National Care Standards Commission (Hansard, 6 November 2002)

§ Lord Peyton of Yeovil
asked Her Majesty's Government:
Whether the way in which the National Care Standards Commission performs its duties is satisfactory.

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)
My Lords, I am satisfied with the performance of the National Care Standards Commission, and with its progress to date.

§ Lord Peyton of Yeovil
My Lords, the noble Lord may find himself in a rather lonely position. Would he, generally speaking, encourage a situation where preference and priority are given to those within the National Health Service who might sometimes make people feel better as opposed to the host of others who will do no such thing? If people go around laying down the law, they should make clear their authority for doing so and that the rule is quite clear, is known, is relevant and is necessary. In the case I brought to the notice of the Minister, is he aware that a small operating theatre used for many years for minor surgery carried out with a local anaesthetic is suddenly upgraded and told it must adopt quite different standards and have two to three feet added to the size of the premises for no purpose at all at a cost of £60,000? Of course, the people who give such instructions do not care about the money.

§ Lord Hunt of Kings Heath
My Lords, the noble Lord will be glad to know that I am not entirely isolated in my view as to the progress made by the National Care Standards Commission. I believe that many observers who have seen it in operation over the past few months believe that it is making a sound start. I agree with the noble Lord that those who are to be regulated should know under what law they are being regulated, that they should know, on the basis of the regulations and the national minimum standards, what is expected, and that the whole process should be transparent.
As regards the substantive issue, I have asked the National Care Standards Commission to look at the specific case raised by the noble Lord. Clearly, I cannot comment further. The National Care Standards Commission seeks to ensure that standards are of a high quality in order to ensure that the public interest is served. But I accept that it needs to adopt a 708 common-sense and proportionate approach to the inspection and regulation process. I do not disagree at all with the noble Lord about that.

§ Baroness Northover
My Lords, how does the Minister defend the Government's decision announced last Friday that various tasks in relation to care homes that were supposed to come under the aegis of the Criminal Records Bureau will be indefinitely suspended, including the listing of those who have harmed vulnerable adults? The decision has been announced because of the chaos at CRB. What action will the Government take to put matters right?

§ Lord Hunt of Kings Heath
My Lords, some of the challenges facing the CRB have been well documented in this House. I do not think that I need to go over them again. The National Care Standards Commission has stated that staff may be appointed on the basis of a self-declaration concerning any criminal record subject to satisfactory completion of other relevant checks such as the POCA register. Staff must then be properly supervised and not work alone. It seems to me, in view of the CRB difficulties, that the commission has made the proportionate response for which the noble Lord, Lord Peyton, asked.

§ Baroness Noakes
My Lords, does the Minister agree that the National Care Standards Commission cannot do its job effectively because, as with so much else in the Department of Health, the Government get involved in the tiniest details such as what the inspector should do about the size of doors in care homes? Is there any possibility that we shall hear in the Queen's Speech next week that Her Majesty's Government will forswear micro-management?

§ Lord Hunt of Kings Heath
My Lords, the noble Baroness will surely know that I cannot possibly anticipate the Queen's Speech. Of course, we do not want to micro-manage the health service or the care system. That is why we introduced our policy of shifting the balance of power, why 75 per cent of the budget of the NHS will, from 2004, be spent by primary care trusts and why we are developing our ideas for the establishment of foundation trusts. Having set national standards for the NHS that the previous government never, ever set, we are in a position where we can decentralise the service much more than the previous administration ever did.

§ Baroness Gardner of Parkes
My Lords, are the Government doing anything to replace the number of care homes that are now being shut as they cannot meet the present standards?

§ Lord Hunt of Kings Heath
My Lords, we must be cautious as regards believing everything that is said in relation to cuts in the number of beds due to the standards being set by the commission. The net loss of care homes over the past four years is 19,000, not the much larger figures often mentioned. The average national occupancy rate is around 91 per cent. I do not 709 ignore the fact that there are problems within the care home sector. That is why we have encouraged local authorities to review the fee structure. I hope that over the next few years as more resources go into personal social services that will lead to secure and stable relationships between local authorities and the care home sector. I also make the point that the whole purpose of setting up the commission was to ensure high standards for the public.