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Health and Social Care Bill

Amendments Nos. 139 and 140 would widen the powers and duties of the Council for Healthcare Regulatory Excellence. The amendments of the noble Baroness, Lady Finlay, would require the CHRE to audit the timeliness and independence of all processes within healthcare professional regulation. I sympathise entirely with the spirit of these amendments. I know that the noble Baroness is trying to ensure that fitness-to-practise procedures in particular happen within acceptable timescales and are fair and independent. I could not agree more with those principles. However, the amendments, as drafted, would extend the remit of the CHRE to every possible facet of healthcare professional regulation at both local and national levels. That would dilute the focus of what is already a small organisation and it would make the CHRE, in having to cover such a wide remit, far less effective in the reporting role that it already has. The noble Baroness, Lady Finlay, may be reassured to know that this existing reporting role extends to all the processes of the health regulatory bodies. The CHRE already has a statutory duty to hold annual reviews of regulatory body performance and to provide an annual report to Parliament, as has been mentioned. Clause 109(6) strengthens its existing review powers by requiring the CHRE, when providing its annual report to Parliament, to state how far each regulatory body has complied with any duty imposed on it to promote the health, safety and well-being of patients and the public. Clearly, the timeliness and independence of regulatory body processes are part of promoting the health, safety and well-being of patients and the public. Therefore, if the CHRE felt that a regulatory body was delaying the hearing of cases in an unacceptable way, or if the independence of a regulatory body’s processes was undermined, it would have to state that in its assessment of the performance of that body as part of its annual report to Parliament. Amendment No. 139A would amend new Section 26(4) of the National Health Service Reform and Health Care Professions Act 2002 by replacing the word ““investigating”” with ““scrutinising””. Before saying why I cannot support this amendment, I must first explain that Section 26 of the 2002 Act sets out that the CHRE may do anything that appears to it to be necessary or expedient for the purpose of, or in connection with, the performance of its functions. Section 26(2) sets out what the CHRE may do, which includes investigating and reporting on how each regulatory body has performed its functions. I know that noble Lords will agree that the ability to report on how each regulatory body does its job is crucial to the CHRE in holding the regulators to account on behalf of patients and the public. Section 26(4), as amended by the Bill, is a clarifying provision and does not confer any additional functions on the CHRE. Instead, it clarifies that the CHRE can consider individual cases to help to compile general reports on regulatory body performance or make general recommendations to the regulatory body. We have therefore used the word ““investigating”” in the amended Section 26(4) to match the wording of the existing legislation, which enables the CHRE to investigate the performance of each regulatory body. Any other wording would be inconsistent and might lead to doubts about the intention of the amended section. I am happy to reassure noble Lords that the word ““investigating”” here absolutely does not mean that there will be a reinvestigation of individual cases; rather, it clarifies that the CHRE can investigate how particular cases have been dealt with by the regulators in order to reach all-important general conclusions about the performance of a regulator. Amendment No. 141 would remove new Section 26A(3) from the National Health Service Reform and Health Care Professions Act 2002. New Section 26A(3), to be inserted by Clause 111, allows the Secretary of State to give directions to the CHRE on the way in which it carries out its functions. The Secretary of State must consult the CHRE, Welsh Ministers, Scottish Ministers and the relevant department in Northern Ireland before giving any directions. I hope that I can satisfy the noble Earl and the noble Baroness, Lady Cumberlege, that this provision is justified. I should add that the noble Baroness is not at all boring; she is asking legitimate questions. I emphasise that this power is not designed to be used regularly. It is a backstop and is to be used only rarely to ensure that the CHRE is able to function properly and that it addresses any key issues of concern in healthcare regulation. It will enable the Secretary of State to require the CHRE to look at a particular public concern about a regulatory issue—for example, if it were widely felt that a piece of work needed to be done to address an issue relevant to all health professional regulatory bodies. The power has also been included as a result of concerns that the CHRE’s workload could occasionally be too great and that, as a small organisation, it might not have the resources to carry out all its functions at the same time. In these circumstances, the Secretary of State could have a role in helping the CHRE to set its priorities. This would allow the CHRE to concentrate its resources on the most important issues where its input was most needed to support patients and the public. In the ordinary course of events, we will reach agreement with the CHRE without needing to use this power. However, there may be a small number of occasions when it is better that the Secretary of State issues directions so that the reason for the CHRE focusing on some areas above others is clear and transparent. It is important to emphasise that the power is intended to direct the CHRE only on the way in which it carries out its functions. It cannot be used to interfere with or change in any way the core functions or results of the work of the CHRE. I hope that I have been able to provide noble Lords with the necessary reassurances and that the noble Baroness will feel able to withdraw her amendment.