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Health and Social Care Bill

My Lords, I support the noble Earl, Lord Howe, in his Amendment No. 43. He has put a powerful case for clarity about the respective roles of Monitor and the CQC. We have a pretty good arrangement now, because the Healthcare Commission is in effect the inspectorate and feeds information to Monitor, which is clearly the regulator. I, too, find it difficult to understand why, in the case of foundation trusts, the CQC could not perform the same inspecting function, taking data from foundation trusts, as the Healthcare Commission does now, but leaving the regulatory sanctions role clearly with Monitor. I strongly support the noble Earl, Lord Howe, and sincerely hope that Ministers will think again about the absolute importance of clarity. Information is another potential source of confusion between the two bodies. I suggest that a small amendment might be made to the amendment to remove the word ““their””. The amendment requires the CQC to promote the efficient and effective use of its own resources. If we removed ““their””, the amendment would require the CQC to promote the efficient and effective use of resources. Let me explain why I think that change could be helpful. In a sense, this is about duplication of functions. The Healthcare Commission and Monitor have worked well to try to ensure that they do not duplicate the demands for information from provider trusts. Each provider trust has to provide information to the Department of Health, Monitor, the Healthcare Commission, perhaps three, four or five primary care trusts—each of which may demand information in a slightly different way—and local authorities. That is an enormously complex set-up. I thought that I would illustrate the point by bringing with me a few pages of our targets from Monitor, the Healthcare Commission, the PCTs, and so on. We are not talking about a few lines of information but an enormously complex set of demands that every provider trust across the country has to tussle with. Each set of demands is not included in the demands of the above organisation, so there is far more to it than at first appears. If these demands are co-ordinated, it is just about manageable. However, it is not difficult to imagine a new, incoming organisation hurling out a lot of demands for information without fully taking on board the impact that would have on all the other demands. The information then has to be collated, entered on to computer, analysed, tabulated and put into documents that people can understand. I strongly support the amendment of the noble Earl, Lord Howe, but argue that there is a bit more to this aspect. It is not just a question of double jeopardy in relation to sanctions.