Health Bill [HL]

My Lords, I thank all noble Lords who have taken part in this debate, not least those who have supported the position that I have taken. I am particularly grateful to the noble Baroness, Lady Murphy. Having listened to her, I accept that there could be rare circumstances in which the power that the Government are seeking might be warranted and might be appropriately used. However, the main issue that I raised relates to new Section 52E. Essentially, the Government have looked at mid-Staffordshire, acknowledged that there has been a failure of management and decided that the way to solve that management problem is by legislating. That is a classic piece of wrong-headedness, although, for the reasons that I gave earlier, it could be even worse. New Section 52E is all about putting Monitor under political pressure and, as my noble and learned friend said, could serve to do the very opposite from what the Government are intending; namely, it could undermine confidence in the system. If people do not think that Monitor is doing its job properly, that is an even worse situation. Not only does Monitor have to act when instructed or requested to act, but it may have only 14 days in which to do so because, as the noble Baroness, Lady Barker, pointed out, the Secretary of State could insist on 14 days. If it then delivers what seems to the Secretary of State to be the wrong answer, there seems to be nothing to prevent the Secretary of State from repeating the request straightaway, thereby redoubling the political pressure. To me, none of that is a very appealing prospect. We then come back to whether deauthorisation is a measure of last resort. From the Minister’s answer, I was not entirely clear about that. The fact remains that Monitor could be trapped by the wording of the amendment. Having taken a detailed look at the facts of the particular case, it might well find that the trust was in breach of its authorisation terms. It might well find that that breach was serious enough to justify the Secretary of State making an order to deauthorise a trust yet, despite that, conclude that it was inappropriate to go down the deauthorisation route. How easy will it be for Monitor to hold fast to that conclusion in the face of intense political pressure? Without wording in the new section to make it clear that deauthorisation should be considered only when other measures have failed, that will not be easy at all. The way to secure improvements in the performance of foundation trusts is much more straightforward than any of this, and noble Lords have referred to it. It is to make sure that there is close liaison between the Department of Health, Monitor and the Care Quality Commission. We do not need legislation to do that. I am sufficiently encouraged by the support that I have received from other noble Lords that I should like to test the opinion of the House. Division on Amendment 1A Contents 103; Not-Contents 164. Amendment 1A disagreed. Motion agreed. Motion on Amendments 2 to 10 Moved by