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Health and Social Care Bill

I do not propose to go through the amendments at length, as we support most of them because they improve the Bill and make changes that we sought to secure in Committee. I particularly welcome the amendments that strengthen the role of the commission with regard to commissioning. My interpretation of Lords amendments Nos. 15 and 16 is that they would allow for the commissioning to be reviewed. I was very taken by the comments of Lord Warner on Report in the other place. He has considerable experience of health matters, and he said:"““In the past, there has been a considerable reluctance on the part of the NHS, and often of the Department of Health and Ministers, to act when commissioners are failing. They are much more willing to act when providers are failing. The Bill is strongly focused on providers, with a registration system and a set of sanctions accordingly.""I do not want to put the noble Baroness, Lady Young, in a difficult position in her future relationships with Ministers and SHAs, but there is an issue about whether, in the Bill, the commission should be able to require some action from the performance managers””.—[Official Report, House of Lords, 24 June 2008; Vol. 702, c. 1349.]" Try as I might, I could see that there was a provision to review, but it was hard to see what sanctions were available if the commission felt there were problems in any area of commissioning. As it is a variable beast that works well in some areas of the country and less well in others, I felt Lord Warner raised a valid point that Lord Darzi did not fully address in his summing-up comments. It would, therefore, be helpful if the Minister were to add to them today, and put some flesh on the bones. I particularly welcome the many amendments that take out the reference to the Secretary of State—in respect of modifying reports, for example. Although there are still some provisions for the Secretary of State, it is pleasing that his role seems to have been almost totally emasculated by the other place. That will be welcomed by those who query whether the new body will be truly independent. It is still not perfect, but it is much better than it was, and it is clearer that there is less provision for Government interference of any kind.