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Health and Social Care Bill

This is a strange group of amendments, in that three completely separate issues are being addressed. The first relates to someone or some people with definite experience in social care services. The points in relation to that were clear and well made. I suspect that any commission will fail unless the various key elements are represented by people who have ““been there and done that””. I want to pick up on the second part of Amendment No. 6, relating to whether the board is non-executive or mixed. I am well aware of, and have served on, NHS boards where there is a mixture, although most of my experience has been serving on boards which have been entirely non-executive. There may be a case—of which I am not entirely convinced, I have to say—for most health service boards having a mixed structure of executive and non-executive members, given that they are subordinate bodies that report up a management line and implement things down a particular set of tram lines. This board is very different. It is about setting a strategy, philosophy and style. The interests and ways of operation of the executives of that body and those of non-executives who set the overall strategy are distinct. I cannot see a case for this body having a mixed board of executives and non-executives. Amendment No. 9 raises a completely different set of issues. I have a lot of sympathy with it. It is perhaps not as precisely drafted and defined as Amendment No. 6, but the principle is clear. In most of the areas that the new commission will regulate, one is talking about people who are very vulnerable. In some instances, they are transitorily vulnerable by virtue of an illness or catastrophe which has befallen them, but in far more cases they will continue to be vulnerable for a variety of reasons. There is a great danger in healthcare and social care, and certainly in mental health care, of over-professionalisation of the way in which those interests are addressed. For that reason, one must ensure that something is built into the new commission, either by this kind of amendment or something else, to act as a counterweight to some of the professional voices which will be heard about a particular style of care, whether it is healthcare or social care.