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Standards in nursing homes and private hospitals are going to be opened up to public scrutiny, health minister Paul...
Standards in nursing homes and private hospitals are going to be opened up to public scrutiny, health minister Paul Boateng promised today.

From April, health authorities will be required to publish their inspection reports on nursing homes, and private hospitals and clinics, giving people the chance for the first time to see how their standards measure up. Social services already publish their reports on residential homes.

Paul Boateng said:

'Change is long overdue in a system which has been neglected for years. Our Social Services White Paper, which is expected later this year, will herald an era of transparency in social care and introduce tougher regulation and inspection.

'Today we are publishing proposals for open reporting and fairer charges for regulation. Homes which look after frail and vulnerable people and clinics which provide private health care should be open and accountable to the public, and inspection findings should be available to anyone who wants them. It's ridiculous that for years people have been able to read reports on residential homes but not on nursing homes or private hospitals. We will ensure that local people have a right to know.'

Charges for health authority inspections will also be increased to reflect their cost. Registration fees will go up by 40 per cent from May, bringing them alongside higher fees charged by councils for residential home inspections which are being increased by 13 per cent

to match rises in inflation over recent years.

'We are determined to see a regulation system which is properly and fairly funded,' said Mr Boateng. 'For years the charges for regulating nursing and residential homes have been allowed to fall behind the cost. Health authorities and councils have been left to pick up larger bills, taking money away from hospital and community care. The government believes the reasonable costs of regulation should be met by service providers.'

Two consultation documents are being published today explaining how the department of health intends to implement the changes in reporting and charges.

For nursing homes, the initial registration fee was last raised in 1990 and the annual fee in 1988. Charges for residential care regulation were last raised in 1992.


1. Local authorities have been obliged to publish their residential home inspection reports since a circular was issued in 1994 - LAC(94)16. There is no obligation for health authorities to publish their nursing home or private health care inspection reports, though

some have chosen to. Local authorities and health authorities are both required to carry out at least two inspections a year of homes in their areas. Inspectors assess basic standards such as nursing staff training, staff to resident ratios, accommodation, and cleaning and washing facilities.

2. Most independent health care provision is regulated and inspected under part two of the Registered Homes Act 1984 which legally defines these services as 'nursing homes'. The services covered are:

independent acute hospitals; independent psychiatric hospitals;

hospices for the terminally ill. And any premises (unless specifically excluded) where: surgical procedures are carried out under general or local anaesthesia; pregnancies are terminated;

endoscopy is carried out; haemodialysis or peritoneal dialysis is carried out; and specially controlled techniques, such as the use of lasers.

3. In 1995-96 there were 350 establishments in England with 10,600 beds registered as independent hospitals and clinics. This compares with 5,500 nursing homes. Health authorities are the regulating authority, and the same arrangements and fees apply as for nursing

homes, although specialist staff are often contracted in for inspections. In addition, private hospitals and nursing homes where

abortions are performed are required by the Abortion Act to be approved separately by the secretary of state.

4. Regulation fees are payable under the 1984 Registered Homes Act. Financial returns suggest fees cover 50 per cent of health authority

costs and 40 per cent of local authority inspection unit costs. Funds may have to be diverted from services to finance inspections. According to national figures for 1995-96, expenditure by health

authorities was£9.2m and fee income£4.7m; expenditure by local authorities was£28.6m, and fee income£11.9m.

5. Responses to the two consultation documents - 'Open reporting in nursing home inspections' and 'Increasing regulatory fees for residential homes and nursing homes' - are needed by 27 February. Copies for the public are available from Department of Health Stores, PO Box 410, Wetherby, West Yorkshire, LS23 7LM.

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