13 FEB 2017

Health Services: Directors

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, by what metrics the effectiveness of Regulation 5: Fit and proper persons: directors is measured; and if he will make a statement.

Philip Dunne The Minister of State, Department of Health

Regulation 5 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, The Fit and Proper Persons Requirement (FPPR) for Directors came into effect for National Health Service bodies on 27 November 2014 and was extended to cover all providers regulated by the Care Quality Commission (CQC) on 1 April 2015.

The regulations include a requirement that they must be reviewed every five years, beginning five years after 1 April 2015. As yet the Department has not undertaken a review of regulation 5. Any such review would be completed with input from the CQC.

The CQC has advised that it is the provider's responsibility to ensure that all directors appointed are fit and proper for their role. The CQC's responsibility is to check whether providers have the right systems and processes in place to assure themselves of fitness.

The CQC has not yet conducted a thorough assessment of the regulations' effectiveness. However, in the first years of implementation, the CQC has received feedback on how the regulation is applied, often driven by an assumption that it is CQC's role to assess fitness directly rather than to assess providers' systems and processes.

In response to this feedback, the CQC has considered whether its current approach is in line with what can be reasonably expected of the CQC within the current regulations. The CQC has therefore begun a programme of work to improve its internal systems and processes for handling referrals under FPPR. There are three areas of CQC's guidance and processes that it is strengthening:

- Passing on all details of FPPR concerns raised with the CQC to providers

Presently the CQC does not pass on all concerns raised with it to providers to ask for an explanation. Instead the CQC assesses whether there are concerns that a reasonable employer should be expected to investigate and if the CQC does not think there is a substantive concern it does not pass the material on. When the CQC does share concerns, it initially summarises the information and will later send on the full material if requested.

CQC's intention is to change both of these steps so providers are notified of all concerns and receive all of the information immediately. The CQC will set out more clearly the type of investigation it expects providers to undertake, following notification.

- Interpretation of "serious mismanagement"

CQC believes there would be benefit in developing a clearer understanding of what type of behaviour constitutes 'serious management'. The CQC has prepared some draft guidance that characterises serious mismanagement and will shortly be publishing this for consultation. The CQC will develop the finalised draft into internal and external guidance as to how it interprets and applies this element of the regulation.

- The way CQC manages and records information regarding FPPR

It is recognised internally that CQC needs to improve the data available to itself about CQC's application of FPPR. The CQC is developing an approach to better enable it to track the volume of FPPR concerns shared with CQC by sector and the actions that result from these.

The CQC aims that, by undertaking the programme of improvements described above, CQC will be better placed to monitor the effectiveness of Regulation 5: Fit and Proper Persons in future.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, in how many instances the Care Quality Commission has asked service providers to instigate fit and proper persons requirement (FPPR) investigations for each year since the FPPR came into force; and how many of those FPPR investigations resulted in a director being discharged from duty.

Philip Dunne The Minister of State, Department of Health

The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England.

The CQC has provided the following information:

The following actions have been taken in relation to Regulation 5 Fit and Proper Persons Requirement:

- CQC management reviews enable the CQC to reach a decision about the next course of action to take in response to a trigger for review, for example when we identify concerns around non-compliance with the regulations during an inspection, at the point of registration, or when we receive a safeguarding alert or concern. As at 8 February 2017 there have been 38 Adult Social Care (ASC), 14 Hospital, 5 Primary Medical Services and 37 Registration management reviews held regarding regulation 5.

There have been 28 enforcement actions under this regulation:

- 21 have been triggered by an enquiry, 16 of which were during the registration process.

- Seven were triggered by an inspection, four at ASC locations and three at Hospital locations.

- In seven cases registration was refused. In five cases registration was cancelled and in a further eight cases the providers were registered with agreed actions. The remainder included recommended fixed penalty notices, urgent and non-urgent imposition of conditions and warning notices.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, for what reasons the Care Quality Commission closed its fit and proper persons requirement process on Paula Vasco-Knight, then Chief Executive of South Devon NHS Foundation Trust.

Philip Dunne The Minister of State, Department of Health

The Care Quality Commission (CQC) has advised that in October 2015 the CQC received information of concern regarding the appointment of Paula Vasco-Knight as Acting Chief Executive at St George's University Hospital NHS Foundation Trust. These concerns related to Paula Vasco-Knight's conduct whilst she was Chief Executive at South Devon Foundation Trust. The CQC followed this up directly with the trust to review whether they had followed appropriate recruitment processes and carried out robust checks to determine Paula Vasco-Knight's fitness prior to her employment.

Based on the extensive evidence supplied by the trust and information provided separately from the Nursing and Midwifery Council the CQC concluded that the trust had not breached the fit and proper persons regulation at that time in relation to that appointment. The CQC informed the trust of this decision in February 2016 but reserved the right to reopen the case in light of any further information received. At the time of this decision, neither CQC nor the trust was aware of the fraud charges.

In April 2016 CQC received new information that led it to re-open the case. In early May 2016 both CQC and St George's became aware for the first time of the criminal investigation and fraud charges being brought against Paula Vasco-Knight. The CQC were subsequently asked by NHS Protect to put the case on hold pending their criminal investigation. St George's University Hospital NHS Foundation Trust suspended Paula Vasco-Knight at this time. These are matters of public record.

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08 FEB 2017

EU Nationals

I raised the question about the rights of EU Nationals in the UK at today's Prime Minister's Question Time

I am not alone in hearing from families long-settled here in Britain who are deeply worried that they could be separated after we leave the European Union. I know the Prime Minister will not want that to happen. Will she reassure all our constituents today that those who were born elsewhere in the European Union but settled here in the UK, married or in partnerships with British citizens will have the right to remain?

Theresa May The Prime Minister, Leader of the Conservative Party

My hon. Friend obviously raises an issue that is of concern all across this House. As she says, it is of concern to many individuals outside the House who want reassurance about their future. As I have said, I want to be able to give, and I expect to be able to give, that reassurance, but I want to see the same reassurance for UK citizens living in the EU. What I can say to her is that when I trigger article 50, I intend to make it clear that I want this to be a priority for an early stage of the negotiations, so we can address this issue and give reassurance to the people concerned.

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07 FEB 2017

Foreign Nationals: NHS Treatment

Sarah Wollaston Chair, Health Committee

Given the Government's stated objective of reducing health inequalities, will the Secretary of State set out how he will guarantee that those who are, for example, homeless or who have severe enduring mental illness—the most disadvantaged in our society, who are unlikely to have the required documentation—will receive the treatment they need?


Jeremy Hunt The Secretary of State for Health

I can absolutely reassure my hon. Friend. What we are doing is based on good evidence from hospitals such as Peterborough hospital, which has introduced ID checks for elective care and has seen absolutely no evidence that anyone who needs care has been denied it. This is not about denying anyone the care they need in urgent or emergency situations; it is about ensuring that we abide by the fundamental principle of fairness so that people who do not pay for the NHS through their taxes should pay for the care we provide.

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07 FEB 2017

Health Select Committee

The Health Committee met to discuss Childhood Obesity and whether this was a 'plan for action' or a 'plan for inaction and missed opportunities'

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06 FEB 2017

Parliamentary oversight of negotiations

Sarah Wollaston Chair, Health Committee

My right hon. Friend is absolutely right to be concerned about the fate of British citizens living in the European Union, but I agree with others who have said that, surely, a goodwill gesture would be a really positive thing for this Government to make. Two of my constituents are a married couple who have been living together in this country for 30 years, and I consider the wife to be as British as anybody else. We should make it absolutely clear that it is inconceivable that this couple should be separated, and that their children should be left with separated parents.

.....

Sarah Wollaston Chair, Health Committee

I wish to start by reading something from a letter I have received from a constituent. He talks about his wife, who was born in the Netherlands. He writes:

"She has lived in this country for over 30 years, brought up three British children and is completely integrated into the life of her local town. She is not part of any 'immigrant community'. She just lives here and is fully at home here. Until now, she has never seen herself as an outsider and has been able to participate fully in local life, thanks to her rights as an EU citizen. In two years' time, she will lose those rights and be a foreigner, dependent on the good will of the Government of the day."

I have written back to and met my constituent, because I think it is inconceivable that our Prime Minister would separate this family. However, many people are not reassured, and he and his wife sought for her to have permanent residency. This involved dealing with an 85-page document, including an English language test and a test about life in Britain, which is insulting to someone who has lived here most of her life and brought up three children here. This process is also very expensive, but the final sting in the tail is that she finds she is not eligible, because she has been self-employed and has not taken out comprehensive sickness insurance. This situation is unacceptable. We need to keep our compassion and keep this simple. It is inconceivable that families such as this would be separated, so we should be absolutely clear in saying so, up front.

Julian Knight Conservative, Solihull

I understand what my hon. Friend is saying about her constituency surgeries. I have had a similar experience and it is deeply upsetting in many respects, but will she join me in reflecting that the EU and Chancellor Merkel could have come to a deal on this earlier? The reality is that they have point-blank refused to discuss it before we trigger article 50.

Sarah Wollaston Chair, Health Committee

I agree with that, and I have also heard from constituents of mine who are British citizens now living in the EU. But my point is that, come what may, it is inconceivable that we would seek to separate families such as this one. There is no doubt that many people are sleepless and sick with worry about this, and we have all seen them in our surgeries. [Interruption.] It is true. I am seeing these people in my surgery. We also need to consider the tsunami of paperwork that we will have to deal with in settling the rights of these citizens if we do not get on with this quickly. We need to keep this simple. There is no way that families such as this should be subjected to a vast bureaucracy and vast expense. We all know that this needs to be settled, so in negotiating, surely, making a bold, open offer as a gesture of good will can do nothing but good in this situation.

Richard Fuller Conservative, Bedford

I agree with my hon. Friend, but my question to her is: can she cast any thought on why the Chancellor of Germany refused the offer?

Sarah Wollaston Chair, Health Committee

I have no idea why this is happening, but I am saying, as an important point to the Chancellor of Germany, that making this clear unilateral offer is the right thing to do, and we should get on and do it. There is no reason not to do so. Even if other countries were to take an obstructive and unreasonable line, it would still be inconceivable that our Prime Minister would separate families such as my constituents. So let us get on with this.

Anna Soubry Conservative, Broxtowe

Does my hon. Friend not agree that the Prime Minister as given her word that this will be a priority and she clearly hears the compassion that my hon. Friend reflects for her constituent, as we all do for all our constituents? We must, as I certainly do, accept the word of the Prime Minister that this will be her priority and that she will sort it.

Sarah Wollaston Chair, Health Committee

I thank my hon. Friend for that. Like her, I do trust the Prime Minister, and that is why I have taken a very reassuring line with my constituents. However, there is no substitute for a clear statement from our Prime Minister that, come what may, families such as this will not be separated, because that is the reassurance they seek. I hear what my hon. Friend says, but I think we should get on and make that offer, because it can be nothing but good to do so.

I also hope the Prime Minister will take further action on the issue of those who work in our NHS and social care. One in 10 of the doctors who works in our NHS comes from elsewhere in the EU, and I would like to say thank you, on behalf of the whole House, to all those workers and to all those who are working in social care. It would also be very much a positive move if we could say, up front, that those who are working here will be welcome to stay and make it very clear that we will continue to make it easy to welcome people from across the EU to work in social care and in our NHS.

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01 FEB 2017

Developing Countries: Family Planning

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for International Development, what estimate her Department has made of the potential shortfall in funding to charities and non-governmental organisations as a result of the revocation in the US of the Presidential Memorandum of 23 January 2009 Mexico City Policy and Assistance for Voluntary Population Planning and the reinstatement of the Presidential Memorandum of 22 January 2001 Restoration of Mexico City Policy; and what plans her Department has to ensure continued access to (a) family planning advice and (b) safe termination and contraception through its programmes.

James Wharton The Parliamentary Under-Secretary of State for International Development

It is too early to put an exact figure on the financial impact of the restoration of the Mexico City Policy.

The UK firmly believes that supporting comprehensive sexual and reproductive health and rights of women and girls, through proven, evidence-based public health interventions, saves lives and supports prosperity. We will continue to work with all our partners, including governments, UNFPA and civil society partners, to deliver this.

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31 JAN 2017

Post Offices: Rural Areas

Written Answers

Dr Sarah Wollaston Totnes

To ask the Secretary of State for Business, Energy and Industrial Strategy, what the implications for his policies are of the call by the Association of Convenience Stores for the Government to review the costs, income and viability of rural post offices on its Rural Shop Report 2017, published in January 2017.


Margot James Under Secretary of State for Small Business, Consumers and Corporate Responsibility

The Government entrusts the Post Office's management to keep the health of the network under review in order to meet the commitment we have set to maintain the network at over 11,500 branches. The commercial agreements it has with subpostmasters, rural and urban, covering costs and revenue form a key part of ensuring the health of the network. While these arrangements are commercially sensitive between both parties the evidence of their success is in the fact that that the network is at its most stable in decades.

Dr Sarah Wollaston Totnes

To ask the Secretary of State for Business, Energy and Industrial Strategy, whether his Department plans for the increase in Post Office outreach services in rural communities over the last five years to continue; and if he will make a statement.

Margot James Under Secretary of State for Small Business, Consumers and Corporate Responsibility

The Department for Business, Energy and Industrial Strategy keeps the state of the network under review including the provision of rural services through outreaches. Outreaches are provided so Post Office can maintain access to communities, most often in rural areas, where the old post office has closed. These provide a regular part time service, with hours tailored to the levels of demand in the community. They provide a welcomed link to the network for many isolated communities.

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31 JAN 2017

Energy and Industrial Strategy: Topical Questions

Sarah Wollaston Chair, Health Committee

It is 100 years since the destruction of Hallsands village following an act of environmental destruction and vandalism that saw the removal of protective shingle from the shoreline. Communities around our entire coast, including in Start Bay, face an even greater threat from climate change. Will the Minister assure me that he will protect us from an act of environmental vandalism —withdrawal from the Paris agreement?

Nick Hurd The Minister of State, Department for Business, Energy and Industrial Strategy

As the Prime Minister said in Prime Minister's questions last week, this country is fully committed to the Paris climate change agreement—as are all the countries that endorsed the Marrakech proclamation—and we hope that all parties will continue to ensure that it is put into practice.

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31 JAN 2017

Science Funding

Sarah Wollaston Chair, Health Committee

There is great concern about the future of fusion research after Britain pulls out of the EU and Euratom. Will the Secretary of State reassure us that he will continue to support and fully fund the Joint European Torus project and other joint research projects such as ITER—the international thermonuclear experimental reactor—after Britain leaves the EU?

Greg Clark The Secretary of State for Business, Energy and Industrial Strategy

The collaboration between scientists and those in the nuclear sector is one of the important aspects of the continued co-operation that we want and intend to see continue.

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31 JAN 2017

National Assembly of Korea

It was a privilege to meet with Na Kyung-won, chair of the Special Committee on Low Birthrate and Aging Society in the National Assembly of Korea and some of her colleagues. Korea and the UK share many similar demographic challenges as our populations' age and we must find sustainable long term funding and systemic solutions which enable older people to live independently and with dignity for as long as they can.

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