Will the Under-Secretary explain what he envisages the co-ordination of reviews involving? One of the concerns that I have raised is that NHS bodies should not be subject to multiple inspections by different agencies. I therefore welcome what I believe to be the objective of the clause.
However, I should also like to know whether the co-ordination of reviews means that a single body will carry out the review, and whether that provides for CHAI to take on responsibility from other public bodies for the inspection of a particular service or organisation; or whether the aim of co-ordinating the reviews is to ensure that the inspections do not all happen at the same time. That is particularly relevant in the case of the powers that the Bill gives to the Welsh Assembly to inspect an English trust when it chooses to do so. It would be possible for the Welsh Assembly to set up an inspection of an NHS trust in England that provides services to patients in Wales, without any reference to what was happening in England.
Theoretically, the CHAI inspectors and the National Assembly for Wales inspectors could turn up on the doorstep in the same week. I hope that the co-ordination of reviews is designed to ensure that that cannot happen, but I also hope that the Bill goes one step further than that and that the Government do not envisage the National Assembly for Wales sending its inspectors into England to investigate an English trust; rather that CHAI will carry out the review on behalf of another body. Therefore, CHAI, as the organisation with responsibility for carrying out inspections in England, would—whether following a request from an organisation such as the Audit Commission or the
National Audit Office or from the National Assembly—carry out the review itself and simply reflect in its work the questions that the other bodies wanted to ask.
As I am sure the Under-Secretary will agree, it would be insanity for different bodies to make multiple inspections through a year for different purposes, imposing on management time and distracting management from its job. I hope that the Government's intention in the clause is to ensure that that co-ordination takes place and that CHAI is responsible for doing the fieldwork on behalf of any other body, with a right to inspect an NHS hospital.
I do not have any problem with what the hon. Gentleman is saying, but why does he seek further clarity beyond what is in the Bill? Surely it does not make sense to say that in all circumstances CHAI must carry out the assessment or the investigation. What matters is that there are not multiple investigations. If CHAI is prepared to promote co-ordination using whatever public body is best placed to do that work, is that not sufficient?
Absolutely. I totally agree with the hon. Gentleman. However, two different situations could arise. CHAI could simply timetable multiple inspections to ensure that they did not happen at the same time in the same week, or it could bring different bodies together and say, ''We want to ask you questions. Let us give those guys the job of asking the questions, doing the fieldwork and coming back to us with the information, which we can then analyse to meet our specific, different purposes.'' The local management would then have to deal with only one set of inspectors banging on the door.
My question to the Under-Secretary is whether co-ordination allows that to take place or whether it would simply ensure that the same thing does not happen in the same week as a result of the activities of different organisations.
My point is a related one. The Under-Secretary will know that the trusts are concerned that they will be exposed to a wide range of different reviews. I want to ask him a question and I quite understand that he may not have the answer now, but I should welcome it at a later date. Could he give the Committee a list of all the public bodies or other persons referred to in the clause that are entitled to carry out reviews or assessments of English NHS bodies or cross-border SHAs? It would be helpful to have a list of those with the competence, so that we have a clearer view of CHAI's role in co-ordinating the work of all those bodies.
On that last point, I can of course provide a full list of those who conduct inspections. It is quite a long list, because of the history of the NHS, the relationship of the royal colleges and so on. This is an attempt to make CHAI primus inter pares, along the lines of the Kennedy report and the Bristol Royal inquiry. In a sense the duty is that of co-ordination. It would be wrong for me to say what form that co-ordination should take, but this is an attempt to reduce bureaucracy and burdens on the front line, as
Kennedy recommended, and to avoid multiple inspections. However, CHAI's functions are set out in the Bill; it will need to work with others, including the royal colleges, CSCI and other inspectorates to carry them out in the manner that it determines.
Question put and agreed to.
Clause 55 ordered to stand part of the Bill.