Clause 42
Health and Social Care Bill
1:30 pm
Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)
The amendments seek once again to limit the scope of the commission to reviews of quality and value for money, rather than economic viability. The debate will be akin to some degree to that on amendment No. 6 to clause 2, at column 175 of the Official Report. I am sure that members of the Committee will recall that I talked about economic regulation covering all aspects of the operation of the social market. The economic regulator would need to possess substantial powers to intervene in order to determine service reconfiguration and the management of NHS trusts, and to determine how service requirements must be met.
However, a quality inspectorate needs to report openly and frankly on the quality of the services provided. There could be tension between the two activities. We hope not, but I dare say that we can all envisage circumstances where the need to drive efficiency from an economic point of view might conflict with the need to warn about the potential of declining standards of care from a quality perspective.
When we discussed the matter before, I must say in fairness to myself that the Minister misrepresented the position. I am putting forward the desire—a party position—not to extend massively the powers of Monitor, which suggests a net increase in regulation, but to transfer the economic regulation role of the CQC to Monitor. As the Minister knows, we were unable to take oral evidence from Monitor. We had hoped to do so, but that was not possible due to compromises made on the programming.
In the foundation trust sector, which is relevant to the work of Monitor, quality and economic regulation are already divided along those lines and to those bodies. Our position aligns with our desire to see all trusts achieve foundation status. I should be interested to hear the Minister’s explanation of his contention that our establishment of an NHS board poses a potential massive conflict of interest. That would happen only if politicians continue to want to run the NHS, rather than to provide the means by which it can be run with clinical priorities as the first order of concern. I hope that the Minister has had time to reflect on matters and sees the merit in our proposals.