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Although the Government have chosen to overturn that amendment in another place, their amendment bringing about that deletion has not been debated in another place by the whole House of Commons. It has only been debated in Standing Committee where the majority in the Government's favour was the narrowest possible one. If an amendment to a Bill is approved by your Lordships--especially one of this significance--I believe that the Government owe it both as a duty and as a courtesy to this House to allow the issue to be debated on the Floor of another place. The fact that this was not done is, I respectfully suggest, most regrettable.
I started with the thought that it would be by no means unreasonable of your Lordships to ask the other place to look at the Lords' amendment again. The logic of the case that it advanced remains clear. Day to day, the NHS and the independent sector work hand in glove; indeed, in many areas, the NHS would simply not survive without the ability to contract out to the private sector. In mental health, for example, 30 per cent of the beds in the independent sector are funded by the NHS. There are many thousands of doctors who divide their time between the NHS and private work. If the duty of quality is to apply to one part of the healthcare system in this country, it should apply across all parts of it.
From the point of view of the patient, there is no case whatever for seeking to draw artificial divisions between the NHS and the independent sector in terms of the standards of care that each should be delivering. Those standards, and the standards of clinical governance overarching them, should be consistent right the way across the board. If they are not, it is difficult to see how the Secretary of State's duty to safeguard and promote the health of the nation--that is to say, the nation as a whole--is being properly fulfilled. But that is the rub for this Government.
I would never accuse the noble Baroness of being ruled by dogma. Her message today was couched in balanced and reassuring tones. But those were not the tones of the press release that accompanied the publication of the consultation document on Tuesday. The headline says:
"Mr. Dobson said, 'Today's document responds directly to widespread patient concern about poor care in parts of the private sector. The small number of people who go private deserve protection'".
To be positive about this document, it does at least open up as a possibility that a new independent regulatory body could contract with the commission for health improvement, as the noble Baroness mentioned, to carry out inspections. It also suggests that clinical and professional standards in the private sector could be the subject of regulations or a statutory code of practice. All that suggests that there could be a de facto, if not a de jure, unitary framework of regulation. That is what the independent sector wants. It wants to come under the wing of CHIMP and NICE. It wants better regulation. It wants nationally consistent quality standards. I am the first to recognise that there may be more than one way of achieving those aims and I look to the noble Baroness for some further reassurance.
As we have seen from the consultation paper, which we read with considerable interest when it was published on Tuesday, the Government are moving towards consistent standards of clinical governance so that, for instance, suspensions can take effect in the independent sector on receipt of an "alert" letter. There is therefore a strong prospect of seamless clinical governance between the two sectors which we welcome.
Moreover, we on these Benches look forward to further moves. We look forward to a prospect of wider consistency of quality of treatment. While not agreeing with the precise mechanics suggested in the consultation paper, we welcome the commitments the Minister has given and some of the statements in the consultation paper, for instance the clear recognition of the inadequacies of the existing regulatory structure and the commitment to protect all members of the public, including private patients as well as patients in NHS hospitals. Further, we welcome a recognition that it is important that patients who choose to use the independent sector are reassured that they receive services that are safe. We welcome the further statements made today by the Minister explaining the paper, and the preference for a single regulator for the acute independent healthcare sector rather than putting him under the regional commissions. We believe that is at least a step in the right direction.
We also welcome the recognition that that single regulator of independent healthcare might well want to take advantage--and be able to take advantage--of the particular expertise of the commission for health improvement. We believe that there is considerable potential synergy between the responsibilities of that single regulator and the work of the commission itself. However, we believe that some further assurances are needed. For instance, we need the assurance that NICE guidance for doctors in the NHS on the treatments that they use can also be adopted by the new independent regulator, and that the independent regulator could also introduce all or part of the national service frameworks.
The Select Committee on Health in another place has carefully considered the matter, as the noble Baroness mentioned. However, we seek the assurance that if it recommends--it certainly appears to be moving in this direction--that a common duty of quality is extended across the two sectors, the Government will carefully consider that proposal as part of the consultation
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