Ex-NHS manager Baroness Young of Old Scone (formerly Barbara Young) has been nominated as the candidate to chair the new Care Quality Commission, which starts its work in April 2009. The nomination is subject to a process of ratification by a pre-appointment scrutiny hearing and report from the House of Commons Health select Committee. Health Secretary Alan Johnson will then consider their view, prior to making the appointment.

The new Care Quality Commission will replace the Healthcare Commission, the Commission for Social Care Inspection and the Mental Health Act Commission - the main regulators of quality. It will also take on the new responsibility of assessing the quality of primary care and general practice, and will have an annual budget of £155 million.

Barbara Young’s early career was spent in public relations and in health services management. She was chairman and then president of the Institute of Health Services Management (IHSM, now the Institute of Healthcare Management) from 1986 to 1988, and an international fellow of think-tank the Kings Fund in 1985-86 and 1990-1991. Since 2000, she has been chief executive of the Environment Agency. She is also a trustee of the Blairite think-tank the Institute for Public Policy Research (IPPR).

Baroness Young was regarded by colleagues during her NHS management career as formidably bright, capable and a good operator. She was also rare in standing up for NHS managers to the then-PM Baroness (Margaret) Thatcher while at the ISHM. Her early career as a press officer in Scotland brought her into contact with PM Gordon Brown

Already a controversial job
The salary for the post became an issue of controversy, when it was revealed to be £60,780 for a three-day week. The outgoing chair of the Healthcare Commission, Professor Sir Ian Kennedy, earned a full-time salary of £159,059 and Dame Denise Platt, chair of the Commission for Social Care Inspection, earned £84,456 on a part-time basis.

The Health Secretary’s above-mentioned role in making the final decision on the appointment of the neascent organisation’s chair attracted criticism earlier this year. Conservative heaklth spokesman Andrew Lansley questioned why the NHS Appointments Commission was not making the decision.

The Health and Social Care Bill proposes that the secretary of state appoints the chair and members of the Care Quality Commission, yet the chair of the Healthcare Commission, Lansley noted in a Commons debate, was currently appointed by the Appointments Commission, asking Mr Johnson, “why is he reducing the independence in the appointments process?'” Johnson replied that heading the Care Quality Commission was “a far more fundamental position”, and one which required accountability to Parliament.

Moreover, in written evidence to the Commons public bill committee, Monitor (the foundation trust regulator) expressed concerns over overlap between its function and that of the Care Quality Commission, which would have statutory powers over foundation trusts. Monitor suggested that this directly conflicts with its own statutory 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."