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Health and Social Care Bill

moved Amendment No. 75: 75: Clause 42, page 20, line 31, leave out ““NHS provider”” and insert ““provider of NHS care”” The noble Earl said: This is a probing amendment, prompted by genuine puzzlement. In Clause 42 we find the provisions which will enable the commission to conduct periodic reviews. Subsection (2) refers specifically to English NHS providers, for each of which the commission will have to review the healthcare provided, assess the provider's performance and publish a report. The question posed by this amendment is why this provision should not also encompass anyone who provides NHS care; in other words, any independent provider contracted to the NHS. The Explanatory Notes make it quite clear that we are only talking about NHS bodies that provide services. That seems odd. Part of the point of the Bill is, at long last, to place the NHS and the independent sector onto an equal footing for regulatory purposes. We must look forward to Clause 45 to find anything relating to periodic reviews of non-NHS providers; but there we see that such reviews will rest entirely at the discretion of the Secretary of State. There is a regulation-making power in Clause 45 that would enable him to require the commission to review some or all registered service providers; some or all regulated activities; or particular aspects of a regulated activity. I question why the review of non-NHS providers should be subject to approval in regulations, which may or may not be made, whereas the review of NHS bodies would be provided for in the Bill. We are not talking here about situations where an NHS trust subcontracts with an independent provider—my understanding is that those situations would indeed be covered by Clause 42—but where services are directly commissioned by a PCT or a GP from a private provider. What are the Government’s intentions as regards enabling the CQC to review these services? How will the CQC be expected to configure itself and to plan ahead if there is uncertainty about what services it is going to monitor and regulate? As I have said, I am genuinely puzzled by what the Bill appears to propose here and I therefore beg to move.