Sections 161-181; Schedules 17, 18 and 19
Part 6 covers a range of issues including:
- establish a cap on adult social care cost contributions
- enable the secretary of state to intervene in the event of a local authority failing in its provision of adult social care
- create a duty for the CQC to inspect adult social care
- the appointment of medical examiners
- require the secretary of state to arrange for a review into disputes relating to treatment of critically ill children
- mandatory training on learning disability and autism
- enable changes to be made to the professional regulation system
- set minimum standards for food and drink in hospital settings.
Sections here also:
- require the secretary of state to report on the government's information sharing policy for purposes relating to child safeguarding or children's health or social care
- maintain the provisions for at-home early medical termination of pregnancy
- enabling regulations to allow more products to be centrally stocked and supplied free of charge to community pharmacies
- restrict the advertising of certain food and drink products
- ensure informed consent with no coercion or financial gain for the donation of organs
- lengthen the storage time for gametes and embryos
- prohibiting unlicensed cosmetic procedures
- provide for implementation of more comprehensive international reciprocal healthcare arrangements
- make regulations regarding food information and labelling
- introduce powers for the secretary of state to introduce, terminate or vary water fluoridation schemes.
Section 163: Regulation of local authority functions relating to adult social care
This section sets out a duty for the CQC to conduct reviews, assess performance and publish reports on the exercise of regulated care functions by English local authorities relating to adult social care.
The secretary of state will set objectives and priorities for the CQC's assessments. The CQC is required to determine indicators of quality to assess local authority performance and prepare a statement setting out the frequency of reviews and a methodology for assessing local authorities' performance, with flexibility to set different indicators, objectives, and priorities for different cases. The secretary of state has powers to direct the CQC to revise its quality indicators, assessment framework, and frequency and methodology for different cases.
NHS Providers view and activity
We sought and received reassurances from the government on the floor of the House that these powers will be used infrequently by the government so as not to disrupt CQC reviews. They also affirmed that the government will fully respect the independence of the CQC.
Section 166: Cap on care costs for charging purposes
This establishes a cap on the amount that adults can be required to pay towards eligible care costs over their lifetime. The government has indicated these provisions will be commenced in October 2023.
Section 167: Provision of social care services: financial assistance
This enables the secretary of state to give financial assistance to bodies engaged in social care provision or connected services. The secretary of state may direct an NHS trust or an SpHA to exercise any of the functions of the secretary of state in relation to this financial assistance.
Section 168: Regulation of health care and associated professions
This section enables changes to be made through secondary legislation to the professional regulation system. It also permits a currently regulated profession to be removed from statutory regulation when the profession no longer requires regulation for the purpose of the protection of the public. It also provides an updated list of the legislation that regulates professions. The section clarifies that a profession is to be treated as including 'any group of workers', whether or not they are generally regarded as a profession, indicating that senior managers and leaders could be considered as part of these provisions.
Section 169: Medical examiners
This section amends the Coroners and Justice Act 2009 in England and allows for NHS bodies, rather than local authorities, to appoint medical examiners. This means that every death in England and Wales will be scrutinised either by a coroner or by a medical examiner. It also introduces a duty on the secretary of state to ensure that:
- enough medical examiners are appointed in the healthcare system in England
- enough funds and resources are made available to medical examiners to enable them to carry out their functions of scrutiny to identify and deter poor practice
- medical examiners' performance is monitored by reference to any standards or levels of performance that they are expected to attain.
The section also introduces a power for the secretary of state to give a directions to an English NHS body in order to:
- require the body to appoint one or more medical examiners
- set out the funds or resources that should be made available to a medical examiner
- set out the means and methods that may be employed to monitor performance of a medical examiner.
These sections do not give any English NHS body any role in relation to the way in which medical examiners exercise their professional judgment as medical practitioners.
Section 171: Storage of gametes and embryos; and Schedule 17
Amends provisions in the Human Fertilisation and Embryology Act 1990 pertaining to the storage of gametes and embryos.
Section 172: Advertising of less healthy food and drink; and Schedule 18
Schedule 18 amends the Communications Act 2003 to restrict the advertising of certain food and drink products.
Section 173: Hospital food standards
This section provides for regulations to be made to set minimum nutritional standards for food and drink provided in hospital settings.
NHS Providers view and activity
During the passage of the Bill, we impressed on the government the need consult trusts, foundation trusts and ICBs when drafting regulations on food standards. We secured ministerial assurances (col 338) on the floor of the House that they will continue to use existing legal powers and obligations to engage with trusts, the food standards and strategy group, and the NHS food review expert group through the NHS food review.
Section 177: Review into disputes relating to treatment of critically ill children
This section requires the secretary of state to arrange for the carrying out of a review into the causes of disputes between (on the one hand) persons with parental responsibility for a critically ill child and (on the other) persons responsible for the provision of care or medical treatment for the child as part of the health service in England. A report on the outcome of the review must be published and laid before parliament.
Section 180: Licensing of cosmetic procedures; and Schedule 19
The section empowers the secretary of state to make regulations to establish a licensing regime in connection with non-surgical cosmetic procedures.
Section 181: Mandatory training on learning disability and autism
This amends the Health and Social Care Act 2008 so that regulations under section 20 of that Act must require service providers to ensure that each person working for the purpose of the regulated activities carried on by them receives training on learning disability and autism which is appropriate to the person's role. The secretary of state must issue a code of practice about compliance with requirements imposed by virtue of these new provisions.
Section 172 and Schedule 18 (advertising of less healthy food and drink) will come into force on 1 January 2024 following a delay announced by the government on 17 May 2022. As part of the May 2022 Queen's Speech the government indicated that the social care cap will come into force in October 2023.