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Health and Social Care Bill

I apologise that I was unable to take part at Second Reading but I strongly support the amendment, because it reminds me very much of my immediate reaction when I heard of the Chancellor’s intention to merge 11 inspectorates into three. It reminds me of a very short regulation that I once found on a military wall, which stated, ““A breach of common sense is a breach of the rules””. When we discussed the merger of the inspectorates of police, probation, prisons and courts into something called the Inspectorate for Justice, Community Safety and Custody, I reminded your Lordships that the proposal was not a good idea because it was a confusion of three separate functions, all of which are required in public sector bodies, all of which are carried out differently and all of which, as the noble Lord, Lord Warner, said, have different scopes, functions and purposes. Those functions are regulation, audit and inspection. What concerns me is that this proposal repeats exactly the same mistakes as were made in that previous proposal, because it confuses the three separate functions. Indeed, I noticed that in his closing speech at Second Reading the Minister described the proposed new body as being both a regulator and an inspectorate. It cannot be both. Having been an inspector, I know what would be involved—I had to be a regulator as well—and I certainly did not carry out inspection as an audit, because that would have been entirely unclear. What also worries me about this is what has been hinted at by my noble friend Lady Howarth: the submergence of social care, in this case under health, which is the major player in this proposal. In the same way, I am extremely concerned at what has happened to CSCI, which has been split in two. Half is going under education, as the noble Baroness mentioned, and is in danger of being submerged there under the style of an inspection or audit carried out by Ofsted, while the elderly will remain with the Department of Health together with mental health, which is yet another different function. The loser in all this is social care—the care of children and the elderly, both of whom have mental health needs quite apart from any other needs. I am meant to be in the Chamber now discussing something to do with young people in care. Until the reorganisation before the re-reorganisation, they were part of an organisation that was designed to look at care holistically, but quite deliberately the Government are breaking that up. This is desperately unwise. That is not to say that it is not a good thing to bring mental healthcare, healthcare and social care closer together in the care of the elderly, but that does not need a merger. The situation that will inevitably arise if you bring three specialist organisations together is that each of them will be weakened by trying to compromise. That lesson is learnt over and again. It is the lesson in IT, for example: big systems crash when you try to amalgamate them. Distributed databases with their own strengths that can be interrogated and can work together are the best way to proceed. The classic example, which we debated in this House only last year, was the very good report on safeguarding children that was led by CSCI. It did not organise everyone but had experts from all the other inspectorates coming together and working for a common purpose. The amendment is absolutely right. It says, ““Hang on. Halt. Throughout Second Reading CSCI was praised almost universally for what it was doing—for the standards it was setting, the paths it was treading and the pioneering it was doing. It hasn’t yet delivered what it was given to do and now you’re breaking it up””. I hope that the Minister, in the same spirit in which he has taken away the previous amendment to look at the question of the purposes and principles, will do the same with this one, as I do not believe that the regulatory impact assessment is a full and proper assessment of all the implications of what is proposed. I hope that in doing so the Government will consider what is being done to social care as a whole by splitting it in two and dividing its expertise, when expertise is crucial in all aspects of social care.