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Health and Social Care Bill

Amendment No. 92 seeks to give the commission the power to recommend that the Secretary of State takes special measures in relation to significant failings it identifies in an NHS body, which reflects existing provision in Section 53 of the 2003 Act. Indeed, we have had discussions in a similar vein on Amendments Nos. 40 and 89. I similarly hope that I can persuade the Committee that Amendment No. 92 is not necessary. As I have explained, the commission will have significantly greater powers to intervene directly with NHS providers than is currently the case, because it will fall within the ambit of the registration regime. It will therefore be able to apply conditions to registration, issue warnings or penalty notices and, in serious cases, suspend or cancel registration. I have also set out that there is nothing preventing the commission, as part of its duty to keep the Secretary of State informed under Clause 49, from recommending that the Secretary of State takes particular measures if it feels that that is necessary. I therefore believe that the powers in the Bill closely match what is being proposed in this amendment. However, in line with our intentions to create a more intelligent regulatory environment, streamline the system for providers and ensure that issues are dealt with where they arise rather than centrally, the commission must also act in the wider context of NHS performance management. I have described the assurance framework we are putting in place for achieving world-class commissioning to ensure that PCTs are effective and well supported in this aspect of their work, and the emphasis that this puts on the role of the SHAs in strengthening performance management in the NHS. Where the commission takes action in relation to a breach of registration requirements, it is required under Clause 35 to notify the relevant PCT and SHA so that it can take action to prevent the issue escalating. As discussed, we would also expect it to take account of the results of periodic reviews if they give cause for concern. I believe that these strategies will help to ensure that services improve locally and will be much more effective than intervention from the centre. I hope that that satisfactorily explains why we do not believe that the clause proposed by the noble Earl is necessary and that, therefore, he will withdraw his amendment.