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Health and Social Care Bill

In Committee it is open to any noble Lord to make a contribution at any stage—I make that point for the benefit of all noble Lords. I listened closely to the noble Lord, Lord Darzi, and I wonder if he could deal with two points. I spoke about the huge change that is going on which is due to come into effect in the next two to three years in terms of provision. He said that the structure of the NHS will not change as a result of his review. I understand that, but is it not his intention that a great many more services will be provided by the ambulance service, for example, and by GPs, who are critical to the NHS and who are in a community setting? It is not clear whether they are to be brought under the scope of this Bill. Although he does not intend to change the structure of the NHS, what happens where and who delivers services will change enormously. The noble Lord mentioned, rightly, that the Government want continuity that builds on all the good work of the existing regulators. He mentioned the Care Standards Act. That piece of legislation that I know and love well—I sat through hours of debate during its passage—was designed for a time when the majority of care services were provided en bloc by public authorities. For example, a great deal of the Act relates to the provision of residential care by public authorities. My point is that, for the foreseeable future, the nature of social care services will change dramatically. Residential care services may well continue, but there will be a massive change in how they are managed, as opposed to commissioned, by individual users. That is the agenda being pursued by the noble Lord’s colleagues in the department. I remain unconvinced and still have a number of queries that I hope that the Minister might be able to take on board.