Clause 50

Health and Social Care Bill – in a Public Bill Committee at 3:00 pm on 17th January 2008.

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Studies as to economy, efficiency etc.

Photo of Stephen O'Brien Stephen O'Brien Shadow Minister (Health)

I beg to move amendment No. 35, in clause 50, page 25, line 21, leave out ‘Commission’ and insert ‘Independent Regulator of Foundation Trusts’.

Photo of Jimmy Hood Jimmy Hood Labour, Lanark and Hamilton East

With this it will be convenient to discuss the following amendments: No. 36, in clause 50, page 25, line 36, leave out ‘Commission’ and insert ‘Independent Regulator of Foundation Trusts’.

No. 37, in clause 50, page 25, line 43, leave out ‘Commission’ and insert ‘Independent Regulator of Foundation Trusts’.

No. 38, in clause 51, page 26, line 2, leave out ‘Commission’ and insert ‘Independent Regulator of Foundation Trusts’.

Photo of Stephen O'Brien Stephen O'Brien Shadow Minister (Health)

I hope that the Committee feels duly excited by the fact that we have turned a page on the selection list.

The amendments would place the studies into efficiency and economy within the remit of Monitor instead of the commission. Amendment No. 38 is consequent on clause 51 requiring the studies to be published. I do not need to reiterate last week’s debate on clause 2 and amendment No. 6, or the one that we had earlier today on clause 42 and amendments Nos. 30 and 31. I hope that the Minister feels more favourable towards the tremendous work that Monitor will be able to offer, given that these points have come  up consistently during the course of our consideration of the Bill. Furthermore, I hope that he recognises the distinction in its expertise in and attitude towards economic regulation, as well as the other aspects of regulation that we have looked at.

Photo of Greg Mulholland Greg Mulholland Shadow Minister (Health)

Without getting into the substantive issue, there is a clear need to clarify the apparent duplication, which is what the hon. Gentleman is teasing out. It is a genuine concern that the Government must try to resolve. I look forward to the Minister’s comments.

Photo of Ben Bradshaw Ben Bradshaw Minister of State (Regional Affairs) (South West), The Minister of State, Department of Health

The amendments would remove the function of undertaking studies into economy and efficiency from the new Care Quality Commission. That returns to our earlier discussions about the extension, or otherwise, of the role of Monitor. I shall deal with that matter in some detail now, because it is a sensible point at which to do so.

As I have argued before, the amendments would considerably widen the scope of Monitor, which is currently only a regulator of NHS foundation trusts. As I am sure that the Committee knows, Monitor has no role in regulating adult social care, commissioners or other NHS health care providers. The Care Quality Commission on the other hand will be a regulator of both health and adult social care, and so the regulation of the NHS is only a part of its work.

There is a need for a commission that can take a completely independent view of whether health and adult social care providers, including NHS foundation trusts, meet essential safety and quality requirements and impose tough sanctions when they fail to do so. As we set out in our consultation on the future regulation of health and adult social care in England, that is a very different role from that performed by Monitor, which has a specific role in ensuring that NHS foundation trusts are well managed and financially strong, with statutory powers to intervene should they be in breach of their terms of authorisation. Having greater autonomy than other NHS bodies, NHS foundation trusts require Monitor’s specific regulation to ensure good value for money for the taxpayer from public assets.

By contrast, it will be important that the Care Quality Commission can take a consistent view of the safety and quality of care across all types of provider, including NHS foundations trusts. The wider scope proposed for Monitor by the amendment would serve to distract Monitor from its current, vital, specific focus, which is on foundation trusts. It would therefore be quite difficult for it to have a function of undertaking studies in relation to other NHS bodies and English local authorities. I would go so far as to say that Monitor may not necessarily be considered a fully disinterested party if it were to carry out reviews of economy, efficiency or effectiveness in other organisations while having a specific role in authorising, monitoring, regulating and driving forward foundation trusts.

Given those considerations, the function of undertaking the kind of studies described in clause 50, and the  publication of the results and recommendations arising from them, should sit squarely with the Care Quality Commission rather than Monitor. In that light, although I do not expect him to do so, I ask the hon. Member for Eddisbury to withdraw the amendment.

Photo of Stephen O'Brien Stephen O'Brien Shadow Minister (Health) 3:15 pm, 17th January 2008

I am please to be able to give him some pleasure. I will withdraw the amendment on the basis that we have had an outing on the matter before and we know where we stand. As we go consistently through the Bill it is important to recognise how this interleaves, so those considering our deliberations either on Report or in another place will be able to pick up the threads. I have a modicum of confidence that some light may come onto the issue as the Bill progresses and the merits of Monitor’s involvement may surface. On that basis, I beg to ask leave to withdraw the amendment.

Amendment, by leave, with drawn.

Clause 50 ordered to stand part of the Bill.

Clauses 51 to 55 ordered to stand part of the Bill.