Last month I attended a lecture by Robert Francis QC at the Royal Society of Medicine. Predictably, he was reflecting on the lessons from his Inquiry into events at the Mid Staffordshire Hospital Trust. At the end of a powerful lecture, challenging doctors to take action, he was asked for his reaction to the lack of progress on his recommendation to regulate care assistants. He responded by saying that in his view, “too little was being done”, adding that he was waiting with interest to see how the recommendations of the Cavendish review would unfold.
There is broad consensus that Camilla Cavendish provided a very clear direction on the roles and responsibilities of employers and managers, the importance of training and supervision and mentoring for support workers, emphasising the vital role they play in delivering health and social care. However, these mechanisms will not stop the tiny minority of individuals in the care sector who commit serial offences, and who successfully move from one care setting to another without redress. This is the group that HCPC have suggested require legislative change to bring them into a system of personal accountability.
Part 7 of the recently published Law Commissions Health Bill was therefore a welcome development in this long running, complex, and challenging area. The draft legislation from the Law Commissions make provisions for professional regulators to establish barring schemes which would allow investigation and adjudication of unregistered care workers. If a complaint was upheld, the individual would be barred from working in the sector and would be put on a list circulated to employers and available to the public on the internet. This would be a cost effective and proportionate mechanism for dealing swiftly with poor care.
The evidence from Australia, where this scheme is already in place, is that it is having a positive impact, proving a critical deterrent to those who would circumvent the system of accountability. We know from the data there that this kind of behaviour is not common, but where it does occur it can have a devastating effect on patients, service users and their families. After the shocking events of Winterbourne View, I wrote a piece on this blog which described why regulators as well as employers needed to act to bring about change in the care sector. The subsequent stories of appalling care in Mid Staffordshire, in Lanarkshire, in West Sussex and London, all point to the need for legislative change. I commend this section in the Law Commissions' Bill and look forward to seeing it become law. HCPC, if given powers to take action in the social care sector, will do so with vigour and determination.
Anna van der Gaag
Health and Care Professions Council
The Independent, 9 April 2014
Flynn M (2012) Winterbourne View Hospital: A Serious Case Review. South Gloucestershire Safeguarding Adults Board