the elderly.
§ Mr. O'Brien
We must accept the hon. Gentleman's point. The observations that I have made are not mine but those of people from Northern Ireland who have their finger on the pulse when it comes to disabled and old people. The order will cater for the disabled and elderly, so if we do not get it right, those vulnerable people will suffer most. It is accepted that people in Northern Ireland need such an order more than those in the United Kingdom. It is therefore important that the debate should highlight those issues and that the Minister should note that the order needs to be looked at further.
The report goes on to say:there are proportionately more disabled people in Northern Ireland than in Britain and this holds true for every age group and every severity category.Although we speak of homes for the elderly and disabled, people in every age group should be considered in this debate. The report says: 925The only conclusion which can be reached from this evidence is that a substantially higher proportion of adults under pensionable age are disabled than might be expected if experience in Britain is taken as the norm.It is accepted in Northern Ireland that that is a fact, so the order should deal with that. The document also says:There is growing concern that while there is legislation to divert money from Social Security to the Health Boards to help pay for services for people who might otherwise end up in an institution, no decisions have been made yet on how much money will be available or how it will be calculated. This is despite the fact that the new system should be in place by next April, only 10 months away"—it was only 10 months away when this document was published—With this level of uncertainty over money, planning becomes a virtual impossibility.Not only are elected Members saying that the matter should be watched carefully, but organisations which cater for the most vulnerable in Northern Ireland are saying that we need more information about how and where resources will be applied once a decision has been taken. I hope that I am wrong to predict that, tomorrow, that document will be intensified by the Chancellor's autumn statement. Because of what I have outlined in my contribution and the lack of accountability, we intend to oppose the order today.
§ Mr. Peter Robinson (Belfast, East)
I shall not attempt to take advantage of the Parliamentary Under-Secretary of State, who has a semi-detached relationship with the Department for which he speaks and for which he is answering today. However, having listened to the apologia that he was asked to present to the House, I found it refreshing to listen to the studied consideration of the order presented by the hon. Member for Normanton (Mr. O'Brien). He made a most helpful contribution, and I shall attempt to avoid simply endorsing and duplicating the issues that he raised. Instead, I shall try to deal with some of the other matters dealt with in the order.
It is fortuitous that the forces that came into play in unforeseen circumstances earlier today have allowed the order to be given considerable attention when it might otherwise have received only scant consideration of about 90 minutes after 10 pm. I am not sure whether the Minister is as pleased about that prospect as hon. Members from Northern Ireland. I think that he is finding it difficult to keep up the show of delight on his face. However, circumstances have given us an opportunity to debate the order in greater detail.
The Department received 13 communications during the consultation process. The association to which a number of colleagues and I have referred, and which represents 60 per cent. of the care beds in Northern Ireland, did not exist in its present form when the letters seeking consultations were sent out. One of the 13 communications that the Minister received was from someone who is now that association's executive officer. Although 13 replies may not seem very many, they represent the substantial majority of carers in private sector nursing homes in Northern Ireland. The Minister will appreciate that there is a need to allow small, private and voluntary homes in Northern Ireland to have the same opportunities as both statutory homes and the one or two major private nursing homes.
926 The most unusual and perhaps most dangerous part of the order is contained in schedule 1, which seeks to introduce a new article—article 14A—into the Health and Personal Social Services (Northern Ireland) Order 1972. That appears to be a radical departure from normal Government procedures and practices.
Section 14A(2) allows the Department toassist any body or person carrying out any arrangements under paragraph (1)",which states:The Department may make arrangements for the provision by any other body or person of any of the health services on such terms and conditions as may be agreed between the Department and that other body or person.It is not clear from the drafting—perhaps the Minister will clarify this when he replies—whether that provision will operate on a commercial, voluntary, gift or preferential basis. I do not know, and cannot determine from the legislation, whether open tendering is to be the order of the day. I believe that many in Northern Ireland will suspect that the Department may have made arrangements with large care providers, of which there are two in Northern Ireland, to give them some form of preferential treatment. Alternatively, the Department may have already entered into arrangements with those major carers in Northern Ireland to give them some care provision.
§ Rev. Ian Paisley
Does not the order give power to the board to hand over properties to its chosen people? In fact, does it not give the board power to hand over the properties without asking for payment?
§ Mr. Robinson
My hon. Friend is correct. I think that it is article 14 of the order that allows the Department to give away its own premises. It does not state the basis on which that might occur. It also allows the Department to make available to anybody the vehicles, equipment and materials as well as the services of any of the staff employed at the premises.
The order needs further clarification by the Minister, and I am delighted that he will have an opportunity to do so. However, it is suspected that the order will allow unfair commercial advantage to anyone who receives favourable treatment from a Government Department. Such treatment may well be in contravention of the European economic treaty and may show that, within the context of Northern Ireland, the Government are prepared to give preferential treatment to national or local organisations. When he responds, will the Minister assure us that the Department will make commercial open tendering an important aspect of care provision in Northern Ireland?
Article 15 of the order follows on from the main provisions contained in article 14. It appears that the Government may even dispense with public property—certainly its use—for nothing, a negligible amount or whatever charge they think fit without reference to the considerations of either the public or the Exchequer. How much accountability will there be within that process? What overall controls will be applied on the execution of the order?
§ Mr. Andrew Mackinlay (Thurrock)
The hon. Gentleman raised an issue that I want to refer to later. Is not article 15 of the order a sneaky way of overcoming the legal difficulties in which the Government found themselves in relation to social services? If article 15 is read in conjunction with the 1972 order, the Government will be able to create social service trusts. The order, which 927 refers to registered homes, appears to be a misnomer as it relates to the setting up of trusts, despite the fact that Lord Arran promised separate legislation to set up trusts.
§ Mr. Robinson
The hon. Gentleman makes a good point and I shall listen to his contribution with great interest if he is called to speak later. The matter is of particular concern to those in Northern Ireland, which does not have the degree of control and accountability that exists elsewhere in the United Kingdom.
The new article 50 increases the inspection powers of the Department's inspection unit. May I make it abundantly clear that no hon. Member is suggesting that the standard of inspection or care should be reduced, or that the degree of accountability in the system should be removed. Everyone wants the highest standards in Northern Ireland, and I shall later outline the distinctions and comparisons between the inspection levels in Northern Ireland and those elsewhere in the United Kingdom. Nobody is suggesting that we should stop inspections or make it easier for unscrupulous people to get away with an unsatisfactory standard of care.
The Department has set up an inspection system, and proposed another one. The association to which I referred has a natural desire to ensure that it admits only those who provide the best care and attention. Article 50 increases inspection powers and 50(2)(a) states that an inspector maymake such examination into the state and management of the premises and the services provided therein as he thinks fit;".Inspections should be limited to matters that are relevant to the health and welfare of patients. The legislation should not be drafted in wide terms that will allow the examination of accounts, business practices and confidential information. That may well be an invasion of privacy even under the Data Protection Act 1988.
Article 50(2)(b) gives the power toinspect any records (in whatever form they are held) relating to the premises, or any person for whom services have been or are to be provided there;".That is also an unwarranted invasion of the privacy of residents in those homes. Medical and personal records are private and should not be made available to any person who is not medically competent or qualified or properly authorised to inspect them.
§ Sir James Kilfedder
I have many residential care homes in my constituency, but I have not received any of the criticisms mentioned by the hon. Gentleman. From whom did he get those criticisms, and has he expressed them to the Secretary of State for Health?
§ Sir James Kilfedder
The hon. Gentleman has spoken about dangers in the order. I heard at the weekend from a friend who owns a residential care home, but I have not heard from anyone else or from the association to which the hon. Gentleman refers. Has the hon. Gentleman made representations to the Secretary of State for Health? When did he receive representations from the Northern Ireland Care Homes Association?
§ Mr. Robinson
I would be delighted to respond to all those questions. If there were a competition to see which Northern Ireland constituency has the most nursing and residential home beds, my constituency by far would take 928 the prize. Over many months I have spoken to the owners of those homes who are greatly concerned about how the Department is currently operating.
As I said earlier, the association to which I refer was not formed when the Department called for various issues to be clarified and for presentations. Representatives of the association came to the House today and it is only within the past few hours that a number of hon. Members were alerted to the concerns. I assure the hon. Member for North Down (Sir J. Kilfedder) that if many of us had had the details that we now have we would have been pounding on the door of the elusive and noble Lord who has refused thus far to meet representatives of that association.
Article 50(2)(c) states that an inspector mayrequire the owner of, or any person employed in, the premises to furnish him with such information as he may request.That is another wide provision. The Minister should say that it must be construed that the information can only be that which is "reasonably required" that is covered by such a provision.
Article 16 defines a nursing home. Why are children's homes, which are covered by the Children and Young Persons Act 1969, not to be included? It is improper and unfair to exclude either voluntary homes or homes covered by that Act. Children and young people have every right to live in premises that are every bit as comfortable and well maintained as a private sector home. The best way to do that is to keep those children and young people within the same inspection and regulation system that governs the private sector.
Article 16(2)(b) states that exemption from the legislation will apply toany premises managed or provided by a government department, a Board, an HSS trust, or by any other body constituted by a statutory provision or incorporated by Royal Charter".There is no logical reason for that: they should be treated in exactly the same way as private sector premises.
Under the order, any property owned by the board does not have to be inspected or registered. That will lead to a rapid deterioration in all the services therein. Refusing to grant the children and young people of Northern Ireland the benefits and protection of an independent inspectorate and placing them in a regime where they will not be adequately and properly inspected means that they will not be adequately protected. The order should be changed o take account of that.
Article 25 covers representations to the tribunals about which the Minister spoke in such glowing terms. I think that article 14 covers the tribunals. The wording may give a false impression and perhaps the Minister can allay any fears. Owners of homes are worried that they will have to make oral or written representation in person. Will they have the right to be represented legally or in some other way at the tribunals?
Article 25 allows the board to give a home owner the opportunity to state his case. The Minister will appreciate that many owners will think that they are not the best people to present a case. They should have every opportunity within the law to be represented by solicitors or barristers. As the regulations are not available to us, we cannot determine the basis upon which the tribunal may sit and the procedures that it may adopt.
I said earlier that I would comment upon the comparison between inspections in Northern Ireland and those elsewhere in the United Kingdom. There seems to be 929 a feeling that in some way inspections in Northern Ireland are of a lower standard than those that pertain elsewhere. That is not true. I shall provide some figures for the House which will help our consideration and allay any worries, and, when the Minister is persuaded, as I have no doubt he will be, not to press the order but to take it away there will be adequate inspection in Northern Ireland.
I understand that the inspectorate in Northern Ireland is three or four times the size of the inspectorate in Great Britain. One inspector in Great Britain with whom the association has had discussions looks after about 63 homes and works part-time for two days a week. The Southern board has about 84 homes, four inspectors, a unit manager and a secretariat. As one might imagine, homes in Northern Ireland are closer together and much easier to reach. I do not know exactly how many homes are in the Eastern board area—there are probably about 200—and that board has about 12 inspectors. Therefore, Northern Ireland has a much higher inspection rate than elsewhere in the United Kingdom.
Perhaps the Minister will confirm that much of the legislation is directed at making the provision self-financing and that, consequently, the cost of the inspectorate will be passed to the home owners. If that is the case, there will be a substantial difference between the cost applied in Great Britain and that applied in Northern Ireland. Because it will be significantly greater in Northern Ireland, it could make a difference when it comes to the viability of homes, and therefore make the situation even worse.
I am grateful for the patience of the Minister and the House, and I trust that the Minister will be able to respond to those points. I hope that the many other matters that will relate directly to the regulations that will flow from this legislation will be matters that the Minister and the Department will be prepared to go into in great detail with the association representing the majority of the homes in Northern Ireland so that they can deal with any misunderstandings and take into consideration any changes that the association might wish to be made.
§ Mr. John D. Taylor (Strangford)
The matter before the House is the care of the elderly in Northern Ireland. The hon. Member for North Down (Sir J. Kilfedder) hit the nail on the head when he said that there was little that was more important than that. We have many facilities for caring for the elderly in Northern Ireland, including private homes, the residential nursing homes that are the subject of the order, homes provided by public authorities such as the Eastern health and social services board and private homes such as the Sandown homes, which provide an excellent service across the Province.
We also have homes provided by the Churches—I am thinking here of the excellent residential unit, appropriately named Taylor court, run by the Baptist church in Belvoir in my constituency. Other homes are organised by local authorities—for example, Mount Alexander at Comber, Loch Cuan house in Newtonards and Northfield house in Donaghadee. Housing associations also provide excellent facilities for the elderly.
Whether it is through the public service, the Churches, the voluntary organisations, private enterprise or local 930 authorities, Northern Ireland provides well for the elderly. However, there is a growing problem, because, as with the rest of the United Kingdom, the demographic trend means that there will be a greater need, year by year, to provide for the ever-increasing section of our community that can be described as "elderly".
Normally, debates on Orders in Council last for 90 minutes. The Minister is lucky this evening because he has managed to get five or six hours for the debate. That is an unusual experience for Members representing Northern Ireland because, for once, we have time to speak about something that affects our people. However, the Minister looked like a guilty man—he had guilt written from one ear to the other. I rather suspected that he was upset that he was not able to push through the order in 90 minutes. He was horrified that he had to take on board and present a proposal which would be debated for five hours and to which there would be opposition from all parts of the House.
The Minister has mentioned various organisations, which have already been dealt with by the hon. Member for Normanton (Mr. O'Brien), whose speech I commend because he articulated the concerns of the ordinary people of Northern Ireland, concerns with which the Minister could not identify. The Minister simply identified himself with a system of government that is repugnant to the people of Northern Ireland and that we reject.
The Minister spoke about health boards and the health and social services councils. At one stage, he said that the role of the boards was similar to that of councils in England. That is nonsense. The councils in England are elected by the people of England. The boards in Northern Ireland are appointed by the Minister and are not responsible to the people of Northern Ireland. That is the difference between the administration of health and social services in Northern Ireland and in England. That is why the Minister is guilty.
§ Rev. Ian Paisley
Does the right hon. Gentleman agree that the Anglo-Irish conference in Dublin can put forward names of people to serve on the boards? Therefore, people are nominated to the boards by the Minister and by Dublin, through the Anglo-Irish Agreement, which the Secretary of State was trying to tell us is a good thing.
§ Mr. Taylor
The hon. Gentleman is correct. That is another reason why the Minister is a guilty man.
The boards are hand-picked by the Minister, after consultation with the Dublin Government, but with no consultation of the people of Northern Ireland. They are quangos. They are part of a dictatorship in which we have no say. The Minister unashamedly declared that only 13 representations had been made during the consultation period, but that is only the result of the evil system of government in Northern Ireland, which the Minister represents. People did not make representations to the Minister, because they knew that, apart from a few minor recommendations, they would be ignored and the Minister would come to the House with an Order in Council, which would be pushed through in 90 minutes.
Earlier, when asked a question, the Minister spoke in reply but did not answer. The question was whether Members representing constituencies in England, Scotland, Wales or even Northern Ireland—more so Northern Ireland in the context of tonight's debate—could amend an Order in Council. The answer is that they 931 cannot. Because we cannot amend the Order in Council, people do not take part in the consultation process. They know that, even if they make representations, they will be automatically ignored by a dictatorial Minister, who will then introduce an Order in Council that cannot be amended and that goes through on the nod.
The Minister spoke of the wonderful part played by the health and social services boards. Throughout Northern Ireland, they are known as a joke. Members of boards are hand-picked by the Minister. They are his stooges. They have no respect in the community. Anyone who stands up against the Minister and the Department has his knuckles rapped and he then resigns, as happened with a constituent of mine. Sir Edward Archdale had to resign because he did not want to be a yes-man for this Northern Ireland administration, which operates as a dictatorship through the health and social services boards.
As the hon. Member for Normanton said, the Government are not answerable to the people of Northern Ireland. This is the seventh anniversary of the Anglo-Irish Agreement, which was signed in 1985. We have had that deadlock for seven years, and the Minister represents that evil system of government in which we are ruled by quangos and which the people deeply resent.
The quango in my area, the Eastern health and social services board, which operates in the council area of North Down, Ards and Castlereagh, is intent on closing most of the hospitals. North Down and Ards together cover the most rapidly growing population in Northern Ireland. The Minister praised that board, so I must respond to him. It operates in an area where 80 per cent. of the people are Protestant, but 65 per cent. of its employees are Roman Catholic. The Minister refuses to hear anything about the underemployment of Protestants and the discrimination against them by that board. I must raise those subjects, because the Minister referred to the health boards and their role in the supervision of homes.
I am sorry to have to make those points, but it is important that the nonsense of Orders in Council being presented to the House is exposed and that the British people should know that we in Northern Ireland are coming to the end of our tether and will not accept democracy as it is presented by the Minister. We rebel against it. We reject it. The time has come for a change in Northern Ireland, where, as the hon. Member for Knowsley, South (Mr. O'Hara) has said, in matters of health and social services the administration should he answerable to the people. That is what we must have. Only when we do can we approve orders of this nature. That is why we shall join Her Majesty's Opposition in opposing the motion tonight.
§ Mr. Eddie McGrady (South Down)
I am grateful for the opportunity to participate in tonight's debate. In the interests of the inhabitants of residential homes, be they care or nursing homes, and given the problems and concerns of home owners, I intend to deal exclusively with the order. I do not intend to make political points.
The Minister referred to consultation, and it may be that he did not have to hand the information to deal adequately with the questions that were put to him about the number of responses received. However, if he would care to look at it, I have with me ministerial 932 correspondence regarding the draft order. The inflection in the Minister's voice when he referred to the 13 responses suggested criticism.
That contradicts the Minister's explanatory document, item 4(c) of which stated that the recent consultative exercise in Northern Ireland invoked widespread support for the new legislation. That widespread support is not particularly evident tonight, nor is it particularly evident among those to whom I speak in Northern Ireland. However, the document might be referring to a different set of people altogether, with whom we are not acquainted. The consultation was early and adequate, but little cognisance was taken of the recommendations and suggestions that would have improved the order.
None of us can pretend that our contribution tonight will change the order one iota. Therefore, we must bend the Minister's mind to its consequences. I emphasise that we are all aware that of paramount importance is the quality of life for the inhabitants of the residential care and nursing homes—the old, the sick, the infirm, the mentally disabled, alcoholics and drug addicts. Those are the people with whom we must all be primarily concerned. What I say must be taken in the context of that overriding consideration. Nothing that I say tonight must in any way detract from or diminish the quality of provision and care that the less fortunate in our community, those who are disabled in the ways that I described, should have.
The order is important, because of the current transition in Northern Ireland from the statutory provision of residential care to its provision by the private and voluntary sector. That is endemic in my constituency, and I note the remarks made by the right hon. Member for Strangford (Mr. Taylor) in the same context.
Within a small area, three statutory homes have recently been closed. When I pointed out to the Minister responsible that one of them, Morne house in Newcastle, had been closed, he was shocked and surprised. Such homes cannot be closed without his authority and imprimatur, but he did not know that it had been closed. That is the extent of the Eastern board's authority, and the same is true of the Northern, Southern and Western boards.
They all have an almost dictatorial attitude towards closing homes by stealth. They create the atmosphere that something will be closed and, before a month is out, people who cannot fend properly for themselves cannot obtain the right advice or seek accommodation elsewhere, the residential role diminishes and it becomes a self-fulfilling activity. I have seen it, I despise it and I hope that the Minister will intervene and stop such action by not only the Eastern health and social services board but the Northern, Southern and Western boards.
I am in favour of the principle of patient choice in private and statutory accommodation. However, we are in a transitional period—
§ Rev. Ian Paisley
The hon. Gentleman knows something about the closing of the homes. He will be aware that board members told residents in the homes that were to be closed and their relations that, if the residents did not go into a certain home quickly, it might fill up and they would have to move perhaps 20 miles away. Therefore, instead of a proper choice, there was no choice at all because only one home was available. Surely that does away with an individual's personal choice.
I thank the hon. Gentleman. That is the very point that I was trying to bring out. The very activity that he describes has occurred on several occasions. I have described it as an unacceptable way for any board to act. As a consequence of that activity, choice is diminishing week by week and month by month. It is the consequence not so much of board policy as of departmental policy —the so-called care in the community regime. More importantly, it is the consequence of the shortfall in funding which has befallen the health boards and which they are about to experience even more drastically. The Eastern health and social services board, to which the right hon. Member for Strangford referred, faces a shortfall of £20 million in the next tranche.
Those of us who are familiar with the new private homes in our constituencies will readily accept that they have a high standard of provision. As far as a lay person can see, they provide a high standard of care and nursing. According to rumour, many of those private and voluntary homes, which are superior to the statutory homes but were built 10, 15 or 20 years ago, will be required under new regulations to make considerable improvements to bring them up to the standards required by the new regime. That is acceptable on the basis that there is full consultation and that financial assistance is available to assist the transition.
The subject of consultation has been much discussed this evening. Would it not have been more appropriate for the Department, rather than sitting in the ivory tower of Stormont, to write asking the registered homes for their opinion of the order? After all, Government Departments are very good at writing letters, or at least sending out circulars: I receive a good many, most of which are consigned to the waste paper basket. Surely that would be more positive than sitting back and saying, "No one told us what they wanted."
One of the order's main defects is not what is contained in it but what it empowers the Department and the Minister to do following its passing. Built into almost every part of it are virtually open-ended powers to make further regulation in regard to inspection, registration or tribunals. The Minister spoke in his opening speech of a requirement for detailed and substantial regulations to be made; but they have not been made, so we cannot debate them tonight. Moreover, once they have been formulated and published, we shall have very little control over them.
Let me sum up my point about consultation. I think that the Government should ask the Northern Ireland Care Homes Association—and the voluntary and private sector homes that do not belong to that association—to help in the preparation of rules and regulations that will benefit both residents and owners. That, surely, is the best way forward.
The order has some extraordinary features. The hon. Member for Belfast, East (Mr. Robinson) mentioned the exclusion of children's and young persons' homes. Given recent history both in this country and in Northern Ireland, I feel that that sector should be brought within the scope of the order. The Minister may say that it is dealt with in other legislation; if so, I hope that he will undertake to review and update that legislation, because it clearly is not working properly.
As others have pointed out, it is inexplicable that health and social services trust homes and homes governed by chartered bodies or statutory boards have been excluded from the inspection provisions. According to a one-liner in 934 article 3(2)(g), the board can exclude any establishment that it wishes to exclude. That drives a horse and cart through the legislation. Under article 4(4), small homes are excluded in certain circumstances; but no one seems to have decided how a small home should be defined. Certainly, the Minister did not do so in his opening speech. How small is small, and how big is big? The conditions governing registration, refusal to register and the cancellation of registration are not at all clear. Moreover, they are subject to further rules and regulations which I understand are to be published a month after the order comes into effect.
§ Mr. Peter Robinson
Could that not betray a slip on the part of the Department? Effectively, the order is a charter for the boards to give away all their homes; the Department, and the boards, may well intend to end up with no homes at all, so that they need not include them in legislation. They may intend to give them away, either to the big operators or to someone else.
§ Mr. McGrady
Indeed. I think that the hon. Gentleman drew our attention to that possibility earlier when he referred to the provision in article 14A under schedule I, which empowers the Department to hand over premises, property, fixtures and fittings to another person's custody and usage. If the boards were to use that vehicle, they could rapidly denude themselves of all their homes—and, given the budgetary restraints that will have been imposed on them, that is very likely. The intention is for homes affected by the provision to be transferred to more or less recognised charities such as Help the Aged, but that will not necessarily happen. It could be argued that such organisations are not equipped to deal with the administration involved.
The implementation of the inspection provisions is also in doubt. The order tells us nothing about how inspections will be carried out. It mentions self-financing, but I do not know whether that phrase is used in the context of the United Kingdom, Northern Ireland or the boards. Standards are not mentioned either. Presumably, they will he the subject of yet another series of regulations, to be published after the order has been passed. Nevertheless, the question of standards of medical care, staffing, buildings, equipment and the general ambience of homes is problematic. Both the boards and home owners should be consulted, so that common standards can be agreed and applied to everyone's benefit, not least that of residents.
I am bothered by what is not in the order, rather than by what it contains. We know the mechanics: the motion will be passed, and no passage, phrase or word in the order will be changed. It is a fait accompli. Let me make a special plea to the Minister: that he will not publish a series of regulations about registration, inspection and tribunals until he has engaged in full consultation with the people and the boards concerned in what, for want of a better word, we must call an industry—an industry that cares for the aged, the sick, the mentally ill, the infirm and the addicted. That is the proper way in which to protect the interests of the less able and favoured members of society —interests which we should have most at heart—and also to protect those who provide the premises in which such people are cared for.
§ Mr. David Trimble (Upper Bann)
Let me begin—as did my right hon. Friend the Member for Strangford (Mr. Taylor)—by complimenting the hon. Member for Normanton (Mr. O'Brien) on his speech. Unfortunately, he is not in the Chamber now, but his useful contribution dealt with a number of serious issues.
Before I deal with the details of the order, I must, as always, register a protest at the way in which the legislation is being introduced. As is usual with Northern Ireland legislation, this is being done by Order in Council. As the hon. Member for Belfast, East (Mr. Robinson) said earlier, Orders in Council are usually debated for 90 minutes. Tonight, because of the collapse of business earlier in the day, we have more time. Had we been proceeding according to the normal amount of time allotted to orders, the debate would have ended nearly half an hour ago, in which case I should have been unable to speak. There is some small mercy, therefore, in the collapse of the earlier proceedings. However, the collapse of the earlier proceedings and the fact that the order is being debated earlier than expected has caused embarrassment to at least one of my hon. Friends.
§ Mr. Trimble
He is indeed.
As other hon. Members have mentioned, the collapse of the previous business means that we have five and a half hours in which to debate the order, but it does not matter whether we take five minutes, five hours or 50 hours, because nothing that we say tonight will have any effect. The order is unamendable: whatever the Minister may say in his wind-up speech, the order will go through virtually on the nod. It is a form of law-making that is indefensible.
§ Rev. Ian Paisley
I am sure that the hon. Gentleman has noticed that, according to the Order Paper today, the business managers of the House thought that the first business would go beyond 10 o'clock, for there is a 10 o'clock motion on the Order Paper, so we should have had one and a half hours—perhaps from 11.30 onwards, because the first business could have gone on for another hour and a half at least. The point is that this issue, which is so vital and which needed time, might not have been debated at all tonight due to lack of time.
§ Mr. Trimble
The hon. Gentleman is correct. When I saw the 10 o'clock motion on the Order Paper this morning, my heart sank. I thought that it meant that our business would not come on until the small hours of the morning. Instead, it has come on a little earlier than expected.
The Minister was on the Treasury Bench when we discussed the first business on the Order Paper. I think that he heard me comment that the Bill that we were then debating extended to Northern Ireland and contained substantive Northern Ireland provisions in primary legislation. I notice that the explanatory document relating to the order states that this order brings Northern Ireland legislation into line with legislation in this matter in England and Wales—the Registered Homes Act 1984 and the Registered Homes (Amendment) Act 1991.
936 It ought surely to have been possible, at least with regard to the 1991 Act, to take the same course as was taken earlier today on the Maintenance Orders (Reciprocal Enforcement) Bill—that is, to have included the equivalent legislation in the 1991 Bill when it was going through the House. We could then have had it a year earlier. We have had to wait at least a year—perhaps longer when it comes to some aspects—for this order. There is no reason why Northern Ireland legislation should not be included in the English equivalent when it is going through the House. There is no technical reason why that cannot be done. It would have the added advantage of enabling a more serious and more purposeful debate to take place. Moreover, more interest might be taken in the legislative process if things were done that way.
In reply to an intervention during his speech, the Minister said that only 13 representations had been made during the consultation period and that none of them was made by political parties. The Minister shot himself in the foot in a massive way by saying that, because the interventions of other hon. Members made it clear that considerable representations had been made by various parties and that the Minister involved, who is represented tonight by the Minister on the Treasury Bench, had on occasions declined to see people.
As the Labour party spokesman, the hon. Member for Normanton, said tonight, there is a tremendous absence of accountability in Northern Ireland: it is non-existent there. That is absolutely correct. My right hon. Friend the Member for Strangford has made the point absolutely clear with regard to boards and councils appointed by the Minister. All the new health and social services boards are appointed by the Minister. The health and social services councils are also appointed by him. There may be the odd elected representative on a council, but that person owes his place to the Minister's favour. He is swamped by the Minister's nominees, who are drawn from a remarkably narrow segment of social and public opinion within Northern Ireland.
It may be a little better with quangos. Quangos are objectionable in themselves, but things would be a little better if the appointments made by Ministers to quangos in some way represented the community as a whole, instead of taking people from a narrow social band—largely from the hangers-on to the Stormont castle system: persons who generally have no roots in that society and who cannot be regarded as representing the community at large, let alone identified political groupings.
It is extremely rare for any person who is in any way connected with the political party that I represent ever to be apointed to a quango. If one or two slip through and are appointed, it is usually a sign that that person suffers from some moral or other defect.
§ Mr. Beggs
I am aware of an elected Unionist councillor who serves on one of the most recently established quangos. I am sure that my hon. Friend agrees with that councillor's observation—that the chairman was tame and had been selected purely and simply because he would never vote or allow members of that council to raise any controversial matter.
§ Mr. Trimble
That is right. I am grateful for my hon. Friend's intervention. It echoes the point made earlier by my right hon. Friend the Member for Strangford who referred to the experience of one of his councillors, Sir 937 Edward Archdale, who found the situation so intolerable that he resigned. I did not intend my earlier comments to be interpreted as meaning that the limited number of councillors who are appointed to the boards are persons who are not struggling against the system. Some of the councillors who have been appointed were appointed because they were malleable. Others are not so malleable. Lest there be any misunderstanding about this, my comments were directed towards the non-elected representatives—the vast number of persons who are appointed.
§ Madam Deputy Speaker (Dame Janet Fookes)
Order. Before the hon. Gentleman continues with his speech, I should say that although I am trying to follow his argument as best I can, it seems to be straying rather far from the subject of registered homes.
§ Mr. Trimble
Registered homes are supervised, Madam Deputy Speaker, by health and social services boards, to which health and social services councillors are supposed to give advice. Consequently, the constitution of the health and social services boards is, I suggest, a matter that one can touch on, since it relates also to the greater problem of the complete absence of accountability within the public service in Northern Ireland. That is a matter of great and general importance.
As the explanatory document says, there has been a tremendous increase in the number of residential and nursing homes in Northern Ireland in recent years. Many of those residential and nursing homes are admirable and provide a good service. However, there have been exceptions. Some have given cause for concern. On a number of occasions I have had communications with the Minister regarding homes. In some cases, I have even had to ask for inspections to be carried out.
In general, I would welcome a measure which provided for registration and greater regulation. In broad principle, we welcome registration, regulation and inspection. My right hon. Friend the Member for Strangford said that because of the way in which the legislation is being enacted we shall vote against the order, but that should not be interpreted as rejection of a system which would lead to better regulation and control of this sector. We welcome the principle of greater control and supervision.
I am worried about the extent of that control. The grounds for refusal of registration relate to the character of the applicant and the nature of the premises—their physical condition, equipment, and so on. Another ground for refusal isthat the way in which it is intended to carry on the home is such as not to provide services or facilities reasonably required.The grounds for refusal are set out in article 8(1). The refusal of registration provides a degree of control.
The order contains nothing further about the way in which it is intended to carry on the home being such as not to provide services or facilities reasonably required. It would have been helpful if regulations had been provided. Under article 28, the Department is given the power to make regulations on several matters. Some of the matters with which the regulations may deal are set out in the Bill. They include facilities, numbers of staff, the number of 938 staff to be on duty at any time, the information given to residents about complaints procedures, and notification of events which occur in the home.
I am worried about the range of matters that will be covered by the regulations. I may be wrong, but it seems to me that the matters covered by regulations will provide the basis for detailed control through inspection, refusal or withdrawal, or registration. If the regulations do not cover a certain matter, it may slip out of the net. I am thinking of simple complaints such as those that I have received from persons in homes that they were deprived of pocket money. Will it be possible to take such matters into account in an inspection? The order does not refer to small matters of that nature. We should like to know what matters the regulations will cover.
The hon. Member for South Down (Mr. McGrady) complained about the extent of the power to make regulations. That reminds me of a debate that we had last week on the Asylum and Immigration Appeals Bill. Important asylum and immigration matters were to be covered in regulations. For that debate, the Home Office made available draft regulations so that, when we discussed that Bill, we had the draft regulations in front of us and hon. Members were able to talk about them. That resulted in a sensible debate on the Bill. Where are the draft regulations to be made under the order? Why is the procedure followed last week not adopted for Northern Ireland legislation? Why do we not have the regulations before us when so much of the meat of the legislation will be in the form of regulations?
I suggest that, in future proceedings, the Minister and his officials take account of the need to ensure that the House has sufficient information before it in the debate to make an effective judgment. If we had draft regulations on the conduct of residential care and nursing homes, we would be able to comment more about the extent of regulation and the Department's control which may be exercised.
It has been said that the regulations will be published shortly. However, when the regulations are published they will not be subject to any effective parliamentary control; they do not come before the House. There is no practical way in which such regulations can be brought before the House. That is another defect of the procedure for Northern Ireland legislation.
Linked to the power to carry out inspections are the regulations which lay down the conduct for residential homes. That is a key matter. I welcome a power of inspection. It is necessary. Again, important matters in article 29, which provides for inspection, will be dealt with in regulations. I deprecate that. Reference has been made to some of the provisions in schedule 1 and a new article 50, which is to be inserted by schedule 1(7) into the Health and Personal Social Services (Northern Ireland) Order 1972. That new article 50 provides powers of inspection. The article says:Any person authorised by the Department may at any reasonable time enter and inspect any premises (other than premises in respect of which any person is registered under the Registered Homes (Northern Ireland) Order 1992)".That relates to premises which are not registered. There is a need for such a power to ensure that a home which should be registered is covered by the legislation and the regulations so that it may be inspected. That is a good provision.
939 The new article 50(4) refers to the way in which the inspection is carried out. It caught my attention as a good provision. New article 50(4) says:Any person inspecting any premises under this Article—(a) may interview any person residing there in private"—There must be an express power to speak to residents in private. Elderly people in residential homes are sometimes nervous about their circumstances and feel vulnerable to the management of the home. They may feel worried and afraid. Perhaps their fears are groundless. It is easy for elderly people to be worried about the future. When homes are perhaps not run as well as they could be, the residents may be afraid to complain. I have had experience of that when complaints have reached me in my capacity as Member of Parliament.
I would be delighted if a similar provision for the inspection of registered homes were inserted in new article 50(4). It is a small point, but effective inspection is necessary and important. The power to inspect may be abused. The hon. Member for Antrim, North (Rev. Ian Paisley) referred to a way in which the power to inspect had been abused. Such abuse is not a reflection on the regulatory system provided; it is a reflection on the character of the boards and the way in which they have developed, free from any accountability, parliamentary control or supervision.
I shall mention a few other matters. The legislation provides an emergency procedure. That is good, but I wish to query one aspect. Under the emergency procedure a board may apply to a justice of the peace for an order cancelling registration. If the justice of the peace thinks that there will be a serious risk to the life, health or well-being of the residents, he may make the order.
The order also contains an appeal provision. Presumably, the appeal provision is intended to be a hurdle or filter to ensure that a board does not act capriciously, that it has some grounds and that those grounds are examined by another person. That provision may appear reasonable to a person who is not from Northern Ireland. Here in England, justices of the peace have judicial functions. They are magistrates. They appear on magistrates' benches and discharge an important range of civil and criminal business, so they are persons accustomed to acting in a judicial manner and having an important judicial function to discharge. That has not been the case in Northern Ireland since 1935. Ever since then, all the functions that people think of as being discharged by magistrates have been discharged by a professional judiciary—people who in England and Wales would be stipendiary magistrates.
The post of justice of the peace continues in Northern Ireland, but it is an honorific title, given to worthy chaps, and their function is simply to sign warrants occasionally—
§ Mr. Trimble
The comments being made underline the fact that a justice of the peace in Northern Ireland has no significant judicial functions. It is eccentric to put our justices of the peace in the position of having to decide 940 whether to close a residential or nursing home immediately, with all the implications involved for the person carrying on the business and the people employed in it. Why was it not thought proper, or possible, for the applications to be made to resident magistrates? That would be the equivalent—the sensible thing to do. When the Minister replies to the debate, will he deal with that question? Yes, let us have an emergency procedure, but let us have a sensible procedure.
§ Mr. William Ross: (Londonderry, East)
As the order is supposed to apply the 1984 Act to Northern Ireland, does my hon. Friend not consider it highly possible that the draftsmen did a straight lift, without realising that the provision was not applicable in Northern Ireland conditions?
§ Mr. Trimble
When it comes to the origins of the drafting of legislation, anything is possible, especially in view of the fact that the Maintenance Orders (Reciprocal Enforcement) Bill, which went through all its parliamentary stages so rapidly earlier today, was needed to correct an error made in earlier legislation. The order before us may not be a similar slip, or error, but I believe it to be a misjudgment of a different kind.
The order does not apply the equivalent provisions in the English legislation with regard to mental nursing homes. The explanatory document says:The Department believes that the registration and inspection powers proposed for Boards in respect of all nursing homes should enable Boards adequately to safeguard the welfare of all residents whatever their individual disabilities and needs.The Minister touched on the point briefly, but I did not get a clear picture of the thinking behind the decision not to include the category of mental nursing homes. I should like him to deal with the matter in more detail in his wind-up speech. Is it envisaged that persons with mental disabilities should be in ordinary nursing homes, or that there may be homes catering specifically for such people? Is it thought that the existing regulations are sufficient?
It is important that we know what the Government think, because we can see the way in which their policies are evolving, so that much provision in residential and other homes will move into the private sector. It is important that the Minister should give us a clear picture of the sort of private sector provision that is intended for persons with mental disabilities. It may be thought that there will be no private sector provision. I should like more detail on that.
Other hon. Members have raised another matter in connection with facilities and services moving into the private sector. The amendments being made to the 1972 order by schedule 1(2), which inserts the new article 14A—
§ Rev. Ian Paisley
I have a document before me issued by the Southern health and social services board, which includes reference to private nursing and residential care for persons with mental handicaps. it contains a whole series of proposed regulations for the private sector, so the Government must have it in mind to include provisions for such persons.
§ Mr. Trimble
I thank the hon. Gentleman for that information; it underlines the need for a more detailed and open approach from the Minister, to explain what will happen.
941 I shall not go in detail into the new article 14A and 15 to be inserted into the 1972 order, because I believe that another hon. Member, who I suspect is better informed than I, wishes to deal with the subject.
The provisions permitting property and equipment to be used by private sector bodies say that such use is to beon such terms and conditions as may be agreed between the Department and the body or person".I echo the concern expressed by the hon. Member for Belfast, East (Mr. Robinson) to ensure that there is a level playing field and that certain organisations are not treated more favourably. If there is to be a degree of private sector involvement and competition in the provision of services, let it at least be introduced on a proper commercial basis.
Significant services are moving out of the state sector and into the private sector. My hon. Friends have explained earlier the consequences involving the closure of hospitals, nursing homes and residential homes in some areas. The Minister gives me a brief wintry smile. He may recall the correspondence that I had with him when he was also responsible for Spelga house, in Banbridge in my constituency; it was part of Banbridge hospital, and involved state provision of long-term continuing care for elderly persons.
For years there have been proposals implying that Spelga house will be run down and closed. In his opening speech, the Minister talked about lack of representations on such matters. Yet he will recall the occasions on which we made representations to him, and the occasions on which he refused to meet us, saying that we should have the opportunity to meet him only when the official closure procedure, was brought into operation. Spelga house has been effectively closed: no new admissions have been made for a long time, and as the elderly residents age and die their number is diminishing. So there is no state provision of continuing care for elderly people in the Banbridge area; people now have to go further afield, because Spelga house is effectively closed.
The closure procedures have not been operated, and still no provision is made for effective consultation. Yet with the new-fangled boards without elected representatives, and the councils with elected representatives being effectively smothered, there is no way in which local people can make their voices heard.
All that highlights our concern—especially in view of the fact that, as the Minister knows, in the case of Spelga house there has been a trail of broken promises under both the previous board and the current board. That increases our concern about the way in which the new semi-privatised and private provision has been introduced into the health service—the order facilitates that process. Although we welcome in principle the prospect of regulation, inspection and control of nursing homes, the context in which they are being introduced causes us nothing but concern.
§ Mr. Andrew Mackinlay (Thurrock)
My desire to intervene, albeit briefly, in the debate is prompted by two considerations. The first is that I like to think that, in a small way, I represent the interests of trade unionists in the House. A number of trade unionists have made representations to me about the draft order because they are legitimately concerned about its implications not only 942 for their livelihoods but for the service to which they are dedicated, and which they think could be prejudiced by its implementation. Their anxiety is prompted by the effect that the order will have on the clients and patients whom they serve.
The second reason why I am pleased to have caught your eye, Madam Deputy Speaker, is that I take seriously our role in Parliament of endeavouring to check the Executive. In the brief time in which I have been here, I have noticed that measures whose debates have the least attendance often justify the maximum scrutiny. That is true of this order.
When the Minister took us through the draft order in his opening speech, he was clever when he came to article 37, which relates to schedule 1. He said that the purpose of article 37 and of schedule 1 was to overcome some minor legal difficulty, but he did not amplify what that legal difficulty was. If I can do nothing else, I invite the Minister to amplify the point. I am greatly concerned that what will be slipped through in the guise of schedule 1 is a major change in the administration, not only of health care, but of social services in the Province of Northern Ireland.
A little while ago, Madam Deputy Speaker, you drew to an hon. Member's attention the fact that the order is called the Registered Homes (Northern Ireland) Order 1992. That was a legitimate point for the Chair to make. It crossed my mind that you, might not have had an opportunity to study the order in detail. Using schedule 1, the Government intend, under the misnomer of an order on registered homes, to introduce a major change in the administration of health and social services which transcends the narrrow issue of registered homes.
The proposed change deeply concerns people who work in health and social services in the Province. I invite you, Madam Deputy Speaker, and other hon. Members to examine the new article 14A in schedule 1, which says:The Department may make arrangements for the provision by any other body or person of any of the health services on such terms and conditions as may be agreed between the Department and that other body or person.That provision is drawn widely and has caused some concern. The Minister should have given far more amplification of what was intended by its inclusion in the schedule.
My fear and that of Northern Ireland trade unionists who have expressed their worries to me is that the Minister intends to overcome the Government's difficulty in trying to implement health and social services trusts within the Province. The Health and Personal Social Services (Northern Ireland) Order 1991 has run into difficulty in that the Government are unable, because health and social services are integrated in the Province, to create a trust for social services under previous legislation. If the order goes through tonight, article 14A will be added to the Health and Personal Social Services (Northern Ireland) Order 1972, coupled with article 15, which is also included in the schedule. The Government will be able to effect trusts without any further debate or consultation within the Province. It is disgraceful that a provision that will greatly affect the administration of health and social services in any part of the United Kingdom should be dealt with in this way.
I draw attention to one immediate flaw of this method of legislation. Bills applying to England and Wales and to Scotland have a long title. That acts as a useful check list for legislators and for the Chair who can see whether hon. 943 Members are keeping to the subject. However, there are no long titles in Northern Ireland orders. If there were, the Government and the Minister would have been rumbled when introducing, in the guise of the order, a major change in the administration of health and social services. I hope that consideration can be given to incorporating a long title in Northern Ireland orders so that hon. Members and the Speaker can see exactly what is involved.
The explanatory note accompanying the order buttresses my concern. It says:Schedule 1 lists minor amendments to existing legislation mainly required as a consequence of the Order.If one reads the schedule again and again, one finds that the explanatory document is wholly misleading. These are not minor amendments to Northern Ireland legislation; they are major amendments. To suggest that they are mainly required as a consequence of the order is demonstrably untrue.
If the Minister believes that my charge is unfair and unfounded, I hope that he will take it from me that others, especially in Northern Ireland public sector trade unions, will read reports of our debate and will want a categorical assurance that the order will not be the measure by which the Government remedy what they consider to be a flaw in or lack of legislation so that they can promote their desire of creating trusts in health and social services in Northern Ireland.
Lord Arran, who is the appropriate Minister in the other place, has promised that there will be separate legislation relating to the trusts, especially in relation to dealing with the services administered by the health boards, which in England and Wales would be local authority social services. Lord Arran has promised separate legislation, but the fear tonight is that, under the darkness of the evening, the power for the creation of social services trusts has been slipped into the order. I hope that there will be no equivocation. I trust that the Minister will either come clean and admit that the order will affect the trusts or say that the hon. Member for Thurrock is wrong.
§ Rev. Ian Paisley (Antrim, North)
As a Northern Ireland Member, I welcome the free exchange across the House tonight. I wonder what any hon. Member, including you, Madam Deputy Speaker, would think if he or she had to say to a constituent, "Oh, you should have written about Bill. You should have written about your opposition and about what amendments you wanted. My hands are tied. If you have not written in, when I stand up in the House, the Government will say that there was no real representation." That is the mess we are in tonight.
People in Northern Ireland expect their elected Members to deal with issues after they have lobbied them, not after they have written letters. I am amazed that the explanatory document on the order states:the recent consultative exercise in Northern Ireland … evoked widespread support for new legislation.Only one Member from Northern Ireland supports the legislation. All the other Members who represent Northern Ireland oppose it.
I am told that the Minister will answer every question that he has been asked, so I want to ask him some questions. Are the 100 people who wrote in in respect of 944 the first proposal to lay a draft the "widespread support" for new legislation? If 100 people write in, is that widespread support for legislation?
§ Rev. Ian Paisley
On whose authority was the issue included in the background and scope of the draft? When and how was it decided that the matter should be included?
No hon. Member who has spoken tonight is for the irresponsibles. I am against the irresponsibles involved in the care of the elderly. I have taken up cases in that regard and I shall continue to do that. The irresponsibles in Northern Ireland must be dealt with. However, there are no people more irresponsible than those on the boards and they flout the law.
The Minister should consult Lord Arran about the home in Broughshane. The board gave me a categorical assurance that the home would not be closed until a deputation of the citizens and I met the Minister. However, the board proceeded immediately to pressure the people in that home. They were told that, if they did not pick another home close by, they would be sent 20 miles away. Those elderly people collapsed under that intimidation. How can the board officials love the elderly and care for them when they stoop to that level after having promised an hon. Member that no action would be taken?
Lord Arran can confirm that I raised that issue with him. I told him that his office had told us that the home would not be closed, but that that had already happened and the people had been shifted under severe pressure. The irresponsibles in Northern Ireland are on the boards.
It is terrible that the people comprising 60 per cent. of the representation of the homes cannot make representations to the Minister. When those people came to me, I advised them to become organised, because they were not organised. They were individual people who were running homes and they found that the board was exercising a heavy hand. I told them that, if they were not organised, they would not be able to speak with one voice. However, they found that, once they were organised, they ran foul of the board and its officials.
It is no laughing matter when board officials use threats on the telephone. I have raised such matters with Lord Arran. I presented him with a dossier of complaints and I had correspondence with him about those serious matters. I hope that the Minister will take them seriously. No one who makes a legitimate complaint should be intimidated for making that complaint. After all, the trade unions fought for the right to organist: Everyone has the right to organise and state the issues clearly before people whom they believe are dealing with the issues in a legal way.
I hope that the Minister will say that the people who run 160 homes and supply 3,600 beds will at least be listened to. It is amazing that I have to make that plea tonight. Those people should be consulted and the Minister must contact those homes. It is no good saying that, if we place a statement in the press, representations can be made and everything will be well.
§ Sir James Kilfedder
Is the hon. Gentleman telling the House that the Northern Ireland Care Homes Association or its predecessor was totally unaware of the order? That is not true. I understand that they had consultations with officials. The order does not come as a surprise to them tonight.
§ Rev. Ian Paisley
It may come as a surprise to the hon. Gentleman, who said that no representations had been made to him, to learn that those people met him in June. He gave them 12 minutes of his time and did not reply to their representations.
§ Rev. Ian Paisley
I am not getting excited. The hon. Gentleman seems to believe that the 160 homes that supply 3,600 beds are run by people who are not to be depended on. Those people are open and they come to hon. Members openly. They declare who they are. If they were not responsible people, they would not want to reveal themselves. If they were a body of people with black marks against them which could be proved, they would not deal with the matter openly.
I remind the hon. Member for North Down (Sir J. Kilfedder) that he said that no such representations had been made to him—only representations from one. However, tonight I received a note to the effect that those people met the hon. Member for North Down in June. The hon. Gentleman gave them 12 minutes of his time and after they left there was no further comment or response to their representations.
§ Sir James Kilfedder
I utterly refute the allegation that the hon. Gentleman just made, and I treat it with the utmost contempt. It is contemptuous of him to make that allegation in the House tonight without consulting me beforehand and taking my word for it that I do not dismiss any complaint from a constituent in the manner that he described. I was the one who informed an owner of a residential home at the weekend that the order was to come before the House this week. The hon. Member for Antrim, North (Rev. Ian Paisley) and his colleague the hon. Member for Belfast, East (Mr. Robinson) were then informed. They were surprised because they did not know that the order was to come before the House today.
§ Rev. Ian Paisley
All I shall say to the hon. Member for North Down is that the gentlemen concerned are in the Strangers Gallery. Let him meet me immediately after the debate and meet them face to face. It was utterly despicable of the hon. Gentleman to try to attack the character of my hon. Friend the Member for Belfast, East (Mr. Robinson) in that way. The hon. Gentleman knows that I do not make, and have never made, charges without dealing with them. So we will meet those gentlemen after the debate. The hon. Gentleman will be face to face with one of his constituents and he can answer to him.
This is a most serious matter. It is regrettable that any charge should be made against anyone who runs a home in Northern Ireland who is trying publicly to do something to canvass support for his point of view. If people are irresponsible, they must be dealt with. I would not support any proposal that would not deal adequately with the care of people in nursing homes and I would not tolerate any derogation from the proper standards and I am known for that. If anybody derogates from the proper standards, it is the boards.
946 A lady died in Waveney hospital, in the heart of my constituency, at the weekend. When I telephoned Lord Arran, he confessed to me that the board had not even told him. Her body was found at a rubbish tip. That should have been reported immediately to the Minister. The first man to tell the Minister's office was myself. The board members did not even think it worth while to tell the responsible Minister. Those are the people who are to have power under the order. It is time Ministers took those people in hand and dealt with them in the way that they need to be dealt with.
I have been a minister of the gospel for 46 years. I visit hospitals and I have pastoral concern for people. I will not cover up for anybody who runs a nursing home wrongly, but the people who have come to me are respectable people who run decent, honourable nursing homes. I object to any form of intimidation from board members because they do not like what is happening.
The whole board system is absolutely ridiculous. As we sit in the House tonight, a board of faceless individuals is making decisions. The hon. Member for North Down knows the position in his area. We know what is happening in County Down at present. It is already happening in my area. We will have more cuts tomorrow. What will happen to the elderly, the aged and the infirm? A country that cannot look after its elderly does not deserve anything. We all should have concern for such matters, and that is why I speak on this issue tonight.
It is essential for the Minister to get the message. He should consult the Secretary of State now, withdraw the order and let us all sit around the table together. Speaking about getting around tables, what better subject could motivate every party in Northern Ireland than care for the elderly and care for those who need our help? The Minister should take the order back. What difference will it make if he takes it back for a month? The difference will be an order that will be better, more substantial and more helpful—
§ Rev. Ian Paisley
And more acceptable to all the people concerned.
The tragedy is that, no matter what we say, we cannot alter a dot or stroke a T in the order. No hon. Member from outside Northern Ireland would like to have that system of government. It is utterly detestable that that is how we legislate for Northern Ireland. As I often say when I speak outside Northern Ireland to people who want to know what is happening, "It is interesting that, as a Member from Northern Ireland, I can help to amend legislation for Scotland, England and Wales, but I cannot amend legislation for the people who sent me to the House of Commons". That system needs to come to an end as quickly as possible. We are now reaping what the sowing has been. If we sow the wind, we reap the whirlwind. Why should the elderly, the aged and the people who need help have to reap the whirlwind? I appeal to the Minister to take action.
Will the Minister help us and say, "Before the regulations are finally drafted and laid, we will have proper discussions about them so that they will be made as acceptable as they can be to all the interests concerned"? Surely that would be a step forward. We have never before been able even to glance at regulations. They just rode on the back of an order and that was it.
947 I am particularly worried about two aspects of the order. The first is in regard to employment in homes. As far as I can gather from the order, board officials can say to the owner of a home, "You cannot employ that person," and they do not need to give any reason. The owner of the home is bound to ask, "Why can I not accept that person?" We have intimate, close, so-called fair employment legislation—my attitude to it is well known in the House—but the employer has to abide by it. An applicant can say to the employer, "All right, I am going to take you to law. You will not give me a job, but I have all the necessary qualifications." Why can he not be given the job? It is not because the owner would not employ him; it is because the board says that he cannot employ him.
Will the Minister assure me that the board will take responsibility and that the applicant can take action against the board and not against the person who was going to employ him?
§ Rev. Ian Paisley
And that it pays the compensation that would be meted out if the man proved his case in court. That important point needs to be hammered home to the Minister. We need an answer tonight. How can people who want to run homes and run them well be put in that position by this legislation?
The matter has not been thought out at all. What the hon. Member for Upper Bann (Mr. Trimble) said about justices of the peace shows that it was lifted from English legislation. Justices of the peace in Northern Ireland have very little power. Tory candidates who do not win elections usually get a JP-ship just to keep them happy. The Democratic Unionist party has a heavy slice of the vote, and among us we have three JPs. I used to have to go to an Official Unionist to ask him to sign my election returns. They were always absolutely accurate, of course, and I had no bother with him.
I was amazed. I thought that the Government were bringing justices of the peace back into action. "Justice of the peace" in Northern Ireland is just like an honorary title that is given to people of good standing. All that JPs are asked to do is sign warrants, and many of them do not want to sign warrants. When they see the police coming, they get away because they might have to sign a warrant against their friends and they would not like their signatures to be on the warrant.
The Minister should take care when he is lifting legislation from England into such orders. The draftsmen are not very competent. If they are drafting legislation for Northern Ireland and do not know what a justice of the peace in Northern Ireland is, how can they do the intricate work of drafting? I trust that the Minister will take that point on board.
The Government are giving away public property. As I read the order, board members can say, "You will do that, but we will do what we like." Board members are not tied by any regulations. They can change them. They can say, "That does not apply." At any time they can change any measure that we are supposed to pass tonight. They can do exactly what they like.
I should like a public inquiry into the many people who have been placed in certain private homes when public homes have been closed down. Why has there been discrimination? Why do some people in the private homes industry have all the beds that they want filled, and not 948 only filled but paid for and held in trust for the board, when other people are doing their best to make a livelihood in that sector? Those matters need to be addressed by the Minister. The boards should not be given such massive powers.
The hon. Member for Normanton (Mr. O'Brien) made an excellent speech in which he touched the very core of the matter. He referred to the boards' massive powers. It is amazing that in a democracy we are prepared to hand over such powers to a board. The right hon. Member for Strangford (Mr. Taylor) has told us who the members of the boards are. The boards consist of defeated candidates who could not get elected and of people who were employed by the Government for years, Government pensioners. Does anyone think that they will rock the boat? If we refer to the biographies of the people who are on these quangos, we discover that many of them were in Government employment.
The chairman of a new quango was appointed recently. Who is he? He is the former head of the civil service, Sir Ken Bloomfield. Of course, he has to get a nice little job. Does anyone think that he would rock the boat? We had experience of him from the days of Terence O'Neill. We know that he used to write Terence O'Neill's speeches, and we all know what happened to Terence O'Neill.
Will the Minister give an assurance that no person who was employed by the Government will be on one of these tribunals? Will he give an undertaking that the tribunals will be independent bodies to which people can put their case?
§ Mr. Allan Rogers (Rhondda)
I hope the hon. Gentleman is not trying to convey to the House that this system of appointments to quangos is peculiar to Northern Ireland. It is peculiar to the Conservative Government, as we have seen in Wales, with the viceroys who operate as Secretaries of State both in Wales and in Northern Ireland.
§ Mr. Rogers
And also in Scotland. With absolute impunity they appoint Tory party officials, ex-officials and the husbands and wives of Ministers even to quangos to run the affairs of our countries.
§ Rev. Ian Paisley
No doubt the hon. Member for Rhondda (Mr. Rogers), speaking for the Principality, knows what he is talking about. However, the hon. Gentleman has two advantages. At least Wales has local government with some power and he can elect people as councillors. In Northern Ireland local government can only empty bins, look after cemeteries and build a few leisure centres; that is all it can do.
Of course, local authorities are consulted. The consultative programme in Northern Ireland is immense. Councils can sit till three o'clock in the morning just to be consulted, and they do. The pay is better after a certain hour. I do not blame them. Then they are abused by their constituents because they do not make decisions—but they are not allowed to make decisions.
In addition to having local government with some power, Welsh Members have the right to move amendments to legislation that affects them. We have no right to move any amendments tonight. This is the law of the Medes and Persians—we take it or we leave it. There 949 are many things in the order with which I agree but I cannot vote for one part and reject another. I must vote against the whole measure.
The subject is so important that it would be a fine gesture on the part of the Minister if he were to consult and were to say, "This is a troublesome order, and there has been much opposition from all over the House. We will take time to reconsider it." By doing that, the Minister would be doing good service to the people of Northern Ireland and to the House. When he meets me, his boss talks to me about morale outside. The best thing that he could do for the morale of the people of Northern Ireland would be to take the order back and reconsider it; then the people might say that there is some hope of politics succeeding. I make that appeal to the Minister. He should argue his case. I should be happy for the debate to be adjourned so that he might argue his case before we come back to the matter again.
We can do nothing now about what is in the order, but we can do something about the regulations if the Minister gives us the chance. That is not as good as having the order right, but at least it will help us to satisfy those who have the interests of the residents of homes at heart.
I have various documents here about key workers. I have one entitled "New Key Workers", which was sent to a home. It says that everyone in the home will have a worker who will be in charge of that individual person to deal with pre-admission work, admission work, record keeping, care programmes, reviews, bathing, clothes, personal shopping, beds, hair care, appointments, liaison with relatives, liaison with other professionals and special interests. We are told in the Minister's document that all that is to cost nothing.
I had better read it to the Minister so that he will know what his document says. By the way, this is the same document that was said to have evoked widespread support. It states:What is it going to cost? The order will not lead to any significant increase in public expenditure. The introduction of fees is intended to make the board's work of registering and inspecting private and voluntary sector residential care homes and nursing homes self-financing.Are the homes to pay for the resident worker? We are told that the only increase in public sector staff will arise with the establishment of a registered homes tribunal, and that only a part-time secretary will be needed for that.
The Minister should get the document which has been issued for consultation. He should not ask me how I got this document but I have got it. It is entitled "Private Nursing/Residential Care for Persons with a Mental Handicap". It is a draft document issued by the Southern health and social services board. In regard to key workers it states:The board will identify a key worker for each service user. The key worker will maintain on-going links with the service user and home staff and will monitor, on behalf of the board, the well-being of the service user. The role of a board appointed key worker should be seen as distinct from the role of a primary care worker identified for an individual service user as part of a home's operational policy.
Is all that to be paid for by the home?
- Key workers will:
- have access to service users;
- have access to care plans and be involved in care reviews;
- be informed of any significant developments that may occur concerning the service user;
- except in emergency situations be consulted regarding any change in care objectives for service users."
§ Mr. Peter Robinson
Will my hon. Friend take into account that not only will the key worker have to be paid for by the homes if the system is to be self-financing, but the inspectorate, which is three or four times greater in Northern Ireland and therefore three or four times more costly than in Great Britain, will also have to be paid for by the homes?
§ Rev. Ian Paisley
Yes, I take that into account. That will tell against people who will he able to give proper care, because finances will be cut and a major cut in the finances of the health and social services boards in Northern Ireland will flow from what happens in the House tomorrow. The future is bleak. The Government seem to be saying that they will do away with the public sector and put such provision in to the private sector, but the private sector will have to finance it. The Government will not have that responsibility. The Minister must come clean with us about that tonight.
§ Sir James Kilfedder (North Down)
I shall speak briefly to welcome the order. The hon. Member for Antrim, North (Rev. Ian Paisley) requested the Minister to withdraw the order, but I ask him not to do so.
First, I do not like the Order-in-Council procedure and I have criticised and attacked it in the Chamber on many occasions. I find it unacceptable, but it is the way in which legislation has been introduced in Northern Ireland.
Secondly, I do not like the Eastern health and social services board, which is the bureaucracy in charge of the health service in my area of North Down. The bureaucrats spend most of their time looking after their own welfare rather than the welfare of the people that I represent.
I must make plain my approach to the order. One subject which concerns me deeply is the welfare of the elderly in residential homes. Within the scope of the debate, strangely enough, we have heard mention of the Anglo-Irish Agreement, and of Protestantism and Catholicism, and Dublin has been dragged into it. We have heard mention of pay for councillors for sitting long hours, of the last Prime Minister of Northern Ireland, and of a former head of the civil service there. Allegations were made about dictatorship; and a personal attack was made on the Minister. I ask him to brush such personal remarks aside. As I have said before, he is recognised as a person who has shown that he is genuinely sincere about Ulster and the Ulster people.
I care about the welfare of elderly people in residential homes, and I welcome the order for that reason, because it requires all residential care homes to be registered and and to be inspected regularly and properly. What is wrong with that? I am concerned because many of my constituents are in such homes. I have talked to them and have visited many of the homes in my constituency. I have also talked to relatives and friends of residents in care homes for the elderly. I am worried about the way in which they may be treated by unscrupulous proprietors.
As I said in an intervention in the speech of the hon. Member for Normanton (Mr. O'Brien), elderly people are among the most vulnerable in our community. We must do everything possible to defend them.
951 Certain matters have been mentioned in the debate which would give cause for consideration, but if the order is defective let us put it into effect as quickly as possible and then introduce amendments to it.
For every day that goes by an elderly person may be left at the mercy of someone who cares more about profit than about the welfare of the people in their accommodation. There is nothing wrong with the profit motive. It acts as an incentive to encourage interested people to offer accommodation to those in need of care because of age and infirmity. The overwhelming majority of owners of residential homes look after residents properly.
I am worried about the unscrupulous few—and it is no use saying that there are only a few. If one elderly person is ill-treated by a proprietor of a residential home and we do nothing about it, we are as guilty as the people in charge of the home. That is why I praise the Minister for introducing the order. It is not his Department, but he has brought such matters before us in the past on behalf of the Minister with responsibility for health, the Earl of Arran, who is in another place. I know from my experience that he is only anxious to do what is best for people in Northern Ireland.
In the past five years residential care homes have mushroomed throughout the United Kingdom. Northern Ireland is no exception. As in the rest of the United Kingdom, Northern Ireland has a few unscrupulous owners who are not as caring about their residents as they should be. The order can deal with those few who, lamentably, have little or no regard for elderly residents. We all know what can happen to an elderly person in someone else's care. It may involve a tight budget for meals, providing food of a quality and quantity below what elderly residents should have. I have heard that accusation made against a particular home and I have relayed the complaint. It may also involve an unacceptable degree of sedation. We have read in the press—the report applied only to Britain but we must be aware that it happens elsewhere—about armchairs that were deliberately used to detain the person placed in them.
The order is to care for people in residential homes and ensure, on behalf of the people of Northern Ireland, that elderly people who are placed in the care of others for payment are not treated in a manner that insults their dignity, robs them of their pride or undermines their health.
The vast majority of residential care home owners are caring and the homes are well managed. Having seen some homes in my constituency, I have been impressed by the attentiveness of the staff and the homely atmosphere. It would be wrong of me to mention particular homes, but when one enters certain homes one feels the warmth of the staff—the matron and others—and when one talks to the elderly residents one knows that the staff really care for those in their charge. It gives me a great feeling of joy when I enter such homes, but makes me extremely concerned about other homes where things may be happening which we would not like to see happen to our elderly relatives.
§ Mr. Peter Robinson
That is precisely the point that I made during the course of my remarks. Does the hon. Gentleman agree that, if it is right to regulate and license those homes in the private sector, homes that are under the control of the board or any other statutory body and children's and young persons' homes should also be brought under the same inspectorate? If it is right in the 952 case of one, is it not right in the case of the other? If the hon. Gentleman believes that it would be right to include them under the order, why pass defective legislation?
§ Sir James Kilfedder
It is a strange logic to say that, because the legislation is defective, legislation that would be beneficial to so many people should be denied to them simply because it could have incorporated something else. If I thought about it, I could probably extend the hon. Gentleman's list. The list has been put forward as an excuse for delaying the introduction of the order. It is not a justification for delay.
Naturally, I would welcome the extension of the order to other statutory homes, but I do not think that the Minister should delay the order. He is doing his duty by the people of Northern Ireland. He knows that I would be prepared to criticise him if I felt that he was failing in his duty. He would welcome suggestions from me or any other hon. Member who wishes to see the order approved, and I have no doubt that he will take them on board in the implementation of the order.
§ Mr. Rogers
I thank the hon. Gentleman for giving way, and excuse myself, as a fellow Celt, for interfering. I am in a dilemma. Earlier the hon. Gentleman said that we should accept the legislation although it might well be defective, as we could later alter it. He also said, as did other hon. Members, that the legislation cannot be altered. Does that mean that the hon. Gentleman is imploring us to support defective legislation because it can later be altered, when it cannot be? Does he mean that, in order for the legislation to be amended, it has to be thrown out and completely new legislation introduced?
If I understood him correctly, the hon. Member for Antrim, North (Rev. Ian Paisley) asked the Minister to take the order away for a month, look at it again and iron out the problems that have been highlighted. I know that I am making a rather lengthy intervention—
§ Madam Deputy Speaker
I think that that is an understatement, and the hon. Gentleman must resume his seat.
§ Sir James Kilfedder
I am only repeating what people have said, which is that there are defects in the order. If there are, I would welcome improvements to the order.
§ Sir James Kilfedder
I shall not give way to the hon. Gentleman, as we must get on.
I would welcome improvements to the order, but we should allow it to proceed. I have not received any representations from the registered home owners stating that the order should be amended line by line. I have heard from only one lady at the weekend, who told me about one aspect of the order. I have a high regard for her; she runs a home of excellent standards. That is the only representation that I have heard.
If the order were defective, surely the Minister would have received a stream of complaints, recommendations and amendments. I am sure that hon. Members present would have been briefed about the order's defects; I have not been briefed about any.
§ Mr. Rogers
I can tell the hon. Gentleman of one defect in the order, having made a quick perusal of it. If the so-called justices of the peace, who are symbolic in Northern Ireland, are asked to allow an appeal, action to close down the home is taken by a board, and any appeal is made to the board. Therefore, the board acts as judge and jury in its own action. Surely that is fundamentally wrong in any legislation.
§ Sir James Kilfedder
I cannot find the place now, but I think that if the hon. Gentleman studies the order he will see that there is a right of appeal to a tribunal against any of the board's decisions.
I believe that the order will result in better protection for elderly people. The call that I issue from the House tonight is that residents in residential homes for the elderly, and their relatives and friends, should be aware of the fact that they are now provided with a more effective opportunity to lodge complaints about poor standards or ill treatment. That call must go out. It will comfort the relatives of those in care to know that there is an effective means of dealing with complaints. Good registered home owners should welcome that. The lady of whom I spoke —I do not wish to mention her name—is an excellent home owner.
If the Care Homes Association wishes to maintain a high standard, it should support any legislation that deals with the unscrupulous few.
There is a clear onus on all hon. Members to safeguard the person of the elderly, their dignity and their rights. Every law and every regulation that flows from it may seem irksome to many good people, whatever their sphere of activity. However, they must realise that we are legislating to root out those who have nothing but ill will for their residents. By doing so, we shall safeguard the welfare of the elderly in homes throughout Northern Ireland.
Hon. Members have spoken about inspection. Up to now, the inspection of homes has been inadequate, and I am not sure how the new legislation will operate. However, more inspections should improve the standards of homes. I have always said that the Government should spend more money on carers—related or voluntary—who look after the elderly in their own homes with their possessions around them and a knowledge of the local shops and churches and so on.
Perhaps, when I was replying to the intervention of the hon. Member for Rhondda (Mr. Rogers), I should have mentioned statutory homes. In my area, the Banks statutory residential home for the elderly is threatened with closure. There are vacancies in the home but they are not filled because officials want to kick out the residents and take over the home. The officials already have a foot in the door and want to convert the home to palatial offices for Eastern board bureaucrats. The Minister must make sure that the board does not get away with that.
§ Sir James Kilfedder
No. The hon. Gentleman had his say. [Interruption] I ask the hon. Gentleman to keep quiet.
I urge the Minister to look into that matter because it would be a grave injustice to the residents of that home if 954 the board suddenly closed it. Those elderly people are worried about their future. I shall shortly present a petition on behalf of the people of Bangor urging the House to save the Banks residential home and to block the door to the bureaucrats in the Eastern board.
§ Mr. Allan Rogers (Rhondda)
The issues raised in the debate have general application in the United Kingdom.
The hon. Member for North Down (Sir J. Kilfedder) said that we should be extremely concerned about the condition and care of the elderly in the community. I agree. The Government should provide more resources so that the elderly can be looked after in their own homes rather than in hospital or residential homes where, occasionally, the standard of care is not all that we would wish.
§ Rev. Ian Paisley
If the board is such a wicked, bad, rascally body that the hon. Member for North Down (Sir J. Kilfedder) wants the Minister to take it in hand, is it not strange that he also wants it to be given more power so that it can inspect all the homes where old people are in care?
§ Mr. Rogers
I would not want to get involved in the problems of any specific board in Northern Ireland, or in any other aspect of the government of Northern Ireland, with which I disagree entirely.
If the hon. Member for North Down is saying that there is a problem with that home, and he has to petition Parliament in an attempt to rectify the problem, then there is obviously something wrong. From my admittedly superficial perusal of the order, I should not have thought that it would put that right. As I understand it, if someone objects to what is going on in any of these homes, the right of appeal under article 27 is to a tribunal. But the tribunal is appointed by the Minister. If both the tribunal and the board are appointed by the Minister, where is the independent review of any issue about which, for example, the hon. Member for North Down wishes to complain?
There is something fundamentally wrong with the order, and we shall vote against it. The Minister should take it away and have another look at it. It would not be the first time that that had happened, but the Government are so arrogant in the way they govern the country that that is asking an awful lot. As I said earlier, my Northern Ireland colleagues should not feel too isolated on this. Scotland and Wales have the same problem all the time, with the arrogance of the viceroys who rule in the Welsh and Scottish Offices.
I wholeheartedly agree with Northern Ireland Members of Parliament and my own Front-Bench spokesman who have said that they will vote against the order. I am sure that I shall be told off for interfering in the debate, but as I have recently been appointed Front-Bench spokesman for foreign affairs—
§ Mr. Rogers
I shall leave Hong Kong for another occasion, but I may have a locus in this debate, too.
Northern Ireland is part of the United Kingdom and it deserves the best of legislation. Therefore, we should reject the order.
§ Mr. Hanley
I am pleased to be able to reply to the debate. Right hon. and hon. Members will know how assiduous Northern Ireland Members of Parliament are in carrying out their duties. On occasions such as this they find it easy to fill any time that becomes unexpectedly available to them. This is my first night off after six months of the talks process and I could not have thought of a better way to spend the evening. I never expected that the evening would end early and I intend to fill it as best I can by answering the points that have been raised. The extra time is a blessing.
I was interested in the little vignette of a speech made by the hon. Member for Rhondda (Mr. Roberts) a few moments ago. I note that it is the first time that the Labour party has said that it will vote against such legislation. I had a cursory glance in the Library earlier and I noted that the legislation on which the order is based, the Registered Homes Act 1984, was apparently not voted upon in the House. The Registered Homes (Amendment) Act 1991, the other Act upon which the order is based, was also not voted upon and went through almost formally.
It is interesting, therefore, that the Opposition intend to vote against the order tonight. I shall return to the impact of a defeat, which I would take as a vote of —confidence[Interruption.]—in myself, of course. I want to answer as many points as possible, so I should be grateful for as few interventions as possible.
The decision to review the existing legislation governing the regulation of private and voluntary sector residential care and nursing homes in Northern Ireland was, as several hon. Members have said, the result of two major influences.
The first was the substantial growth in such homes in recent years and the growing pressure on the registering and inspecting authorities which existed at the time to ensure that there were satisfactory standards of care and accommodation and that they were maintained. The second influence was the legislation to which I have referred and its associated subordinate legislation. It is important to remember that that legislation was supported by the House without Division. The legislation gave registering authorities in England and Wales strength and powers to regulate residential care and nursing homes.
Following a comprehensive consultative exercise with a wide range of interested statutory, voluntary and private sector organisations and indviduals, the general consensus emerged that in Northern Ireland we should, as far as possible, bring our legislation broadly in line with that of the 1984 Act.
I mentioned earlier that there were more than 100 responses to the consultation on the draft order and then there were 13 responses. I mentioned that none of those 13 came from hon. Members. Hon. Members have explained why there were only 13, but the reason for such a small number of responses was not merely that no legislation could be altered at this stage in the House but that there was proper long-term consultation in designing that legislation. The legislation was therefore properly consulted on in advance.
The draft order has the great merit of drawing together in one piece of legislation all the primary provisions governing the registration and inspection of both categories of homes.
956 The hon. Member for Belfast, East (Mr. Robinson) asked if I could give an assurance that the Northern Ireland Care Homes Association would be consulted about regulations to be prepared by the Department. That was also mentioned by the hon. Members for South Down (Mr. McGrady) and for Antrim, North (Rev. Ian Paisley).
I can give a categorical assurance that such consultation will take place. Draft regulations will be issued to a wide range of private, voluntary and statutory sector organisations within the next week, including the Northern Ireland Care Homes Association. The draft regulations will go to all representative bodies and all
I welcome the hon. Member for Normanton (M r. O'Brien) to his new post, and congratulate him on his speech. He suggested that the boards were not truly accountable, and that they would allow standards to slip. Standards will be governed both by subordinate legislation and by guidelines prepared by responsible professional bodies. I dealt with that point earlier. I do not believe that standards will be allowed to slip, nor do I accept that the boards are not truly accountable. Each board has had to establish an advisory committee to provide a link between the inspection units and the public interest. Moreover, I took pains earlier to stress the arm's-length establishment of the units. I hope that no one who reads my speech imagines that the units will be anything other than independent and reliable.
The hon. Member for Normanton should realise that, if home owners have any genuine complaints about the way in which inspection units have treated them under existing Northern Ireland legislation, my noble Friend Lord Arran will be anxious to hear about it. I shall suggest holding a meeting with those who have specific complaints.
The new legislation will actually make it easier for home owners to appeal against decisions made by registration and inspection units. As I explained to the hon. Member for Antrim, North, that will be done by way of the Registered Homes Tribunal, to which a number of hon. Members have referred. The tribunal will benefit from the presence of a panel of professional experts who, as I said earlier, will build up a body of useful case law.
I must admit that the Department of Health and Social Services originally had no strong views about the need for a change from the existing courts appeal system, and doubted whether the likely number of appeals would justify the establishment of a separate tribunal system. In subsequently opting for such a system, it took account of several points.
First and most important, the majority of those who commented on the matter during the consultation exercise —in response to the initial consultative paper—were in favour of a tribunal system. Secondly, the positive feedback from registration authorities and proprietors of homes in regard to the performance of tribunals in England and Wales seemed to suggest that a similar system would be sensible in Northern Ireland. Thirdly, it was felt that Northern Ireland would benefit from the professional expertise of the tribunals' members and, as I have said, from the accumulation of a useful body of case law 957 relating to a specialised aspect of health and social services activity. A fourth consideration was the speed with which cases could be dealt with, and the comparative cheapness of the process.
Some hon. Members have suggested that tribunals might be full of "tainted" appointees. I assure them that the Lord Chancellor appoints a panel of legally qualified people to act as chairmen of tribunals. The Department appoints an independent panel of other experts, but they must have the appropriate medical, nursing and social work experience, and no officer of the Deparment can be appointed to a tribunal.
§ Mr. William O'Brien
I thank the Minister for the kind remarks that he made earlier. We are told that the Lord Chancellor will nominate some tribunal members, and that the boards will nominate others. Will any of the users of the services—residents, or people who work in the homes—be able to sit on tribunals and express their views on issues that are raised?
§ Rev. Ian Paisley
On a point of order, Madam Speaker. Can you confirm that this debate can run until 11.30 pm?
§ Mr. Hanley
The hon. Member for Antrim, North ticked me off earlier in the debate. He said that I was laughing during his speech. I was not laughing; I was wincing. At the moment that I winced, the volume control in some part of the House had clearly developed a fault. It was one of the speakers, I think—the speaker at the time, perhaps. I can assure the hon. Gentleman that nothing that he said was a laughing matter.
To the hon. Member for Normanton, the answer is no. These are medically qualified people. [Interruption.] If there are any failings in the system, we shall try to address them in due course, but my feeling is that in that instance there are unlikely to be any failings.
§ Mr. Hanley
I was about to refer to the hon. Gentleman, but if he would like me to give way I am prepared to do so.
§ Mr. Hanley
I am trying to answer the questions that the hon. Gentleman raised in his earlier interventions, but if he would like to ask a few more questions, please carry on.
§ Mr. Robinson
I am grateful for the Minister's patience. In terms of many of the Northern Ireland tribunals—for example, the unfair constructive dismissal tribunals—it is recognised that a legally competent person should chair it, that somebody might represent the interests of the employers and that somebody else might represent the interests of the employees. Can the Minister not provide the same balance in the tribunals that he intends to set up?
§ Mr. Hanley
I have already answered that question. In answer to another comment, I said that we shall look at the issue. I believe that I have dealt sufficiently with that point.
958 The hon. Member for Belfast, East (Mr. Robinson) referred to inspection units and said that they employed four times as many staff as the inspection units of local authorities in England and Wales. Arm's-length inspection units in England and Wales are provided by local authorities to inspect only residential care homes. They do not inspect nursing homes. Therefore, it is unfair to seek to compare their work load with those of arm's-length inspection units in Northern Ireland, which will be responsible for inspecting both residential care homes and nursing homes.
Reference was made to the costs involved. It will be for the Minister concerned to set the fee levels. The boards will have to tailor their costs to fit that particular cloth.
The hon. Member for Belfast, East also referred to article 25. Was it not unfair, he said, that owners of homes should be expected to represent themselves? They will be allowed legal representation. I am grateful to the hon. Gentleman for enabling me to clarify that matter.
The hon. Member for Normanton referred to accountability for the regulation of homes, by reference to the Northern Ireland Care Homes Association. So far as I am aware, the Northern Ireland Care Homes Association's request for a meeting with Lord Arran did not include any reference to the need to amend the draft order, nor did it say that it wished to influence its contents. I have already stated that there was considerable consultation and that, as the hon. Member for Belfast, East also mentioned, all the bodies in existence in Northern Ireland in January 1992 were asked to comment on the order. The Northern Ireland Care Homes Association is in existence now. That changes the matter greatly for the future. I shall refer again to the association in a few moments.
The hon. Member for North Down asked whether there should be tighter regulation of standards in the interests of vulnerable people. If we stick with the existing legislation, home owners will not have to pay fees. When we examine the establishment of fees, it is right to consider whether such establishment would be fair and reasonable. I assure the professional associations that the establishment of such fees will be done carefully. We shall not try to establish levels of fees which are seen as unfair.
That leads to the point which was raised by three or four hon. Members about the costs of key workers. I shall come back to that matter when I refer to the speech made by the hon. Member for Antrim, North.
The hon. Member for Normanton referred to Disability Action's commentary on the policy and planning research unit survey. Although that may or may not have been out of order, it was nevertheless an important point. The commentary is simply the first of seven studies to be published under the policy and planning research unit survey. I assure the hon. Gentleman that the matter is being taken fully into account. Disability Action will be called to give evidence to a steering group which is overseeing the survey and considering its implications for policy. Disability Action was consulted during the drafting of the order.
This is the first time that I have met the hon. Member for Thurrock (Mr. Mackinlay) across the Floor of the House. I met him for the first time a few weeks ago in Northern Ireland. I congratulate him on the keen interest that he takes in the affairs of the Province. We are grateful 959 for the interest that he and his Back-Bench colleagues have shown. I hope that they benefited from their visit to Northern Ireland.
The hon. Member asked whether the order was a back-door method of creating trusts. The provisions which schedule 1(2) inserts into the 1972 order have nothing to do with any health or social service trust. They merely put the private sector on a level playing field with the voluntary sector.
Perhaps I should explain that in more detail. The existing Northern Ireland legislation contained in article 71 of the Health and Personal Social Services (Northern Ireland) Order 1972 permits health and social services boards to enter into contracts with voluntary organisations—non-profit making organisations—to provide any of the health and personal social services. Unfortunately, similar powers do not exist to permit the boards to enter into contracts with private sector organisations for the provision of such services. Therefore, the provisions in paragraphs 2(1) and (2) in schedule 1 specifically ensure that, when implemented, boards will have clear powers to enter into contracts for the provision of any health or personal social services by both voluntary and private sector organisations. I can imagine the lobbying that would have taken place if such a provision had not been included in the order.
I should hate to see any delay in the implementation of provisions to allow local boards to enter into contracts with the private sector for the provision of health or personal social services. Such services include not only residential and nursing home care but day care, respite care and domiciliary support. If the House is saying that it does not wish the private sector to provide any of those services, I invite it to vote against the order tonight.
The hon. Member for Belfast, East referred to new article 50 which will amend the 1972 order. Proposed article 50, as amended, does not apply to registered homes. I assure the hon. Gentleman that it applies to other premises such as day centres. The rights of inspection and entry into registered homes are contained in proposed article 29. The hon. Member for Belfast, East asked whether children's homes should be included in the order. Children's homes are already protected through the provisions for registration and inspection in the Children and Young Persons Act 1969. That is probably what the hon. Member for North Down meant, too. However, I understand that my noble Friend Lord Arran intends soon to bring forward a new proposal for more up-to-date legislation based upon the children's order which operates elsewhere in the United Kingdom and to which other hon. Members have referred. That will all be taken into account shortly.
The hon. Member for Belfast, East also asked why schedule 1 discriminated against the public sector by allowing boards to sell their homes to voluntary organisations. There is no discrimination. As I have said before, schedule 1 is specifically designed to ensure that providers of services in the private sector can compete freely with voluntary organisations for contracts from health and social services boards to supply any of those services.
Another question asked by the hon. Members for Belfast, East and for North Down was whether the order applied to statutory homes provided directly by health boards. No, the order refers only to private and voluntary sector residential care homes and nursing homes, but the 960 Government are determined that the same high standards of care should apply commonly across the statutory, the voluntary and the private sectors. With that aim in view, the four health boards created the arm's-length inspection unit, to which I have already referred.
The hon. Member for Belfast, East also said that the boards were not allowing open competition. The boards will purchase places from as wide a range of homes as possible. After all, it is their duty to offer their clients choice. It would not be in their interests to negotiate only a small number of block contracts. Boards are being encouraged to draw up clear specifications for their care requirements and to invite tenders from those interested in providing such care. That would include members of the association which the hon. Gentleman mentioned.
My noble Friend will wish to ensure that the boards' contractual operations are monitored carefully, so that clients' needs come first. The boards' primary duty will be to seek tenders against very precise specifications.
The hon. Member for South Down asked about approval for the closure of statutory homes. I can assure him that the case for the closure of any board homes must be defended by the board concerned and presented to the Minister. Then the Minister has to decide whether he prefers to approve the board's decision. That process has led certain hon. Members to say that consultation with the Minister had been refused.
I was the Minister responsible for health and personal social services for nearly 18 months, and I remember that there were many requests for meetings and consultations on behalf of homes and other organisations. The practice is that, if there is a decision to be taken by a health and social services board, that decision must be taken first. Then, if the matter is passed to the Minister because it is major or controversial, consultations with him are welcomed, and are carried out. If we refuse to meet a delegation, that is merely because the proper time for such a meeting is after the local board has made its decision.
§ Mr. McGrady
The Minister has missed the point. De facto if not de jure, the homes are closed before the Minister has an opportunity to say whether they should be closed. The action on the ground by the health board is to run down the home by whatever means possible so as to ensure that it is not viable. The board then presents a valid case for closure to the Minister. The point we made was that representation should be allowed to take place with the Minister before that process is entered into.
§ Mr. Hanley
I hear what the hon. Gentleman says. If he wants to put specific cases to my noble Friend Lord Arran, I should be grateful if he would do so. I would certainly deprecate practices such as he has described.
The hon. Member for South Down asked whether all homes had been consulted. As I have said, there was earlier consultation. In 1988, the consultation document was sent to every home owner and the published proposals went to every home owners' body in existence at the time. I have -already mentioned the subordinate legislation—the regulations—which will be issued next week. I have already promised hon. Members that if they want a copy of those, they can receive one.
The hon. Member for South Down said that small homes were not defined. They are defined in paragraph 4(5) as homes providingresidential accommodation with both board and personal care for fewer than 4 persons".961 The important point is that we do not clutter up small homes with a tremendous amount of legislation. That would be wrong. The small homes should be of the right standard and they should be subjected to some tests. However, the full rigour of the law would mean only that small groups of people helping others out would feel that they were under a weight of legislation.
I was asked why it had taken so long for the legislation to come through from 1985. One reason, as I mentioned earlier, is that legislation already exists to regulate the registration and inspection of residential care homes in Northern Ireland and there is separate legislation to regulate the registration and inspection of nursing homes.
Until the early 1980s, there was no significant increase in establishments. We have referred to the new establishments which have been created. The House may not know that between 1982 and 1987, the number of places in nursing homes rose from 347 to 1,564—an increase of 350 per cent. Consultation began at that stage.
I do not deny that there have been unavoidable pressures and priorities within the Department, such as the major review of community care policy, and the need to consider and to provide at short notice for the legislative provisions required to implement the Government's other policy objectives on community care in Northern Ireland. However, the delay enabled us to gain valuable experience from the Registered Homes Act 1984, so it has helped us in providing for vulnerable people in a community setting.
The hon. Member for Upper Bann (Mr. Trimble) asked why the Registered Homes (Amendment) Act 1991, which refers to the registration of small homes, was not made directly applicable to Northern Ireland. That is a fair question. The answer is that it would not have been possible. The 1991 Act amended the 1984 Act, which does not apply to Northern Ireland. The existing Northern Ireland legislation already required small homes to be registered. The order re-enacts the existing Northern Ireland provision and states specifically what will be required of small homes as opposed to larger homes.
The hon. Member for Upper Bann also pointed out that mental nursing homes are a separate category in the 1984 Act and he wanted to know why there was no mention of such homes in the order. In providing for the registration of mental nursing homes as a separate category of nursing home, the Registered Homes Act 1984 seeks to make special provision in the case of cancellation of registration or the death of the registered person for patients in the home detained under the Mental Health Act 1983.
Replication of such a provision in Northern Ireland legislation is not required because a mentally disordered person can be compulsorily detained under the Mental Health (Northern Ireland) Order 1986 only in a statutory hospital or institution—in practice, a psychiatric or mental handicap hospital or unit—or in a private hospital as defined in article 90 of part 7 of the 1986 order. There are currently no such private hospitals in Northern Ireland. Therefore, article 90 has not been brought into effect.
It is not thought necessary to define a special category of mental nursing home because in Northern Ireland people with a mental illness or mental handicap may be admitted to nursing homes, but only on a voluntary basis. The registration and inspection powers accorded to boards 962 by this order in respect of nursing homes will enable the boards to safeguard the welfare of all patients of nursing homes whatever may be their individual health status or care needs.
The hon. Member for Upper Bann and the hon. Member for North Down referred to justices of the peace. The hon. Member for Antrim, North believed that there was sloppy drafting of the term "justice of the peace". I pay tribute to the noble people who take up the responsibilities of justices of the peace in Northern Ireland.
The 1984 Act in respect of England and Wales refers to justices of the peace. We followed the term in the drafting of the order because the Northern Ireland courts service had to examine the issue. Once the issue had been examined, the service felt that it should be approved because of the need for urgent cancellation of a licence. As the hon. Member for North Down said, if an unsuitable person is running a home, that person should be put out of business as soon as possible.
The hon. Member for Antrim, North asked me to define "widespread" in terms of consultation. Clearly, that is a matter of opinion. The hon. Gentleman also referred to the home at Broughshane. Perhaps the hon. Gentleman will write to me or to my noble Friend Lord Arran. The hon. Gentleman said that my noble Friend is aware of the case, but I assure him that I shall ask for the matter to be investigated again. That applies also to the serious case involving the death to which he referred.
§ Mr. Hanley
The Department has assured me that it is not aware of that. If it is meant to be aware of it, we shall certainly look into it again.
§ Rev. Ian Paisley
The Minister's colleague has replied to me. I have a letter on my desk saying that he had received my message and that he had taken care of it. He was indignant that the board had done in Broughshane what it should not have done.
§ Mr. Hanley
I am grateful for that information. Neither I nor the officials advising me today were aware of that and I apologise for that. However, if my noble Friend Lord Arran knows about the matter, I am sure that he is dealing with it properly.
There are four or five other points to which I could refer. However, I hope that the House will have heard enough about the order to give it the same treatment as was given to the main legislation—that is, to allow it to go through without a Division. I am grateful to the hon. Member for North Down for his comments. If the order is lost, however, it will not be just for a month, as some hon. Members have stated. We shall have to republish a proposal, reconsult and queue again for parliamentary time—and the very people to whom the hon. Gentleman referred will suffer. We would not be waiting for the Danes before enacting the legislation"it might take a lot longer than that.
Hon. Members will agree that I have listened carefully to the points that have been made and I hope that I have dealt with the vast majority of them. I remain convinced that the provisions in the draft order will make a significant contribution to safeguarding the welfare of people in Northern Ireland who require care in private voluntary sector residential care homes and nursing homes. I commend the order to the House.
§ Question put:—
§ The House divided: Ayes 187, Noes 147.965
|Division No. 85]||[10 pm|
|Adley, Robert||Gill, Christopher|
|Alexander, Richard||Gillan, Cheryl|
|Amess, David||Greenway, Harry (Ealing N)|
|Ancram, Michael||Greenway, John (Ryedale)|
|Arbuthnot, James||Griffiths, Peter (Portsmouth, N)|
|Arnold, Jacques (Gravesham)||Hague, William|
|Arnold, Sir Thomas (Hazel Grv)||Hamilton, Rt Hon Archie (Epsom)|
|Ashby, David||Hamilton, Neil (Tatton)|
|Atkinson, David (Bour'mouth E)||Hampson, Dr Keith|
|Atkinson, Peter (Hexham)||Hanley, Jeremy|
|Baker, Nicholas (Dorset North)||Hargreaves, Andrew|
|Banks, Matthew (Southport)||Haselhurst, Alan|
|Banks, Robert (Harrogate)||Hawkins, Nick|
|Bates, Michael||Hawksley, Warren|
|Bendall, Vivian||Heald, Oliver|
|Beresford, Sir Paul||Heathcoat-Amory, David|
|Bonsor, Sir Nicholas||Hendry, Charles|
|Booth, Hartley||Hill, James (Southampton Test)|
|Boswell, Tim||Horam, John|
|Bottomley, Rt Hon Virginia||Howard, Rt Hon Michael|
|Bowden, Andrew||Howarth, Alan (Strat'rd-on-A)|
|Bowis, John||Hughes Robert G. (Harrow W)|
|Brandreth, Gyles||Hunt, Rt Hon David (Wirral W)|
|Brazier, Julian||Hunt, Sir John (Ravensbourne)|
|Bright, Graham||Hunter, Andrew|
|Brown, M. (Brigg & Cl'thorpes)||Jack, Michael|
|Browning, Mrs. Angela||Jenkin, Bernard|
|Bruce, Ian (S Dorset)||Jessel, Toby|
|Burns, Simon||Jones, Gwilym (Cardiff N)|
|Burt, Alistair||Jones, Robert B. (W Hertfdshr)|
|Butler, Peter||Kilfedder, Sir James|
|Butterfill, John||King, Rt Hon Tom|
|Carlisle, John (Luton North)||Knapman, Roger|
|Carlisle, Kenneth (Lincoln)||Knight, Mrs Angela (Erewash)|
|Carrington, Matthew||Knight, Greg (Derby N)|
|Carttiss, Michael||Knight, Dame Jill (Bir'm E'st'n)|
|Cash, William||Knox, David|
|Chaplin, Mrs Judith||Kynoch, George (Kincardine)|
|Chapman, Sydney||Lait, Mrs Jacqui|
|Churchill, Mr||Legg, Barry|
|Clappison, James||Leigh, Edward|
|Clifton-Brown, Geoffrey||Lidington, David|
|Colvin, Michael||Lightbown, David|
|Congdon, David||Lloyd, Peter (Fareham)|
|Coombs, Simon (Swindon)||Lord, Michael|
|Cope, Rt Hon Sir John||Luff, Peter|
|Couchman, James||McLoughlin, Patrick|
|Currie, Mrs Edwina (S D'by'ire)||McNair-Wilson, Sir Patrick|
|Davis, David (Boothferry)||Malone, Gerald|
|Day, Stephen||Mans, Keith|
|Deva, Nirj Joseph||Marlow, Tony|
|Dicks, Terry||Marshall, Sir Michael (Arundel)|
|Douglas-Hamilton, Lord James||Martin, David (Portsmouth S)|
|Dover, Den||Mayhew, Rt Hon Sir Patrick|
|Duncan, Alan||Merchant, Piers|
|Elletson, Harold||Mitchell, Andrew (Gedling)|
|Emery, Sir Peter||Moss, Malcolm|
|Evans, Jonathan (Brecon)||Neubert, Sir Michael|
|Evans, Nigel (Ribble Valley)||Oppenheim, Phillip|
|Evans, Roger (Monmouth)||Page, Richard|
|Evennett, David||Paice, James|
|Faber, David||Patnick, Irvine|
|Fabricant, Michael||Pattie, Rt Hon Sir Geoffrey|
|Fairbairn, Sir Nicholas||Peacock, Mrs Elizabeth|
|Fenner, Dame Peggy||Porter, David (Waveney)|
|Fishburn, Dudley||Powell, William (Corby)|
|Forsyth, Michael (Stirling)||Redwood, John|
|Forth, Eric||Richards, Rod|
|Fox, Sir Marcus (Shipley)||Riddick, Graham|
|Freeman, Roger||Robertson, Raymond (Ab'd'n S)|
|French, Douglas||Robinson, Mark (Somerton)|
|Gallie, Phil||Rowe, Andrew (Mid Kent)|
|Gardiner, Sir George||Ryder, Rt Hon Richard|
|Garel-Jones, Rt Hon Tristan||Sackville, Tom|
|Scott, Rt Hon Nicholas||Viggers, Peter|
|Shaw, David (Dover)||Walden, George|
|Shaw, Sir Giles (Pudsey)||Walker, Bill (N Tayside)|
|Shephard, Rt Hon Gillian||Waller, Gary|
|Sims, Roger||Wardle, Charles (Bexhill)|
|Skeet, Sir Trevor||Waterson, Nigel|
|Smith, Tim (Beaconsfield)||Wheeler, Sir John|
|Speed, Sir Keith||Whittingdale, John|
|Spink, Dr Robert||Widdecombe, Ann|
|Sproat, Iain||Wilkinson, John|
|Stephen, Michael||Willetts, David|
|Stern, Michael||Wilshire, David|
|Streeter, Gary||Winterton, Mrs Ann (Congleton)|
|Sweeney, Walter||Winterton, Nicholas (Macc'f'ld)|
|Sykes, John||Wood, Timothy|
|Temple-Morris, Peter||Yeo, Tim|
|Thomason, Roy||Young, Sir George (Acton)|
|Thompson, Patrick (Norwich N)|
|Thurnham, Peter||Tellers for the Ayes:|
|Townend, John (Bridlington)||Mr. Andrew MacKay and Mr. Timothy Kirkhope.|
|Twinn, Dr Ian|
|Ainger, Nick||Hood, Jimmy|
|Ainsworth, Robert (Cov'try NE)||Howarth, George (Knowsley N)|
|Allen, Graham||Howells, Dr. Kim (Pontypridd)|
|Armstrong, Hilary||Hoyle, Doug|
|Ashton, Joe||Hughes, Kevin (Doncaster N)|
|Austin-Walker, John||Hume, John|
|Banks, Tony (Newham NW)||Hutton, John|
|Barnes, Harry||Illsley, Eric|
|Bayley, Hugh||Jackson, Helen (Shef'ld, H)|
|Beggs, Roy||Jamieson, David|
|Benton, Joe||Jones, Jon Owen (Cardiff C)|
|Bermingham, Gerald||Jones, Lynne (B'ham S O)|
|Berry, Dr. Roger||Jones, Nigel (Cheltenham)|
|Blunkett, David||Jowell, Tessa|
|Boyce, Jimmy||Kaufman, Rt Hon Gerald|
|Bradley, Keith||Keen, Alan|
|Burden, Richard||Kennedy, Jane (Lpool Brdgn)|
|Byers, Stephen||Khabra, Piara S.|
|Callaghan, Jim||Kilfoyle, Peter|
|Campbell, Mrs Anne (C'bridge)||Kirkwood, Archy|
|Campbell, Menzies (Fife NE)||Leighton, Ron|
|Campbell-Savours, D. N.||Lewis, Terry|
|Chisholm, Malcolm||Litherland, Robert|
|Clapham, Michael||Livingstone, Ken|
|Clelland, David||Lloyd, Tony (Stretford)|
|Clwyd, Mrs Ann||Loyden, Eddie|
|Coffey, Ann||McAllion, John|
|Connarty, Michael||McCartney, Ian|
|Cousins, Jim||McFall, John|
|Cryer, Bob||McGrady, Eddie|
|Cummings, John||McKelvey, William|
|Davidson, Ian||Mackinlay, Andrew|
|Davies, Bryan (Oldham C'tral)||McMaster, Gordon|
|Dixon, Don||McNamara, Kevin|
|Donohoe, Brian H.||Madden, Max|
|Dowd, Jim||Mahon, Alice|
|Dunnachie, Jimmy||Mallon, Seamus|
|Eastham, Ken||Marek, Dr John|
|Enright, Derek||Marshall, David (Shettleston)|
|Etherington, Bill||Marshall, Jim (Leicester, S)|
|Evans, John (St Helens N)||Martlew, Eric|
|Fatchett, Derek||Meale, Alan|
|Flynn, Paul||Michael, Alun|
|Foster, Derek (B'p Auckland)||Michie, Bill (Sheffield Heeley)|
|Fyfe, Maria||Milburn, Alan|
|Godman, Dr Norman A.||Miller, Andrew|
|Godsiff, Roger||Morley, Elliot|
|Golding, Mrs Llin||Mowlam, Marjorie|
|Grocott, Bruce||Mullin, Chris|
|Gunnell, John||Murphy, Paul|
|Hall, Mike||O'Brien, Michael (N W'kshire)|
|Hanson, David||O'Brien, William (Normanton)|
|Heppell, John||O'Hara, Edward|
|Hill, Keith (Streatham)||Paisley, Rev Ian|
|Hinchliffe, David||Parry, Robert|
|Home Robertson, John||Pike, Peter L.|
|Pope, Greg||Stevenson, George|
|Powell, Ray (Ogmore)||Stott, Roger|
|Prentice, Ms Bridget (Lew'm E)||Strang, Dr. Gavin|
|Prentice, Gordon (Pendle)||Taylor, Mrs Ann (Dewsbury)|
|Prescott, John||Taylor, Rt Hon John D. (Strgfd)|
|Primarolo, Dawn||Thompson, Jack (Wansbeck)|
|Quin, Ms Joyce||Trimble, David|
|Reid, Dr John||Tyler, Paul|
|Robinson, Peter (Belfast E)||Walley, Joan|
|Roche, Mrs. Barbara||Wardell, Gareth (Gower)|
|Rogers, Allan||Watson, Mike|
|Ross, William (E Londonderry)||Wicks, Malcolm|
|Sheerman, Barry||Williams, Alan W (Carmarthen)|
|Short, Clare||Wise, Audrey|
|Skinner, Dennis||Wright, Dr Tony|
|Smith, Andrew (Oxford E)|
|Smith, C. (Isl'ton S & F'sbury)||Tellers for the Noes:|
|Smith, Llew (Blaenau Gwent)||Mr. Martin Jones and Mr. Thomas McAvoy.|
|Steel, Rt Hon Sir David|
§ Question accordingly agreed to.
That the draft Registered Homes (Northern Ireland) Order 1992, which was laid before this House on 19th October, be approved.