Clause 93 - Training for persons working in regulated activity

Care Bill [Lords] – in a Public Bill Committee am 3:00 pm ar 28 Ionawr 2014.

Danfonwch hysbysiad imi am ddadleuon fel hyn

Question proposed, That the clause stand part of the Bill.

Photo of Andrew Rosindell Andrew Rosindell Ceidwadwyr, Romford

With this it will be convenient to consider new clause 27—Registration of H ealthcare S upport W orkers—

‘(1) The Secretary of State must by regulations provide for a system of registration of healthcare support workers (“the registration system”) under which no unregistered person should be permitted to provide for reward direct physical care to patients currently under the care and treatment of a registered nurse or a registered doctor in a hospital or care home setting.

(2) The system shall apply to healthcare support workers, whether they are working for—

(a) the NHS,

(b) independent healthcare providers,

(c) in the community,

(d) for agencies, or

(e) as independent agents.

(3) Persons care for members of their own family or caring for persons with whom they have a genuine social relationship shall be exempt from the provisions of subsections (1).

(4) The registration system shall include a national code of conduct for healthcare support workers.

(5) The registration system shall include national standards for education and training of healthcare support workers.

(6) The code of conduct, education and training standards and requirements for registration for healthcare support workers shall be prepared and maintained only after consultation with all relevant stakeholders including, but not limited to—

(a) regulatory bodies,

(b) professional representative organisations, and

(c) the public.’.

Photo of Jamie Reed Jamie Reed Shadow Minister (Health)

Clause 93 will amend section 20 of the Health and Social Care Act 2008 to enable the Secretary of State, through regulations, to specify the bodies or persons who can set training standards in respect of a specific group of workers. It will allow the Government to specify in regulations the person who sets the training standards and to whom those standards apply. Groups to whom the standards could apply include health care assistants and social care support workers.

New clause 27, which my hon. Friend the Member for Leicester West and I tabled, relates to clause 93 precisely. The clause is rather vague and does not sufficiently deal with concerns expressed by the Francis report. It does not put any duty on the Secretary of State to advance provisions immediately and does not say to whom the regulations must apply. It was said in the other place that Robert Francis is widely reported to be disappointed with some aspects of the Government’s response to his report, and there is disappointment about clause 93.

During deliberations on the Bill in the other place, my noble Friend Lord Hunt of Kings Heath clearly outlined how the clause is left wanting. Clearly defined parameters determining the mandatory level of training are crucial to maintain standards. If there is to be mandatory training, the logical extension is that there must be a list somewhere of those who have completed that training, which would be by its nature a list of trained health care assistants. Additionally, if someone is trained but not performing at the ability that is required, there needs to be a way of removing the qualification. This is de facto regulation of health care assistants, but without the label.

The Prime Minister’s commission on the future of nursing and midwifery noted that training to support workers was variable and recommended that they should be better trained. Earl Howe stated that the Secretary of State would issue a mandate to Health Education England to ensure that minimum training standards for health care assistants would be established by spring this year. Will the Minister update Members on this mandate? I seem to recall its being mentioned earlier in our deliberations, so I hope that he will say that it will be available before Report. If that will not be the case, perhaps he will update us with progress on that.

Will the Minister also answer several questions that were asked in the other place? How far will the mandate go and what will it cover? What impact will it have on existing health care support workers? Will the training extend to them, or will it apply only to new people  coming into the health care profession? It is unwise to have a two-tier work force in such an important area as health care.

If a minimum training standard is established, does that become a qualification to be achieved? If so, and a qualification is awarded, will that be recognised nationally and will there be a list of those who have achieved it, much like for any other qualification that anybody in any industry would be expected to hold? A simple, small step along that path takes us towards regulation, yet the details provided do not allow one to assess the proposals properly.

Luckily for the Government, new clause 27 would fill the gap left in the Bill. It is based almost entirely on a recommendation made by Robert Francis—the only difference is that the new clause would place the duty on the Secretary of State to bring forward proposals. We are mindful that the Secretary of State might be from a different party, but the politics of this are irrelevant; it is about the practicality and efficacy of the measure.

Francis recommended that a code of conduct and charters be brought forward by the Nursing and Midwifery Council. Subsection (6) of the new clause would require the Secretary of State to consult a wide range of groups, including the NMC, to ensure that relevant partners could have an input in the process. I shall briefly explain each subsection of the new clause.

Subsection (1) would require the Secretary of State to bring forward regulations to provide for a new system of registration for health care assistants, which would ensure that no unregistered person would be permitted to provide direct care to patients, whether in a hospital, a care home or at home. Subsection (2) outlines the bodies with which health care assistants would need registration to be employed, while subsection (3) would exempt family carers from the registration process. Subsections (4) and (5) expand on what would be required of the registration process—namely a code of conduct, and national standards of training and education—and, as I said, subsection (6) lists statutory stakeholders that would need to be consulted in the development and maintenance of these standards. Given the detail we have been able to set out in the new clause, will the Minister explain why clause 93 is so vague? If there have been further discussions about the scope of the proposed regulations, will he give us an update?

We all agree, I think, that it is unacceptable that the security guard at the door of a hospital is more regulated than the health care assistant attending to a vulnerable patient within it. The care certificate developed by Camilla Cavendish is a welcome step in the right direction, but the questions I have posed still stand. Will action be taken if people fall below the required standards and can their certificate be revoked? If so, this is regulation by another name, which prompts us to ask why the Government have gone only part of the way there. It behoves us all to remove any suggestion that this is a process of public relations rather than the development and implementation of practical solutions.

This important issue needs to be aired fully, so will the Minister commit to informing the Committee of the Government’s progress on the matter before we have the  opportunity to vote on the new clause at the end of the Committee’s proceedings? Perhaps I will not need to press it to a Division, or perhaps we will need to reassess and take a new approach on Report, but I will welcome the Minister giving some assurances about the points I have raised.

Photo of Paul Burstow Paul Burstow Democratiaid Rhyddfrydol, Sutton and Cheam 3:15, 28 Ionawr 2014

I have a quick question and a reflection. The reflection is that the issue relevant to the new clause is not new, but long standing. Some Government Members feel—I certainly do—that it was left parked and not dealt with for a long time. One of the reasons why was that although the previous Government undertook to introduce regulation in this area, when it came to implementing it, the scale of the task, alongside many others better to regulate the work force, simply meant that it was never done. A promise was made and repeated several times, but never delivered, so it is important that this Government do not make the same mistake of being beguiled into making a promise on which they fail to deliver. That is why the Government’s approach of having a certificate is a much more powerful way of driving an agenda that is about improving the quality of training and standards of staff.

For the tool to be as powerful as it can be, it needs to be a portable, rather than something that a person has in just one place. Once someone has gone to work for a care provider, that care provider invests in them as a person and trains them, and when they move to the next place, their certificate should carry a record of that training with it. It then becomes an asset not only to the individual, but to the whole sector. It becomes valuable, because it reflects the fact that many care providers invest in and train their staff. It will also expose those that do not, which is another reason why the tool would be useful.

It will be helpful if the Minister assures us that the certificate is intended to be portable and that arrangements will be made so that information about skills gained and additional training, through the various accreditation routes, is properly recorded. A subsequent employer will then have the benefit of that knowledge and may make judgments about where it invests its training resources for that individual and their onward professional development. I look forward to his response.

Photo of Grahame Morris Grahame Morris Llafur, Easington

I do not disagree with any of the comments made by the right hon. Member for Sutton and Cheam, and I support what my Front-Bench colleague said.

There is an overwhelming case for appropriate training for the UK’s 1.3 million health care support workers. They do a fantastic job, and not just in hospitals, but in homes and care homes. They are a large and valuable part of our work force and they deserve recognition for their work. For too long, there has been little to regulate because of the lack of a clear standard against which health care support workers could be judged. We should not forget that the measure would require the Secretary of State to provide for the regulation of health care assistants, in line with the Francis report. I welcome it as a further step towards raising the standards of care that people will receive.

Following the recommendations of the Francis and Cavendish reports, regulations would make powers to allow health care assistants and social support workers  to receive the support that they need to provide high-quality and compassionate care. Too many health care support workers are not recognised for their work, and nor do they have adequate contact with supporting bodies, so one would hope that the measure would ensure that health care support workers would get more of the recognition and support that they deserve. I emphasise that organisations such as the Royal College of Nursing have welcomed news of regulation for health care assistants and support workers, which will grant such people recognition for the important roles that they play through being supported by national standards and receiving, as the right hon. Gentleman indicated, a certificate of care once they have completed the mandatory training.

As well as supporting health and social care workers in their training, if employers have a duty to check that all health and social care workers in their employment have completed the necessary training and possess the care certificate, it will allow employees to operate in a more effective, consistent and efficient manner. Most important will be the benefits to those receiving care. The introduction of a code of conduct, education and training standards, and requirements for registration, will help to prevent substandard care and reduce inequalities. I am confident that regulations will help to avoid some of the worst examples of poor care.

It is important not to be complacent. The Minister and our Front-Bench team have said many times that the issue is about culture and changing culture, but such regulation deals with only minimum standards—standards that are already exceeded in many cases. There are examples of very good practice and we should always be striving to achieve the highest possible standards for health care support workers and to deliver the best care for patients.

Photo of Bill Esterson Bill Esterson Llafur, Sefton Central

I am really pleased that my hon. Friend is making these points. I completely agree with how welcome the moves are. Does he agree that ultimately what we need to get the best standard of care is to see those people who work in the care sector as professionals and to elevate such workers to having a profession?

Photo of Grahame Morris Grahame Morris Llafur, Easington

I completely agree with my hon. Friend. Unless we value the people who work in the service, especially the veritable army of care and support workers and health care assistants, we will not achieve the necessary improvements in standards, outputs and care for people being looked after.

Although the legislation will improve the lot of the cared-for, carers and employers, we should note that it is only an advancement from what has previously been a very much unregulated service. There are still a lot of opportunities to improve culture and promote professional development to support our invaluable health care support workers and improve care.

Photo of Daniel Poulter Daniel Poulter The Parliamentary Under-Secretary of State for Health

I have much sympathy with the sentiments expressed by the hon. Member for Easington and the shadow Minister. Government Members are united in the belief that we need to ensure that 1 million or so health care support workers are in the right place to receive the right training, so that they can deliver high-quality care.

The Francis inquiry flagged up a number of concerns that we have touched on today. It is important to highlight that we all recognise that investing in our health care work force is vital if it is to be properly placed to deliver high-quality care. It is important that training and education of the work force is seen to be everyone’s business, but in particular the business of health and care providers. That point was well made in the brief speech of my right hon. Friend the Member for Sutton and Cheam. I hope to give him some reassurance later.

The purpose of new clause 27, which was tabled by the Opposition, is to provide reassurance that health care assistants who care directly for patients are capable and caring. I hope to reassure the Committee that the Government are already taking strong action to provide such reassurance to patients and the public. For that reason, we are also debating clause 93, which will give the Secretary of State a power through regulations to name a person or persons to set training standards for a specific group of workers.

My right hon. Friend the Member for Sutton and Cheam has rightly aired concerns about the number of older people being abused in their own home, including by their carers. Our common aim should be to prevent abuse and to act quickly and effectively when abuse occurs. The best approach is for everyone to see safeguarding as their business, and to know how to respond if they are concerned. As we have discussed throughout the day, clauses 42 to 47 provide for a number of actions on safeguarding aimed at establishing the local authority as the lead co-ordinating organisation for safeguarding locally, as well as providing for a new duty to carry out an inquiry where there is cause to suspect that an adult is at risk of abuse and neglect.

The provision of personal care by health care assistants and social care support workers falls within the definition of a regulated activity relating to vulnerable adults. Under the Safeguarding Vulnerable Groups Act 2006, those workers are subject to checks by the Disclosure and Barring Service—what I would probably refer to as a Criminal Records Bureau check. That provides a further layer of reassurance by helping employers to make safe recruitment decisions and prevents unsuitable people from working with vulnerable groups. Employers have a further role through recruiting, training and supervising staff. Individuals must appreciate that they are responsible not only for delivering safe care and support, but for challenging any poor care, neglect or abuse they witness or discover.

We must be clear that the regulations covering CQC registration already place a legal obligation on employers in relation to the training of their staff. The regulations state that employers should ensure that their staff receive

“appropriate training, professional development, supervision and appraisal” to enable them to carry out their responsibilities safely and to an appropriate standard. When providers do not comply with registration requirements, the CQC has a range of enforcement powers that it can use, including prosecution. Statutory guidance on compliance with this registration requirement has been published.

Safeguarding is everyone’s business, and many systems are already in place to ensure that, but we know that we need to do more. It is the duty of health care providers to look after not just patients, but their staff, and ensure that they are properly trained to safeguard and care for their patients.

We recognise that there is concern about ensuring levels of training and, sometimes, the competence of the health and care support work force. That is understandable when those workers provide what is often intimate and personal care, sometimes to very vulnerable people. We all want those who provide care to do so safely, effectively and with compassion. Holding a list of people who have completed minimum training and signed up to a code of conduct, as proposed in the new clause, would not be a statutory regulation. Indeed, the accredited voluntary registration scheme, which was envisaged and discussed under the Health and Social Care Act 2012, has proved to be difficult to implement for health care assistants. No one has come forward to set up a scheme, so we have chosen to take a different route—that recommended in the Cavendish report. I will come to that later.

We do not believe that registration is appropriate or proportionate for health care assistants, who are lower-paid workers and may work part time. They would find the cost of registration fees burdensome, and we do not want to dissuade people from a career in caring. Statutory regulation, for which there have been frequent calls, including in the other place, is a much broader process and would be even more burdensome. It involves setting standards of conduct, protecting commonly recognised professional standards, establishing a single list, and providing a way in which complaints can be dealt with fairly and appropriately, including through the ability to strike off an individual.

It is important to draw a distinction between a more regulatory framework and training standards, and the Cavendish review draws out that distinction very well. It makes the point that any form of regulation may focus more on an ethical code of conduct than training standards in the workplace. Although there is obviously an overlap between the two, there is of course a distinction between functions. Even if we considered moving towards a more regulated system for health care assistants, regulation could bring additional burdens, including the possibility of insurance levies being required for people practising as health care assistants and the additional burden of paying to be on a register. That additional burden might deter some of the lowest-paid workers, particularly part-time workers, from providing care and engaging in the work that they enjoy. We do not talk enough about that unintended consequence, but we must be aware of it.

There is an argument that regulation can raise professional standards and esteem, and the hon. Member for Sefton Central touched on that. Other groups that we hold in high esteem are not regulated, or are surrounded by less of a framework; for example, some therapists do not have a rigid regulatory framework. We must recognise that a more rigid framework might bring with it fees and financial burdens for the workers, which could deter people from taking up the kind of work that we are discussing.

I am sure that we would all agree that it is the duty of the health care provider to make sure that it is looking after patients properly—that is the point of view of the Government, and the sentiment has been expressed by the Opposition—and key to that is having skilled and properly trained staff to deliver high-quality care.

The new clause focuses only on health care assistants, and omits to include social care support workers, who are far more numerous and often under less supervision, as my right hon. Friend suggested. It is important that quality assurance in the work force is given across both health and care. Other parts of the Bill focus strongly on the integration of health and care. The Department published the first mandate to Health Education England last year; the next will be published very soon. We often talk about a mobile work force who have to work across a variety of care settings. It is important that the standard of training for that important work force is set across both health and care, and does not focus only on health.

In general, we know that the work force in a hospital—perhaps the one across the river from here, where I trained—will be very well trained by the NHS, but the concern is often raised that although the social care work force provide intimate personal care in the community and in care homes, employers and providers of care do not always pay the same rigorous attention to education and training, which could be to the detriment of patients. We want an approach that raises the game across both health and care for a combined, integrated work force. I am sure that the hon. Member for Copeland would also want that; it must surely be our objective. The Government are taking action, and we consider our approach to be the right one.

I turn to the Cavendish inquiry and report, which followed on from the Francis inquiry and led us to the position that we have adopted in the Bill. The Cavendish inquiry, which reported back on 10 July last year, made a number of recommendations on how the training and support of over 1.3 million health care assistants and social care support workers can be improved to ensure that they provide care to the highest standard. Among other measures, it proposed that health care assistants and social care support workers should undergo the same basic training, based on existing best practice, and should obtain a certificate of fundamental care. We accept Camilla Cavendish’s recommendation that a care certificate should be developed.

Clause 93 allows the Secretary of State a power to make regulations to specify a person or persons to set training standards for a specific group of workers. Once the regulations have gone through the parliamentary process and come into force, the person or persons specified will provide a set of common training standards for health care assistants and social care support workers who work for a registered provider of any regulated activity. In the first instance, we envisage that the person specified will be Health Education England, which will work with key partners to deliver the care certificate. An update on that will be delivered in the refreshed second mandate to Health Education England, which will be published in the next few weeks.

The care certificate will need to take full account of the standards set by the person appointed to do so by the regulations made under clause 93—as I said, we  envisage that being Health Education England—and will be key to ensuring that those standards are applied consistently throughout both the health and care sectors. Once the certificate has been launched, the intention is for the CQC to update its guidance about compliance to refer to the certificate. Portability is clearly an issue, as we have discussed, and I hope to reassure my right hon. Friend the Member for Sutton and Cheam on that in a moment. Completion of the certificate by the relevant work force could be used as evidence of compliance with the registration requirement in relation to all CQC-regulated activities, in the same way as completion of the common induction standards is currently used in social care settings.

My right hon. Friend raised the important point of the portability of the certificate. It is our intention that the certificate will be portable between employers, enabling workers to move seamlessly around the system. However, the primary responsibility and duty is for the CQC to inspect the employer, to make sure it has invested in its work force. It will be for the CQC to be satisfied that the work force meet the required standards for training and development.

Photo of Paul Burstow Paul Burstow Democratiaid Rhyddfrydol, Sutton and Cheam 3:30, 28 Ionawr 2014

It is reassuring to hear that. Can I be clear that that portability extends to the recording on the certificate of qualifications obtained during a period of work with a particular employer, so that the next one has the benefit of that?

Photo of Daniel Poulter Daniel Poulter The Parliamentary Under-Secretary of State for Health

These matters will be for the CQC to look at. The important thing is that we also recognise that a care certificate that is valid today may well not be adequate in five or ten years’ time. It may be that the CQC would like to see people refresh their training. It may be that the basic standard of care needs to be modified and adapted as we go forward because of advances in care, or because there are other requirements that it is important to put into it. It may be that Health Education England or another body appointed to develop the training certificate will need to modify it as time goes on.

We have to be careful about seeing the certificate as a panacea that always delivers good care. That is why we need to leave the CQC the flexibility to inspect against other training requirements, and the ability to update the certificate of care as time goes on. As with all health care training, a surgeon trained in 1950 may not have the skills to operate in 1980 or today, although they may have the same basic knowledge of anatomy—we certainly hope they do. Similarly, it is important that other aspects of health care training are modified appropriately as time goes on, in order to meet the needs of patients.

Photo of Sarah Newton Sarah Newton Ceidwadwyr, Truro and Falmouth

May I press for more clarity on this important point? A lot of very good care providers provide their own in-house training because, as my hon. Friend rightly identified, there is a paucity of high-quality training. Will there be a scheme for accreditation for care providers who have already invested in good quality training, sometimes working with partners?

Photo of Daniel Poulter Daniel Poulter The Parliamentary Under-Secretary of State for Health

My hon. Friend rightly picks up on the fact that some care providers have very high training standards, and others do not. That variability is the  concern that was raised in the Cavendish inquiry, and that is what we are looking to address. The way we envisage the system working will be set out in regulations. Health Education England will very likely be the designated body, and more detail will be published in the mandate about first steps and the timetable for how this will be developed. HEE would look to develop fundamental standards of care. The CQC would then inspect to make sure that training providers had ensured that their work force had that care certificate, and that they had staff with the right training skills across all the aspects of care required. It may be that some of the care that is required for the basic training certificate is not good enough and more things need to be added, depending on the setting and the staff mix required. That is a judgment for the CQC to make.

The fundamental point is that we need the variability in training standards ironed out and the standard to be raised, so that we raise the game of those providers who have not adequately invested in their staff, to the detriment of patients. We must raise the game so that there is, at the very least, a care certificate that we would expect all health care staff to have. It would be for the CQC to inspect health care providers and make sure that their staff comply with that. That is how we envisage this to be delivered, but further regulations will come forward in due course. The Government have made it clear that regulation is no substitute for a culture of compassion and effective supervision. The care certificate aims to improve the consistency and performance of the health and care support workers, without placing a disproportionate additional burden on either employers or the work force.

We have decided to tackle this issue of raising standards in training. By focusing on the right training support and leadership, we will provide the high-quality care that patients deserve. I am confident that right hon. and hon. Members will agree that these actions are proportionate, and I ask Opposition Members not to press the new clause to a Division.

Photo of Jamie Reed Jamie Reed Shadow Minister (Health)

I genuinely thank the Minister. This is the first time I have ever been involved in any kind of debate where I have advocated a position, only for the Minister to completely, totally and utterly agree with it and then refuse to accept where that logic leads to.

Portability is critical, and the right hon. Member for Sutton and Cheam is right to mention it. If any kind of certificate is held by anyone at all, a centrally held record will surely exist somewhere. I cannot, for the life of me, determine the difference between a register and a centrally held record that tells us exactly who has a particular certificate, when they got it and whether they are fit to practise. What is the difference between a centrally held record and a register? The Minister made this point passionately and convincingly, so does he believe that it is correct that someone who holds a certificate but fails to meet its standards—or the standard that the certificate suggests—should continue to be able to practise under the auspices of that certificate? I suggest that it is not right.

Does the Minister also agree that a valued, supported, accredited work force will deliver a better standard of care? He is right to point out that there are excellent  examples of care. The kinds of care that we seek to achieve are precisely the kinds of care that we all want for each other, for ourselves, for our parents and for colleagues across the House. Looking to Francis’s scathing view of the “gentleman’s agreement” type of professional conduct and practice, does that not strongly suggest the need for a register of health care assistants? Finally, is not the scale of the need laid bare by the fact that while 1.3 million people are employed by the NHS, as the Minister says, a further 1.3 million people are employed across the health and social care sector?

Photo of Daniel Poulter Daniel Poulter The Parliamentary Under-Secretary of State for Health 3:45, 28 Ionawr 2014

I welcome those further comments. There is no disagreement on either side of the Committee about what we are trying to achieve, which is a work force in which training standards are consistently better. We also recognise that the failings at Mid Staffs, where the issues that the hon. Member for Copeland raises come from, were failings of regulation and the failures of a purely list-based system. To say that regulating a profession or having a list is a foolproof solution to anything and is the only way to raise standards has, from first principles, been shown not to be the case at Mid Staffs.

The big lesson I take from that is that ensuring that we have a work force best placed to look after care receivers—as well as all the other issues flagged up at Mid Staffs, such as the need to have a more open and transparent culture—is fundamentally about making sure that providers invest in the education and training of their work force. Workers must also be supported to understand what they need to speak up about, such as poor care, and how to speak up.

That is very much the Cavendish review’s approach, which is that this is not about regulation, but about raising the group’s esteem and potentially breaking through glass ceilings. There is an issue with health care workers sometimes struggling to progress to become nurses even though they have the compassion and other attributes that would make them exceptionally good nurses. The review also recognises that broader issues need to be addressed. Part of the challenge is that we often see things through the prism of the NHS when the vast bulk of the care work force exists in the community providing care in people’s homes, care homes, nursing homes and other environments. There is too much variability in the training of that work force. The Cavendish review found that the best way forward is to deal with parity of esteem—to raise the esteem of the health care assistant work force and the care work force—but also, importantly, to raise training standards and make it the business of every health care provider to invest in their work force. We need, at the very least, a de minimis standard of care. The Care Quality Commission must inspect the care provided in a care home or hospital and take a view on it. It is not just about de minimis standards, but about recognising that sometimes, in different care settings, different care standards need to be applied. The CQC must also look at the operation of the work force as part of a multidisciplinary team, which is an important aspect of care.

As part of the portability issue that has been raised, we must also look at how those issued with certificates can be recorded within existing systems. The NHS staff database is one example of how we could do that, to make it much easier to see whether someone has acquired  a care certificate. An important difficulty with that—this is exactly why we have introduced revalidation for doctors, and the Nursing and Midwifery Council are looking at doing the same for nurses—is that just because somebody qualified as a doctor in, say, 1995 does not mean that they do not need to prove that their skills and knowledge are still up to date. The same argument would apply with this sort of register, which is why it would not necessarily, as we saw from the Francis inquiry, ensure the quality of services.

Registration with professional groups is part of ensuring the quality of services, but we must also make sure that we have the right training in place. That is why we have followed the Cavendish review recommendation and we believe that the training certificate is the right way to proceed. Through the regulations that we introduce, we will support the development of that certificate to raise the game throughout the care sector and health care sector on education and training standards, and we will support the portability of the assessment and training standard.

Photo of Jamie Reed Jamie Reed Shadow Minister (Health)

We will return to the matter on Report, but I do not seek to divide the Committee now.

Question put and agreed to.

Clause 93 accordingly ordered to stand part of the Bill.

Clause 94 ordered to stand part of the Bill.