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Health and Social Care Bill

My Lords, my name is not added to any of these amendments. The reason for that is that I do not want a consolation prize. I am clear about what I want: a commission whose objectives are sufficiently clearly set out that its purpose is unmistakable and one which involves the right people making those objectives become a reality. I do not underestimate the difficulty of what is being attempted here. I hesitate to say this in front of the right reverend Prelates but—this follows on from the comments of the noble Lord, Lord Walton of Detchant—someone once said to me that trying to get health and social care groups to talk to each other in a meaningful way was like trying to get one bunch of people who believed that health professionals are gods to speak to another bunch of people, social workers, who have strong doubts about the existence of god but who are absolutely certain that, whatever else he is, he is not a health professional. The standing of any regulator depends on the way in which it is set up—the objectives that are given to it and, often, the strength of the personalities and depth of experience of the people who go along to it. One problem is that we do not know who will be involved at any one time; we could have someone who was extremely forceful and knowledgeable about mental health, which might make us feel differently about the rest of the composition. We also need a body that is sufficiently resilient to be able to advise government when their policy is wrong and withstand the pressure that can fall on regulators when scandals happen. Scandals are one of the main drivers of policy, particularly in health and social care. We need a strong body that can ride out the storm of a scandal and keep true to its strategic objective. I am not convinced that we have got an answer but I am convinced that we need to set out in statute the composition of the commission. That is why I would like the opportunity, between now and Report, to find out from the existing commissioners what, in their experience, has enabled them to do their jobs as well as they have done. In particular, I wish to find out from them what enabled them to be proactive and what made them sit up and think afresh. Has it been coming into direct contact with users; has it been doing long-term work with subgroups of people; or has it been the dynamic process of bringing different people together and moving them forward? I want to end up with something like Amendment No. 2, which will mean that at any point when a strategic or major decision is made there is somebody who comes from a background sufficiently different from everybody else in the room who has the power to say, ““No, what you are doing is wrong. Think again””. However, I should still wish for the opportunity to talk to Ministers and the existing commissioner to make sure that finally, we get this right.