Government about-turn as CHI role extends to inspect private hospitals

The Commission for Health Improvement faces a massive extension of its role and will now inspect private as well as NHS hospitals, following a concession by the government in its attempts to steer the NHS Reform Bill through the House of Lords.

The announcement by junior health minister Lord Hunt last week marks an about-turn by the government since Frank Dobson was health secretary. Mr Dobson had refused to countenance bringing private hospitals under the NHS regulatory and quality standards umbrella, instead putting them under the separate National Care Standards Commission - due to start work on 1 April.

The government later overturned an amendment to the 1999 Health Act allowing CHI to regulate both NHS and private hospitals.

But the NHS Reform Bill's difficult journey through the Lords continued last week with Conservative peer Earl Howe moving an amendment to create a health inspectorate from a merger of the NCSC and CHI.

In response, Lord Hunt told peers, the government was 'sympathetic to the thinking behind the amendment'. Citing an earlier pledge 'to rationalise the number of bodies' inspecting healthcare, he said: 'When we enacted the Care Standards Act [in 2000], we considered it right that the regulation of private healthcare should be different from arrangements for the review of NHS bodies by CHI. But life has moved on.'

This meant that although private healthcare would remain under a licensing system, 'CHI should now act on the National Care Standards Commission's behalf to inspect independent hospitals'.

This would be done by bringing section 9 of the Care Standards Act into force 'shortly' and making regulations allowing CHI to exercise the NCSC's inspection function in private hospitals.

In debate on a separate amendment, Lord Hunt described the move as a 'halfway-house' and 'a transitional phase' while the government considered how to ensure closer working and 'over time, organisational integration' between CHI, the NCSC, the Audit Commission and the Social Services Inspectorate.

CHI communications director Matt Tee said: 'We welcome the move because it recognises the change That is taken place with the way the NHS is using the private sector, and any possible duplication or confusion when it comes to reviewing the private sector will be sorted out.'

A spokesperson for the Independent Healthcare Association, which had originally lobbied for CHI to cover private healthcare, said it welcomed the move 'on the proviso that independent hospitals are on a level playing field with their NHS counterparts in terms of standards and the regularity of inspections'. The NCSC was due to inspect hospitals twice a year, in comparison with CHI's four-yearly reviews of NHS bodies, he said.

The NHS Reform Bill's slow progress through Parliament is set to be further delayed by a fourth committee day in the Lords after Easter, with a cross-party coalition of peers preparing to force through an amendment to create locality-based patients councils.