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Health and Social Care Bill

Schedule 1 to the Bill sets out various matters relating to the constitution of the commission. It makes various provisions necessary to establish the commission and to enable it to carry out its functions independently and competently. I have great sympathy with the proposal that social expertise be reflected on the board of the commission. The commission will need to be composed of members from a variety of backgrounds to ensure that it can discharge its functions effectively. We fully recognise this and made it clear in the information made available by the appointments commission to potential applicants for the posts of shadow commissioners. The shadow chair, when appointed, will be involved in the recruitment of commissioners and will be in the best position to assess what combination of skills and expertise would be most useful to help the commission realise its goals across its full range of functions. I anticipate that there will be members with social care expertise. It is arguable that the background of the commissioners is less relevant than their collective responsibility to ensure that the commission fulfils all its statutory responsibilities. These include substantial responsibilities in the social care field. The commission will be held accountable for how it discharges them. The amendments also propose that all members of the commission be appointed on a non-executive basis. The wording that we have adopted in Schedule 1 is exactly the same as that used in the Health and Social Care (Community Health and Standards) Act 2003, under which both the Healthcare Commission and CSCI are comprised of non-executive members. It is our intention that the same model will apply for the Care Quality Commission. Amendment No. 9 proposes that the commission appoint a children and adult rights director with specific responsibility for embedding a rights-based approach. It suggests that they would be an employee and also a member of the commission, which seems to contradict the principle in Amendment No. 6 that the commission should have only non-executive members. That aside, I have to disagree that the amendment is necessary. The commission will already be under a duty to safeguard and promote the rights and welfare of children and vulnerable adults under Clause 2. We have also ensured that the proposed registration requirements are consistent with requirements in the European Convention on Human Rights. As a public authority, the commission will be under a duty to act compatibly with the Human Rights Act. At Second Reading, my noble friend Lord Patel of Bradford referred to the excellent work that the Mental Health Act Commission has done in its project, Human Rights: Making It Real, to embed a human rights ethos into the work of the commission. This work has also been embraced by the Joint Committee on Human Rights. There is nothing preventing the commission from taking a similar approach. Indeed, I shall encourage it. As I said at Second Reading, we are working with the Mental Health Act Commission and other commissions to ensure that the Care Quality Commission learns from the culture and ways of working that they have developed. Again, while it may be tempting to specify that there should be board members with specific remits in relation to the particular functions or responsibilities that the commission will have, I do not agree that this would add anything over and above what we have already committed to. The commission may or may not decide to have specific members leading on particular issues for the board. I believe that there are arguments both for and against that approach. It can mean the difference between the compartmentalisation of a particular issue and the integration of that issue into every aspect of the organisation’s work and culture. There is also nothing to prevent the board appointing experts to give specific advice where it is needed and to provide additional expertise. Indeed, the Bill as drafted specifically provides for this. Fundamentally, though, as an independent body the new organisation should establish the division of responsibilities and the organisational structures it decides it needs to best carry out its statutory functions, rather than imposing something centrally. Having given our reasoning for not specifying particular posts on the board and clarifying that Schedule 1 provides for a non-executive board, I hope the noble Baroness is now content to withdraw the amendment.