Directors in charge of care homes and hospitals could be charged with criminal offences if there are failures in care at their organisations under new plans to stem cases of appalling treatment witnessed at Winterbourne View and Stafford Hospital.
Care and support minister Norman Lamb will say that those in charge of organisations where abuse occurs should be held to account.
He will unveil new plans to address the loophole in the system where providers responsible for failures in care can escape prosecution.
Mr Lamb said the proposals will make it easier for the Care Quality Commission (CQC) to prosecute providers and their directors where there are clear failures to meet very basic standards of care.
Since the CQC took charge of regulation of health and social care in 2009, there have been no such prosecutions, a Department of Health spokeswoman said. She said that providers responsible for appalling care can escape prosecution, even in the worst cases, because the CQC can only prosecute when it has previously issued a warning notice to the provider and it has failed to comply with that warning notice.
Officials want to remove the layer of protection for health and care providers and enable the CQC to be able to prosecute without giving notice.
"Scandals like Winterbourne View and Mid-Staffs have damaged confidence in our health and care system," Mr Lamb said. "Part of our commitment to rebuilding that trust comes from making sure that people at all levels are held to account for failings when they occur. Whilst there must be a sharper focus on corporate accountability, more needs to be done to ensure those responsible for leading a care organisation are up to the job. I hope that providers and people who use services and their families will respond to this consultation as we look to take these proposals forward."
Mr Lamb will also introduce a "fit and proper" test for directors and if they fail the assessment they will be sacked. The proposals are part of a wider remit of changes to the way the CQC regulates health and social care providers.
Mr Lamb said the new plans would seek to impose fines rather than jail terms following prosecutions. He told ITV's Daybreak: "We're not jailing but it would be unlimited fines and it will be for the awful cases. If you break the fundamental standards that you have to comply with as a provider of care, and you are responsible for that, there are consequences, and I think that's what the public expect."
He added: "There's also a culture when awful things happen, there's a cover-up, people get paid off, they get gagged from talking about it. That has to end. These pay-offs have to end and people at the top of the organisation should be held to account."