Speeches by Johnson.

“No, I am not. Schedule 8 Transfer of HSSIB’s Functions to CQC”

“I rise to discuss new clauses 3 to 5 and 43, which I am sure that the Whips will not let me forget. I understand the sentiment behind the Liberal Democrat new clauses. The hon. Member for Winchester is keen to ensure that uses of NHS data are limited to uses for which people can consent, uses in relation to their care …”

“Considering that the national quality board is tied directly to the NHS, how does direction from the NQB square with the independence of the new investigation unit? On top of that, as the Minister will be aware, the impact assessment says that the topics of “the vast majority” of investigations are expected to be direc…”

“The impact assessment speaks of”

“Is there not a third issue: that the local authority and the ICB will no longer have congruent areas and will therefore look at different populations?”

“As I understand it, the objectives of the Bill are to replace the local healthwatch with a less independent, internalised gatherer of patient experience feedback. The objectives appear to be featuring feedback more centrally in strategic decision making, getting people into the room and simplifying the patient landscap…”

“My right hon. Friend will be aware that it is not the only thing that the CQC is being asked to take on. It is also being asked to take on the regulation of event healthcare, which is another new function for the CQC, all at a time when, as he says, it has its own difficulties to manage.”

“The other question is more fundamental: if HSSIB is rolled into the CQC, what happens if the HSSIB unit finds a problem with healthcare that is caused by the CQC failing to properly regulate or properly inspect? In the Committee’s first oral evidence session, I asked the chief executive of HSSIB how that would work in …”

“Will the hon. Gentleman give way?”

“My hon. Friend is making a very important case about the importance of the perception of independence and the safe space actually being safe. There is a risk that people feel that they will be hounded or—”

““clear direction to the new investigation unit”.”

“On pages 8 and 9 of the Dash review, Dr Dash talks about this. She states: “Recommendations are…focused on inputs, rather than outputs or outcomes, and fail to…balance…risks within organisations and across systems…the existence of so many recommendations causes considerable confusion for staff. They result in more clin…”

“I thank the hon. Gentleman for that intervention, but I think this comes to part of the problem. When producing a list of faults—of things that are wrong with the service—and saying, “We need to improve the culture; it needs to be better”, we need to ask, “Okay, but how? What will be the deliverable, measurable way of …”

““If we were a directorate in the CQC, as outlined in the legislation, it would be very difficult for us to comment on how the CQC was looking at different areas and how it was managing certain aspects of safety. I think there is also concern about our ability to make effective recommendations to the CQC if we are a dir…”

“The Minister seems to be saying that her reasoning for moving HSSIB into the CQC is to ensure that actions take place in response to the recommendations. But if HSSIB outwith the CQC makes recommendations that are delivered by the provider organisations, commissioned by the ICBs and overseen by Ministers, and then the …”

“My understanding is that, in the past, HSSIB has provided services to not only British health services but overseas health services, which were, in some cases, charged for that service, as it is a world-leading organisation. Why would the Minister not want that to continue?”

“There is a serious risk of a chilling effect if the Committee just waves these clauses through. The impact assessment indicates that Ministers want to preserve HSSIB’s safe space, but I do not see how that is feasible. In its submission the King’s Fund wrote:”

“The Minister has reassured us that, although it has not been lifted and shifted from the original, the amendment is a duplication of another clause. Therefore, we believe the Committee—”

“Will the Minister give way?”

““The transfer of the functions of HSSIB into the Care Quality Commission (CQC) also raises questions around people being able to trust the system and come forward with their concerns and issues.””