Health and Social Care Bill

For the purposes of Chapter 2, Clause 5 effectively sets the outer boundary for the kinds of activities that could be included as regulated activities in regulations under Clause 4. The definitions have been framed deliberately widely to allow scope in the future for new models of provision to be added to the list of activities regulated by Clause 4. I have a great deal of sympathy with this discussion on public health and I should like to give some examples of public health activities that might be registered and those that might be considered as part of a review. The definition of ““health care”” in Clause 5 explicitly includes all forms of healthcare provided to individuals. Any public health services that provide healthcare to individuals could therefore fall within the scope of registration under Chapter 2 and might include, for example, a smoking cessation clinic or sexual health clinic. It seems appropriate for the Bill to allow for the possibility of providers of these services to be registered in the same way as providers of other sorts of healthcare. Therefore, although public health campaigns do not fall within this definition, we believe that it is important for the commission to be able to look at public health campaigns generally in respect of its other functions. For example, if a PCT runs a public health campaign, the commission should be able to consider that in its assessment of how well the PCT is meeting the needs of the local population. That is why Clause 92 clarifies that, although these kinds of activities do not fall within the definition of healthcare for the purpose of Chapter 2 only, they will fall within the definition for the purposes of reviews, special reviews, investigations and so on, thus, it is hoped, helping to remedy the ““lard pot”” issues outlined by the noble Baroness, Lady Cumberlege. I hope that my explanation has gone some way towards satisfying the noble Earl and the noble Baronesses that public health services are already included within the remit of the Care Quality Commission to the right and appropriate extent. With Amendment No. 35, the noble Earl is looking to ensure that registration of people who provide personal care specifically excludes domestic arrangements, such as where the personal care provided to a relative would not usually be on commercial terms. Although I do not wish to pre-empt the outcome of our current consultation, I expect that domiciliary care agency provision is likely to be covered, as is currently the case. I do not expect that there will be any call to regulate purely domestic personal care arrangements, such as care provided by relatives, neighbours and so on; nor do I think that it would be practical or desirable to do so. I have to tell noble Lords that my next words are underlined in my briefing notes, so I shall try also to underline them in my remarks. As such, although I understand and agree with the underlying point, I think that the amendment is probably unnecessary. With that clarification, I ask the noble Earl to withdraw the amendment.