Key Facts

• Amendment 110 removes devolved Ministers from the definition of 'public authority'.
• Amendment 111 requires the Secretary of State to gain consent from devolved governments before making regulations under section 2.
• Amendment 146 makes healthcare agreement regulations subject to affirmative resolution procedure and requires impact assessments.
• The Bill allows the Secretary of State to make payments without limits on amount, recipients, or type of healthcare.
• McCabe suggests requiring both Houses' resolution and an impact assessment for regulations under the clause.
• He asks for a commitment from the Minister regarding adequate resources for cost recovery.
• Section 5 of the Healthcare (European Economic Area and Switzerland Arrangements) Act 2019 obliges the Secretary of State to consult devolved Administrations before making regulations in devolved areas.
• Amendment 146 would ensure that regulations implementing reciprocal healthcare agreements are subject to the affirmative procedure, requiring impact assessments before draft regulations can be laid.
• The Government plans comprehensive impact assessments and analysis with the DAs before entering into any new reciprocal healthcare agreements.
• The issue was reported by the Public Accounts Committee.
• It involves treatment for overseas patients, including prescription charge recuperation.
• Reciprocal health care arrangements are unclear and need clarification.
• The clause will enable reimbursement of healthcare costs and exchange of data for reciprocal healthcare agreements.
• Comprehensive agreements can help people access necessary healthcare services abroad and reduce burdens on NHS trusts.
• The UK aims to bring EU and rest-of-the-world agreements under the umbrella of a new global health insurance card.
• Amendment 145 aims to ensure direct involvement of service users and providers in reviews.
• Government new clause 60 concerns default powers for the Secretary of State regarding adult social care.
• Government new clause 61 addresses the Care Quality Commission's powers related to local authority failings.
• Clause 121 proposes that the Care Quality Commission will assess the quality of a local authority’s care offering.
• Amendment 145 seeks to involve service users and providers in the assessment process.
• New clause 60 gives the Secretary of State greater powers over local authority social care functions, including issuing directions.
• New clause 61 removes the Care Quality Commission's ability to issue a notice of failure to a local authority.
• Scotland spends over 43% more per head on social care than England.
• The Feeley review highlights that almost half of those receiving care are people of working age.
• Up to 30% of care workers in rural Scotland were European citizens before EU membership ended.
• Clause 121 inserts proposed new section 46A into the Health and Social Care Act 2008.
• The CQC will publish a report assessing local authorities' performance in adult social care functions by 2023-24.
• Over 790 responses were received during consultation on the CQC's new strategy.
• The Government has been promising a social care Green Paper for over 10 years.
• The Bill contains approximately 120 clauses about NHS reform and only two about social care reform.
• McCabe withdraws amendment 145 based on the Minister's comments.
• Amendment 147 gives the CQC a duty to review integrated care systems.
• Reviews will focus on leadership, integration, and quality and safety.
• The CQC will publish reports on each ICS area within the coming year.
• Integrated care systems (ICS) will manage billions of pounds in funds.
• McCabe highlights sector-led improvement by local authorities as an asset to be developed alongside the inspection regime.
• The Minister agrees with McCabe's points and supports drawing on existing assets for improvement.
• The amendment would require consent from devolved governments for orders affecting Scotland, Wales, and Northern Ireland.
• The debate highlights issues around professional qualifications and registration across the four nations.
• In Scotland, new steps are being taken to register care staff as part of professionalising social care.
• The amendment would require professional regulators to raise awareness of rare and less common conditions among health and care professionals.
• The UK rare diseases framework identifies increasing awareness as one of its four priority areas due to challenges in receiving accurate diagnoses.
• There is a need for reforms in workforce training and resourcing to improve awareness of rare conditions.
• Amendment 142 would amend section 60 of the Health Act 1999.
• Clause 123 will enable future changes to make the regulatory landscape more streamlined.
• The independent review of the regulatory landscape is due by the end of the year.
• Clause 123 amends section 60 of the Health Act 1999.
• The amendment allows removal of a profession from regulation through secondary legislation.
• There are differences in professional regulation between England and the devolved nations.
• The current section 60 powers lack flexibility in removing professions from regulation or closing regulatory bodies without primary legislation.
• Secondary legislation can bring new professions into regulation but lacks equivalent powers to remove them.
• The power to abolish a regulator covers all health and care professional regulators, but it requires public consultation and affirmative parliamentary procedure.
• There are no plans to abolish the General Medical Council (GMC) due to its crucial role in regulating medical practitioners.
• The amendment aims to include stillbirths and deaths related to childbirth in medical examiners' remit.
• In 2017, the Court of Appeal highlighted that the law relating to coronial investigations of stillbirths had not changed since 1887.
• Between March and June 2019, a consultation on proposals for coroners to investigate term or post-term stillbirths was conducted.
• The Civil Partnerships, Marriages and Deaths (Registration etc) Act 2019 requires the Secretary of State to prepare a report on whether and how the law should be changed to require coroner investigations of stillbirths within five years.
• The amendment allows NHS bodies to appoint medical examiners.
• Medical examiners will scrutinise proposed causes of death in non-coronial cases.
• The system aims to improve data quality and transparency.
• Amendments ensure alcohol is considered 'less healthy' for TV programme services watershed.
• Proposes new clause requiring full and open formal consultation before adjustments to nutrient profiling model.
• Acknowledges the need for clarity regarding involvement of devolved Governments.
• One in three children leave primary school overweight.
• One in five children are obese by the time they finish primary school.
• The Government's approach goes beyond a watershed to full prohibition on advertising unhealthy products.
• Amendments 139 and 141 deal with alcohol regulations.
• Television broadcasters and UK-regulated on-demand programme services will be liable for breaches of the HFSS TV watershed.
• Advertisers are liable for any breaches of paid-for online prohibition.
• Broadcasters have a system to pre-clear adverts, regulated by Ofcom and ASA with clear consequences for non-compliance.
• There is ambiguity regarding the liability of online platforms under new regulations.
• Amendment 113 would require the Secretary of State for Health and Social Care to obtain consent from Devolved Administrations before exercising regulation-making powers granted by schedule 16.
• The provisions cover advertising less healthy food and drink on TV and internet services across the UK.
• Telecommunications and internet services are reserved matters under the devolution settlement.
• The Government aims to remove up to 7.2 billion calories per year from children's diets through advertising restrictions.
• Childhood obesity affects one in every three children leaving primary school overweight or obese.
• Estimated annual NHS cost of obesity-related conditions is £6.1 billion, with societal costs at £27 billion.
• The Advertising Standards Authority (ASA) has robust rules to protect children from alcohol advertising.
• Malnutrition affects about 3 million people in the UK.
• Health and social care expenditure on malnutrition is estimated at more than £23 billion a year across the UK.
• Around one in three patients admitted to hospital are malnourished or at risk of becoming so.
• The enforcement of food and drink standards in hospitals is currently not statutory.
• Clause grants powers to the Secretary of State to impose requirements on NHS hospital premises.
• Independent review of NHS hospital food was published in October 2020 following a listeria outbreak linked to six deaths.
• Health and Social Care Act 2008 gives CQC powers over nutrition and hydration standards.
• Amendment 149 seeks to allow local authorities to commence fluoridation schemes.
• Amendment 150 aims to give local authorities and the Secretary of State shared ability to initiate fluoridation projects.
• Amendment 151 would remove the Secretary of State's power to transfer costs of fluoridation to other public bodies.
• Fluoridation saves nearly £13 for every pound spent in deprived communities within five years.
• The Water Industry Act 1991 is relevant to the fluoridation process.
• Subsection (6B) of clause 128(2)(d) allows the Secretary of State to direct another body to pay for a scheme instead of Public Health England.
• Tooth decay is significant in England, leading to over 35,000 hospital admissions for the extraction of decaying teeth among people aged 19 or under in 2019-20.
• The cost of these hospital admissions was estimated at £54.6 million.
• Fluoridation can reduce tooth decay by up to 28% and hospital admissions by up to 68%, especially in deprived areas when water contains at least 0.7 mg of fluoride per litre for five-year-olds.
• No new fluoridation schemes have been implemented for the past 40 years.
• Clause 128 transfers power to initiate, vary or terminate fluoridation schemes to the Secretary of State and allows cost-sharing with water undertakers and public sector bodies.
• There are currently no schemes in the system according to the Minister.
• Local authorities, such as Nottingham City Council, have made commitments in their council plans.
• Amendment 149 is withdrawn.