INTRODUCTORY (Hansard, 19 November 2003)

§ The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman)
I leg to move, That this House agrees with the Lords in the said amendment.

Mr. Deputy Speaker
With this we may take Lords amendments Nos. 66 to 113 and 194 to 219.

§ Dr. Ladyman
This group of amendments relates to part 2 of the Bill, which establishes independent inspectorates for health and social care. All the amendments represent Government concessions or technical changes to improve the Bill's drafting.
We made several significant concessionary improvements to part 2 in response to sensible suggestions made in the other place and during the Bill's progress through the Commons. Lords amendments Nos. 65, 81, 83 and 93 will require the Commission for Healthcare Audit and Inspection, the Commission for Social Care Inspection and the National Assembly for Wales, during the course of their inspections and so on, to have regard to the quality of information provided to the public by national health service and social care bodies.
Lords amendments Nos. 66 to 68, 71, 74, 84 to 86 and 88 will enable the Secretary of State to set out in regulations how individual national health service and social care bodies may make representations to the Commission for Healthcare Audit and Inspection and the Commission for Social Care Inspection before reports or performance ratings relating to them are published. Lords amendments Nos. 72, 76 and 110 create a clear duty for the Commission for Healthcare Audit and Inspection and the independent regulator of NHS foundation trusts to co-operate in the exercising of their functions. However, it remains unlikely that the independent regulator would be regularly in receipt of information about the quality of health care provided because it will not inspect—inspection will remain the role of the Commission for Healthcare Audit and 871 Inspection. Lords amendment No. 73 provides that the commission has a function, rather than a power, to promote effective co-ordination of reviews and so forth in the provision of health care by, or for, English national health service bodies and cross-border special health authorities.
Lords amendments Nos. 87 and 92 will provide that the Commission for Social Care Inspection and the National Assembly for Wales will have the function of undertaking studies on value for money in relation to local authorities. Lords amendment No. 79 will strengthen the relationship between the Commission for Healthcare Audit and Inspection and the Audit Commission by placing a duty on both to co-operate in areas in which they both have functions. That will reduce the burden of inspection on the NHS.
Lords amendments Nos. 95 and 96 make it absolutely clear that following the inspection of a boarding school, the Commission for Social Care Inspection or the National Assembly for Wales must publish a report on whether a child's welfare has been adequately safeguarded and promoted. Lords amendment No. 97 makes it clear that the Commission for Social Care Inspection or the Assembly must send a copy of any such report to the school in question.
Lords amendments Nos. 111 and 112 place a new statutory requirement on the Commission for Healthcare Audit and Inspection and the Commission for Social Care Inspection to prepare and publish a code of practice on access, handling, use and disclosure of confidential personal information. Lords amendment No. 102 provides for a clear regulation-making power to require information to be made available to the public about health and social care complaints procedures. Lords amendment No. 113 will strengthen the duty of co-operation between the Commission for Healthcare Audit and Inspection and the Assembly to minimise the burden of inspections in cross-border areas.
Finally, amendment No. 194 and related amendments to schedules 6 and 7 require the Secretary of State to delegate—in practice, it will be to the NHS Appointments Commission—the responsibility for appointing the chair and members of the Commission for Healthcare Audit and Inspection and the Commission for Social Care Inspection. That was our policy intention. It is now an explicit requirement.

§ Mr. Lansley
I am grateful to the Minister for setting out the purpose of the amendments and for recognising that they respond to sensible and reasonable amendments proposed in the Lords. I thank our colleagues in the other place for raising some of the issues.
The Minister referred to the Government's policy intention on appointments to the chair and members of the Commission for Healthcare Audit and Inspection and the Commission for Social Care Inspection. I do not recall Ministers being that explicit in Committee, but I am happy that they have accepted the value of specifying that in legislation. Likewise, there was pressure in Committee in another place in respect of how the Commission for Health Improvement and the regulator should co-operate. It should not be at the discretion of CHAI to appoint itself as an advisory body 872 to the regulator and to provide information on its own initiative. It is more reasonable to provide a structure of complementary and parallel duties. My colleagues and other noble Lords in another place put pressure on the Government to ensure that the code of practice on access to information covers other bodies that have access to such information and that they treat it with respect. It is right that the Government accepted that.
It has been helpful for the Government to accept a range of other substantive suggestions, at least to part 2, made in another place and to respond to arguments. We should recognise that whatever the outcome of our discussions on part 1, we always intended the Bill to proceed in a form that would support not only a restructured audit and inspection system for the health service and social care, but a structure for the establishment of standards. For example, much will hang on the clause in part 2 on quality. If we have a structure of standards based on clinical evidence, peer review and clinical practice—something to which members of the NHS can look for guidance—the Government of any party will, I hope, be able to move towards that as the basis on which people will establish practice in the NHS and against which their performance is genuinely measured, rather than the targets and the bureaucratic structures that have been the Government's preference over the past few years. Part 2 is important and I am happy that we can proceed with it on a more agreed basis.

§ Mr. Burstow
I also want to express my appreciation of my colleagues in the other place who worked diligently in Committee and at other stages to draw out some of the issues that the Minister responded to by accepting the Lords amendments. In particular, I highlight the important concession on co-operation between the Commission for Healthcare Audit and Inspection, the regulator and the Audit Commission. That will help to lighten the burden of the regulation appropriately. In Committee, we touched on the powers of the Commission for Social Care Inspection to report and alter aspects of how a school or college discharges its duties. The other place deliberated on that in a little more detail in Committee, for which we are grateful.
Finally, I wonder whether the Minister could tell us whether the Government plan to consult on issues of convergence of standards, which I understand were debated in the other place on 10 November. Have those consultations started, and what will the timetable be? It would be useful to know at an early stage the timetable for publishing the codes of practice that will apply to both new commissions. We welcome the architecture we have arrived at for inspection and regulation. The final step will be to have only one body that is capable of regulating and inspecting both health and social care.

§ Dr. Ladyman
I am pleased that we have broad support for the concessions that the Government have made. I hear what the hon. Member for Sutton and Cheam (Mr. Burstow) says about the possibility of having a single body for inspection. The Bill contains a duty for the CHAI and the CSCI to co-operate, so I hope that they will work closely together on many issues. Whether we will ever reach the point of having one body will be for some future Minister to worry 873 about. The hon. Gentleman asked about specific timing issues. I will obtain that information for him and write to him.