Clause 2 - Independent Regulator of NHS Foundation Trusts
Health and Social Care(Community Health and Standards) Bill
9:45 am
Dr Evan Harris (Oxford West and Abingdon, Liberal Democrat)
That was an interesting contribution, and a fair point was made. I hope that the hon. Member for South Cambridgeshire (Mr. Lansley) will recognise that much of what he says, although perhaps not all of it, is consistent with the amendments that stand in my name and in the names of my hon. Friends. Our amendments would ensure that the regulator—or the office of the regulator, since it should comprise more than one person—was based within the new Commission for Healthcare Audit and Inspection. I will explain the two main reasons for seeking to do that.
First, although the NHS may not be said to be over-regulated with regard to the level and depth of quality inspection—too much of which is superficial—it has been well established that there are multiple organisations roaming round the NHS and subjecting it to inspection. In fairness, that point was well made by Conservative spokesmen in other debates. I remember them making the point that a trust might be subject to inspection by a whole group of acronyms—an alphabet soup of acronyms—all allegedly involved in ensuring that qualities improve, whether that be in the current Commission for Health Improvement, the National Patient Safety Agency, the National Clinical Assessment Authority or any of a whole series of organisations.
Indeed, one of the reasons why the Government have found it necessary to revisit the Commission for Health Improvement is the need to integrate that with the current National Care Standards Commission in the new inspectorate. It also must be integrated with the Audit Commission's health functions, which is another area in which trusts are liable to be inspected.
It is bizarre for the Government to say that they are reducing the number of bodies that will inspect the NHS by integrating the functions of the National Care Standards Commission as they apply to private health care with the Commission for Health Improvement under CHAI, which are then to be merged with the health functions of the Audit Commission. At the same time, a brand new regulator will be set up whose functions, if one looks carefully, will be to consider quality and audit issues.
One reason for the amendments is to do what the Government should be doing—to continue the drive to reduce and to streamline the inspection and audit regime in the NHS.
The second reason is our strong feeling that a properly independent Commission for Healthcare Audit and Inspection must have the prime role in quality control, inspection and audit in the NHS. The Government's proposals for an independent commission do not provide that independence, but I hope that the Bill will be amended to ensure that they do. An independent, overarching quality control mechanism is vital, and it should apply to the whole of the NHS. We must not create an impression that foundation trusts must reach a different level of quality or have a different system of audit and inspection, except in the matters that make them foundation trusts rather than NHS trusts. Those should not be clinical issues. Most of the quality control, inspection and audit should be in common
between foundation trusts and other NHS trusts, if the Government are to be believed that there will not be a beggar-my-neighbour device in the NHS. However, many fear that that will be a consequence of the Government's sham-elitist approach to the selection of foundation trusts.