Social Care (Hansard, 25 January 1994)

§ 6. Mr. Austin-Walker
To ask the Secretary of State for Health when she expects to carry out a review of regulation and inspection in social care.

§ Mr. Bowis
As part of the Government's deregulation initiative, we are already looking at a number of areas of regulation in social services. There will be a review of the independence and effectiveness of inspection next year.

§ Mr. Austin-Walker
The Government recognise the need to protect individuals through registration and inspection in some forms of social care, but does the Minister share my concern that no such protection is afforded to those people receiving domiciliary care in their own homes? Does he recognise that an increasing number of people will receive domiciliary care, and that that is increasingly being provided by private organisations and agencies? Will the Minister now give detailed consideration to the Licensing of Domiciliary Care Agencies Bill which was introduced in the other place by my noble Friend Lord Ashley and previously in this House by my hon. Friend the Member for Wakefield (Mr. Hinchliffe)?

§ Mr. Bowis
I am glad to hear the hon. Gentleman acknowledge that domiciliary day services should increasingly be provided by the voluntary and private sectors, and I share his view that we must do whatever we can to ensure that high standards are maintained. The question is how quickly we can find and monitor the evidence of good practice that is necessary in order to set out a proper programme of high standards.
The Department has issued guidelines and advice to independent sector firms that might be considering setting up domiciliary day services which we shall follow up. In the meantime, as my noble Friend Baroness Cumberlege said in the other place, local authorities that provide such services have an absolute right and duty to define within the terms of the contracts the standards of service that they expect to be provided. That is the first step. The second step is to continue to monitor such services, and the third step is to keep an open mind, as I shall do, on whether further protection will be needed in future.

§ Mr. Wilshire
Whatever my hon. Friend decides on the general issues of inspection, will he set up a special inspection of Surrey county council's social services department. [HON. MEMBERS: "Reading."] Is he aware of his inspectorate's report on six child deaths in Surrey which apparently arose from child abuse? [HON. MEMBERS: "Reading."] Is he further aware of the non-accidental injuries and severe brain damage caused to my constituent, Thomas Harris, at the hands of a registered child minder? In the light of the judge's criticisms last Thursday of the county council's team adviser, whom he described— [HON. MEMBERS: "Reading."]
I know that I am reading Madam Speaker. I wish to quote the judge's comments correctly.

§ Madam Speaker
If the hon. Gentleman knows that he is reading, he must know that he is out of order.

§ Mr. Wilshire
In the light of the judge's criticism of the team adviser, who he described as showing "bumbling inactivity"; in view of his criticism of the case conference which, he said, "chose to ignore the risks"; and in view of the general approach, which the judge described as showing a "lack of urgency", does not my hon. Friend consider that an immediate inspection of Surrey county council is required?

§ Mr. Bowis
I am sorry that Opposition Members reacted as they did to this case. The House and the nation will have watched with horror the effects of that small child's injuries as we saw him crawling around his living room. The first thing that the House should do is to send its sympathy to that child and his mother and to wish them well for the future.
Secondly, whenever instances of this kind occur, of course there should be investigations and inquiries, and I am glad to hear that Surrey county council has instituted an internal inquiry and has also brought in the area child protection committee to ensure that there is an independent element in that investigation.
We will always keep the quality of inspection and social services under review, regardless of the area concerned. It should be pointed out that all the cases mentioned by my hon. Friend occurred before implementation under the Children Act 1989 of the circular about shaking, in particular, which we distributed to all county council social services departments, as they regulated child minders. I hope and pray that the case to which my hon. Friend referred is never repeated.

§ Mrs. Mahon
Why does not the Secretary of State set up a statutory register for domiciliary workers in the private sector? Surely the Minister is aware that the elderly and the sick are very vulnerable in their own homes. Common sense dictates that, if tragedies are to be avoided, there should be a formal register.

§ Mr. Bowis
As I have said, we are keeping an open mind on the question of monitoring local services in the domiciliary sector. We will continue to consider the standards of good practice that we should be setting and disseminating throughout the country.
There is nothing to stop local social services departments from setting their own standards and discussing them with the voluntary and private sectors. I hope that all social services departments are not simply consulting the independent sector but involving it in the provision of services. That will enable us to agree standards, to set up local registers of approved firms and —through contracts and, ultimately, by whatever means prove necessary—to secure the national standards that we want.