1.  The Minister has undertaken to examine the issue of publicly arranged health and social care provision and the Human Rights Act again in the context of this Bill. We look forward to the Minister's amendment in good time for a full debate on this issue in the House of Lords. (Paragraph 1.3)

2.  A number of Members in the House of Commons shared our serious concern that the Bill does not adequately highlight the importance of a human rights based approach to the work of the CQC. A clear framework for the protection of the rights and dignity of vulnerable users of health and social care could and should be provided in this Bill and we recommend that the Government bring forward amendments in the House of Lords to remedy this shortcoming. (Paragraph 1.4)

3.  Many of the details [Part 3] of this Part, including safeguards for individual rights, are left to secondary legislation. It remains our view that it is inappropriate for legislation which has serious implications for individual rights to be based principally on enabling powers with detailed safeguards left to secondary legislation. We outline some examples and proposals for clarification, below (Paragraph 1.12)

4.  The Bill clearly makes provision for the deprivation of liberty in respect of both "infection" and "contamination", through provision for detention at hospital or elsewhere and through the use of isolation and quarantine measures, without limitation on duration or the circumstances in which an individual may be held. (Paragraph 1.14)

5.  We accept that public health measures may need to be taken to meet a significant risk caused by contamination by biological, toxic, radioactive or other agents. The provisions for detention, isolation and quarantine in these circumstances must be clearly defined and accompanied by appropriate safeguards to avoid arbitrariness. If this is not done, the European Court of Human Rights would subject any application based on a breach of Article 5(1) to very close scrutiny. With proper safeguards, we think it likely that the European Court of Human Rights would accept the Government's argument that diseases caused by contamination fall within the listed exemptions to the Convention right to liberty. Without such safeguards, we consider that the Court will be less inclined to accept the Government's view that the Convention definition of "disease" should cover powers to deprive a person of their liberty as a result of contamination as well as infection. (Paragraph 1.18)

6.  Amendments should be brought forward to clarify the provisions in Clause 124 and New Section 43C during the Bill's passage through the House of Lords. (Paragraph 1.23)

7.  If the Bill is designed to empower the Secretary of State, or the Welsh Ministers in Wales, to impose administrative detention, quarantine or isolation, the Government must provide evidence of the need for such a broad, undefined power and there must be clear and effective safeguards on the face of the Bill to ensure that Health Protection Regulations operate in a way which ensures that people are protected from arbitrary detention in breach of the right to liberty. (Paragraph 1.24)

8.  We recommend that the Minister explain to Parliament why the general power to impose restrictions and requirements should not be more comprehensively defined in the Bill. In particular, he should explain why the power to enable the imposition of Special Restrictions and Requirements should not be expressly limited to defined circumstances where a uniform, national response may be necessary to meet a serious and imminent threat to public health. (Paragraph 1.32)

9.  We have consistently stressed our view that Section 6 HRA should not be used as a "safety-net" to ensure that broadly drafted powers are exercised in a way which affords respect for individual rights. In order to foster legal certainty and to reduce the risk that individuals rights are unnecessarily endangered, appropriate safeguards should be included on the face of the Bill. (Paragraph 1.34)

10.  Despite our concerns about their breadth, Health Protection Regulations made under these proposals would benefit from a clear statement from the Government about compatibility with Convention rights, accompanied by sufficient analysis to aid parliamentary scrutiny. (Paragraph 1.35)

11.  We recommend that the provisions are amended to remove the subjective element from the analysis of proportionality and to require that any restriction or requirement imposed is proportionate to its aims, including both to its immediate goal and the threat posed to public health. (Paragraph 1.37)

12.  We consider that the restriction of certain Health Protection Regulations to circumstances where there is a "serious and imminent threat" is an important one. However, this safeguard is undermined by the failure to include on the face of the Bill provisions which (a) impose a renewable maximum time limit on the time a person may be subject to Special Restrictions or Requirements imposed by Health Protection Regulations; (b) make clear that Special Restrictions or Requirements must be lifted when they are no longer either necessary or proportionate to meet the serious and imminent threat they are designed to meet, and (c) provide a clearly defined mechanism of review in order to ensure that the restrictions continue to be necessary and proportionate to the risk or threat posed to public health. (Paragraph 1.40)

13.  The requirement that Health Protection Regulations which impose a Special Restriction or Requirement must provide for an appeal to a magistrates court and for a "right of periodic review" is an important and valuable safeguard. However, we are concerned that substantive details of these rights are to be left to secondary legislation and need not be consistently applied in relation to each set of Health Protection Regulations. (Paragraph 1.41)

14.  The Government must provide a satisfactory justification for their views that some of the basic details of these important safeguards should be left to secondary legislation or otherwise such safeguards should be on the face of the Bill. (Paragraph 1.41)

15.  We do not think that it is appropriate for a Minister subjectively to determine the process for parliamentary consideration of measures which may engage individual rights on a case by case basis. Where individual rights may be engaged, the relevant provisions should be contained in primary legislation and subject to full parliamentary scrutiny. Failing that, the affirmative resolution procedure should always apply to any categories of regulations which may engage individual rights. (Paragraph 1.42)

16.  We consider that, in the light of the types of emergency which the Government considers these regulations may be necessary to meet (for example a nationwide outbreak of Ebola, SARS or another life-threatening illness) the emergency procedure in this Bill should be amended to reflect the provisions of the Civil Contingencies Act 2004. (Paragraph 1.43)

17.  We consider that the protection of the individual right to liberty would be enhanced by the express acknowledgement on the face of the Bill that detention, isolation and quarantine are measures of last resort which should only be imposed if no other measures are capable of effectively reducing or removing the risk to public health. (Paragraph 1.49)

18.  We recommend that the Bill be amended to provide greater protection for persons against the continued arbitrary application of a series of [Public Health] Orders without review, particularly where those Orders relate to detention, isolation or quarantine. (Paragraph 1.50)

19.  We will propose these amendments to enable this issue to be debated in Parliament and to hear the Government's justification for its current position, particularly in the light of any scientific advice. (Paragraph 1.50)

20.  We are concerned that there is no provision on the face of the Bill for Public Health Orders to be based on objective medical evidence. The Bill should be amended to require Regulations made under New Section 45G(7) to include a requirement that no Public Health Order may be made, or remain in force, without objective medical evidence. (Paragraph 1.53)

21.  We expect that any draft Regulations proposed under this Part of the Bill should be made available well in advance of their being laid before Parliament to allow for full debate. We look forward to receiving a copy of these draft Regulations when they are available. (Paragraph 1.54)

22.  We agree with the Government's analysis that, provided the heightened civil standard is applied in the most serious cases [by Fitness to Practice Panels], it is unlikely that a serious risk of incompatibility with the right to a fair hearing will arise. Provided that a hearing is otherwise fair, and the heightened standard is applied, we consider that it is unlikely that the right to a fair hearing will be undermined through the application of the civil standard alone. (Paragraph 1.60)

23.   Given the importance of the role to be played by Legal Assessors, it is important that they are provided with appropriate guidance and training on the requirements of Article 6 ECHR and the need to identify the most serious cases where a heightened standard of proof may be required. In any case where the allegations involved may lead to a serious sanction (such as removal from the register), including on appeal, or which may also amount to a criminal offence, a Fitness to Practise Panel must apply the higher standard. (Paragraph 1.60)

24.  We are concerned that the Minister relies on the proposed offences which will apply to disclosure of information to illustrate how strongly the CQC and its staff will be concerned by the need to protect personal information. The Minister should be asked to explain why it is necessary to have a broad defence based on reasonable belief in the expediency of providing material to a person or body in pursuit of their statutory functions. (Paragraph 1.65)

25.  We are disappointed that draft copies of these Regulations [which will provide the detail of how the general duty of disclosure proposed in the Bill will work] have not been made available in time to inform parliamentary debate. (Paragraph 1.68)

26.  The Minister should be asked to explain why the ability to disclose information in response to a request should not also be limited by reference to a threat to patient safety. (Paragraph 1.69)