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Health and Social Care Bill

I put my name to this amendment in support of my noble friend. I agree with a lot of what the noble Lord, Lord Low, and the noble Baroness, Lady Barker, said. If this brave new commission is to win the trust and respect of the public and those that it regulates in the National Health Service and in social care, and if that trust is to be maintained, it is critical that its independence is maintained. That is a key factor. Earlier, we discussed NICE. In the area that NICE covers, no politician has dared to interfere. Its independence has been recognised, except when Patricia Hewitt was Secretary of State, when there was uproar: the NHS cried, ““Foul! This is not what you should be doing””. I am anxious that the commission, which will have a wide remit, should also have that independence. Monitor, the new regulator, has much more freedom. It is independent of the Department of Health. The NHS Act 2006 states that the independent regulator, "““must not be regarded as the servant or agent of the Crown or as enjoying any status, immunity or privilege of the Crown””." The remit and responsibilities of Monitor, which are very important, are much narrower than the Care Quality Commission’s. The definition of independence is, ““not depending on authority””. Surely what we are all seeking is that the commission should not depend on authority. I am sure that the Minister when she replies will say that it would be very strange if you had a regulator that ignored the breadth of government policy, and the parameters are very broad. Of course that is right. We believe in democracy and at a general election the electorate will vote for the party whose policies they prefer. Once elected, the new Administration’s manifesto commitments and the policies that flow from them are very much respected because we live in a democracy. So there is no quarrel there. However, as my noble friend and other Members of the Committee have said, we strongly object to the wording of Clause 2(4), which is much too prescriptive. It gives the Secretary of State the power to direct the regulator to carry out certain functions that the Secretary of State wants performed. It is not about independence but about control. Of course there is a worry that the regulator may act inappropriately or ignore government policy, although that is unlikely if she wants to keep her job. If an issue arises, the Secretary of State could well request the regulator to take account of a policy and then make that request public, to use the words of the noble Lord, Lord Low. When we use that device—when the Secretary of State makes a request that is written down and made public—we know that the process is transparent and informs the public of the issues that are being addressed. That seems a sensible way forward. Under the Bill, the Secretary of State always has the ultimate power to change the regulator. Indeed, I think back to when this happened with the gas regulator, who wanted to introduce competition much faster than the Secretary of State in that field thought desirable. I feel strongly about this. We shall return to the question of independence time and time again.