Health Bill [HL]

Continuing with the theme of consultation, the three amendments in this group would include the Care Quality Commission within the scope of the Secretary of State’s consultation, first, for the appointment of a trust special administrator; secondly, for the giving of a regulator’s notice by Monitor in the case of a foundation trust; and, thirdly, in the preparation of a draft report by a trust special administrator which recommends the appropriate remedial action to the Secretary of State. There is a strong argument that as the main regulator of quality in health and social care, the Care Quality Commission needs to be included in the list of those to be consulted. If the trust is failing on grounds of the quality of the services it provides, which is likely to be the case in most instances, the CQC needs to be consulted in order to advise on the decision to appoint a trust special administrator. The CQC, in carrying out its duty to make an assessment of the current quality of services, will have important information which may be critical in reaching the very important decision. The CQC is likely to have been involved in the earlier stages of managing the failure through its duty of registration, which may be followed by enforcement action. Again, it will have information to inform the decision. The processes of registration and of managing serious failure through appointing trust special administrators are inextricably linked and this escalation needs to be smooth and co-ordinated. To enable that, the CQC needs to be involved in the whole process, which I think needs recognition in primary legislation. Once the trust special administrator is appointed and has published a draft report stating the actions he or she recommends to the Secretary of State, there is a 30-day consultation period of the plan. While a number of other relevant organisations must be consulted—we have already discussed staff—I find it really surprising that it does not include the Care Quality Commission. The CQC should be included on this list because any changes made to services would involve it in varying the registration of those services. We could easily land ourselves in the unfortunate position of a trust special administrator proposing a reconfiguration which the CQC found to be unregistrable. I can understand that the Minister may wish to argue that if this exception is made it may open the floodgates to many other organisations which wish to be a statutory consultee. However, in my mind, none would seem to be quite as relevant as the CQC, with its special duties and the information it possesses. Alternatively, the Minister may argue that the CQC would be consulted as a matter of course. However, given that the CQC will be inextricably linked in these processes, it seems sensible to eliminate doubt and to make it clear in the Bill. I beg to move.