Debate on the Address

I would agree that we have an arms race and that we should negotiate down spending, rather than spending even more. That is the problem with what the hon. Member for Southend, West is suggesting. Simply criticising those on one side of the argument does not really help; a consensus is required. I hope that the legislation that is introduced will provide us with a route through all this. The reason I want to speak in the debate today is particularly to address one of the measures in the Queen's Speech. I will not cover the full range of measures that it sets out. The measure that I want to talk about partly reflects something that the hon. Gentleman was talking about: the fact that successive legislation has created a new architecture for aspects of health and social care regulation and inspection over the past 10 years. That has been done in a piecemeal way, and yet another piecemeal change to the system is proposed in the health and social care Bill that will shortly come before us. In essence, the proposal is to bring together the Commission for Social Care Inspection and the Healthcare Commission to form a new body, to be called the body for care quality. That may well be the right thing to do. Indeed, during the passage of the legislation that set up the two separate commissions, I argued very strongly that we should have a single commission that would be consistent in following the needs of people in different care settings as they went through their journey in the health and social care system, and ensure that good quality care standards were met wherever the person might be. The danger now, however, is that we have already been through two sets of changes to the way in which we organise social care inspection and regulation. The National Care Standards Commission was set up only to discover on its first day of operation that it would be abolished and replaced with the Commission for Social Care Inspection. Now the Commission for Social Care Inspection will go the same way. All reorganisations lead to managerial loss of focus. They almost inevitably result in people wondering and worrying about their own futures, perhaps more than about the people for whom they are meant to provide a service. The organisation that will be established under the Bill also runs the risk of a loss of focus on social care generally, because the focus tends to be the big relation—the health service. As a result, social care will become even more of a poor relation in the new organisation. I am concerned about the Bill because it is a missed opportunity to get the regulation right and to deal with the abuse of older people in this country. Earlier this year, the Government funded a study, along with Comic Relief, that was undertaken by King's college London and the National Centre for Social Research. Quite rightly, the Government wanted to establish the true prevalence of the abuse of older people. It was the first time that such a study has been done, and the Government are to be applauded for funding it. The study found, as a top line, that 342,000 people over the age of 66 are victims of one form of abuse or another. I am talking about things such as fraud or theft; psychological or emotional abuse; assault, including the use of restraint, ranging from physical restraint to the use of chemical restraints; and even rape. When we drill down into that figure of 342,000, we find that 105,000 people suffered 10 or more instances of neglect and that 42,500 people were the victims of sexual abuse. Furthermore, if we look at how the research was done, we see that it excludes everyone in care homes and anyone in the community with dementia. So although the figure is disturbing—342,000 people over the age of 66 suffer from abuse—it is not the complete picture. More of our fellow citizens suffer from abuse than the survey suggests. That is why there is an urgent need to move from a system of voluntary guidance to one in which there are legal protections for vulnerable older people. The case that I am making is not new. That compelling case has been made for over a decade. It was made in 1995 in a Law Commission report, in 2004 by the Select Committee on Health, and this year by the Joint Committee on Human Rights. I have a concern about the Bill in the Queen's Speech, but I hope that, even at this stage, we can use it to deal with three serious gaps. The first is a need to close the loophole in the Human Rights Act 1998 that means that private and voluntary sector-run care homes are outside the scope of the Act. Secondly, we need to give the new commission that is to be established under the legislation the power to investigate individual complaints; there is uncertainty about that. Thirdly, there should be an accessible and effective statutory procedure that protects vulnerable adults at risk of abuse. To take the last of those three points first, the Law Commission made proposals to close the protection gap back in 1995. It said that it had no confidence in the adult protection procedures that existed at the time. The problem is that there has been no change since then. It also proposed that social services departments be given powers to protect vulnerable adults similar to those that exist for protecting children: a duty to investigate; powers for magistrates courts to issue entry warrants, temporary protection orders and removal orders; and an offence of obstructing officers acting on behalf of the court. I do not understand why, in 10 years, such sensible proposals by the Law Commission have not been enacted. The Court of Appeal acted to fill the vacuum. In 2000, the Court expressed grave concern about the obvious gap in the legal framework. Lord Justice Sedley said that the Court had to"““speak where Parliament, although the more appropriate forum, was silent””." That led to the creation of a new procedure for protecting vulnerable adults called the declaratory relief, but the courts did not intend it to be a substitute for action by Parliament. That is why the Queen's Speech disappoints; it is yet another Queen's Speech that misses the opportunity to act to close the gap. It may seem odd that much clearer legislation should be needed to make it obvious that regulators of our care homes should investigate complaints about the services that they regulate, but it does appear that such legislation is needed. The Commission for Social Care Inspection said that it does not believe it has the power to investigate complaints, yet complaints are surely a critical part of ensuring compliance with standards through the system and of ensuring that we drive standards up, rather than accept standards below those for which the House has legislated. The Commission for Social Care Inspection is moving from a two-inspection-a-year system to a system in which there is self-assessment most of the time and in which most care homes will have an inspection once every three years. The commission says that the responsibility for investigating individual complaints rests not with it but with local authorities. However, local authorities do not have the power to do the job that the commission says they should be doing. In particular, people who self-fund—those who pay for their care and are not funded by local authorities—seem to be excluded from any recourse. The complaints gap leaves frail, vulnerable people with no one to turn to when things go wrong and they need to complain, except for the people who run the home. The Joint Committee on Human Rights was right to say that complaints should be investigated by an independent third party. That is what I hope the proposed legislation will ensure when it comes forward. That is one reason why I am so disappointed with the Queen's Speech. Finally, there is a rights gap. It is absurd that vulnerable older people in private and voluntary sector-run care homes are not within the scope of the Human Rights Act. That gap was identified by the courts five, six or seven years ago. The Act should apply in all circumstances, but it does not. It applies to council-run care homes, but if the council pays for care in a private or voluntary sector-run home, the writ of the Human Rights Act does not run once someone has crossed the threshold. Ten years after the Government came to power, and despite the compelling case for tackling the scandal of elder abuse, we do not have a legislative framework that is fit for purpose. The Government responded to the Climbié case, which convulsed and led to a change in the child protection system, but we should not have to wait for an older person to become a victim of the tragic circumstances that led to the convulsion of that system to achieve the necessary changes to protect our seniors. The reality is that someone who is the victim of abuse at the age of 80 will probably be dead before justice is done, which cannot be right. It is surely time that Parliament did what the Law Commission recommended 10 years ago, and legislated to provide the safeguards that older people need. I hope that that is what will happen when the Queen's Speech turns into legislation.