My Lords, I listened carefully to the points made in this debate, particularly those made by the noble Earl, Lord Howe. I find this brave new world that we are moving into—of which he painted such an attractive picture—a bit puzzling. In the previous debate on the trust special administrator, we heard that the trust special administrator comes into play when this wonderful piece of architecture around commissioning has failed to deal with the job. The CCGs, supervised by NHS England, have simply not been able to deliver the changes that are required through the commissioning arrangements. In that area, the fall-back position which the Government insist that we have, is a trust special administrator, often to make good the deficiencies of an unsatisfactory commissioning set-up. The Government do not seem to have quite as much confidence in their new architecture for commissioning as the noble Earl suggested.
I turn to my amendment, which in effect maintains the status quo and the ability of the CQC to decide, in the light of the evidence it has had from its reviews of performance by providers, that there is a systemic problem with commissioning, the making of arrangements for adult social services. It seems odd that we should
just leave this, in effect, to all 152 local authorities and put in place another hurdle to be got over, which is the approval of two Secretaries of State, before the CQC can actually act in the area of commissioning. We have to bear in mind that in the good old days, when I was a director of social services in local government, I had to look over my shoulder at the Audit Commission as to how we were behaving and making our arrangements. The Audit Commission, however, has gone the way of all flesh, so that is the end of another watchdog that was there to make sure, without being too obtrusive, that there could be thematic reviews of the way local authorities carried out their commissioning behaviour. I do not think that this architecture is robust enough to safeguard patients, and I wish to test the opinion of the House.