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Health and Social Care Bill

The noble Baroness is completely correct that competition and choice are powerful levers to drive up service quality, deliver better value and reduce inequalities. Indeed, that is the Government’s view. Yet they can be effective only if, as she said, there are clear rules guiding and governing behaviour in the healthcare system. I agree that developing competition principles and rules, and promoting transparency and fairness in competition, as Amendment No. 102 seeks to do, is very important. Indeed, in December 2007, the Department of Health published principles and rules for co-operation and competition as part of the NHS 2008-09 operating framework. In addition, in December, the Secretary of State made a commitment to establish a non-statutory co-operation and competition panel to provide independent advice on competition issues arising from the application of those principles and rules that have not been able to be resolved locally. One of the functions that we currently propose for the panel is providing feedback and making recommendations to the department on how it should update the principles and rules for co-operation and competition. The noble Baroness asked how we will ensure that the panel is sufficiently independent and adequately resourced. It will have a high-calibre independent chair and operational vice-chair who can call on a range of relevant experts to resolve competition issues in the NHS, including competition economists, lawyers, consumer advocates and procurement specialists. It is intended that the panel will be established by October 2008. The Department of Health is currently working with a range of regulators, including the OFT, Monitor, the Advertising Standards Authority and other government departments to ensure that the panel’s approach is robust and achieves a consistency of values and approach with other regulators. We therefore see the panel, rather than the Care Quality Commission, as having the remit to advise the Department of Health on the principles of competition. This is in line with the results of our consultation on the future regulation of health and adult social care in England, which considered a role for the Care Quality Commission in competition issues. We propose that the panel has a role in advising the Department of Health and its stakeholders, such as other regulators, on competition rules, and we are establishing formal relationships between the panel and other relevant regulators to ensure that the panel operates effectively and efficiently. Once the Care Quality Commission is established, those discussions will commence. That said, Clause 50 enables the commission to promote or undertake more general studies and make recommendations. In the course of carrying out those studies or any of its other statutory functions, the new commission may identify good practice that could inform competition rules and principles or other aspects of competition. Clause 49 constitutes a mechanism for the commission to feed such advice to the Secretary of State. I hope that I have explained our position sufficiently well to allow the amendment to be withdrawn.