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Health and Social Care Bill

My Lords, I was going to support Amendment No. 8, tabled by the noble Lord, Lord Lipsey. I do not see that the demands of integration, which are a real potential strength of the commission, are incompatible with the need for specialisation. Indeed, no cake is indivisible; it has to be split up in some way or another. The main board of the commission will probably need specialist advice on issues dealing with health, social care and mental health. It is the role of the main board of the commission to bring those streams together in an integrated way and achieve cross-fertilisation. My position has moved somewhat, as has that of other noble Lords, as the debate has gone along. Indeed, it has moved further in the course of this debate, as I shall indicate in a moment. As discussions have taken place between Committee and today, I have been keen to see that we are not too prescriptive about what we put in the Bill and that we leave the new commission room to make sufficiently flexible arrangements as to its structure so that they can be changed over time to meet changing circumstances. That does not absolutely preclude putting something definite, such as specialist committees, in the Bill. For example, the Commission for Equality and Human Rights, which is often referred to in this context, has a disability committee which has been established for five years and the question of whether it should continue at the end of that period will be subject to review. We could do something like that in this Bill. However, I am persuaded that we should not do anything too prescriptive, and perhaps Amendment No. 2 will achieve that. I think—I should be glad if the noble Earl, Lord Howe, would confirm this—that Amendments Nos. 2, 5 and 6 hang together, so I would not want Amendment No. 2 to be agreed to without Amendments Nos. 5 and 6. They refer to slightly different things and stand together as a package. However, what has most decisively caused me to shift my position further today is the fact that the noble Lord, Lord Lipsey, no longer wishes to press his Amendment No. 8. Indeed, he pre-emptively withdrew it even more forcefully than he withdrew Amendment No. 1.