---

Health and Social Care Bill

moved Amendment No. 39: 39: Clause 6, page 3, line 24, after ““registered”” insert ““or working for a registered organisation”” The noble Earl said: In the absence of the noble Baroness, Lady Finlay, and at her express request, I shall move Amendment No. 39. It is a probing amendment about GP practices and community services. It is not at all clear from the announcements made by the Government to date, or from their recent consultation document, what their intentions are—or, indeed, what their inclination might be—as regards bringing GPs within the registration requirements of the Bill. The Minister may say that it is too soon for the Government to give such an indication, but GPs are currently in a rather strange position. Being independent contractors, they fall outside the current inspection regime, yet 80 per cent or more of all NHS care is delivered in primary care and community settings. That figure is likely to go up over the next few years as we see the growth of practice-based commissioning and—dare I say?—the advent of polyclinics. More and more care will be shifted out of acute hospitals and into the community. It would therefore seem extraordinary if the quality of care provided in GP surgeries or in polyclinics were not to be monitored by the commission. The NHS, as we know, is a mixed economy. It would be helpful if the Minister could tell us how Part 1 is likely to affect GP practices both large and small as regards the quality assessment of services and what will happen to other independent practitioners or bodies that contract to work for an NHS organisation. Do the Government envisage that these individuals and very small bodies will need to be registered with the CQC? I hope that the Minister will be able to provide some clarification. I beg to move.