Health and Social Care Bill

I am drawn to the amendment and I was considerably persuaded by the case made by the noble Lord, Lord Warner. While not completely connected to the points he made, perhaps I may spend a moment or two on Clause 14 which, at first sight, appears to contain some puzzling provisions. I have been prompted to raise these questions by the Relatives and Residents Association, to whose work I pay tribute. The intentions behind the clause are difficult to understand. It deals with what one might term slow suspensions—that is to say, suspensions that will not take effect pending written representations and any appeal to the Care Standards Tribunal of a decision to suspend. It is difficult to see the circumstances where this power would be invoked given that it will potentially not take effect for many months. There is a requirement in the clause to specify a time period for the suspension—for example, three months—but what happens if an appeal to the Care Standards Tribunal takes seven or eight months to be heard after the initial decision to suspend? If there is a risk of harm to anyone—let us say the residents of a care home—then it is likely that the regulator would choose to use the urgent procedure provided for in Clause 27. Once a notice is served under that clause, it takes effect immediately. There is then provision for an appeal to the Care Standards Tribunal. The threshold in Clause 27 appears to be relatively low, which raises the question of what the threshold is under Clause 14. Ofsted has the same test as under Clause 27 with regard to childminders and daycare providers in the sense of reasonable cause to believe that there will be an exposure to risk. However, the Ofsted regime is further qualified by a statutory purpose to reduce or eliminate risk or to allow for an investigation to take place. The Ofsted suspension period is limited to six weeks plus a further six weeks, and then a continuing suspension if matters are beyond Ofsted’s control—for example, where there is an ongoing police investigation. Can the Minister elucidate the intention behind Clause 14 and the kinds of circumstances where it might be thought appropriate for the CQC to invoke it? It would appear that the suspension applies to the entire registration. Is that correct or will there be the option to apply it to part of a service? What would need to happen to the residents of a care home if a service provider’s entire registration were to be suspended? I am struggling with the thought of what might happen to an acute hospital trust if its registration were to be suspended in full under the clause or, for that matter, Clause 27. It would be helpful if the Minister could take us through how the provisions are intended to work.