Health and Social Care Act 2008

The main aims of the Bill are to enhance professional regulation and to strengthen the response to infectious disease and contamination.  Included in the proposals are plans to create an integrated regulator, the Care Quality Commission, which will be responsible for providing assurance about patient safety and quality of care.

The Bill follows up on two Department of Health consultations which investigated adult social care regulation, public health and the control of disease.  A Department of Health White Paper on professional regulation also preceded the Bill.

Alan Johnson, secretary of state for health, opened the second reading of the Health and Social Care Bill in the Commons.

He summarized the key aims of the Bill:  to introduce improved and integrated regulation of the healthcare system and those who work within it; to assure patient safety and quality of care; and to remove provisions that are no longer relevant to the needs of the patient.

Johnson announced the creation of a new integrated regulator for health and adult social care in England, the Care Quality Commission, which will combine the functions of the Healthcare Commission, the Commission for Social Care Inspection and the Mental Health Commission.  He said:

“As services become jointly commissioned and the boundaries between health and adult social care are broken down, it makes sense for our new integrated regulatory framework to work across those boundaries as well.”

Johnson responded to an intervention by Joan Humble (Lab, Blackpool North and Fleetwood) clarifying that social care will have parity with health care under the new commission. He specifically commented on the strengthening of the monitoring of the Mental Health Act 1983.

Johnson responded to further interventions from the following:

Mark Pritchard (Con, The Wrekin) on operational problems with practice-based commissioning;

Andrew Lansley (Con, South Cambridgeshire), shadow secretary of state for health, on the appointment of the chairman and members of the care quality commission;

Rob Marris (Lab, Wolverhampton South-West) on the regulation of inexpert psychotherapy;

Kelvin Hopkins (Lab, Luton North) on the need for more patient-centred care.

Johnson continued, speaking of the government White Paper, “Trust, Assurance and Safety”, which set out wide ranging reforms building on the recommendations of the Shipman inquiry and the chief medical officer’s report, “Good doctors, safer patients”.  Here, Lansley commented on the need for a coroners Bill.

Johnson spoke further on the Bill’s powers to enhance control of infection and disease and the introduction of payments of £190 for mothers from the 25th week of preganancy.

Lansley indicated that his party would want to make certain amendments to the Bill, including the introduction of a specific statutory provision for Healthwatch.  He said they were in support of the breaking down of boundaries between health and social care.

In his final comments, Lansley concluded:

“Again this Bill feels a little like the groundhog day of health legislation because it is almost literally two years ago that I was standing here listening to your predecessor (Patricia Hewitt) who was telling us that what became the 2006 legislation was the last word in regulation.''

Sandra Gidley (Lib Dem, Romsey) responded for the Liberal Democrats.  She dismissed the payment to pregnant mothers as a gimmick but said that her party backed the overall aims of the Bill.  She commented on the importance of careful scrutiny in the committee stages.

Health minister, Ben Bradshaw, responded for the government stating that he was pleased that the main provisions of the Bill appeared to have “broad support across the House.”

In regards to complaints he stated that the main priority of the regulatory body was safety and quality for patients and stated that the new commission will have a role in deciding whether organisations deal with complaints properly.  He also stated he could reassure Sandra Gidley that fears of health domination were not justified in the subsequent discussion on the Bill.

In response to the shadow health secretary he assured him that the Bill proposed no change to the independence of the appointments system for members of the care quality commission.  He also highlighted that little had been heard from the Conservative Party on their alternative Bill.

He concluded by highlighting that the government had “put record investment in the NHS” and that the Bill will build on what has been achieved over the last ten years.  He stated that it will lead to “fewer quangos, less bureaucracy, better safety and quality, more transparency and genuine accountability.”

House of Commons

First reading: November 15 2007 [HC Bill 9]

Second reading: November 26 2007

Health and Social Care Bill Committee:

• 1st sitting: January 8 2008 (am)
• 2nd sitting: January 8 2008 (pm)
• 3rd sitting: January 10 2008 (am)
• 4th sitting: January 10 2008 (pm)
• 5th sitting: January 15 2008(am)
• 6th sitting: January 15 2008 (pm)
• 7th sitting: January 17 2008(am)
• 8th sitting: January 17 2008 (pm)
• 9th sitting: January 22 2008 (am)
• 10th sitting: January 22 2008 (pm)
• 11th sitting: January 24 2008 (am)
• 12th sitting: January 24 2008 (pm)
• Bill as amended: [HC Bill 52]
  

Remaining stages: February 18 2008

House of Lords

First reading: February 19 2008 [HL Bill 33]

Second reading: March 25 2008

Grand Committee:

• 1st day: April 21 2008
• 2nd day: April 29 2008
• 3rd day: April 30 2008
• 4th day: May 6 2008
• 5th day: May 12 2008
• 6th day: May 14 2008
• 7th day: May 21 2008
• 8th day: May 22 2008
• Bill as amended: [HL Bill 62]

Report stage:

• 1st day: June 16 2008
• 2nd day: June 24 2008

Third reading: July 1 2008 [HL Bill 132]

Consideration of Lords Amendments: July 15 2008

Royal Assent: July 21 2008