Health and Social Care (Safety and Quality) Bill — House of Commons, 2015-01-09
Topic: Health
Jeremy John Elton Lefroy (Conservative, Centre-right): I beg to move, That the Bill be now read the Third time I thank all those who have worked with and supported me in bringing the Bill to this stage. I especially thank my hon. Friend the Member for Stone (Sir William Cash), who, as I mentioned on Report, has been an inspiration, as have Julie Bailey, Ken Lownds and many others who campaigned for the Francis inquiry. My hon. Friend the Member for Mid Norfolk (George Freeman), who is now a Minister, was also a driving force—clauses 2 and 3 are substantially based on a Bill that he had previously introduced—and I thank him for his work and support. I also thank all hon. and right hon. Members who served in Committee and who sponsored the Bill I thank the Clerks in the Public Bill Office for all their help, advice and skill, as well as the Bill team and others in the Department of Health, who worked extremely hard, for all their skill and advice. Finally, I thank the hon. Member for Copeland (Mr Reed) and his Front-Bench colleagues, and my hon. Friend the Minister and his Front-Bench colleagues for supporting measures that I believe will assist us to get what we all want—higher-quality, safer and more integrated health and social care. That is the purpose of the Bill: if it does not help in some important ways to achieve that, it will serve no purpose. I believe that it will do so for several reasons. First, it will ensure that every Secretary of State makes patient safety a priority at all times. Would that have prevented the tragic events at Mid Staffordshire or in other hospitals, surgeries or care homes? It would certainly not have done so in every case, but I am convinced that the attention given to safety would have done precisely that—prevented much avoidable harm to patients. In the important words of the Prime Minister in response to the Francis report on 6 February 2013: "Quality of care means not accepting that bed sores and hospital infections are somehow occupational hazards—that a little bit of these things is somehow okay. It is not okay; they are unacceptable—full stop, end of story. That is what zero harm—the jargon for this—means.—[Official Report, 6 February 2013; Vol. 558, c. 281.] Secondly, the Bill will put in place another of the necessary building blocks for the integration of health and social care that we all desire. A consistent identifier is not sufficient to bring about integration, but it is most certainly necessary and will help in some way Thirdly, the Bill will help the sharing of information, which is vital for a person’s care. Almost everyone with whom I have discussed this matter has told me of times when they or their loved ones have had to repeat information about their care on several occasions, or found that vital information—perhaps regarding medication or allergies—was simply not available to the person caring for them Finally, the Bill will bring consistency to the objectives of the regulation of the health and social care professions under the overarching objective of the protection of the public During the passage of the Bill, a number of important questions have been raised, both within and without the House. I am grateful to those who have raised them, because it is vital that a Bill such as this receives strict scrutiny A fear was expressed that the consistent identifier would become an ID card by the backdoor. The identifier could never become an ID card because it will be used only to facilitate the provision of health services or adult social care, and it must only be used in the individual’s best interests It has been asserted that there is no need for the duty to share information because the sharing of information is already required as part of the professional duties of health and care professionals. However, Dame Fiona Caldicott’s review in 2013 concluded that such sharing was not always happening as it should as a result of a "culture of anxiety". The legislative landscape was found to be a contributory factor and a risk-averse attitude to information sharing was cited as a barrier to sharing by staff who deliver care directly to individuals. The Bill seeks to provide a remedy, while setting clear limits on the information that can be shared and the circumstances under which it can be shared Others have concerns about the Bill’s introduction of "public confidence in the professions" to the objectives of the regulatory bodies. The Law Commission’s report of April 2014 noted: "It was argued that maintaining confidence in the profession was being used to punish professionals who pose no threat to the public for something which incurred the profession’s, or the public’s, disapproval. Specific examples included a nurse who was disciplined for publishing a work of fiction about euthanasia and an investigation into a doctor’s behaviour at a Parent-Teacher Association meeting. Some argued that the concept of maintaining confidence in the profession was too subjective and difficult to quantify to form the basis of a statutory duty." The report concludes that in constructing the draft Bill on which the provisions of the Bill are based, the Law Commission was "not seeking to change the current legal position or disrupt the relevant case law. The clause restates the existing legislative position that public protection is the regulators’ ‘main’ objective, and recognises that the public interest also consists of promoting and maintaining public confidence and proper standards of conduct and behaviour." I have no doubt that, should the Bill receive its Third Reading today, all the matters that I and others have raised will receive further scrutiny in the other place by experts No legislation can guarantee that there will be safe, high-quality care. Such care is founded on the capability, commitment and compassion of those who work day and night in our health and care services; no law can bring it about. What legislation can do, and what this Bill seeks in some small way to achieve, is to ensure that the framework within which those people work is sound—that the systems, resources, training and regulation that they need to provide safe, high-quality care are in place. In doing so, this is a Bill for both patients and professionals; for avoidable harm and poor care hurt both, while safe, high-quality care is a blessing for all.