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Health and Social Care Bill

I have listened carefully to the debate and I wish to reassure Members of the Committee by repeating that the Government are committed to the independence of the Care Quality Commission. As we have discussed throughout the drafting of the Bill, we have sought to strike the right balance between ensuring that the commission is able to act independently and provide independent challenge while being a key player in the wider health and social care systems. I fear that this is one of the areas where we may disagree about the balance. The new commission will have a wider range of enforcement powers that it will be able to use to take independent enforcement action against registered providers when they do not meet the required levels of safety and quality. For the first time, these will also apply to NHS providers. This represents a significant increase in independence compared with the Healthcare Commission or CSCI. We have sought to explain that the work and independence of CSCI and the Healthcare Commission will be carried forward in how the commission will do its work, including, for example, the rating system as explained by the noble Baroness. In terms of the periodic reviews in Clause 42, we believe that it is important that the Secretary of State should retain a role in setting the indicators. This is to ensure that they are an accurate reflection of the outcomes the Government have committed to delivering in response to what patients, service users and the public have stated they want health and adult social care services to deliver. We intend these indicators to be outcome-focused, covering the full range of health and adult social care services rooted in the department’s strategic objectives. The focus on outcomes provides the flexibility for local organisations to make decisions on priorities for their local communities. For example, we have already discussed the new comprehensive area assessments and how essential it is that the commission’s reviews feed into them. The power for the Secretary of State to set the indicators will help ensure that the reviews support assessments across health and well-being and adult social care, and contribute fully to comprehensive area assessments. The new commission will, from the very beginning, be an integral partner in agreeing with the Secretary of State the right set of indicators to assess and evaluate both health and social care organisations in its reviews. The commission will be responsible for drawing up the methodology by which bodies will be assessed and evaluated, and will be able to advise the Secretary of State on what indicators would be appropriate. However, I have reflected on these amendments and confirm that it is our intention to delegate the function of setting the indicators of quality for English NHS providers to the commission from the outset, in recognition of its role in enforcing the registration requirements providers have to meet. In doing so, it will need to draw on the indicators used to assess commissioner performance so as to align with the outcomes that patients and the public expect.