Health and Social Care Bill

moved Amendment No. 34: 34: Clause 5, page 3, line 13, after second ““care”” insert ““(whether for the treatment of ill health or for the promotion of good health)”” The noble Earl said: I shall speak also to Amendment No. 35. These two amendments can be dealt with quite quickly. The first amendment seeks to clarify what is meant by the term ““health care”” and again picks up a concern expressed by Anna Walker in her evidence to the Public Bill Committee in another place on 8 January, when she said: "““We are very perturbed at the moment the administration requirements explicitly exclude catching work on health, as opposed to health care … People’s health needs to be looked after as well as their health care””.—[Official Report, Commons, Health and Social Care Bill Committee, 8/1/08; col. 12.]" Anna Walker was principally talking about the registration requirements, which are covered a little later in the Bill; Amendment No. 74 in the name of the noble Baroness, Lady Barker, is relevant in this context. But reading Anna Walker’s remarks made me wonder whether the term ““health care”” in Clause 5 needed to be fleshed out. Maintaining and promoting good health, whether for particular NHS patients or particular residents of care homes, or as part of a wider and more general public health programme, are surely as important as the treatment of a person’s illness. Public health programmes are as much about protecting people from the risk of harm in the future as they are about rectifying actual illness, but ““health care”” is normally taken to denote the latter rather than the former. The whole concept of patient-centred care is predicated on the importance of improving not only treatment but also well-being. I was heartened to read the department’s consultation document on the framework for the registration of health and adult social care providers, which has much in it that is focused on outcomes and outcome measures rather than merely on process. That is excellent. The other aspect of this is Derek Wanless’s ““fully engaged scenario””. The health of the nation is not going to improve unless to a great extent we all take greater responsibility for our own health than we have before. Part of the function of the NHS is to promote the right messages to enable that to happen. It is not clear to me whether that kind of activity needs to be explicitly allowed for, if only to remind the commission that it must be. I shall be glad to hear the Minister’s comments. My second amendment is intended to make certain that the definition of ““social care”” does not inadvertently include informal care. It would be unfortunate if it did because, while we envisage the CQC having a role in the regulation of domiciliary care provided by professionally qualified and paid people, it would not be appropriate for it to monitor or assess care given informally and free of charge by friends and family. I hope that the Minister will be able to reassure me on that point. I beg to move.