HL Deb 29 October 2003 vol 654 cc258-60

2.44 p.m.

Lord Clement-Jones asked Her Majesty's Government:

In light of the report of the Better Regulation Task Force on Better Regulation, what is their response to the chairman's statement that "the National Health Service is the greatest victim of regulatory excess".

The Parliamentary Under-Secretary of State, Department of Health (Lord Warner)

My Lords, the Government are committed to reducing burdens on NHS front-line staff and are shifting the balance of power to the local level. But, with NHS spending at £62 billion a year and increasing by more than 7 per cent in real terms annually, public accountability and independent inspection remain essential, as the report of the task force accepts. Public protection also requires effective professional regulation.

Lord Clement-Jones

My Lords, I thank the Minister for that very upbeat reply. He quickly passed over the aspect of regulation but there are at least 36 bodies entitled to inspect NHS hospitals— probably more. The Government have created eight of them in their term of office and have plans to create even more. What concrete steps are the Government taking to simplify the number of regulators and to reduce the burden on NHS front-line staff?

Lord Warner

My Lords, if the noble Lord reads the report carefully he will find that 28 bodies are mentioned, 18 of which are the professional regulatory bodies of professional bodies. If he goes through the report, he will also notice that the authors state that the continuing trend towards separating delivery from central government suggests that the role of independent regulators will become increasingly significant. The Government welcome the report. As the noble Lord will know from our work on the Health and Social Care (Community Health and Standards) Bill, the new Commission for Healthcare Audit and Inspection will reduce the number of regulators.

Baroness Gardner of Parkes

My Lords, what is the cost to the National Health Service of this additional regulation? How much more will it cost than previously?

Lord Warner

My Lords, the answer to the factual question is that I do not know. I shall write to the noble Baroness. The report shows that there is a need for powerful, independent regulators, and that policy is supported by the Government.

Lord Campbell of Croy

My Lords, is it correct that the National Health Service is the largest corporate employer in the United Kingdom? If so, does the Minister agree that that is not in itself a reason for excessive regulation?

Lord Warner

My Lords, by and large, we have a regulatory system that is fit for purpose given the scale of the NHS, the complexity of its activities, the need to protect the public and the need to ensure that public money is spent wisely. As I said, we are talking about a £62 billion a year business which has been much increased through investment by the Government.

Lord Walton of Detchant

My Lords, now that the individual regulatory authorities for the various health professions have been reformed and undergone major reconstitution with government support, is it really necessary to have a council for the regulation of the health professions overseeing the activities of these powerful and well organised individual bodies?

Lord Warner

My Lords, the spirit of the thinking behind that decision echoes some of the ideas in the Better Regulation Task Force report to improve the co-ordination between different regulatory bodies and ensure that best practice is shared. The council tries to achieve that purpose.

Lord Turnberg

My Lords, does my noble friend agree that, while there may have been a rational reason for setting up each of the regulatory bodies at the time, it is the accumulation of large numbers that has such a demoralising effect? Does he further agree that it is lime for the Government to look at the cumulative effect of these bodies and to consider whether some pruning could be arranged?

Lord Warner

My Lords, I accept the spirit in which my noble friend offers his thoughts. However, as I said earlier, there are proposals in the Health and Social Care (Community Health and Standards) Bill to incorporate the functions of four regulators into the functions of one regulator in the form of the Commission for Healthcare Audit and Inspection. The Government welcome the report. They will consider what further steps can be taken and will respond to the report by the end of the year.

Baroness Howarth of Breckland

My Lords, bearing in mind the long list of inquiries into things that have gone significantly wrong both in the health service and in social care, does the Minister acknowledge that good, streamlined regulation is vital to the community in terms of the human cost?

Lord Warner

My Lords, the noble Baroness is right. The names which drip off my lips are Alder Hay, Bristol Royal Infirmary, the Kennedy report and Victoria Climbié, to mention but a few.

Earl Howe

My Lords, are the Government relaxed about the fact that since 1997 the number of administrative staff in the NHS has gone up by 27,330, according to the latest figures that I have, while the number of available beds in the NHS has gone down by 14,000?

Lord Warner

My Lords, I am now aware of those figures as the noble Earl has drawn them to my attention. I do not take from that information anything other than that the efficiency of the NHS has increased under this Government, the numbers of professional staff working in the NHS has increased and the productivity for patients has increased.