As we have already heard, clause 44 covers commissioning by local authorities and primary care trusts and how it impacts upon the services that people receive and the health of the local population; it also provides for scrutiny of the way in which strategic health authorities contribute to those operational issues. The amendments would preclude that last discretion.
Clause 90 defines the terms used in clause 44 and elsewhere in the Bill, and makes it clear that NHS care includes all health care provided by primary care trusts or other people providing health care under arrangements made by primary care trusts. At the moment, as we know, independent sector providers are included in reviews and investigations into adult social care when offering services under agreements reached with local authorities, but not otherwise. Independent health care providers can be covered by special reviews and investigations when they are offering services directly on behalf of the NHS.
That takes us back to discussions that have been a common theme through this period—how far the new Care Quality Commission should involve itself in purely private transactions between individuals and businesses. Special reviews and investigations are intended to provide the commission with the power to consider issues that might undermine public confidence in publicly funded or commissioned services, and to encourage improvement in such services. In those circumstances, we think it right that the scope of the commission’s reviews and investigations under clause 44 should extend to people who provide services under arrangements made by a PCT or a local authority. That will apply whether they are statutory or independent.
The commission will of course monitor and inspect anybody providing regulated activities as defined under clause 4, to ensure that they meet the necessary requirements. The process will be the same whether they are statutory or independent sector bodies. The commission will be able to investigate the failings of a specific provider and take enforcement action as appropriate.
I think that we will be talking about the transition a little later, but I hope not at great length or repetitively. The new Care Quality Commission will be able to conduct urgent reviews on issues that it thinks are a matter of safety or quality in the initial 12 months phase. However, given the substantial registration process that will need to be established within that first year, we believe that there should be a transition period during which it does not conduct the special reviews. We should all note the warm welcome that Anna Walker gave to its continued freedom to conduct whatever reviews it wants. However, until the registration process settles down—it is most important to the new regulatory regime—the reviews that it carries out should concentrate on safety and quality. That is obviously a sensible approach.