Health and Social Care Bill

moved Amendment No. 32: 32: Clause 4, page 3, line 10, at end insert— ““( ) The Secretary of State may make regulations subject to annulment in pursuance of a resolution of either House of Parliament that limit the scope of the services to be registered under Chapter 2 where he considers that the risk to service users is insufficient to justify regulation or where the Commission advises that registration should be deferred for a period of time.”” The noble Lord said: This is a probing amendment aimed at future-proofing the scope of the new commission and enabling it to take on new functions in an orderly way. There has been a good deal of discussion about the scope of the commission’s remit, and I do not intend to go over that in great detail, but certainly this afternoon’s discussion suggests that there is some uncertainty about the precise scope of the commission. We are getting into a tangle about what is provided for in legislation and what is provided for in a consultation document that is still out for consultation with no firm decisions having been taken. We are being asked to take quite a lot on trust in that area. The other point that I want to make is that the dividing line between clinical services and cosmetic services is becoming increasingly blurred, especially in areas such as dentistry. When is something clinically necessary and when is it cosmetically preferred? The only thing that seems to be certain is that in the future the range of technologies and treatments and the places where they are located are likely to change and, in some cases, are likely to be very different from what we know now. That is not a subtle plug for polyclinics or anything else; it is just a statement of the way in which technologies and treatments are, in reality, changing. It is also likely that new professionals will appear and that they will be in new groupings in new types of facilities. In those circumstances, I think that there is a case in any risk-based regulatory system to start from a different position from that in the Bill. The amendment would put the onus on the Secretary of State to show that there is insufficient risk for particular activities to be regulated in subordinate legislation; otherwise, all services will be included in the health sector. This is what the first part of Amendment No. 32 would do. The second part addresses some of the concerns about the Bill expressed at earlier Committee sittings; namely, that the new commission may be swamped by new functions and activities in relation to the resources available to it. I have therefore provided for time-limited exclusions for the commission where that can be shown to be appropriate. That seems to me a practical and sensible way to proceed. I recognise that we may be too far down the track for the first part of the amendment to have much appeal to the Government. Therefore, I shall be neither peeved nor surprised if I get a fairly friendly but dusty response to it. However, I should like to hear my noble friend’s arguments in a little more depth than she has been able to give so far about how the legislation will be future-proofed and whether we can really be certain that it is likely that the legislation, as currently drafted, will be able to cope with a range of new services that may cause concern. Cosmetic surgery is a good example of where, in the past, we have struggled to keep up with potential damage in the regulatory system. On the second part of the amendment, I should like to know how the Government will ensure that the commission is suitably placed to take on its new functions without a provision of the kind that I have provided for. I beg to move.