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Health and Social Care Bill

moved Amendment No. 75C: 75C: Clause 42, page 21, line 1, leave out subsection (4) and insert— ““(4) The Commission shall exercise its functions under this section by reference to such indicators of quality from time to time devised by it and approved by the Secretary of State.”” The noble Baroness said: We do not like the way Clause 42 has been written, particularly subsections (4), (5), (6) and (8). The clause gives powers back to the Secretary of State which, to put it simply, we do not want him to have. The amendments would restore the position established by the Health and Social Care (Community Health and Standards) Act 2003. These subsections, being introduced in 2008, represent a diminution of the powers of CSCI and the Healthcare Commission. In particular, the Secretary of State is taking to himself powers which under existing legislation belong to the commissions. These changes will give further control to the Secretary of State, although I thought we were all for devolving power and decentralising these things. It does not look like it here. The amendment to subsection (4) would reinstate the wording of the Health and Social Care (Community Health and Standards) Act 2003, but uses the phrase, "““by reference to such indicators””," rather than ““by reference to criteria”” as in the Act. It is a small but important change. The amendment would ensure that the Care Quality Commission devised the indicators of quality and the Secretary of State approved them. In other words, both functions would not be held by the Secretary of State. Although the Secretary of State can delegate this function to the commission under subsection (5), there would be no need to if he or she had confidence in the Care Quality Commission. As the Bill stands, it looks more like an arm’s-length body obeying the Department of Health than an independent body advising and informing the Secretary of State objectively and authoritatively. There are good reasons for the Care Quality Commission developing indicators of quality and its own methodology for assessing performance: it would reinforce the commission’s independence from the Government; it would enable the public to have confidence in the credibility of the findings of the commission, which they would not have if it was under the diktat of the Secretary of State; the Secretary of State would not duplicate the expertise of the Care Quality Commission; and it would give credence to the Government’s statements that they are transferring the powers of the existing commissions into the Care Quality Commission, which we thought was their intention. Taken as a whole, the clause changes the nature of the accountabilities. It is clear that the Care Quality Commission will be accountable for delivering its functions through annual reviews and a five-yearly fundamental review. The clause allows the Secretary of State to take on responsibility for those methodologies without having the responsibility of making it work. It would therefore undermine the credence of government statements that they would build on the experience and expertise of the existing commissions. We strongly feel that the Secretary of State has to trust the new Care Quality Commission to set the criteria. It is an independent body, and the general public would expect it to be so. I beg to move.