First Reading of Paul Burstow's Private Member's Bill: Care of Older People (Human Rights) Bill

Speech delivered on Wed 11th Jan 2006

Mr. Paul Burstow (Sutton and Cheam) (LD): I beg to move,

That leave be given to bring in a Bill to amend the Human Rights Act 1998 to extend the definition of public authority to include any body that is regulated under the Care Standards Act; to provide for clear nutritional standards to apply in all establishments providing care for older people; to place certain duties on the Food Standards Agency; to make provision in relation to mentally incapacitated persons; to confer new functions on local authorities in relation to persons in need of care or protection; and for connected purposes.

I suspect that the name Victoria Climbié will be well known to hon. Members on both sides of the House, but the name Margaret Panting may not be so well known. What is the difference between them? Victoria's tragic death convulsed the child protection system, resulted in two criminal prosecutions, led to the Laming inquiry and the Children Act 2004. Margaret's death did not even result in anyone being charged for the 49 injuries on her body, including razor blade cuts and cigarette burns. The difference between Victoria and Margaret was 70 years.

The purpose of my Bill, first and foremost, is to safeguard vulnerable older people from abuse and neglect. My Bill comes in three parts. Part 1 seeks to close a loophole in the Human Rights Act 1998. Thanks to the way in which the courts have interpreted the meaning of "public authorities" under section 6 of the Act, when someone crosses the threshold of a privately run care home the writ of the Human Rights Act does not run. Quite simply there is a protection gap, and it is the old and the vulnerable who are falling through the gap.

When older people are neglected or mistreated in a care home, when relatives are told they cannot visit because they ask awkward questions, when a married couple are told that, against their wishes, they cannot stay in the same care home and when an older person is evicted from a care home, it is rarely seen as a human rights issue, but often a case of poor practice or standards. Yes, of course standards matter, but first and foremost those are violations of a person's human rights. Such a restrictive interpretation of the Act is not what Parliament or the Government wanted, yet that is what has happened.

As many as nine out of 10 care homes are operated by private organisations. Two thirds of people living in those homes are paid for by local councils. Despite the legal duty on public authorities under the National Assistance Act 1948, the Human Rights Act does not apply. Privately run care homes are not public authorities. The rights of people who pay for themselves are even more at risk. They do not even have the possibility of a vigilant local authority using its contracting muscle to safeguard their dignity and welfare. The Joint Committee on Human Rights concluded more than two years ago that the courts should be interpreting the Human Rights Act more widely. It said:

"We urge the Government to intervene in the public interest as a third party in cases where it can press the case for a broad, functional interpretation of the meaning of public authority under the Human Rights Act."

The report was good, but it left the matter to the courts to resolve in time, and time is something that the frail elderly in care homes do not have.

Two years on, little has changed. The Government have not stepped in to put matters straight. They have not tried to amend the Act. As the law stands, two people can receive broadly the same service—one in a council home and the other in a private home—yet not enjoy equal protection under the law. My Bill would ensure that there would be such equal protection.

Part 2 of my Bill deals with nutrition in care homes. It is a scandal that in the 21st century, elderly people in care are starving to death. The facts speak for themselves. One in 10 care home residents lose up to 5 per cent. of their body weight within a month of being admitted to a home and 10 per cent. of their body weight within six months of admission. Much malnutrition goes undetected, but it is clear from even the available research that malnutrition in care homes is at epidemic levels. According to research by The British Association for Parenteral and Enteral Nutrition, more than one in five residents in care homes are malnourished, which means that there are 44,000 older people who are the victims of malnutrition today in England alone.

The personal cost of such poor treatment is incalculable and unacceptable. The cost to the taxpayer of treating malnutrition in long-term care has been estimated at £2.6 billion a year, which is a shocking waste. According to figures from the Commission for Social Care Inspection, almost one in five care homes in England fail to meet the most minimal of national standards for meals and mealtimes.

Since publicising my intention to bring in the Bill, I have received many messages of support from residents and the relatives of residents who have been neglected in care homes, care home cooks who have experienced bad and good care homes and have offered help with menu ideas, and health professionals who have shared their concerns about patients who have been starved in care homes. One lady reported that her mother was nearly starved to death while she was a resident in a care home. Like many of the other residents at the care home, the elderly lady suffered from dementia and needed help with feeding, but none was provided. Residents were left to fend for themselves and relatives were banned from the dining area. When news came that the care home was to be closed, conditions deteriorated further. Residents were forced to live on a diet of Angel Delight and beans on toast—sometimes pilchards on toast. Residents were left for up to 16 hours between meals because the cooks went home at 4 pm. When the manager was asked what the residents could eat at night, he told relatives that there was a pot of fish paste in the fridge. Fortunately, when the lady moved to a new home, the care that she received was so much better that she put on a stone in a month.

Unlike the standards that are to be introduced in schools, the standards for care homes say next to nothing about nutrition. The Government have rightly decided to implement nutrient-based standards for school meals and it is time that they did the same for care homes. My Bill would put in place such nutrient standards.

The third and final part of my Bill would give local authorities the task of investigating alleged abuse and the teeth to protect vulnerable adults. The Health Committee reported on elder abuse in 2004. It struggled at that time to get an accurate fix on the scale of the problem because official figures simply do not exist. However, the Committee heard evidence that there could be as many as 500,000 elderly people being abused in the UK at any one time. What do I mean by abuse? I am talking about theft, imprisonment, mental and physical torture and even rape. I am talking about care homes misusing drugs to make managing older people easier due to a culture in which the convenience of staff comes ahead of the needs of residents. I am talking about maltreatment and neglect that denies vulnerable older people their dignity and sometimes even their lives.

More than a decade ago, the Law Commission said that the law to protect vulnerable people who were at risk of harm was outdated and ineffective—it still is. My Bill would place a duty on local authorities to investigate when they have reason to believe that a vulnerable person is suffering, or is likely to suffer, significant harm or serious exploitation.

The House must not wait for an elder abuse scandal to hit our national headlines. It is essential that we have action now on basic rights, proper nutrition and protection from harm. They are essentials, not luxuries, so I commend the Bill to the House.

Question put and agreed to.

Bill ordered to be brought in by Mr. Paul Burstow, Annette Brooke, Bob Russell, Stephen Williams, Peter Bottomley, Mrs. Joan Humble and Mr. John Leech.

Mr. Paul Burstow accordingly presented a Bill to amend the Human Rights Act 1998 to extend the definition of public authority to include any body that is regulated under the Care Standards Act; to provide for clear nutritional standards to apply in all establishments providing care for older people; to place certain duties on the Food Standards Agency; to make provision in relation to mentally incapacitated persons; to confer new functions on local authorities in relation to persons in need of care or protection; and for connected purposes: And the same was read a First time; and ordered to be read a Second time on Friday 3 March, and to be printed [Bill 112].