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Health and Social Care Bill

I suspect that I am probably not going to clarify this any more happily than any other noble Lords, but I shall do my best. My understanding of Amendment No. 75 is that it is intended to widen the scope of periodic reviews to independent sector providers of NHS care. I agree that, as the private sector is increasingly playing a role in helping to deliver effective public services, we must ensure they are subject to the same scrutiny and assessment, so that the public can determine whether they are getting value for money. Under subsection (1) of Clause 42, the commission is already required to carry out reviews of the provision of healthcare by primary care trusts and by others under arrangements made by PCTs. This already means that the commission will review the provision of NHS care by independent providers as part of its review of how well PCTs are commissioning and providing services for their local populations. The same applies to local authority commissioning of adult social services under subsection (3). In addition, under Clause 45, there is provision to extend the periodic review functions through regulations. This would enable wider reviews of independent sector provision to be carried out and it is our intention to use this clause to continue the quality ratings system that CSCI has just introduced once the registration system is up and running in 2010. The situation in the NHS is different. There is a large number of small, private sector NHS contracts and we do not think it would necessarily be appropriate that there should be reviews of every individual independent provider of NHS care which would be hugely resource-intensive. It is more appropriate for small contracts to be managed by PCTs with an oversight by the commission through reviews of the provision of healthcare by and on behalf of PCTs. If necessary, we can also use the powers in Clause 45 to require the commission to conduct additional reviews of certain providers or of particular types of care. Therefore, I think that the Bill provides scope to meet the intention behind Amendment No. 75 and I ask the noble Earl to withdraw it.