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Health and Social Care Bill

moved Amendment No. 92: 92: After Clause 45, insert the following new Clause— ““Failings by English NHS providers (1) This section applies where the Commission conducts a review under section 42 or 45, or a review or investigation under section 44, in respect of an English NHS provider. (2) If the Commission considers that the English NHS provider is failing to discharge any of its functions to an acceptable standard, then subject to subsection (3) the Commission must— (a) inform the Secretary of State of the fact, and (b) recommend any special measures which it considers the Secretary of State should take. (3) If the Commission considers that the failure is not substantial, it may instead— (a) give the English NHS provider a notice under subsection (4), and (b) inform the Secretary of State that it has done so. (4) A notice under this subsection is a notice which specifies— (a) the respects in which the Commission considers that the English NHS provider is failing, (b) the action which the Commission considers the English NHS provider should take to remedy the failure, and (c) the time by which the Commission considers the action should be taken. (5) If the Commission recommends that the Secretary of State should take special measures in relation to the English NHS provider, the Commission must, if the Secretary of State so requests— (a) conduct a further review under section 44 in relation to the English NHS provider, and (b) include in its report under subsection (4) of that section a report on such matters as the Secretary of State may specify.”” The noble Earl said: This amendment is very much in the same vein as Amendment No. 89, which the Minister kindly said that she would take away and consider. It has been prompted by puzzlement on my part as to why under Clauses 46 and 47 the commission is to be given powers in relation to failings by English local authorities and Welsh NHS bodies but is not being given similar powers in relation to failings in relation to English NHS bodies. The key point here is that when the CQC has conducted a review or investigation of an NHS trust, it may have uncovered issues that need to be addressed not only by the trust but by the wider NHS community. In those circumstances, where patients are seriously at risk and there are lessons to be learnt of general applicability, the CQC should have the power to make appropriate recommendations to the Secretary of State. It may not be right in certain situations for the commission to suspend or cancel a provider’s registration. That course of action could well be thought not only too draconian but also impractical. If, for example, as at Northwick Park hospital, failings are uncovered in maternity services, the closure of the whole unit is simply not an option, bearing in mind the need for expectant mothers in the locality to have a hospital in which to give birth. On the other hand, there could well be a case for the commission to say, ““We have inspected the maternity unit at Northwick Park and uncovered significant failings. We believe that these have relevance for the local health economy and the wider NHS. Here are our recommendations for the Department of Health to promulgate as necessary””. Under the Bill as drafted, it does not appear possible for the commission to do that—it can only publish reports. That is a significantly less far-reaching power than the power currently given to the Healthcare Commission. For that reason alone, the power should be reinstated here. Again, however, it looks decidedly odd that the commission is to be able to do everything that I have described when it has investigated a Welsh NHS trust or an English local authority, but not when it has investigated an NHS trust in England. I hope that with that explanation, the Minister will consider the amendment in a positive light. I beg to move.