Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)

I beg to move amendment 122, in clause 10, page 6, line 34, leave out ‘annulment’ and insert ‘approval’.

Thank you, Mr. O’Hara. We move to clause 10, which deals with more regulations under clause 8. The premise of amendment 122 is simple: the House should be given the opportunity to debate the regulations proposed in clause 8 regarding the form and content of the quality accounts. Presently, the regulations will be introduced into the Bill by way of a statutory instrument that the House will have the opportunity to annul. If we were given the chance to debate the regulations through approval of the secondary legislation rather than annulment, the Government could benefit from the views of the House on the scope and content of their regulations.

Without sight of the regulations, it is impossible to ascertain whether quality accounts will be rigorous and objective enough to paint an accurate picture of a trust’s services, or indeed the quality of those services. Although we endorse the notion and principle of quality accounts, we have not yet been given the opportunity to scrutinise the detail of the proposal. The regulations would raise a number of issues for debate, such as the circumstances in which the Secretary of State might exempt a trust from producing a quality account and the extent to which the regulations provide for an objective account of quality based on outcomes. In previous debates, we have certainly touched on the former, and the Minister, in responding to a previous proposed amendment, stated that the Secretary of State would have the power to exempt a trust from producing a quality account.

I think that the Government have in mind very small suppliers of NHS services who might find that producing quality accounts is neither proportionate nor particularly relevant to the service supplied. We must be extraordinarily  careful that that cannot be used to exempt from producing quality accounts pioneer technological suppliers or those at the riskier end of providing services to the NHS, as more innovative suppliers can often be. If quality accounts are not produced, there would at least have to be no expectation that quality assurance—or the requirement for patient safety, of course—would be lessened by the granting of the exemption. It is easy enough to imagine a small operation for which it would be disproportionate or a terribly minor part of an overall service given, but we need some reassurance that the measure is not a potential way to get out of the obligation to produce quality accounts.

As with so much of the Bill, we do not have the draft secondary legislation or the proposed detail of the quality accounts. We have some examples, but the Minister rightly observed that that is not what is expected in the final iteration and analysis. The amendment would therefore be helpful in giving the Government, and indeed the House, the opportunity to take a view on whether the approach is working well, rather than simply using the process of annulment.

Mike O'Brien (Minister of State (Health Services), Department of Health; North Warwickshire, Labour)

Our original proposal was to use the affirmative route on the first occasion and the negative route thereafter. We amended the Bill in the other place to address recommendations by the Select Committee on Delegated Powers and Regulatory Reform that the negative route would suffice in this case. We have responded to that by taking our present position. Of course, we will want to engage extensively with external stakeholders on the design of the rules for quality accounts. We have already heard the views of more than 1,000 interested parties, and we want further consultation when appropriate before bringing things forward.

I do not see that much would be added by using the affirmative route for approving these often detailed regulations and procedures. We need to ensure that the various stakeholders are engaged; if they have concerns, they will doubtless bring them not only to our notice but to that of Opposition Members. The stakeholders will therefore be able to ensure that appropriate discussions are held should regulations prove controversial. However, we envisage that the development of the regulations would not usually be a matter of considerable controversy.

The hon. Gentleman said that we must not create a process under which various organisations can get out of providing quality accounts, and I agree with him. We need to be careful how the exceptions are used. That is why we want to consult on their detail, and when we should use them and when not. We do not want to impose unnecessary burdens on small organisations or small providers of limited services; but we want to be sure that if there is an issue about the quality of service that a patient may receive, there is an opportunity to consider whether quality accounts ought to be delivered. That may well be the outcome of the consultation on the particular providers of equipment that the hon. Gentleman mentioned.

I hope that the hon. Gentleman understands why we took the route that we did in our approach to statutory instruments, which was in response to the suggestions by the Select Committee on Delegated Powers and  Regulatory Reform in the other place. We have taken that view on board and responded to it. To some extent, I believe that we deserve credit for having done so.

Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)

I recognise how the position reached in the Bill came about, but it was necessary to probe to obtain that confirmation. The intent is clear and I agree with it. The main thing is to ensure that there is no opportunity for misunderstanding. That exchange, in itself, should suffice. I beg to ask leave to withdraw the amendment.