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Health and Social Care Bill

Much of what I might have said has been said. I support the amendment somewhat despondently, because I do not think it has any hope of success. I feel I need to place on record my serious concerns about where this will take us. Much of what the noble Lord, Lord Low, has quoted from Sir Ian Kennedy illustrates those concerns. As I said at Second Reading, I was the deputy chair of the National Care Standards Commission. We read, when it was leaked to the Times, that we were to be abolished, and then heard a few weeks later that we were indeed to be abolished and changed. That was before the commission had had the opportunity to put on the ground the services that needed to be put in place to develop good regulation. We managed to do a reasonable job in the following two years, but hoped that the Commission for Social Care Inspection would be able to pick up the baton and develop the commission, which I believe it has done. As that commission itself would say, however, it is in no way yet in a settled position. The commission holds the view that structural change in the regulation of social care and healthcare at this time is premature. It is about timing. I do not believe that anyone thinks there is no value in looking at this issue carefully and in detail for the future, and I would be delighted to be involved in redesigning services that gave continuity of care to people on the ground. Indeed, I have been trying to look at that in social housing, but trying to get Ministers to understand what the problems are in the spectrum of social housing linked to benefits is extraordinary. The same sort of problems occur in social care, but regulation is not the way to put that right. That is why I keep coming back to the purpose of the Bill, as mentioned by the noble Lord, Lord Low, and, I believe, the noble Lord, Lord Ramsbotham. I would feel more respect for the Government’s position—for which I do not hold the noble Lord, Lord Darzi, responsible, although he is probably very loyal to his position—if they were to say, ““We have to reduce the number of regulators to save money and this is the way we’re going to do it””. That would show that they were doing it, irrespective of the quality. However, to call the new body the Care Quality Commission has all sorts of issues around it. The second reason why I feel despondent is that I have been involved in the development of the first commission; I originally worked in a children’s department that was then merged into a social services department to become a ““holistic”” service; I saw reorganisations in different ways in social services about 14 times in 14 years; and I recently had the experience of sorting out CAFCASS, an organisation where, again, a merger was not thought through with regard to services being taken in from the local authority. If the Government are really set on this course under this timescale—and I can see they probably are, although under the amendment it could not be the same timescale—I can only ask them to understand the implications of the merger on the users and providers of services who will find themselves picking up the pieces and, as the noble Lord, Lord Low, said, spending far more time in meetings contemplating issues around computers, forms and service delivery than in getting resources to the front line—as we have been doing in CAFCASS in the past few years—so that the users of the service benefit from the resources in the system. That is all I have to add. I support the amendment simply because it would give us more time to look at these issues.