Draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2025

The Committee consisted of the following Members:

Chair: Sir Desmond Swayne

† Ahmed, Dr Zubir (Glasgow South West) (Lab)

† Barclay, Steve (North East Cambridgeshire) (Con)

† Bennett, Alison (Mid Sussex) (LD)

† Billington, Ms Polly (East Thanet) (Lab)

† Brown-Fuller, Jess (Chichester) (LD)

† Charalambous, Bambos (Southgate and Wood Green) (Lab)

† Curtis, Chris (Milton Keynes North) (Lab)

† Ellis, Maya (Ribble Valley) (Lab)

† Evans, Dr Luke (Hinckley and Bosworth) (Con)

† Ingham, Leigh (Stafford) (Lab)

† Martin, Amanda (Portsmouth North) (Lab)

† Owatemi, Taiwo (Lord Commissioner of His Majesty's Treasury)

† Shanker, Baggy (Derby South) (Lab/Co-op)

† Shastri-Hurst, Dr Neil (Solihull West and Shirley) (Con)

† Smyth, Karin (Minister for Secondary Care)

† Stafford, Gregory (Farnham and Bordon) (Con)

Thomas, Fred (Plymouth Moor View) (Lab)

Kay Gammie, Committee Clerk

† attended the Committee

Second Delegated Legislation Committee

[Sir Desmond Swayne in the Chair]

Draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2025

18:00:00

I beg to move, That the Committee has considered the draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2025. This statutory instrument will amend the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which are due to expire after 31 March this year. It will remove the expiry date and amend the five-year period from which the regulations are required to be reviewed. Prior to the laying of this SI, the principal regulations required review every five years from 1 April 2015. The first post-implementation review was delayed until 2022 due to the pandemic. We therefore wish to conduct the next review in 2028. These regulations do not change any existing policy. The 2014 regulations set out the activities that are regulated by the Care Quality Commission and the fundamental standards with which all health and social care providers registered with it need to comply. These regulations are before the House now because if we do not amend the 2014 regulations, they will automatically expire and the CQC will have no powers to fulfil the requirements in the 2008 Act. Nor will there be an obligation on providers that are currently required to register with the CQC to comply with the fundamental standards set out in the 2014 regulations. I know that some Members may have been expecting to see further changes following the report by Dr Penny Dash on the CQC’s operational effectiveness, which uncovered significant failings in its internal workings. Its operational failings, however, do not require changes to legislation. The new chief executive Sir Julian Hartley has put in place measures to address them urgently. The regulations are silent on provisions relating to the use of restraint and on the regulation of medical care at temporary cultural and sporting events, on which the Department consulted last year. We have not overlooked those sensitive areas, and we continue to progress the work on finalising policies on them. The consultation responses on the proposal to make the use of restrictive practices notifiable to the CQC within 72 hours showed support for the measure, but highlighted a number of practical concerns, primarily that the proposed timeframe could place an additional burden on staff and risk an impact on patient care. As the Government said in their response to the consultation, further work is needed to ensure that we have the right definitions, systems and processes in place before we proceed with legislative changes. The Government will lay a statutory instrument in due course to remove the exemption relating to the regulation of medical care at temporary cultural and sporting events. With this change, providers of such care will be required to register with the CQC for the first time. I commend the regulations to the Committee and hope that hon. Members will join me in supporting the amendments that they make.

18:03:00

It is a pleasure to serve under your chairmanship, Sir Desmond. I thank the Minister for stepping in, and we agree that this SI needs to be passed with urgency. I also agree that it is not the place for a discussion of the CQC and its failings. She highlighted a couple of issues of concern, on which I would like to probe the Government a little, such as ending the exemption for sports arenas and cultural events. Given the Manchester Arena bombing and inquiry, it is clear that protections need to be in place, but the Opposition are concerned about the burden on small businesses and charity groups, which may well have to deal with the red tape involved in being regulated by the CQC. I would therefore be grateful if the Government considered producing an impact assessment of that red tape and how it will work in practice. CQC registration makes perfect sense when there are medical interventions in arenas, but how is it likely to work for a small football club run on a voluntary basis, or for a charity? At this point, I declare an interest: my brother is a sport and exercise medicine consultant and the medical director of the Lawn Tennis Association and so could in theory come within scope of some of these changes. As part of the consultation response, the Government stated that “further policy and operational consideration” was needed. Will the Minister clarify what that means in practice? I also want to ask the Minister a question about regulation 5 of the 2014 regulations, which set out the criteria for an individual to be considered a fit and proper person to take up a role as a director of a health service body or provider. The last Government started a review of the duty of candour expected of healthcare professionals. Will the Minister provide an update on when the Department will publish the outcome of that consultation, and have the Government made an assessment of how the outcome of the consultation may affect the provisions of the 2014 regulations as they relate to criteria for directors of health and care providers? Overall, the Opposition are supportive of the direction in which the Government want to go with this legislation. We understand the urgency of the timetable in front of us, but the concerns felt by Opposition Members will need to be addressed, so that we do not inadvertently overburden some of these institutions, which are already feeling difficulties when it comes to regulation. I would be grateful for the Minister’s answers.

18:06:00

I thank the hon. Gentleman and other Opposition Members for their support for the regulations. The hon. Gentleman makes an important point regarding care at sporting and temporary cultural events. We all remember the awful events at Manchester Arena and the lessons to be learnt from there. Although there is some good practice in healthcare provided at some of these events, there remain examples of poor, unregulated healthcare that does not sufficiently protect members of the public, so it is right that the CQC has oversight of the sector. I recognise the hon. Gentleman’s points about proportionality—that is essentially the word I would ascribe to these measures. People need to be assured that there is safety and some proportionality, and I think those points should be taken on board for the next phase of this work. If we need to come back to him specifically on that or write to him about how it proceeds, we will absolutely do that. We all want to support events in our communities and support the volunteers and people who come forward for such things. They are a really important part of the fabric of our lives, so I think it is very important that people have assurances around that. I will have to come back to the hon. Gentleman on the further questions that the he asked about the CQC and the fit and proper persons test. As he rightly says, they are not a matter for this SI, but as the work goes on and as we listen to our colleagues in the other House, and their debate about the Mental Health Act in particular, there will be a number of issues that we want to make sure are dealt with properly and that will come into the next phase. We will endeavour to make sure we update him on progress with that work as well. Patient safety is a top priority for us, and the CQC plays an important role in ensuring that providers meet the standards of care that we expect for the public—patients, carers, and families and loved ones. Its purpose is to monitor, inspect and regulate health and care services and make sure that providers meet the fundamental standards of quality and safety.

The Minister quite rightly raised the important issue of patient safety. In October, the Government appointed a new boss of the CQC. The Minister will be aware that, in January, following a BBC investigation and whistleblower evidence, families alleged serious wrongdoing regarding a number of baby deaths at the hospital of which the new CQC boss had been chief executive for the past 10 years. Can the Minister say how that has been factored into the appointment of the new CQC boss or whether the families, in the view of the Minister, were wrong in the concerns they raised?

In appointing Sir Julian Hartley, proper processes were conducted. He was seen to be fit and proper to lead the CQC, and we have confidence in his ability to do so.

He was appointed in October. Whistleblowers, the BBC investigation and families have raised concerns regarding maternity services at Leeds. The Minister will be aware that there is renewed scrutiny of maternity safety and rightly so. That is a key issue for the CQC. Were the families wrong in their concerns? What has the Minister done to investigate them? Quite rightly, she highlighted the point of patient safety.

The right hon. Gentleman makes an important point about maternity care, which is very sadly an issue of concern in many places across the country. Of course, those patients and families are absolutely right to call out poor care where they have seen it. It is absolutely right that that is fully investigated, and that is what we would expect at Leeds and in other places around the country. The CQC’s leadership in ensuring that we have safety and confidence is critical for the role. On that basis, we would like to move forward with this SI to remove the expiry date in the 2014 regulations, to amend the five-year period and to ensure that health and care providers continue to be required to register with the CQC and comply with the fundamental standards set out in the 2014 regulations after 31 March this year. We also want to make sure that services continue to be required to provide a safe and high quality standard of care. Question put and agreed to.

18:11:00