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Health and Social Care Bill

My Lords, I have enormous respect for the noble Lord, Lord Lipsey—at least, I always have done in the past and I have known him for a disconcertingly long period. However, the arguments that he put forward this afternoon in support of his amendment, which he told us at a very early stage in the discussion he was not intending to press to a vote, were perhaps some of the weakest that I have heard in your Lordships’ House. First, he employed a traditional gambit, which is to set up the arguments that you say that the opposition to your proposition are going to put forward and then knock them down, but not necessarily set out the most convincing of those arguments, but simply knock down three almost at random. Even when the noble Lord knocked them down, I found it slightly less than convincing. He said that it is universally the case that the problems of delaying an amalgamation are exaggerated. Like the noble Baroness, Lady Barker, I have had considerable experience of mergers and amalgamations. I can tell him what happens when there is a period when nothing much is happening. People obsess about the implications for them personally. It does not necessarily mean that they rush to the nearest appropriate or inappropriate job, but they obsess about it. They obsess about the positioning of the desks, who has the largest room, and whether the carpets and natural light will be as good, together with all the substantive issues that ought to concern them. Were the noble Lord to press the amendment to a vote—he has already told us that he will not—and it was passed, its effect would be to produce a period of three months in which very much less work would be done by either the predecessor commissions or the new commissions, because people would be obsessing about minor details. That in itself would be an unfortunate consequence. There might have been a very good case for the amendment had the Government not already listened to many of the points made in Committee. When the Bill passes from your Lordships' House, we will have a very different Bill in terms of how the commission is set up and the objectives before it. Had that not happened, a case for delay—three months or maybe even more—might well have been justified, but the Government have listened and have responded. They have changed the focus of the commission; they propose to give it a whole set of clear objectives; they will have improved the Bill substantially. The main argument in favour of the amendment moved by the noble Lord, Lord Lipsey, has disappeared. The noble Lord then gave us two other arguments that I cannot believe that my noble friend Lord Darzi was going to put forward: the fact that the House of Commons has spoken and the fact that the noble Baroness, Lady Young of Old Scone, has been appointed. Those arguments are not relevant to this point. The question is: do we believe that the commission as now proposed makes sense? Even if we have some lingering doubts about it, everyone is now working on the basis that the new commission will be established. It is difficult to see what will be gained by further delay so that a slightly dubious process can be gone through in which someone will weigh up the arguments and the Government will respond to them—no doubt with the closed mind that the noble Lord, Lord Lipsey, described—apart from three months of attrition while people contemplate their navel rather than carry out the health and social care inspections that are so important and so needed.