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Baroness Gale: My Lords, I want to speak against the amendment. The Secretary of State has already announced the need for organisational integration of CHI, the National Care Standards Commission, the SSI and the Audit Commission to create the commission for healthcare, audit and inspection, and to integrate the health work of CHI with the private healthcare function of the NCSC and the work of the Audit Commission. I understand that this has been welcomed by those who work in that field.

It should be remembered that the work of the National Care Standards Commission has only just been established. A major reorganisation and shake-up such as is set out in Amendment No. 10 is not feasible or desirable at this stage.

Of course, all existing bodies should work in the closest co-operation and they have already expressed their intention to do so. A single new body for inspecting healthcare in both the NHS and the private sector is already planned. This merger needs time and sensitivity to settle down, and we should not seek to complicate the situation further as would happen if the amendment were to be accepted.

Lord Hunt of Kings Heath: My Lords, I am grateful to the noble Baroness, Lady Northover, for her probing amendment, which I have great pleasure in responding to. All I can say is that I believe that there is complete consistency in all that I have said on these

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matters in this House, going back over the years of pleasure that I have had in bringing NHS Bills before the House.

So far as concerns my remarks in Committee and where we are now, what the Budget Statement and the Statement by my right honourable friend the Secretary of State for Health took forward was the consideration in the Kennedy report, which argued for a review of the regulatory bodies to ensure greater clarity and greater consistency. That is what has happened, and the announcement took place two weeks ago.

The noble Lord, Lord Clement-Jones, raised an interesting question as to whether we should have put together a health and social care inspectorate rather than two single inspectorates. We considered carefully whether we should go down the route of establishing a single health and social care inspectorate—to which the amendment moved by his noble friend would lead, although the title "health inspectorate" would not be very appropriate if we went down that route. An assessment took place and a number of criteria were considered. They included the impact on the burden of service providers, the effect on organisational stability, the effect on the cost of inspections and a number of other matters.

In the end, we came to the conclusion, particularly given the nature of the organisational change that would have to take place, that it would be better to keep to a health inspectorate and social care inspectorate, but making it clear to the new organisations—and primary legislation will be required—that they would have a duty to co-operate together. As I have said, legislation to establish the new inspectorial bodies will be introduced as soon as we have worked through the practical details and as soon as parliamentary time allows. As to whether I introduced a new definition of what "somewhat premature" means, the six-week gap between my saying that and now should not be taken as a general precedent for a definition by government as to what "somewhat premature" means.

Life moves on, and the question now is how to ensure that in the interim we continue arrangements with the National Care Standards Commission and with CHI to ensure that their current functions are managed effectively, while setting up as soon as we can the interim arrangements for taking forward our new proposals. As noble Lords will know, CHI is currently able to review arrangements for clinical governance in NHS services provided by the independent sector, including those provided by independent hospitals. We are examining how we may take forward that work.

The Bill gives CHI a new function of inspection against published standards and that responsibility will be extended to services for NHS patients wherever they are treated. We have deliberately made provision in the Care Standards Act 2000 for CHI to be able to exercise the functions of the National Care Standards Commission and vice versa. Of course, in answer to the noble Baroness, Lady Noakes, we shall seek to ensure that those arrangements and agreements are

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completed as quickly as possible. I have no argument with her in terms of wanting to ensure that that is put in place as quickly as possible.

I noted with interest what the noble Baroness had to say about her discussions with the chief executive of the National Care Standards Commission. He made a statement when we announced the decision for two inspectorates, and said that he welcomed the proposed legal requirement for the new commissions to co-operate with one another. He also said that we must ensure that the interests of service users are at the heart of the reform. In our project plan for taking this work forward we shall work closely with the commission, with CHI and with the Audit Commission to ensure that there are smooth transition arrangements.

It is worth making the point that the new health inspectorate will be staffed largely by current employees of CHI, the commission and the Audit Commission. Of course, they will continue their existing important work until the new body comes into being. We appreciate that the transfer of staff needs careful thought and we shall ensure that that takes on a seamless transition to minimise the impact on current staff. On the issue of working together in the interim, we shall meet with CHI, the National Care Standards Commission and the Audit Commission to ensure that that happens as effectively as possible.

The noble Lord, Lord Clement-Jones, referred to the decision of Dame Deirdre Hine not to seek re-appointment to CHI when her term of office comes to an end. I take this opportunity to place on record my and the Government's appreciation of the tremendous work that she has undertaken.

On whether the inspectorate will be an inspectorate or a developmental agency, one needs to be abundantly clear that it will be an inspectorate. That is our intention. We have always seen the modernisation agency as the main developmental arm of the National Health Service, but we expect the new inspectorate—

Lord Clement-Jones: My Lords, can the noble Lord kill the rumour that the Secretary of State would rather like the inspectorate to be like Ofsted with Mr Chris Woodhead?

Lord Hunt of Kings Heath: My Lords, that is the first time I have heard the suggestion that Mr Woodhead may be appointed to the health inspectorate. It would be wrong of me to engage in speculation about who would be appointed because that will follow from the process of legislation. That sounds rather unlikely.

7.45 p.m.

Lord Clement-Jones: My Lords, I meant "like Mr Woodhead" and not actually Mr Woodhead. That would be a fate that I had not contemplated for the new Audit Commission.

Lord Hunt of Kings Heath: My Lords, as far as I know there is no one like Mr Woodhead! I pay tribute to Dame Deirdre Hine and I say quite clearly that the body is to be an inspectorate. Of course, we would

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expect the inspectorate to build on the achievements of the commission, CHI and the Audit Commission. We are building up a great deal of expertise as to how effective inspections work. I certainly agree with him when he implies that inspection is not just about sticks, but also about carrots and about acknowledging successes. If one reads the reports by CHI, one will see that while, quite rightly, they pinpoint problems and concerns, they also highlight successes within individual organisations.

On the Audit Commission, I note what the noble Baroness, Lady Noakes, says, which was echoed by the noble Lord, Lord Clement-Jones. I make it clear that we are talking about the value-for-money studies and not the more general responsibilities of the Audit Commission that will remain with that commission in relation to the NHS. On data quality issues, the Audit Commission report did not paint an altogether wholly depressing picture. Beware of Audit Commission press releases that sometimes do not always reflect the degree of comment within the Audit Commission's report itself. Yes, it pinpointed problems but it also showed areas where the NHS has improved. We have made clear to the NHS that boards of NHS organisations are responsible for their own quality data. There are distinct signs of improvement in quality, but we shall urge the NHS to do even better in the future.

Baroness Northover: My Lords, I thank the Minister for his reply. I beg to differ with the noble Baroness, Lady Noakes. It is not noble Lords on the Liberal Democrat Benches, or those on her Benches who have drawn closer to the Government, but the other way around. Amendment No. 10, which was formerly a Tory amendment, is a probing amendment, a vehicle and not a detailed prescription. It was tabled in order to explore exactly what the Government have in mind. I am not sure how far we have achieved that. It is certainly very welcome when a Minister, in his consistency, moves from opposing us to supporting where we stand. I would welcome such consistency any time. We look forward to seeing the Government's detailed plans as soon as possible. In relation to private hospitals they cannot come too soon. Meanwhile, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

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