Health Bill [HL]

The Addison rule was written for a purpose, and this is the moment it was written for. I know it is intensely annoying for the Minister if the chairman of the Care Quality Commission keeps leaping to her feet and explaining things that really are in his provenance, but I cannot leave the amendments of the noble Earl, Lord Howe, unchallenged. First, I shall say a couple of general things about quality accounts. The Care Quality Commission absolutely welcomes the initiative and very much recognises what the noble Lord, Lord Darzi, is trying to achieve. Indeed, it has been very pleased to have the supporting information from noble Lords on the implementation of quality accounts, which I think makes it very clear how CQC’s regulatory information will form part of the quality accounts and how CQC will be involved in determining the content of quality accounts. It very much welcomes that. On Amendment 38, the noble Earl, Lord Howe, is right to say that the accuracy and completeness of the information in quality accounts needs independent verification. However, I do not think that it is a job for the CQC. The job that needs to be done is the equivalent to getting the bean counters in to make sure that your financial accounts are right. We do not want to be bean counters, even in a quality context. The Care Quality Commission thinks that there is a job there, a good market niche, for the variety of account validators that has sprung up around accounts. For example, environmental accounts are now audited by environmental accounting auditors. It supports the view that the accounts need to be independently verified, but it does not want the job of doing it, thank you very much. Under Clause 7(3), if the Care Quality Commission spots something a bit off beam or not correct, it can challenge it and have it changed, and it welcomes that role. However, the Care Quality Commission does not want to be the comprehensive independent auditor of quality accounts. I shall comment on the statements made by the noble Earl, Lord Howe, about accreditation. Accreditation has huge value and is an opportunity in a variety of ways to help encourage providers to take responsibility for the quality of the services that they provide. The Care Quality Commission has been having some interesting conversations with the Royal College of General Practitioners about how the college’s voluntary general practice service accreditation proposals could be used to reassure the CQC, as a regulator, that the service is of good quality. That will depend on whether the accreditation process can be made sufficiently comprehensive to cover all the bases that the Care Quality Commission needs covered, but it will be taking that forward with the Royal College of General Practitioners. If there was a good accreditation scheme generally in use across a service, it would encourage providers to take part in it. The Care Quality Commission would expect to spend more time with services that did not offer that accreditation reassurance than with services that did. For example, the pathology scheme, which is excellent, needs to get to a point where all providers of NHS pathology services are accredited under it. I agree wholeheartedly with the view that accreditation should be a part of the regulatory toolkit, but please do not make the Care Quality Commission a bean counter. Since I have to keep the Minister happy, I should say that we are now 33 days away from the Care Quality Commission.