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Health and Education

I thank the hon. Gentleman for that point; it allows me to say that these are not anecdotes but actual occasions of which I am personally aware. How does the Bill propose to tackle what are, I hope, pockets of appalling care? We are to have a single inspectorate—the care quality commission—instead of the three existing bodies. Is that an economising move? Will it have enough resources? The timing seems pretty poor. The Healthcare Commission is just getting to grips with having annual health checks instead of star ratings and surely needs time to refine that process. Is self-certification of compliance with standards a reliable system? The bodies are to be merged in March 2009—what will be the effect in the meantime? The Healthcare Commission has picked up 19 weak hospitals on quality of care, and it needs time to follow that up. I am worried by the reform of the complaints process, particularly the loss of the second stage. The Healthcare Commission seems to be escaping from that process because it is insufficiently resourced to cope with the huge number of complaints that it receives. I do not understand why the Department of Health paper, ““The future regulation of health and adult social care in England””, states:"““We do not believe the investigation of complaints from individual patients or users of services sits easily with the functions of a regulatory body.””" Why ever not? One of the best ways of assessing what is happening with an organisation's performance is to examine complaints and the responses to them. When we lose referral to the Healthcare Commission, we lose the automatic inclusion of an independent opinion, which is absolutely necessary in clinical cases. There is a stress on the use of PALS—patient advice and liaison services. Those are not independent and have been widespread casualties of the financial deficits and actions taken to balance the books. I would like to know whether most trusts are like mine, which, when I last inquired, had precisely one PALS officer for three hospitals. The Independent Complaints Advocacy Service is extremely helpful, but we still depend on the trust that is being complained about calling in independent advisers of its own choosing. The paper, ““Making experiences count: a new approach to responding to complaints””, mentions the use of independent mediators and specialist advocates, including:"““People independent of the service provider, the commissioning organisation and even the locality, who could be called on to conduct an investigation where complaints cannot be resolved satisfactorily and/or there are complex issues involved.””" An independent review is absolutely crucial before the case has to go to the ombudsman. My main concern is whether a merged inspectorate can really cope with the vital issues of improving quality of care in failing hospitals. Is the complaints process being watered down to the disadvantage of the complainant?