MPs backs ‘negative register’ of care workers in wake of abuse scandals

The government should implement the Health and Care Profession Council’s (HCPC) proposals for a ‘negative register’ of care workers in England, an influential committee of MPs has said.

The commons health committee’s 2014 review of the HCPC found that introducing a ‘negative register’ of staff ruled unfit to work in adult social care after investigation would “offer far greater public protection” than the system of voluntary registration of care staff previously mooted by the Department of Health (DH).

The committee said it was concerned by “a series of reports of abuse by social care workers”. In April of this year a BBC Panorama investigation exposed poor care at the Old Deanery care home in Essex.

The Law Commission drafted legislation that would have given health and care regulators the power to establish ‘negative registers’ subject to government approval. However, the anticipated draft bill was not included in this year’s Queen’s Speech which laid out the government’s plans for the final year of this parliament.

Care minister Norman Lamb has subsequently said the government will consider making some changes to health and care workers regulation via secondary legislation, but his comments did not refer to a negative register.

David Tredinnick MP, acting chair of the Health Committee, said: “Continuing concerns about regulation of the social care workforce need to be addressed, and we support the HCPC’s proposal of a negative register as the most effective first step in providing protection for the public.”

“We were surprised that the government does not intend to make progress with the Law Commission Bill on regulation of health and care professionals. For that reason we think it is important for the government to set out as soon as possible what changes it intends to implement to the procedures of regulators…to make sure that they are as effective as possible,” he added.

In 2011, the Department of Health proposed a voluntary register for care workers but the committee found that “no progress” had been made since then and said it agreed with the HCPC that “voluntary registration would not be effective”. The HCPC believes a negative register is needed because it is cheaper than registering all social care workers and more likely to be effective than voluntary registration or self-regulation.

The HCPC’s proposals would introduce a statutory code of conduct for adult social care workers in England. Significant breaches of this code would be reported to the HCPC for investigation and staff found unfit to practise would be added to a ‘negative register’. Under the plans it would be a criminal offence to work in adult social care in England whilst on the negative register.

The HCPC also proposes introducing a requirement for managers of CQC registered adult social care services to undergo statutory regulation like other regulated professional groups, such as social workers.

In evidence to the committee, the Professional Standards Authority (PSA), which oversees regulators including the HCPC, said it had identified several issues around a negative register. It said that a negative register “would not stop an initial instance of harm to a service user” because action could only be taken after an event and raised issues around funding for the scheme.

“The costs of running the negative register would not necessarily be borne by the occupational group as is the case with assured voluntary registers and statutory professional regulation. If this is the case, it is not clear who will pay for the barring scheme,” the PSA said in evidence.

The HCPC has previously said the scheme would most likely be paid for by a levy on employers or by the government.

In a joint statement issued in response to the committee’s report HCPC chair Anna van der Gaag and Marc Seale, the regulator’s chief executive, said: ‘We share the Committee’s concerns on reports of abuse by adult social care workers and welcome their recommendation that the Government should publish plans for the implementation of our proposals for a negative register.

“Legislation is needed if we are to deliver a robust system of regulation for this group. As we reported to the Committee, we believe our proposals are proportionate, cost effective and stronger than the current system, allowing the regulator to effectively deal with the small minority whose conduct makes them unsuitable to work in this area.”

A Department of Health spokesperson said: “Following the Francis Inquiry, we need to make sure that our professional regulation system is fit for the future. We are committed to legislate on this important and complex issue when Parliamentary time allows.

“In the meantime, we are already using secondary legislation to make any urgent changes necessary to make sure that patients can continue to be confident that they are receiving safe care. We welcome the committee’s report and will respond to the recommendations in due course.”