Clause 2
Health and Social Care Bill
11:00 am
Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)
I beg to move amendment No. 6, in clause 2, page 2, line 28, leave out paragraph (c).
We move amendment No. 6, given that amendment No. 5 depended upon amendment No. 4 being carried, and I do not want to press that further. In clause 2(5), amendment No. 6 seeks to divest the CQC of its function of economic regulation. It may help the Committee if I draw attention to the fact that the amendments to clause 50 would relocate that role to Monitor, an existing body that already has the necessary expertise and practice. Those who remember the programming sub-committee will recall that we had hoped that Monitor would be able to give evidence during the oral evidence sessions. The Government chose not to take up that suggestion, but here is where it would have been relevant for our considerations.
Economic regulation covers all aspects of the operation of the social market. An economic regulator needs to possess substantial powers to intervene in order to determine service reconfiguration and the management of NHS trusts and to decide how service requirements must be met. A quality inspector needs to report openly and frankly on the quality of services provided. There is a tension between the two: the need to drive efficiency from an economic point of view may conflict with the need to warn about the potential of declining standards of care from a quality perspective. Oddly enough, the example that my hon. Friend the Member for Tiverton and Honiton gave in the last group would be a good example to bear in mind as we look at that tension.
For example, the economic regulator may sanction the rationalisation of a trust’s estate from two sites to one. That is something we can all imagine, as we often face testing decisions in our constituencies. However, that may be detrimental from a quality perspective. If the two regulatory functions are combined, there is a risk that one side of the argument will be lost, and such conflicts of interest will make a regulatory regime, in which economic regulation and quality inspection are combined, unsustainable. The amendment gives rise to the opportunity for those two functions to remain separate, as indeed they are, with Monitor, highly qualified and well experienced, taking the role of economic regulation, and the CQC functioning as a quality and value for money inspectorate.