You do not mention an important question for the new super-regulator, writes Don Redding. Will it exist to serve patients and service users, and if so, how will it engage with them?

The Health and Social Care Bill does not say whether the Care Quality Commission will be advised by service users in developing its methods and processes; or whether it will continue the best practice of current regulators by involving service users in its work, for example as lay inspectors or "experts by experience".

Patient, consumer and social care charities including the Picker Institute have inspired amendments to the bill, supported by both opposition parties, that would give the commission a principal duty to serve the interests of patients, service users and the public; a subsidiary duty to engage these groups in its work; and a "service user panel" to advise it from the inside on building these interests into all its plans and approaches.

The government says it wants all these things - yet has so far rejected the amendments. Health, it seems, is somehow different to communications, financial services and food standards, where similar measures are written clearly into the recent legislation. We suspect that these may be issues into which the Lords will enjoy sinking their teeth.

Don Redding, head of policy, Picker Institute Europe