Care Quality Commission could threaten accountability, Monitor warns

In written evidence to the Commons public bill committee, the foundation trust regulator expressed concerns over plans for the Care Quality Commission, which is expected to cost£140m.

The commission will be created under the Health and Social Care Bill by merging the Healthcare Commission, Commission for Social Care Inspection and Mental Health Act Commission. It would have statutory powers over foundation trusts, which Monitor said would overlap with its role in ensuring foundation trusts are efficient, effective and economical. It said: "Giving two regulators powers of intervention over the same bodies risks confusion, duplication and loss of accountability."

Monitor has called for the bill to be amended so there are clear differences between the roles of the two bodies.

It is happy for the new commission to identify any failings on the part of foundation trusts, but wants to retain sole responsibility for intervention.

Granting powers of intervention to both regulators means foundations will face "double jeopardy", Monitor said.

In addition, it "risks failing trusts engaging Monitor and the [Care Quality Commission] in three-way discussions at the point of failure, leading to delay and potentially playing one regulator off against another".

The bill's requirement for trusts to register with the new commission will "not provide any new safeguard, rather it will duplicate Monitor's existing arrangements for NHS foundation trusts".

Last week, the bill came under fire from the Healthcare Commission and CSCI, which felt the plans would weaken their powers and jeopardise patient safety (for more background, click here).

Both regulators were called to give evidence at last week's public bill committee meeting, where health minister Ben Bradshaw reminded them of their earlier support for the changes. He read out the press releases they issued in October, when the bill was first published, welcoming the proposals.

In response, CSCI chair Dame Denise Platt said: "Yes, we broadly welcome the policy direction, as it was a fait accompli at the time and you were in no mood to change it. We recognise the tsunami when it comes."

Healthcare Commission chair Sir Ian Kennedy said: "The principle is right; the time and the content warrant further consideration."

Representatives from the Department of Health are due to appear as witnesses at the public bill committee today.

For more on the new regulator, click here