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Health and Social Care Bill

My Lords, I had not intended to speak at such a late hour, but I feel that I must raise an area of concern which has come to me perhaps a little belatedly. It is prompted by the amendment of the noble Earl, Lord Howe, and the detail of the amendment moved by the noble Baroness, Lady Stern. We are getting ourselves into an increasingly difficult tangle over a set of words which keep being bandied about. I will illustrate this with five or six of these words. I am grateful for the movement that the Government have made in terms of bringing commissioning to bear more in the Bill. We will be discussing that later and I need not go into it now. However, when the Government were in a less accommodating mood in Committee, one of the arguments that was used for not doing this was that they were going to use guidelines in relation to commissioning. We now have in play: targets for performance review, registration requirements, guidelines, indicators of quality, and standards. Even anoraks such as ourselves may, broadly speaking, understand what all those words mean. However, I have to confess that even I am beginning to struggle intellectually with how the words all relate to one another. There is an issue for the Minister—to take them back to some of his colleagues to see whether we cannot get a little more clarity about the precise relationship between these words and what they all mean. We will certainly need a glossary—as will the noble Baroness, Lady Young, as chairman of the commission, together with her colleagues—to understand the relationship between these various pieces of terminology. Before we get to Third Reading, we need a little more clarity about how these words all relate to each other, to what extent they fall under the registration requirements, to what extent they are part of a performance management regime, and to what extent they are part of the information given to the public about how particular bodies are performing. I am sorry to dump this matter on the Minister this late at night, but before the Bill leaves the House I think that we should all be clear how the words relate to each other.