Of all the myriad government bodies that provide and regulate heathcare in England, it is the Care Quality Commission (which inspects hospitals and care homes) that gives ministers sleepless nights.
Privately they admit to no longer having confidence in the CQC to spot and prevent another Mid-Staffordshire scandal – and yesterday's evidence from inside the organisation only confirms that suspicion.
In response, the Department of Health has set up its own inquiry into the workings of the CQC, which is expected to report in the New Year. While that may result in the removal of Cynthia Bower, the body's much-criticised chief executive, in itself it will not address the systemic problems.
The CQC is grappling with having to merge three separate inspection regimes (with different systems, staff and cultures) into one body – while ensuring that it doesn't take its eye off the day-to-day. The CQC must also make do on a budget of just £170m compared with a combined total of £250m for its predecessor organisations, at a time of greatly enhanced public scrutiny.
The danger for the Government – and why ministers are so concerned – is that if another healthcare scandal breaks on the CQC's watch, the blame could fall on them. It is all very well devolving power down, but blame doesn't always travel in the same direction.