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Health and Social Care Bill

My Amendments Nos. 139A and 141 are grouped with the amendment of the noble Baroness. Amendment No. 139A is simple but its purpose is to address an important point. Clause 110, as we have heard, covers the powers and duties of the Council for Healthcare Regulatory Excellence. In proposed new subsection (4)(c), the council is given the explicit power of, "““investigating particular cases with a view to making general reports on the performance by the regulatory body of its functions””," and so on. The word that sticks out like a sore thumb is ““investigating””. Is it really the Government’s intention that the CHRE should carry out investigations into individual cases? The word ““investigate”” is defined in my Chambers dictionary as, "““to search or inquire into with care and accuracy””." I have grave doubts about whether that is what the CHRE should be doing. The purpose of its work is to audit the work of the regulators. In doing that, it certainly needs to look at a selection of individual cases, but it surely will not take it upon itself to investigate those cases ab initio as if it were the Criminal Cases Review Commission or some kind of appeals body. If the CHRE were to do that, not only would that be resource intensive, but the council would run the risk of being looked on by lawyers as a source of useful material from which a case for appeal against an adjudication could be mounted. To say that it can investigate individual cases implies that it will be able to reconsider the evidence and facts of a case as if it were intending to confirm or overturn a panel decision. That is not what the CHRE is there to do. In the amendment, I am suggesting that ““scrutinising”” might be a better word than ““investigating””. To scrutinise means to examine closely, which is surely what is meant here. Amendment No. 141 relates to new Section 26A to be inserted into the National Health Service Reform and Health Care Professions Act 2002, which established the CHRE. Subsection (3) of the new section states: "““The Secretary of State may give directions to the Council as to the manner in which the Council exercises its functions””." I question seriously whether that power is appropriate. We need to remind ourselves what the CHRE is and what it does. It is what is known as an executive non-departmental public body. It is a type of arm’s-length body. ““Arm’s-length”” means that it does not have to refer any of its decisions back to its sponsoring department; its decisions cannot be overturned by the department or by Ministers; it does not have to explain to the department why it has made a particular decision; and it does not have to give the department details of its decisions. In this sense, it is similar to the OHPA and Monitor, both of which are executive non-departmental public bodies. Like them, the CHRE is operationally independent of government and Ministers. The CHRE has two main functions. The first is to oversee and check the medical regulatory bodies and the second is to encourage harmonisation of working methods and practice across the various regulators, as the noble Baroness reminded us. In doing that, it acts as an independent voice for patients. Independence has two elements: independence from the regulators and independence from government. It is no accident that the CHRE is accountable directly to Parliament. It meets in public in all four countries of the United Kingdom to discuss its annual report. Its whole way of working is transparent. Against that background, I do not think that a power of direction in the hands of the Secretary of State couched in broad and general terms is consistent with the letter or the sprit of the founding legislation. I do not think that it should be there. It would be helpful to hear from the Minister why she believes that such a power should be granted.