Health Bill [HL]

My Lords, I support the comments of the noble Earl, Lord Howe. I have been involved in the National Health Service off and on over the past 30 years and Monitor has been the first body to really transform trusts as I have been aware of them. Inefficiencies in the NHS, I am afraid, are a commonplace; they have been there over the years. In their preparations to become foundation trusts, the trusts have to work extremely hard to sort out their governance, to sort out their boards, to appoint new people and to improve their professionalism. Certainly our board—it is quite typical—is now completely different because we had to be different in order to justify our existence as a foundation trust. Therefore I find it difficult to think that somehow it would be a step forward for a trust to be moved from regulation by Monitor to some sort of regulation by the Secretary of State. I agree with the comments that have been made by my noble friend about the fact that Monitor has been required to focus on finance until very recently. My understanding now is that Monitor will have a very good look at the quality accounts of every foundation trust in order to judge us on our quality of service as well as our financial probity. On that basis, the government amendment will be unhelpful and I add my support to the words of the noble Earl, Lord Howe.