First, I agree that improving quality in adult social care is every bit as important as improving it in the NHS, but there are other mechanisms and methods already in place to do that. Local authorities have their own local and national reporting and accountability arrangements, and the Minister for Communities and Local Government has powers to issue standards under the Local Government Act 2003. The Government are committed to a single performance framework for local authorities across all their functions, rather than having a duplication, which we think would be the impact of the amendment.
On the issue of independent health care providers, where a PCT uses private sector providers to provide NHS health care, of course the standards set under the clause will apply to those providers. As we have previously discussed, the registration requirements will ensure that all private and independent sector providers provide services at a particular level. The hon. Lady’s amendment asks for the Government to intervene as a performance manager in private transactions between entirely fee-paying clients or patients. In terms of pushing up standards, we do not believe that it is the Government’s role to intervene on matters of purely private health care. We believe that improvements in the commercial sector should be driven by the suppliers themselves as they strive to improve and attract more fee-paying patients. In a way it goes back to the argument we had two days ago about cosmetics—we must decide on the proper boundary of the role of the state.