Skip to main content

System Management and Reform

Volume 453: debated on Monday 27 November 2006

Today I am publishing two publications which will take forward our commitment to place patients and the public at the heart of the way our health services are run: “The future regulation of health and adult social care in England“ and,

“Code of Practice for promotion of NHS services” which covers promotional activity directed at both the public and commissioners.

“The future regulation of health and adult social care in England” takes forward our commitment to provide a clear and refocused approach to regulation and a framework for management of the health and adult social care systems. This document brings together our response to the wider review of regulation about which we notified Parliament on 19 October 2005, Official Report, column 56WS.

This document is the latest in a suite of publications providing more detail on my Department's proposals for health reform. In recent years, the National Health Service (NHS) and adult social care services in England have responded to profound challenges and change. There have been substantial improvements in services in both sectors, which have delivered significant benefits for patients and service users. But, demographic changes, peoples' rising expectations and advances in medical technology will place demands on both systems to go on improving services.

In all public services, we are making a radical shift from top-down, target-driven performance management to a more bottom-up, self-improving system built around the individual needs of service users and influenced by effective engagement with the public. Increasingly, improvement will be driven by the choices made by service users and healthy competition between different service providers. The NHS and adult social care services are no exception.

This document describes how independent regulation will support these changes in future, within the context of cross-Government objectives to reduce the burden of regulation. The overall aim is to give people the best and safest care possible, with the best possible value for public money. We want to see effective management of the system backed by regulation that gives patients and service users confidence that whichever provider they choose, whether public, private or third sector, they can be assured of a safe and high quality service.

It makes clear our commitment to merge the Healthcare Commission (HC), the Commission for Social Care Inspection (CSCI) and the Mental Health Act Commission (MHAC) and sets out the rationale for the merger. The plans to merge form one of the key strands in the Government's strategy to reform public service inspection. The new organisation will enable greater flexibility in response to an evolving adult health and social care system.

Bringing together the regulation of NHS and adult social care services will have many benefits. It makes sense to patients and service users who want integrated services. It makes sense to service providers who want simple, less burdensome regulation. It makes sense to commissioners who want jointly to commission health and adult social care services. And, it makes sense to the taxpayer who wants regulation to offer value for money.

The proposed merger has provided an opportunity for us to review the functions required of the merged regulator in light of our health reforms and the Local Government White Paper, “Strong and Prosperous Communities”. We have undertaken a detailed assessment of what functionality will be appropriate to ensure that the new regulator will be fit for purpose.

The document outlines what particular regulatory functions will be needed to be undertaken from 2008 onwards, and by whom—the new regulator and other organisations in the wider health and adult social care systems. The change will be evolutionary not revolutionary, building on the excellent work to date by the HC, CSCI and MHAC, to move to a more risk based approach. They will remain in place during the transition period until the establishment of the new regulator.

In addition, the new regulator will inherit and continue the important role currently undertaken by the MHAC in England. In a separate process, we will review the necessary duties and powers required by the new regulator to keep under review the operation of mental health legislation; to ensure that mental health service users are as effectively protected by the new regulator as they are now and to emphasise the importance of equality and human rights in mental health care. This will learn lessons from the effective visiting programme that commissioners have undertaken.

This document launches a three-month consultation on the operational aspects of the identified functions and further detail will be published in spring 2007 in response to the consultation.

Patients have always had a keen interest in their healthcare and patient choice is now a reality in the NHS. Coupled with access to clinical quality information, this will help drive up standards across the NHS. Providers will want to make more information about their services available to patients and referring clinicians in order to help them make choices and advise patients. Appropriate levels of promotional activity by providers are a way of making this information more easily available.

Through promotional activity, providers will develop a better understanding of the needs and wants of patients and GPs. This will enable them to respond and reshape services accordingly and deliver services that better meet those needs.

The “Code of Practice for promotion of NHS services” published today describes how a self-regulatory approach to promotional activity will support these changes, ensuring that information is accurate and reliable. These proposals have been developed by the Department following preliminary discussions with the NHS confederation and a number of stakeholders. This document launches a three-month consultation on the draft code of practice.

I commend these documents to the House.

Copies of both today's publications have been placed in the Library.