Health Bill [HL]

My Lords, it might help the House if I say a few words as the Minister who took the 2003 Bill through this House. The noble Earl, Lord Howe, has reminded us of some of our exchanges. It is certainly true that I swore undying support for the independence of the regulator on the basis that Ministers would resist the temptation to interfere in the workings of foundation trusts when things did not go quite as everyone would want them to go. In the case of mid-Staffordshire, neither the Healthcare Commission nor Monitor covered themselves in communications glory over the way that some aspects were handled. There are some issues on which I have some sympathy with Ministers for intervening. However, proposed new Section 52E crosses the line with regard to the assurances that government Ministers, including myself, gave in good faith about the independence of Monitor. I have not heard the arguments for why we need the proposed new Section 52E. Indeed, the noble Earl, Lord Howe, made some good arguments for why we do not and it is incumbent on Ministers to explain why the amendment is now necessary. What circumstances have changed since the 2003 Act to make that kind of amendment necessary? To add to that, the way that Monitor has behaved for five to six years is, for the most part, overwhelmingly a triumph of successful early interventions when things were going wrong in particular foundation trusts. Admittedly, many of those issues were financial but, even then, Monitor intervened with trusts whose financial circumstances were going off the rails much more rapidly than strategic health authorities, either in their current or previous form, have ever done. In answer to a Question that I put down a couple of months ago, the noble Lord, Lord Darzi, replied that there are still 40-odd existing trusts, not foundation trusts, that have historical deficits. That situation simply would not have happened with Monitor; those sorts of issues would have been tackled earlier. This comes back to the question raised by the noble Earl, Lord Howe: if we return a failing trust to an SHA, what guarantee do we have that the responses in putting things right for local people will be faster than they would have been if left with Monitor? I have some sympathy with the points that the noble Earl has raised.