Health and Social Care Bill

I have some sympathy with these amendments, as my amendments in the following group might indicate. My name is not on these amendments solely because I have one or two questions for the noble Lord, Lord Warner. He said in his introductory remarks that he was completely sold on a risk-based approach to regulation. In the light of some of our discussions in the first two days of Committee, does he accept that, at least in the world of social care, there is a need for a rights-based approach? My key question is whether his definition of ““commissioning”” also includes procurement. Those of us from the social care field understand only too well the difference between the two. Commissioning is an engaging process of negotiation and discussion between stakeholders and potential service providers that sets out what one would ideally like to buy. That is then handed over to the procurement officials, who get down to the realities of what is going to be bought and provided. That process, under the European directive rules, is direct and limited. It is pretty much the same whether it applies to the procurement of social care or of street furniture; indeed, I have seen examples of contracts for social care services that, when one drills down into them, are based on templates for contracts for the procurement of street lighting. It is exactly the same process. Procurement is altogether a much harder legal process, which has much less to do with quality of outcomes and more to do with price and risk. The noble Baroness, Lady Cumberlege, talked about PCTs becoming solely commissioners. That is already happening: Kingston PCT is in the process of divesting itself of all its provision and moving to becoming solely a commissioner and procurer of services. Whether or not that is the Government’s intention, it is becoming a reality. I would be grateful for some clarification.