Under the clause relating to the grant or refusal of registration as a service provider, we are seeking to place some restriction on the actions that the commission may take “at any time”. Amendment No. 9 would add a new subsection (5A) providing that
“the Commission shall be obliged to publish its reasons for any actions it takes.”
Amendment No. 10 does the same for the processes in clause 11.
I am happy that the regulator needs to be fleet of foot—a phrase that I sought to impress on the Minister earlier—in its approach to regulation and that as it registers and reviews services, it might find that important additions are needed to the registration procedure. Our concern is somewhat simple, but twofold. The Bill gives the commission the licence to change the registration of providers at will, and with what regularity it chooses. What assurances can the Minister give that that will not happen to the point at which it could become unpredictable and, at worst, done on a whim, rather than at will?
More concerning, given the lack of independence from ministerial meddling that the CQC has regarding the arguments that we have managed to make, but the Minister has not accepted, are the potential changes in registration that are driven by political exigencies rather than regulatory need, without any reference to the House or consultation with stakeholders. Under what circumstances does the Minister see those powers being used? Does he have examples from the current regulators, and what checks and balances are in place so that they are not abused?
We agree that it is important that there should be a proper procedure for the Care Quality Commission to follow when it makes certain decisions about registering or deregistering a regulated activity or a manager, or about suspending registration or amending the conditions of registration. We have set out those procedures in clauses 22, 23 and 24.
Under clause 22, in particular, we require the commission to give its reasons for such a decision in a written notice to the relevant registered providers or managers. We also agree that the public will want to be reassured that the commission has taken appropriate action where providers fail to meet requirements. We want the commission to publish information in relation to enforcement, but not in relation to some of the rather everyday activities of managing the conditions that it places on the registration of providers or managers. For example, registration conditions could change simply because a provider wished to provide a new service, or to cease to provide an existing service. Conditions can also change as a result of changes in premises or a change in staff. We believe that it would be unreasonably bureaucratic to require the commission to publish its reasons for making those changes in all those areas.
That is why we have made clear in clause 83 that regulations may allow or require the commission to publish information about the enforcement action it has taken. That is so that we can differentiate between enforcement action and routine administrative processes. We believe that extending the requirements in the way proposed in the amendments would be excessively burdensome and bureaucratic.