Health and Social Care Bill

EIGHTH
MARSHALLED
LIST OF AMENDMENTS
TO BE MOVED
IN COMMITTEE

The amendments have been marshalled in accordance with the Instruction of 17th October 2011, as follows—

Clauses 20 to 22
Schedule 2
Clauses 23 to 48
Schedule 3
Clauses 49 to 52
Schedules 4 to 6
Clause 53
Schedule 7
Clauses 54 to 58
Schedule 8
Clauses 59 to 73
Schedule 9
Clauses 74 to 99
Schedule 10
Clauses 100 to 105
Schedule 11
Clauses 106 to 118
Schedule 12
Clauses 119 to 147
Schedule 13
Clauses 148 to 176
Schedule 14
Clauses 177 to 179
Schedule 15
Clauses 180 to 228
Schedule 16
Clause 229
Schedule 17
Clauses 230 to 246
Schedule 18
Clauses 247 to 249
Schedule 19
Clauses 250 to 271
Schedule 20
Clauses 272 to 274
Schedule 21
Clauses 275 to 291
Schedule 22
Clauses 292 to 294
Schedules 23 and 24
Clauses 295 to 303

[Amendments marked * are new or have been altered]

Clause 20

106

[Withdrawn]

LORD PATEL

LORD WARNER

107

Page 17, line 26, at end insert “in delivering better outcomes for patients,”

BARONESS FINLAY OF LLANDAFF

108

Page 17, line 27, at end insert—

“( ) patients have been informed when an adverse event, incident or error has occurred in their care or treatment,”

LORD WARNER

LORD PATEL

109

Page 17, line 28, at end insert “including timely access to services”

LORD NEWTON OF BRAINTREE

LORD BUTLER OF BROCKWELL

109A

Page 17, leave out lines 33 and 34 and insert—

“(5) In discharging its duty under subsection (1), the Board must publish guidance for clinical commissioning groups that includes the option to opt out and explains the extent of compliance with—

(a) the quality standards prepared by NICE under section 231 of the Health and Social Care Act 2011;

(b) indicators included within the NHS Outcomes Framework; and

(c) minimum standards set by the Board on patient related outcomes measures.”

LORD PATEL

LORD WARNER

110

Page 17, line 33, after “the” insert “clinical”

BARONESS ROYALL OF BLAISDON

BARONESS THORNTON

110ZA

Page 17, line 34, at end insert—

“(c) ensuring the continued availability to patients of clinical nurse specialists appropriate to the treatment of their illness.”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

110A

Page 17, line 34, at end insert—

“( ) In discharging its duty under subsection (1), in relation to specialised services, the Board must exercise its functions in accordance with current NICE guidance.”

110B*

Page 17, line 34, at end insert—

“( ) The Board will establish a specification for a national standard for maternity services, and clinical commissioning groups will be required to commission services that conform to that standard.”

BARONESS CUMBERLEGE

LORD PATEL

110C*

Page 17, line 34, at end insert—

“( ) The Board will establish a specification for maternity services, and clinical commissioning groups will be required to commission services that conform to that specification.”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD PATEL

BARONESS FINLAY OF LLANDAFF

111

Page 17, leave out lines 35 to 42

112

Page 18, line 2, leave out “have regard to the need” and insert “act with a view”

113

Page 18, line 4, leave out “reduce” and insert “reducing”

BARONESS GIBSON OF MARKET RASEN

114

Page 18, line 4, after “inequalities” insert “in rural and urban areas”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD PATEL

BARONESS FINLAY OF LLANDAFF

115

Page 18, line 6, leave out “reduce” and insert “reducing”

BARONESS GIBSON OF MARKET RASEN

116

Page 18, line 6, after “inequalities” insert “in rural and urban areas”

LORD RIX

LORD WIGLEY

BARONESS HOLLINS

117

Page 18, line 7, at end insert—

“( ) collect data on the experience and outcomes experienced by all patients and, where the person has a disability, break data down by impairment type”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

118

Page 18, line 7, at end insert—

“( ) reduce health inequalities in the population”

119

Page 18, line 7, at end insert—

“( ) ensure funding to clinical commissioning groups appropriate to the costs associated with the proportion of poor health conditions, life expectancy and levels of deprivation in their area”

120

Page 18, line 7, at end insert—

“( ) work in collaboration with Health and Wellbeing Boards and relevant local authorities”

120A

Page 18, line 7, at end insert—

“( ) reduce inequalities in health status, outcomes and experience between people and between communities in England”

120B

Page 18, line 7, at end insert—

“( ) In having regard to inequalities, the Board shall have particular regard for—

(a) age;

(b) disability;

(c) gender reassignment;

(d) marriage and civil partnership;

(e) pregnancy and maternity;

(f) race;

(g) religion and belief;

(h) gender;

(i) sexual orientation;

(j) geographical variation;

(k) socio-economic variation.”

LORD PATEL

LORD WARNER

121

Page 18, line 9, leave out “promote” and insert “secure”

BARONESS GIBSON OF MARKET RASEN

122

Page 18, line 10, after “patients” insert “in rural and urban areas”

LORD ROOKER

BARONESS FINLAY OF LLANDAFF

LORD HARRIS OF HARINGEY

123

Page 18, line 10, after “any)” insert “and Local Healthwatch”

LORD WARNER

LORD PATEL

BARONESS THORNTON

124

Page 18, line 11, at end insert “including access to or holding of their own medical records”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

124A

Page 18, line 11, at end insert “, including the commissioning decisions of clinical commissioning groups”

LORD WARNER

LORD PATEL

BARONESS THORNTON

125

Page 18, line 11, at end insert—

“( ) In discharging this duty, the Board must publish guidance for clinical commission groups that ensures that patients and their carers and representatives have—

(a) the means to express their views on the quality of services provided,

(b) opportunities to consult with service providers through a variety of means,

(c) access to appropriate information about their care and treatment,

(d) opportunities to consider available treatment options and their risks and benefits,

(e) the opportunity to participate in decisions about their care and treatment and its management, and

(f) the means to ensure informed consent is given to care and treatment.”

BARONESS FINLAY OF LLANDAFF

125A*

Page 18, leave out lines 13 to 15 and insert—

“(1) The Board must, in the exercise of its functions, act with a view to enabling patients to make choices with respect to aspects of health services provided to them.

(2) In discharging its duty under subsection (1), the Board must have regard to whether the health care services delivered by different providers will have an affect on the range of health care services delivered by other providers and their ability to deliver these services in the future.”

125B*

Page 18, leave out lines 13 to 15 and insert—

“(1) The Board must, in the exercise of its functions, act with a view to enabling patients to make choices with respect to aspects of health services provided to them.

(2) In discharging its duty under subsection (1), the Board must not undermine its duties in relation to sections 13D, 13E, 13G or 13M.”

LORD WARNER

LORD PATEL

BARONESS THORNTON

126

Page 18, line 14, leave out from second “to” to end of line 15 and insert “the access, location and provider of the health services available to them at all stages of their life, including information about the performance of different service providers”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

BARONESS FINLAY OF LLANDAFF

127

Page 18, line 15, at end insert—

“( ) In this Act “patient choice” is defined as including—

(a) choice to support healthy living;

(b) choice of provider and the way in which care is provided; and

(c) choice of treatment including self-management support.”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

127ZA*

Page 18, line 15, at end insert—

“13I1 Duty to offer choice in maternity services

The Board must, in the exercise of its functions, have regard to the need to offer choice in the provision of maternity services to promote choice for expectant mothers about where they wish to give birth (to include midwife-led units, consultant-led units or childbirth at home).”

LORD KENNEDY OF SOUTHWARK

BARONESS YOUNG OF OLD SCONE

LORD COLLINS OF HIGHBURY

BARONESS MASHAM OF ILTON

127A

Page 18, line 18, after “from” insert “persons or organisations with expertise in the experience of patients and from”

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

127B

Page 18, line 18, after “persons” insert “from all relevant healthcare providers”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

127C

Page 18, line 21, at end insert—

“( ) medicine, nursing, dentistry, pharmacy, ophthalmology, and allied health professional work”

LORD PATEL

LORD WARNER

128

Page 18, line 21, at end insert—

“( ) In its annual report, the Board must report on the advice it has obtained under this section.”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

128A

Page 18, line 24, after “provision” insert “and commissioning”

LORD WARNER

LORD PATEL

129

Page 18, line 25, at end insert “and the procurement of goods and services”

BARONESS FINLAY OF LLANDAFF

129ZA*

Page 18, leave out lines 26 to 32 and insert—

“( ) The Board may collaborate with research funding bodies to provide funding to promote innovation.”

LORD WARNER

LORD DARZI OF DENHAM

LORD PATEL

129A

Page 18, line 26, after “may” insert “establish an innovation fund as part of its direct commissioning responsibilities and”

BARONESS MORGAN OF DREFELIN

LORD TURNBERG

130

Page 18, line 34, leave out “have regard to the need to”

BARONESS MORGAN OF DREFELIN

LORD TURNBERG

LORD WILLIS OF KNARESBOROUGH

131

Page 18, line 37, at end insert—

“(c) research approved by the health service for the purpose of protecting the public in England from disease or other dangers to health”

BARONESS CUMBERLEGE

LORD PATEL

131A*

Page 18, line 37, at end insert—

“(c) duty to offer choice in maternity services

( ) The Board must, in the exercise of its functions, have regard to the need to offer choice in the provision of maternity services to promote choice for expectant mothers about where they wish to give birth (to include midwife-led units, consultant-led units or childbirth at home).”

132

[Withdrawn]

LORD WALTON OF DETCHANT

LORD PATEL

LORD KAKKAR

133

Page 18, line 37, at end insert—

“13L1 Duty in respect of education and training

The Board must promote education and training of the health care workforce, having taken note of the responsibilities of the regulatory authorities, academic and professional organisations.”

LORD PATEL

133ZA

Page 18, line 37, at end insert—

“13L1 Duty in respect of education and training

(1) The Board must promote education and training of the health care workforce, having taken note of the responsibilities of the regulatory authorities, academic and professional organisations, and consulted Health Education England.

(2) In exercising its functions, Health Education England must take steps to ensure that providers of health services in England have due regard to any minimum numbers of training placements that it may specify.”

LORD SHARKEY

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

133A

Page 18, line 40, after “services” insert “including any public information and advice campaigns”

LORD PATEL

LORD WARNER

134

Page 18, line 40, leave out “an” and insert “a clinically”

BARONESS GIBSON OF MARKET RASEN

135

Page 19, line 1, after “inequalities” insert “in rural and urban areas”

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

135A

Page 19, line 4, at end insert—

“( ) The local presence of the Board must be sufficient to support such integration.”

BARONESS JOLLY

BARONESS TYLER OF ENFIELD

BARONESS BARKER

LORD CLEMENT-JONES

135AA

Page 19, line 16, leave out “encourage” and insert “mandate”

BARONESS WHEELER

135B

Page 19, line 19, after “health” insert “and social care”

BARONESS FINLAY OF LLANDAFF

BARONESS HOLLINS

135C

Page 19, line 25, at end insert—

“( ) The Board must report bi-annually to the Secretary of State on how the Board has discharged its duty to promote integration.”

BARONESS TYLER OF ENFIELD

BARONESS JOLLY

BARONESS BARKER

LORD CLEMENT-JONES

135CA

Page 19, line 25, at end insert—

“( ) Under its duty to encourage integrated working, the Board may encourage the establishment of pilot integrated care pathways for persons who experience the worst inequalities in access to health care.”

BARONESS FINLAY OF LLANDAFF

BARONESS HOLLINS

135D

Page 19, line 33, at end insert—

“13M1 Duty to promote collaboration

The Board must, in the exercise of its functions, promote collaboration between those regulating and commissioning health and social care services.”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

136

Page 19, line 42, leave out from beginning to end of line 1 on page 20

LORD ROOKER

137

Page 20, line 1, at end insert—

“( ) The Board may take specific action to support the development of the voluntary sector, social enterprises, co-operatives and mutuals as it considers appropriate.”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

137A

Page 20, line 1, at end insert—

“( ) The Board must ensure that in relation to its duties under sections 13C to 13N, those persons in the private sector contracted to provide health services must contribute in the same way as public providers towards the achievements of those duties.”

BARONESS ROYALL OF BLAISDON

BARONESS THORNTON

137B

Page 20, line 1, at end insert—

“13O1 Duty to ensure access to clinical specialist nurses

The Board must, in the exercise of its functions, mandate for health services the continued availability to patients of clinical nurse specialists appropriate to those services.”

BARONESS EMERTON

LORD PATEL

LORD MACKENZIE OF CULKEIN

138

Page 20, line 2, at end insert—

“13O1 Duty as to staffing ratios of registered and non-registered staff

(1) The Board must, in the exercise of its functions, establish for health services, and may subject to regulations establish for other services, the ratio of registered to non-registered workers required at any given time by reference to any appropriate register established for workers in those areas.

(2) In the discharge of this duty the Board must publish a list of appropriate registers for the purpose of subsection (1).

(3) The Board must produce guidance to health services to assist in the maintenance of ratios for the purpose of subsection (1).

(4) The Board must also issue guidance on the maximum and minimum numbers of patients per registered nurse.”

139

Page 20, line 2, at end insert—

“13O1 Duty as to mandated staffing ratios and levels

(1) The Board shall, in the exercise of its functions, mandate for health services, and may subject to regulations mandate for other services, the ratio of registered nurses to registered and non-registered health care support workers required at any given time by reference to any appropriate register established for workers in those services.

(2) The Board must publish a list of appropriate registers for the purposes of subsection (1).

(3) The Board must, in exercise of its functions, mandate for health services on the maximum number of patients per registered nurse.

(4) For the purposes of subsection (1), a health care support worker shall be an individual whose work is routinely delegated to them by a registered nurse or midwife or has a qualification in health and social care at level one (or higher) of the Qualifications and Credit Framework in England.”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

140

Page 20, line 8, leave out from second “are” to end of line 9 and insert “consulted”

LORD PATEL

LORD WARNER

141

Page 20, line 8, leave out from “involved” to end of line 9

BARONESS HOLLINS

LORD PATEL

141A

Page 20, line 8, leave out from “involved” to end of line 9 and insert “(by formal and informal consultation with particular regard to the coherence and navigability of typical care pathways)”

LORD RAMSBOTHAM

BARONESS WILKINS

BARONESS HOWE OF IDLICOTE

141AA

Page 20, line 9, after “with” insert “accessible”

LORD KENNEDY OF SOUTHWARK

BARONESS YOUNG OF OLD SCONE

LORD COLLINS OF HIGHBURY

BARONESS MASHAM OF ILTON

141B

Page 20, line 9, after “ways)” insert “directly and through their representatives”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

142

Page 20, line 20, at end insert—

“( ) in obtaining information on the safety of services,

( ) in obtaining appropriate advice,

( ) in promoting innovation, and

( ) in promoting research”

LORD RIX

LORD WIGLEY

BARONESS HOLLINS

143

Page 20, line 20, at end insert—

“ensuring that reasonable adjustments are made so that the views of people with any impairments or disabilities can also be sought in relation to arrangements under this section.”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

143A

Page 20, line 23, at end insert—

“13O1 Duty to monitor and publish information on NHS complaints

(1) The Board must establish and operate systems for collecting and analysing information relating to complaints about services provided by the health service in England.

(2) The Board must make information collected by virtue of subsection (1) and any other information obtained by analysing it, available to the general public.

(3) The Board must establish and operate systems for collecting and analysing information relating to complaints about commissioning decisions made by the Board and clinical commissioning groups.

(4) The Board must make information collected by virtue of subsection (3) and any other information obtained by analysing it, available to the general public.”

143B

Page 20, line 24, leave out from beginning to end of line 2 on page 21

LORD PATEL

LORD WARNER

144

Page 20, line 29, leave out “such persons as the Board considers appropriate” and insert—

“(a) the Care Quality Commission;

(b) Monitor;

(c) all clinical commissioning groups;

(d) Healthwatch England; and

(e) Health and Wellbeing Boards.”

LORD PATEL

LORD KAKKAR

145

Page 20, leave out lines 34 to 36

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

LORD CLEMENT-JONES

145A

Page 21, line 17, at end insert “draft”

LORD WARNER

LORD PATEL

146

Page 21, line 19, at end insert “including its annual operating costs as defined in subsection (6)”

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

LORD CLEMENT-JONES

146A

Page 21, line 20, after first “The” insert “draft”

BARONESS MORGAN OF DREFELIN

LORD TURNBERG

147

Page 21, line 22, after “13E” insert “, 13L”

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

LORD CLEMENT-JONES

147ZA

Page 21, line 24, after first “The” insert “draft”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

147A

Page 21, line 26, at end insert—

“( ) The Board must—

(a) lay the business plan before Parliament, and

(b) once it has done so, send a copy to the Secretary of State.”

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

LORD CLEMENT-JONES

147B

Page 21, line 26, at end insert—

“( ) The Board must lay the draft business plan before Parliament.”

147C

Page 21, line 27, at end insert “following public consultation”

LORD WARNER

LORD PATEL

148

Page 21, line 28, at end insert—

“(6) The Board’s operating costs at inception shall not exceed the costs incurred by strategic health authorities, primary care trusts or the Department of Health in discharging functions transferred to the Board as audited by the National Audit Office, less a discount of 30% or any different figure specified with published reasons by the Secretary of State; and any annual increase in these operating costs shall not exceed the latest Consumer Price Index percentage unless permitted by the Secretary of State.”

149

Page 21, line 32, at end insert “together with an annual statement on the financial and service performance of its own commissioning and that of clinical commission groups in a format specified”

LORD NEWTON OF BRAINTREE

LORD BUTLER OF BROCKWELL

LORD TURNBERG

149A

Page 21, line 38, after “13E” insert “, 13K”

BARONESS MORGAN OF DREFELIN

LORD TURNBERG

150

Page 21, line 38, after “13E” insert “, 13L”

LORD KENNEDY OF SOUTHWARK

BARONESS YOUNG OF OLD SCONE

LORD COLLINS OF HIGHBURY

BARONESS MASHAM OF ILTON

150A

Page 21, line 38, after “13E” insert “, 13M”

BARONESS BAKEWELL

150B

Page 21, line 39, at end insert—

“( ) how effectively the NHS services meet the needs of the older population”

LORD RAMSBOTHAM

BARONESS WILKINS

BARONESS HOWE OF IDLICOTE

150C

Page 21, line 39, at end insert—

“( ) how it discharged its functions under sections 13H, 13I and 13J and empowered patients”

LORD PATEL

LORD WARNER

151

Page 22, leave out line 40

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

152

Page 23, line 29, leave out from beginning to end of line 5 on page 24 and insert—

“(1) The Secretary of State may give directions to any of the bodies mentioned in subsection (2) about the exercise of any functions.

(2) For the purpose of subsection (1) the bodies are—

(a) NHS Commissioning Board

(b) clinical Commissioning Groups”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD PATEL

BARONESS FINLAY OF LLANDAFF

153

Page 23, line 34, leave out from “failing” to “, and” in line 35 and insert “to exercise its functions in a way that the Secretary of State considers to be in the best interest of the National Health Service”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD PATEL

153ZZA

Page 24, line 19, at end insert “and is made with the agreement of that individual or of a person having legal responsibility for that individual’s care”

153ZZB

Page 24, leave out lines 24 and 25

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

153ZA

Page 24, line 31, at end insert—

“Duty to reduce bureaucracy

13Z2A Duty to reduce bureaucracy

(1) The Board must exercise its functions so as to reduce administrative costs in the NHS.

(2) For that purpose the Board must exercise its functions under sections 14A and 14C so as to ensure that at no time there exists more clinical commissioning groups than there were primary care trusts on 1 April 2011.”

Clause 21

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

153A

Page 27, leave out line 35

153B

Page 28, line 19, at end insert—

“223EA Financial duties of the Board: administrative costs

(1) The Board must direct clinical commissioning groups to ensure that their expenditure on administrative costs does not exceed a prescribed percentage of their resource.

(2) The Board must ensure that the total national expenditure by clinical commissioning groups on administrative costs in any financial year from April 2014 does not exceed 55 per cent of total expenditure on administrative costs by primary care trusts in the financial year 2009-2010.”

Clause 22

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

154

Page 29, line 2, after “services” insert “, primary dental services, primary pharmaceutical service, primary ophthalmic services and primary nursing services”

155

[Withdrawn]

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

156

Page 29, line 2, at end insert—

“( ) Subsection (1) shall not apply to any providers who have any financial interest, directly or indirectly, in the provision of any service that the clinical commissioning group may be required to commission.”

LORD WARNER

LORD PATEL

BARONESS THORNTON

157

Page 29, line 7, at end insert—

“( ) do not exceed the number of primary care trusts abolished, less any further reduction that the Board considers better meets its duty under section 13D.

(2A) The total operating costs of all approved clinical commissioning groups shall not exceed the comparable costs of abolished primary care trusts, as audited by the National Audit Office, less 20 per cent.”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

158

Page 29, line 7, at end insert—

“( ) are co-terminus with the boundaries of a local authority or a contiguous group of local authorities”

LORD WARNER

LORD PATEL

BARONESS THORNTON

159

Page 29, line 33, at end insert “providing that it can demonstrate that it can meet the requirements of commissioning competence specified by the Board”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

159A

Page 29, line 36, leave out “or wishes to be”

LORD WARNER

LORD PATEL

BARONESS THORNTON

160

Page 29, line 45, at end insert “and that specifies the competencies required to commission health services”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

160A

Page 29, line 45, at end insert—

“( ) Before the Board considers any application, it must have been subject to consultation with—

(a) the general public;

(b) the relevant local authority;

(c) the relevant Health and Wellbeing Board;

(d) patients receiving primary medical services from providers within the clinical commissioning group.”

BARONESS FINLAY OF LLANDAFF

BARONESS THORNTON

BARONESS WHEELER

161

Page 30, line 10, at end insert—

“14BA Guidance on dealing with conflicts of interest

(1) The Secretary of State must issue guidance, for incorporation in clinical commissioning group constitutions, on how conflicts of interest should be dealt with by commissioning consortia as part of their decision making.

(2) Clinical commissioning groups must have regard to that guidance.”

LORD ROOKER

162

Page 30, line 19, at end insert—

“( ) that the application has the support of the local authority and the clinical commissioning group for the area”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

163

Page 30, line 26, leave out “its functions” and insert “all of its functions as in section 3 of this Act”

LORD WARNER

LORD PATEL

164

Page 30, line 26, at end insert “competently”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

164A

Page 30, line 31, at end insert—

“( ) Before granting an application, the Board must have consulted—

(a) the general public;

(b) the relevant local authority;

(c) the relevant Health and Wellbeing Board;

(d) patients receiving primary medical services from providers within the clinical commissioning group.”

164B

Page 30, line 37, at end insert—

“( ) Regulations made under this section may not be made unless a draft of the instrument had been laid before, and approved by a resolution of, each House of Parliament.”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

165

Page 30, line 42, at end insert—

“( ) the clinical commissioning group assumes the duties as in section 3 of this Act from the date set out in the grant”

166

Page 31, line 5, at end insert—

“( ) Before applying to the Board, a clinical commissioning group must have consulted with—

(a) persons usually resident within the group’s area,

(b) the relevant local authority,

(c) the relevant Health and Well Being Board,

(d) patients receiving primary medical service from providers within the clinical commissioning group.”

166ZA

Page 31, leave out line 8 and insert—

“(3) The Board must, after consultation, determine and publish criteria—”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

166A

Page 31, line 14, at end insert—

“( ) Regulations made under this section may not be made unless a draft of the instrument had been laid before, and approved by a resolution of, each House of Parliament.”

166B

Page 31, line 31, at end insert—

“( ) the general public;

( ) the relevant local authority;

( ) the relevant Health and Wellbeing Board; and

( ) patients receiving primary medical services from providers within the clinical commissioning group.”

166C

Page 31, line 37, at end insert—

“( ) Regulations made under this section may not be made unless a draft of the instrument had been laid before, and approved by a resolution of, each House of Parliament.”

LORD ROOKER

167

Page 32, line 7, at end insert—

“( ) evidence that such an application for merger has the support of the local authority and the local Healthwatch for the area,”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

167A

Page 32, line 12, at end insert—

“( ) Before the Board considers any application, it must have been subject to consultation with—

( ) the general public;

( ) the relevant local authority;

( ) the relevant Health and Wellbeing Board;

( ) patients receiving primary medical services from providers within the clinical commissioning group.”

167B

Page 32, line 17, at end insert—

“( ) No dissolution can be made before consultation has taken place with—

( ) the general public;

( ) the relevant local authority;

( ) the relevant Health and Wellbeing Board;

( ) patients receiving primary medical services from providers within the clinical commissioning group.”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

167BA

Page 32, leave out line 18 and insert—

“(2) The Board must, after consultation, determine and publish criteria—”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

167C

Page 32, line 24, at end insert—

“( ) Regulations made under this section may not be made unless a draft of the instrument had been laid before, and approved by a resolution of, each House of Parliament.”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

167D

Page 32, line 27, after “may” insert “after consultation”

BARONESS FINLAY OF LLANDAFF

LORD WALTON OF DETCHANT

LORD MACKENZIE OF CULKEIN

168

Page 33, line 9, at end insert—

“( ) collaboration between clinical commissioning groups, including neighbouring clinical commissioning groups, for the purposes of joint commissioning;”

LORD WARNER

LORD PATEL

169

Page 33, line 15, at end insert “including an accountable officer who is the most suitable senior employee of the group”

170

[Withdrawn]

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

170A

Page 33, leave out lines 16 to 44 and insert—

“( ) Schedule (Clinical Commissioning Group governance arrangements) has effect.”

LORD WARNER

LORD PATEL

171

Page 33, leave out lines 19 and 20 and insert—

“( ) the standards of good governance of any elected or appointed public body authorised by Parliament.”

BARONESS FINLAY OF LLANDAFF

171A*

Page 33, line 28, at end insert—

“( ) the function of determining what hospitality, gifts and similar incentives clinical commissioning groups and their members may receive from providers of health products, equipment or services,

( ) the function of ensuring that proper public records of hospitality, gifts and similar incentives are kept by clinical commissioning groups,”

EARL HOWE

172

Page 33, line 44, at end insert “or (b)”

173

Page 34, line 2, at end insert “or (b)”

LORD WARNER

LORD PATEL

174

Page 34, line 2, at end insert—

“( ) The Board shall specify the minimum standards of financial and performance information that all clinical commissioning groups are required to publish annually.”

EARL HOWE

175

Page 34, line 16, leave out “function under section 14L(3)(a)” and insert “functions under section 14L(3)(a) and (b)”

BARONESS FINLAY OF LLANDAFF

175A

Page 34, line 30, at end insert—

“( ) individuals who are fully aware of the different aspects of specialist provision in the area covered by the clinical commissioning group”

175B

Page 34, line 30, at end insert—

“( ) individuals from specialist services from the areas covered by the clinical commissioning group;”

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

LORD CLEMENT-JONES

175BA

Page 34, line 30, at end insert—

“( ) individuals who are qualified public health specialists;”

175C

Page 34, line 31, after “persons” insert “, including how such lay persons are recruited and remunerated”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

175CA

Page 34, line 41, at end insert—

“( ) Regulations must specify the arrangements whereby the governing body of a clinical commissioning group must include—

(a) a representative of district councils in two-tier areas;

(b) the Director of Public Health, or his or her representative.”

175CB

Page 34, line 41, at end insert—

“( ) Regulations must specify the arrangements whereby the governing body of a clinical commissioning group must include—

(a) a lay chair appointed by the NHS Commissioning Board;

(b) a lay vice-chair appointed by the NHS Commissioning Board;

(c) a lay member appointed by the relevant local authority;

(d) other lay members appointed by the NHS Commissioning Board.

( ) The total number of lay members must be more than the number of other members.”

175CC

Page 35, line 20, at end insert—

“( ) Regulations may make provision as to how clinical commissioning groups will deal with conflicts of interests of members or employees of the clinical commissioning group.

( ) In particular, a clinical commissioning group cannot commission services from a member of the clinical commissioning group nor promote the services of private sector.”

Before Schedule 2

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

175D

Insert the following new Schedule—

“Clinical commissioning group governance arrangements Eligibility for membership

1 The persons who may become or continue as patient members of a clinical commissioning group are individuals who are on the medical list of providers of primary medical services who are encompassed within a clinical commissioning group.

2 An individual who is eligible to be a patient member may do so on application to the clinical commissioning group.

3 The constitution may provide for an individual to become a member of the clinical commissioning group, unless he or she informed the clinical commissioning group that he or she does not wish to do so.

Board of governors

4 A clinical commissioning group has a board of governors.

5 The members of the board of governors other than appointed members must be chosen by election.

6 Regulations may make provision as to the term of office and eligibility for re-election for elected members of the board of governors.

7 The constitution must provide for the chairman of the clinical commissioning group or (in his or her absence) another person to preside at meetings of the board of governors.

8 The constitution must provide for meetings of the board of governors to be open to members of the public.

9 The constitution may provide for members of the public to be excluded from a meeting for special reasons.

10 The constitution may make further provisions.

Directors

11 A clinical commissioning group shall have a board of directors.

12 The constitution must provide for all the powers of the clinical commissioning group to be exercisable by the board of directors on its behalf.

13 But the constitution may provide for any of those powers to be delegated to a committee of directors or to an executive director.

14 (1) The board consists of—

(a) executive directors, one of whom is the chief executive (and accounting officer) and another the finance director,

(b) non-executive directors, one of whom is chairman.

(2) One of the executive directors must be a registered medical director and another must be a registered nurse or registered midwife.

(3) One of the non-executive directors must be appointed from the relevant local authority.

15 It is for the board of governors at a general meeting to appoint or remove the chairman and other non-executive directors of the clinical commissioning group board.

16 Removal of a non-executive director under paragraph 4(1) requires the approval of three-quarters of the board of governors.

17 It is for the non-executive directors to appoint or remove the chief executive.

18 It is for a committee consisting of the chairman, the chief executive and other non-executive directors to appoint or remove the executive directors.

19 The appointment of a chief executive requires the approval of the board of governors.”

Schedule 2

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD PATEL

175E

Page 280, line 34, at end insert “and shall apply the provisions of paragraphs 19A and 19C and the guidelines in paragraph 19C of this Schedule”

176

[Withdrawn]

BARONESS FINLAY OF LLANDAFF

BARONESS THORNTON

176A

Page 280, line 34, at end insert—

“( ) CCGs must maintain a publicly accessible register of all potential conflicts of interest of those individuals involved in any part of the commissioning process.

( ) The Secretary of State must issue guidance on how conflicts of interest should be dealt with by commissioning consortia as part of their decision making.

( ) Clinical commissioning groups must have regard to that guidance.”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD PATEL

176AA

Page 281, line 34, at end insert “and shall apply the provisions of paragraph 19B of this Schedule”

176AB

Page 281, line 43, at end insert “provided that the public may not be excluded from any governing body meeting during a discussion involving a choice between potential providers”

176AC

Page 281, line 43, at end insert—

“(5) A record of the decisions made at any meeting or part of a meeting from which members of the public are excluded must be published not later than two weeks from the date when the meeting occurred.”

176AD

Page 287, line 12, at end insert—

“Register of interests and conflicts of interest

19A (1) Every Clinical Commissioning Group must keep a register of the financial interests of all members of the Group.

(2) Within 28 days of a member joining a clinical commissioning group, the member must inform the group’s accountable officer of any relevant financial interests requiring registration.

(3) Within 28 days of any change to a member’s registered interests, the member must inform the group’s accountable officer of such change.

(4) The accountable officer shall ensure that the register of interests is freely available to inspection by the members of the public.

19B (1) A director of a healthcare provider organisation, or a general practitioner having a significant financial interest in a provider organisation, may not serve on the governing body of a clinical commissioning group and that organisation.

(2) If a clinical commissioning group enters into negotiations with a healthcare provider organisation and a member of the governing body of that clinical commissioning group is a director or has a significant financial interest in that provider organisation, that member shall take no part in the proceedings of the governing body until such negotiations are concluded and shall then stand down from membership of the governing body if a contract is entered into between the clinical commissioning group and the healthcare provider organisation.

19C (1) The Guidelines on Conflict of Interest for Members of Clinical Commissioning Groups referred to in section 14Z8A are as follows.

(2) You must be honest and open in any financial arrangements with patients; and in particular—

(a) you must inform patients about your fees and charges, wherever possible before asking for their consent to treatment;

(b) you must not exploit patients’ vulnerability or lack of medical knowledge when making charges for treatment or services;

(c) you must not encourage patients to give, lend or bequeath money or gifts that will directly or indirectly benefit you;

(d) you must not put pressure on patients or their families to make donations to other people or organisations;

(e) you must not put pressure on patients to accept private treatment;

(f) if you charge fees, you must tell patients if any part of the fee goes to another healthcare professional.

(3) You must be honest in financial and commercial dealings with employers, insurers and other organisations or individuals; and in particular—

(a) before taking part in discussions about buying or selling goods or services, you must declare any relevant financial or commercial interest that you or your family might have in the transaction;

(b) if you manage finances, you must make sure the funds are used for the purpose for which they were intended and are kept in a separate account from your personal finances.

(4) You must act in your patients’ best interests when making referrals and when providing or arranging treatment or care; you must not ask for or accept any inducement, gift or hospitality which may affect or be seen to affect the way you prescribe for, treat or refer patients; and you must not offer such inducements to colleagues.

(5) If you have financial or commercial interests in organisations providing healthcare or in pharmaceutical or other biomedical companies, these interests must not affect the way you prescribe for, treat or refer patients.

(6) If you have a financial or commercial interest in an organisation to which you plan to refer a patient for treatment or investigation, you must tell the patient about your interest, and when treating NHS patients you must also tell the healthcare purchaser.”

Clause 23

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

176B

Page 35, line 41, at end insert—

“( ) promote awareness of the NHS Constitution amongst providers of primary medical services within the clinical commissioning group”

LORD ROOKER

177

Page 36, line 3, at end insert “in order to ensure that the health needs of the people in the area are met”

THE EARL OF SANDWICH

LORD MANCROFT

178

Page 36, line 3, at end insert—

“( ) In fulfilling this duty, clinical commissioning groups, in estimating the cost of new or enhanced services, must have regard to any existing service provided by the voluntary sector, the support of which may reduce that cost.”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

178ZA

Page 36, line 3, at end insert—

“( ) Each clinical commissioning group must assist and support the NHS Commissioning Board in discharging its responsibilities under section 13D for securing effectiveness, efficiency and economy in the provision of primary medical services.”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

178A

Page 36, line 3, at end insert—

“14PA Duty as to commissioning services

In carrying out its duties in respect of the commissioning of services, each commissioning consortium must, in the exercise of its functions, have regard to the interdependency of services and the impact that the arrangements for the provision of one service may have on the financial and clinical sustainability of other services.”

178B

[Withdrawn]

LORD PATEL

LORD WARNER

179

Page 36, line 6, after “the” insert “clinical”

BARONESS HOLLINS

LORD PATEL

LORD PATEL OF BRADFORD

LORD ALDERDICE

180

Page 36, line 8, after “of” insert “physical and mental”

LORD PATEL

LORD WARNER

181

Page 36, line 11, after first “the” insert “clinical”

LORD WARNER

LORD PATEL

BARONESS MURPHY

182

Page 36, line 11, after “provision” insert “and integration”

183

Page 36, line 15, after “effectiveness” insert “and integration”

184

Page 36, line 19, at end insert—

“( ) In this section “integration” means integration of the assessment and delivery of health and social care services to individuals that benefit their treatment and care.”

BARONESS FINLAY OF LLANDAFF

BARONESS HOLLINS

184A

Page 36, line 19, at end insert—

“( ) In discharging its duty, each clinical commissioning group must ensure that primary medical services comply with NICE guidance.”

184B

Page 36, line 22, after “to” insert—

“( ) promoting integration between primary and secondary care;

( ) defining the core clinical duties of primary medical services, particularly in public health, in the diagnosis and management of disease and in the management of long-term conditions;

( ) defining the responsibilities of primary medical services to provide or ensure promotion of integrated health services that are available at all times;”

LORD KAKKAR

LORD PATEL

185

Page 36, line 23, at end insert—

“( ) In particular, each clinical commissioning group must monitor the performance of primary care practitioners within its area and report its findings to the Board.”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD PATEL

BARONESS FINLAY OF LLANDAFF

186

Page 36, line 26, leave out “have regard to the need” and insert “act with a view”

187

Page 36, line 27, leave out “reduce” and insert “reducing”

BARONESS GIBSON OF MARKET RASEN

188

Page 36, line 28, at end insert “in rural and urban areas”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD PATEL

BARONESS FINLAY OF LLANDAFF

189

Page 36, line 29, leave out “reduce” and insert “reducing”

BARONESS GIBSON OF MARKET RASEN

190

Page 36, line 30, at end insert “in rural and urban areas”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

190A

Page 36, line 30, at end insert—

“( ) reduce inequalities in health status, outcomes and experience between people and between communities in their area, and in England”

190AA*

Page 36, line 30, at end insert—

“( ) facilitate the establishment of maternity networks covering England, which will receive adequate funding in order to carry out their duties”

190B

Page 36, line 30, at end insert—

“( ) In having regard to inequalities, each clinical commissioning group shall have particular regard for—

(a) age;

(b) disability;

(c) gender reassignment;

(d) marriage and civil partnership;

(e) pregnancy and maternity;

(f) race;

(g) religion and belief;

(h) gender;

(i) sexual orientation;

(j) geographical variation;

(k) socio-economic variation.”

BARONESS CUMBERLEGE

LORD PATEL

190C*

Page 36, line 30, at end insert—

“( ) There will be maternity networks covering England and they will receive adequate funding in order to carry out their duties.”

LORD PATEL

LORD WARNER

191

Page 36, line 33, leave out “promote” and insert “pay regard to”

LORD ROOKER

LORD HARRIS OF HARINGEY

192

Page 36, line 34, leave out from “any)” to end of line 35 and insert “and the local Healthwatch for the area, in any decision about commissioning and provision of health services to patients”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD PATEL

BARONESS FINLAY OF LLANDAFF

193

Page 36, line 35, at end insert “and must take steps to inform patients, their carers and their representatives of the right to be involved in such decisions”

LORD WARNER

LORD PATEL

BARONESS FINLAY OF LLANDAFF

194

Page 36, leave out lines 36 and 37

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

194A

Page 36, line 36, leave out “may” and insert “must”

194B

Page 36, line 38, leave out “have regard to” and insert “implement”

LORD WARNER

LORD PATEL

BARONESS FINLAY OF LLANDAFF

195

Page 36, line 39, leave out “under subsection (2)” and insert “in accordance with section 13H”

BARONESS FINLAY OF LLANDAFF

195A*

Page 36, leave out lines 41 to 43 and insert—

“(1) Each clinical commissioning group must, in exercise of its functions, act with a view to enabling patients to make choices with respect to aspects of health services provided to them.

(2) In discharging its duty under subsection (1), a clinical commissioning group must have regard to whether the health care services offered by different providers will have an affect on the range of health care services offered by other providers and their ability to deliver these services in the future.”

195B*

Page 36, leave out lines 41 to 43 and insert—

“(1) Each clinical commissioning group must, in exercise of its functions, act with a view to enabling patients to make choices with respect to aspects of health services provided to them.

(2) In discharging its duty under subsection (1), a clinical commissioning group must not undermine its duties in relation to sections 14S, 14P, 14Q or 14Y.”

LORD WARNER

LORD PATEL

BARONESS MURPHY

196

Page 36, line 43, leave out from “to” to end and insert “the access, location, and provider of the health services available to them at all stages of their life including information about the performance of different service providers.”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD PATEL

BARONESS FINLAY OF LLANDAFF

197

Page 36, line 43, at end insert “and must take steps to inform patients, their carers and their representatives of the right to make such choices”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

197ZA

Page 36, line 43, at end insert “including primary medical services”

LORD KENNEDY OF SOUTHWARK

BARONESS YOUNG OF OLD SCONE

LORD COLLINS OF HIGHBURY

BARONESS MASHAM OF ILTON

197A

Page 37, line 3, after “from” insert “persons or organisations with expertise in the experience of patients and from”

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

197B

Page 37, line 3, after “persons” insert “from all relevant healthcare providers”

BARONESS JOLLY

BARONESS TYLER OF ENFIELD

BARONESS BARKER

LORD CLEMENT-JONES

197BA

Page 37, line 5, after “illness” insert “or maltreatment”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD PATEL

197C

Page 37, line 6, at end insert—

“( ) A clinical commissioning group must consult each local Health and Wellbeing Board for the area it serves on the exercise of its functions, and must provide each such Board with any information it requests excluding any personal data.”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

197D

Page 37, line 6, at end insert—

“( ) In so doing, the clinical commissioning group must—

(a) seek views of all appropriate clinical groups through the commissioning process,

(b) establish a procedure for reconciling different professional perspectives, and

(c) seek agreement of non-GP professional groups in case of significant service changes.”

LORD PATEL

197E

Page 37, line 10, at end insert—

“( ) Having complied with subsection (1), the ultimate decision on how best to arrange the provision of services for the purposes of the health service rests with each clinical commissioning group.”

LORD KAKKAR

LORD PATEL

198

Page 37, line 10, at end insert—

“14VI Duty to consult academic bodies

Each clinical commissioning group must, in the exercise of its functions, consult relevant academic bodies within its area, including academic health science partnerships.”

BARONESS GIBSON OF MARKET RASEN

199

Page 37, line 13, at end insert “in rural and urban areas”

LORD TURNBERG

LORD WARNER

LORD WILLIS OF KNARESBOROUGH

199ZA

Page 37, line 17, leave out “have regard to the need to”

199ZB

[Withdrawn]

BARONESS FINLAY OF LLANDAFF

199A

Page 37, line 19, at end insert—

“14X1 Duty in respect of education and training

Each clinical commissioning group must, in the exercise of its functions, promote education and training of the current and future NHS workforce.”

BARONESS GIBSON OF MARKET RASEN

200

Page 37, line 22, after “services” insert “in rural and urban areas”

LORD RAMSBOTHAM

BARONESS WILKINS

200A

Page 37, line 29, at end insert—

“( ) improve communication skills in children and young people”

BARONESS FINLAY OF LLANDAFF

200B

Page 37, line 29, at end insert—

“( ) reduce duplication and increase collaboration between primary and secondary care”

BARONESS GIBSON OF MARKET RASEN

201

Page 37, line 32, after second “services” insert “in rural and urban areas”

LORD RAMSBOTHAM

BARONESS WILKINS

BARONESS HOWE OF IDLICOTE

201ZA

Page 37, line 32, after second “services” insert “or education or children’s services”

BARONESS FINLAY OF LLANDAFF

201A

Page 37, line 40, at end insert—

“( ) reduce duplication and promote collaboration between care providers.”

BARONESS FINLAY OF LLANDAFF

LORD BROOKE OF ALVERTHORPE

LORD WIGLEY

LORD MACKENZIE OF CULKEIN

202

Page 38, line 2, at end insert—

“14Y1 Duty to reduce alcohol-related harm

Each clinical commissioning group must, in the exercise of its functions, have regard to the need to reduce alcohol-related harm.”

THE EARL OF SANDWICH

BARONESS THORNTON

203

Page 38, line 2, at end insert—

“14Y1 Duty as to addiction to prescribed drugs

(1) Each clinical commissioning group shall have a duty to provide services to those suffering from addiction and withdrawal from prescribed drugs.

(2) In fulfilling this duty, clinical commissioning groups must co-operate with and take account of the work of non-governmental organisations.”

BARONESS HOLLINS

LORD PATEL OF BRADFORD

BARONESS FINLAY OF LLANDAFF

LORD PATEL

203A

Page 38, line 2, at end insert—

“14Y1 Duty as to promoting competition only when demonstrably preferable to integration

Each clinical commissioning group must exercise its functions with a view to securing that health services are provided via a model in which different providers compete to provide the same services only where it can demonstrate to the Board that this would—

(a) improve the quality of those services, including the outcomes that are achieved from their provision,

(b) reduce inequalities between persons with respect to their ability to access those services, or

(c) reduce inequalities between persons with respect to the outcomes achieved for them by provision of those services.”

BARONESS HOLLINS

LORD PATEL

BARONESS FINLAY OF LLANDAFF

203B

Page 38, line 2, at end insert—

“14Y1 Duty as to ensuring flexibility for clinicians to undertake work for the benefit of patients and the wider NHS

Each clinical commissioning group must ensure that organisations providing health services do so on the understanding that they must allow clinicians working for those organisations reasonable time for the undertaking of work for the benefit of patients and the wider NHS.”

BARONESS HOLLINS

LORD PATEL

203C

Page 38, line 2, at end insert—

“14Y2 Duty to promote public health

Each clinical commissioning group must, in the exercise of its functions, act in such a way as to contribute to the improvement of public health.”

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

LORD CLEMENT-JONES

203D

Page 38, line 2, at end insert—

“14Y1 Duty to ensure the priorities of local Health and Wellbeing strategies

Each clinical commissioning group must ensure their commissioning plans address the priorities of the joint Health and Wellbeing strategies of the relevant local authorities.”

BARONESS GIBSON OF MARKET RASEN

204

Page 38, line 6, after “services” insert “in rural and urban areas”

LORD ROOKER

LORD HARRIS OF HARINGEY

205

Page 38, line 11, after “that” insert “Local Healthwatch and”

LORD PATEL

LORD WARNER

206

Page 38, leave out lines 12 and 13 and insert “consulted—”

BARONESS HOLLINS

LORD PATEL

BARONESS FINLAY OF LLANDAFF

206A

Page 38, line 12, leave out from “involved” to end of line 13 and insert “(by formal and informal consultation with particular regard to the coherence and navigability of typical care pathways)”

LORD RAMSBOTHAM

BARONESS WILKINS

BARONESS HOWE OF IDLICOTE

206AA

Page 38, line 12, after “with” insert “accessible”

LORD KENNEDY OF SOUTHWARK

BARONESS YOUNG OF OLD SCONE

LORD COLLINS OF HIGHBURY

BARONESS MASHAM OF ILTON

206B

Page 38, line 13, after “ways)” insert “directly and through their representatives”

LORD ROOKER

207

Page 38, line 24, at end insert—

“( ) in developing commissioning proposals based on needs described by people in the area of the consortium”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

207A

Page 38, line 24, at end insert—

“( ) in decisions of the groups effecting the operation of primary medical services”

BARONESS FINLAY OF LLANDAFF

LORD WALTON OF DETCHANT

LORD BROOKE OF ALVERTHORPE

LORD WIGLEY

208

Page 38, line 40, at end insert—

“( ) Arrangements must be made for two or more clinical commissioning groups to exercise commissioning functions jointly for less common conditions, if the Board advises that these services cannot be effectively commissioned by a particular clinical commissioning group, based on population size.”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

208ZA

Page 40, line 4, at end insert—

“( ) Payments to voluntary organisations should be equal to or exceed the overall level of payments made by predecessor Primary Care Trusts.”

LORD NEWTON OF BRAINTREE

LORD BUTLER OF BROCKWELL

208A

Page 40, line 32, at end insert “subject to section 13E”

BARONESS FINLAY OF LLANDAFF

BARONESS MASHAM OF ILTON

LORD WIGLEY

LORD MACKENZIE OF CULKEIN

209

Page 40, line 32, at end insert—

“( ) Such guidance must cover commissioning for less common conditions.

( ) The Board must involve a range of groups representing patients and carers with expertise in the services to be commissioned in the development of such guidance.”

BARONESS HOLLINS

LORD PATEL

LORD PATEL OF BRADFORD

BARONESS FINLAY OF LLANDAFF

210

Page 40, line 32, at end insert—

“( ) The Board must publish guidance, updated on an annual basis, for clinical commissioning groups on conducting a high quality joint strategic needs assessment (“JSNA”) to ensure that the JSNA captures as accurately as possible the current and future needs of consortia populations in their entirety.”

BARONESS FINLAY OF LLANDAFF

LORD WALTON OF DETCHANT

LORD BROOKE OF ALVERTHORPE

211

Page 40, line 39, at end insert—

“( ) Clinical commissioning groups must demonstrate to the Board that they have acted on their duty to follow such guidance as is published by the Board.”

BARONESS FINLAY OF LLANDAFF

LORD WALTON OF DETCHANT

LORD MACKENZIE OF CULKEIN

212

Page 40, line 39, at end insert—

“( ) The Board must determine the minimum population size and the care services for that population for commissioning of services for less common conditions.”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

213

Page 40, line 40, leave out from beginning to end of line 11 on page 41

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

213ZA

Page 41, leave out lines 12 to 26

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

LORD CLEMENT-JONES

213A

Page 41, line 13, leave out “or” and insert “and”

213B

Page 41, line 16, after “assistance,” insert—

“(aa) building and supporting capabilities,”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD PATEL

213C

Page 41, line 26, at end insert—

“14Z8A Power of Board to refer to relevant professional body regarding conflicts of interest

The Board must refer to his or her relevant professional body any member of a clinical commissioning group whom it reasonably believes to have been in material breach of any of the provisions concerning conflict of interest set out in paragraphs 19A and 19B or the guidelines in paragraph 19C of Schedule 2 as inserted by Schedule 2 to the Health and Social Care Act 2011.”

BARONESS FINLAY OF LLANDAFF

BARONESS MASHAM OF ILTON

214

Page 41, line 38, at end insert—

“( ) The plan must explain how the clinical commissioning group proposes to ensure that commissioning services for less common conditions will be done.”

LORD WILLIS OF KNARESBOROUGH

BARONESS MORGAN OF DREFELIN

LORD PATEL

LORD TURNBERG

215

Page 41, line 41, after “14Q” insert “, 14X”

BARONESS HOLLINS

LORD PATEL

215A

Page 41, line 41, after “14Q” insert “, 14YZ”

BARONESS CUMBERLEGE

215B

Page 42, line 4, at end insert “and to each relevant Local Healthwatch organisation”

215C

Page 42, line 10, after “Board” insert “and “relevant Local Healthwatch organisation””

215D

Page 42, line 11, at end insert “or Local Healthwatch organisation”

LORD ROOKER

LORD HARRIS OF HARINGEY

216

Page 42, line 33, after “consult” insert “Local Healthwatch and”

LORD BEECHAM

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

216ZZA

Page 42, line 34, at end insert—

“( ) The clinical commissioning group must also consult—

(a) the general public,

(b) the relevant local authority, and

(c) patients on the list of primary medical service providers within the clinical commissioning group.”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

BARONESS WHEELER

216ZA

Page 42, line 35, leave out “involve” and insert “obtain the agreement of”

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

LORD CLEMENT-JONES

216ZAA

Page 42, line 36, at end insert—

“( ) The clinical commissioning group must involve each relevant Health and Wellbeing Board in preparing or revising the plan.”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

BARONESS WHEELER

216ZB

Page 43, leave out lines 1 to 10

LORD BEECHAM

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

216ZBA

Page 43, line 38, at end insert—

“( ) No commissioning plan can be agreed or revised by a clinical commissioning group without the consent of the relevant Health and Wellbeing Board.

( ) If the clinical commissioning group and the Health and Wellbeing Board fail to agree, the NHS Commissioning Board will decide whether to publish or vary the plan.”

BARONESS CUMBERLEGE

216ZBB

Page 43, line 40, at end insert—

“14Z12A Opinion of Local Healthwatch organisations on commissioning plans

(1) A relevant local Healthwatch organisation—

(a) must give the Board its opinion on whether a plan published by a clinical commissioning group under section 14Z9(4) or 14Z10(2) takes proper account of evidence from the Local Healthwatch organisation, and

(b) must give the clinical commissioning group a copy of its opinion.

(2) In this section, “evidence” shall mean such views as are known to, or such reports and recommendations as are published by the Local Healthwatch organisation, within the meaning of section 221(2)(d) of the Local Government and Public Involvement in Health Act 2007, at the start of the period to which the plan relates.”

LORD KENNEDY OF SOUTHWARK

BARONESS YOUNG OF OLD SCONE

LORD COLLINS OF HIGHBURY

BARONESS MASHAM OF ILTON

216A

Page 43, line 47, after “14Q” insert “, 14Y”

BARONESS HOLLINS

LORD PATEL

LORD PATEL OF BRADFORD

BARONESS FINLAY OF LLANDAFF

217

Page 43, line 47, after “14Z” insert “and how it has taken guidance issued by the NHS Commissioning Board on ensuring that JSNAs capture as accurately as possible the current and future needs of consortia population in their entirety into account when conducting their JSNA”

LORD WILLIS OF KNARESBOROUGH

BARONESS MORGAN OF DREFELIN

LORD PATEL

LORD TURNBERG

218

Page 44, line 24, after “14V” insert “, 14X”

LORD RAMSBOTHAM

BARONESS WILKINS

218A

Page 44, line 24, after “14V” insert “, 14Y”

LORD PATEL

LORD WARNER

219

Page 44, line 33, at end insert—

“( ) The Board must also consult providers of health and social care.”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

220

Page 44, line 40, at end insert—

“( ) The Board must make arrangements for the full reports of performance assessments as to be published or made generally available.”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD PATEL

220ZA

Page 46, leave out line 7 and insert—

“14Z19 Power on failure or potential failure of clinical commissioning groups”

220ZB

Page 47, line 28, at end insert—

“( ) the relevant Health and Wellbeing Boards,”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

220ZC

Page 47, line 28, at end insert—

“( ) patients receiving medical primary services from providers within the clinical commissioning group,”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD CLEMENT-JONES

LORD PATEL

220A

Page 48, line 29, at end insert—

“14Z21A Declaration of financial interests

A person who is a provider of primary medical services must declare any financial interest that person may have in a commissioning decision by a clinical commissioning group of which he or she is a member and must absent him or herself from the making of any such decision.”

Clause 24

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

BARONESS ROYALL OF BLAISDON

220B

Page 50, line 17, at end insert—

“( ) relevant inequalities”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

220C

Page 50, line 37, at end insert—

“( ) The Board must publish each year details of the methodology used to determine allocations to clinical commissioning groups.”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

221

Page 52, line 20, leave out from beginning to end of line 21 on page 53

LORD PATEL

LORD KAKKAR

222

Page 52, line 34, after “the” insert “health”

LORD PATEL

LORD WARNER

BARONESS JOLLY

BARONESS BARKER

223

Page 53, line 7, leave out from “spent” to end of line 9 and insert “to improve health outcomes”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD PATEL

223A

Page 53, line 7, leave out from “spent” to end of line 9 and insert “(which must be for the benefit of patients served by the relevant clinical commissioning group)”

Clause 25

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

224

Page 53, line 40, at end insert—

“( ) Regulations must make provision that no provider shall be a member of a clinical commissioning group if they have any financial interest, directly or indirectly, in the provision of any service that the clinical commissioning group may be required to commission.”

After Clause 25

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

224A

Insert the following new Clause—

“Clinical senates

(1) There are to be bodies corporate known as clinical senates.

(2) Each clinical senate has the function of supporting the better integration of services in each area of the country.

(3) Each clinical senate has the function of establishing and maintaining a system of the re-validation of doctors within their area.

(4) Each clinical senate must appoint a proper officer.

(5) Each clinical senate has the function of maintaining a system of clinical governance within clinical commissioning groups.

(6) Each clinical senate has the function of establishing and maintaining a system of clinical networks in their area.

(7) No clinical commissioning group can be authorised without the consent of the relevant clinical senate.

(8) No commissioning plan of a clinical commissioning group can be agreed without the consent of the relevant clinical senate.”

Clause 27

LORD PATEL

LORD ROOKER

225

Page 55, line 33, leave out “acting jointly with” and insert “with the approval of”

BARONESS CUMBERLEGE

225A

Page 55, line 33, at end insert “and Public Health England”

LORD PATEL

LORD WARNER

226

Page 55, line 34, after “individual” insert “with appropriate professional qualifications”

LORD PATEL

LORD ROOKER

BARONESS CUMBERLEGE

BARONESS JOLLY

227

Page 56, line 4, at end insert—

“( ) the exercise of the authority’s functions in relation to the control of any outbreak of disease or other public health emergency”

228

Page 56, line 5, at end insert “will be directly accountable to the chief executive of the local authority, and”

229

Page 56, line 6, at end insert—

“( ) The individual so appointed must be a registered public health specialist who has a broad range of professional expertise in public health.

( ) The director of public health shall be a person for whom the head of the paid service is directly responsible and shall be required to report directly to the authority as to the exercise of the post.”

LORD PATEL

BARONESS CUMBERLEGE

230

Page 56, line 6, at end insert—

“( ) The individual so appointed must be a registered public health specialist.”

231

Page 56, line 6, at end insert—

“( ) The individual so appointed must be a person with a broad range of professional expertise in public health.”

232

Page 56, line 6, at end insert—

“( ) The director of public health shall be a person for whom the head of the paid service is directly responsible and shall be required to report directly to the authority as to the exercise of the responsibilities of the post.”

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

233

Page 56, line 6, at end insert—

“( ) The individual so appointed must hold a recognised professional qualification, must be a director within the local authority, and must report directly to the Chief Executive.”

LORD PATEL

233A

Page 56, line 6, at end insert—

“( ) The individual so appointed must—

(a) be appointed according to the statutory process for appointments of directors of public health within the NHS,

(b) be a member of an appropriate professional register, and

(c) report directly to the council chief executive.”

LORD PATEL

LORD ROOKER

BARONESS CUMBERLEGE

BARONESS JOLLY

234

Page 56, line 27, leave out “consult” and insert “have the consent of”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD PATEL

234A

Page 56, line 27, leave out “consult” and insert “receive the agreement of”

Clause 28

LORD PATEL

LORD ROOKER

235

Page 56, line 35, at end insert—

“( ) A local authority shall have the function of ensuring an effective response to any outbreak of disease or other public health emergency in its area and in so doing, shall have regard to any document published by the Secretary of State.”

236

Page 57, line 2, at end insert—

“( ) the exercise of the authority of its functions under section 73A.”

BARONESS EMERTON

BARONESS THORNTON

LORD PATEL

236ZA

Page 57, line 9, at end insert—

“( ) A local authority must consult relevant voluntary aid societies when discharging its functions under section 73A(4)(d).”

Clause 30

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

236A

Page 58, line 11, at end insert—

“(3) This section comes into force on a date to be specified by order by the Secretary of State.

(4) The time specified in subsection (3) must be after such time as the Secretary of State is satisfied that all duties and functions of Strategic Health Authorities are being fulfilled by another body.”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

 

The above-named Lords give notice of their intention to oppose the Question that Clause 30 stand part of the Bill.

Clause 31

LORD REA

LORD HUNT OF KINGS HEATH

 

The above-named Lords give notice of their intention to oppose the Question that Clause 31 stand part of the Bill.

After Clause 31

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

236AA

Insert the following new Clause—

“Local NHS Commissioning Boards

(1) There are to be bodies corporate known as Local NHS Commissioning Boards.

(2) Each Local NHS Commissioning Board has the function of strategic commissioning within their area, including the issue of guidance to clinical commissioning groups.

(3) Each Local NHS Commissioning Board has the function of cooperating with local authorities in their area.

(4) Each Local NHS Commissioning Board has the function of holding the contracts of any general practitioners contracted to provide primary medical services within their area.

(5) Each Local NHS Commissioning Board has the function of establishing and maintaining a system of re-validation of doctors within their area including the appointment of a responsible officer.

(6) A Local NHS Commissioning Board shall have a board of directors.

(7) The board of directors shall consist of—

(a) executive directors, one of whom must be the chief executive and accounting officer;

(b) non-executive directors, one of who must be the chairman.

(8) One of the executive directors must be—

(a) the finance director;

(b) the medical director; and

(c) the director of nursing.

(9) Regulations may make further provision as to the governance of Local NHS Commissioning Boards.

(10) Each Local NHS Commissioning Board is subject to directions issued by the NHS Commissioning Board on the exercise of its functions.”

Clause 32

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

 

The above-named Lords give notice of their intention to oppose the Question that Clause 32 stand part of the Bill.

Clause 33

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

236AB

Page 63, line 29, leave out “by local authorities”

236AC

Page 63, line 32, leave out from beginning to end of line 18 on page 64

“( ) Provided that the requisite public consultations have been conducted in accordance with this Act and the relevant regulations have been issued by the Secretary of State, the running costs of any new fluoridation schemes requested by local authorities shall be met by a transfer of funds from the dental health service budget of the NHS Commissioning Board to the Secretary of State.

( ) In respect of fluoridation schemes for which legal agreements were in place before 1 April 2013, the running costs shall continue to be met from the fluoridation funds transferred on that date from Strategic Health Authorities and Primary Care Trusts to the Secretary of State.”

 

The above-named Lords give notice of their intention to oppose the Question that Clause 33 stand part of the Bill.

Clause 37

LORD PATEL OF BRADFORD

236B

Leave out Clause 37 and insert the following new Clause—

“After-care

(1) Section 117 of the Mental Health Act 1983 (after-care) is amended as follows.

(2) In subsection (2)—

(a) after “duty of the” insert “clinical commissioning group or”,

(b) omit “Primary Care Trust or” in each place it appears,

(c) for “such time as the” substitute “such time as (in relation to England) the clinical commissioning group or”.

(3) After subsection (2C) insert—

“(2D) Subsection (2) above, in its application to the clinical commissioning group, has effect as if for “to provide” there were substituted “to arrange for the provision of”.

(2E) The Secretary of State may by regulations provide that the duty imposed on the clinical commissioning group by subsection (2) above is, in the circumstances or to the extent prescribed by the regulations, to be imposed instead on another clinical commissioning group or the National Health Service Commissioning Board.

(2F) Where regulations under subsection (2E) above provide that the duty imposed by subsection (2) above is to be imposed on the National Health Service Commissioning Board, subsections (2D) and (2E) above have effect as if references to the clinical commissioning group were references to the National Health Service Commissioning Board.

(2G) Section 272(7) and (8) of the National Health Service Act 2006 applies to the power to make regulations under subsection (2E) above as it applies to a power to make regulations under that Act.”

(4) In subsection (3)—

(a) after “section “the” insert “clinical commissioning group or”,

(b) omit “Primary Care Trust or” in each place it appears, and

(c) after “means the”, in the first place it appears, insert “clinical commissioning group or”.

(5) In consequence of the repeals made by subsections (2)(b) and (4)(b), omit paragraph 47 of the Schedule 2 to the National Health Service Reform and Health Care Professions Act 2002.”

Clause 40

LORD MARKS OF HENLEY-ON-THAMES

BARONESS WILLIAMS OF CROSBY

237

Page 75, line 6, at end insert—

“( ) In section 130A of that Act (Independent Metal Health Advocates), at the beginning of subsection (7)(a) insert “subject to paragraph (aa) below,”

( ) In section 130A of that Act, after subsection (7)(a) insert—

“(aa) must make provision to ensure that the help of independent mental health advocates is available to those qualifying patients who are minors;”.”

After Clause 42

BARONESS BARKER

BARONESS MURPHY

BARONESS HOLLINS

BARONESS TYLER OF ENFIELD

237A

Insert the following new Clause—

“Criteria of impaired decision-making for supervised community treatment

In section 17A of the Mental Health Act 1983 (community treatment orders) after subsection (5)(a) insert—

“( ) that because of his mental disorder, his ability to make decisions about the provision of medical treatment is significantly impaired;”.”

Clause 43

LORD MARKS OF HENLEY-ON-THAMES

BARONESS WILLIAMS OF CROSBY

238

Page 77, line 3, after “steps” insert “after consulting with the Secretary of State”

Clause 45

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

 

The above-named Lords give notice of their intention to oppose the Question that Clause 45 stand part of the Bill.

Clause 46

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

239

Page 80, line 2, at end insert—

“( ) In exercising functions under subsections (1) and (2), the Secretary of State must set out how the performance of the Board in relation to these functions will be managed, and how the Board must agree any arrangements for provision with the appropriate Health and Wellbeing Boards.”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

239ZZA

Page 80, line 25, leave out subsection (2)

239ZZB

Page 81, leave out lines 3 to 26

239ZZC

Page 81, line 27, leave out subsection (4)

239ZA

[Withdrawn]

Clause 48

BARONESS WILKINS

BARONESS MASHAM OF ILTON

239A

Page 82, line 32, insert—

“( ) Before a determination is made by the NHS Commissioning Board which relates to pharmaceutical remuneration, it—

(a) must consult a body appearing to it to be representative of persons to whose remuneration the determination would relate, and

(b) may consult such other persons as it considers appropriate.”

Clause 49

LORD WARNER

LORD PATEL

240

Page 83, line 3, after “review” insert “the cost and”

BARONESS CUMBERLEGE

240A

Page 83, line 5, at end insert “, and the extent to which their detailed merits, powers and programmes of work are clear and avoid any duplication or gaps in comparison with other healthcare organisations.”

LORD PATEL

LORD WARNER

241

Page 83, line 12, at end insert—

“( ) Healthwatch England”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

241A

Page 83, line 12, at end insert—

“( ) Clinical Commissioning Groups”

LORD WARNER

LORD PATEL

242

Page 83, line 12, at end insert—

“( ) In discharging the function under this section, the Secretary of State must publish an annual statement to Parliament of—

(a) the administrative cost of each body listed in subsection (2),

(b) the percentage of the health service budget these administrative costs represent, and

(c) the percentage increase of these administrative costs in relation to the previous year.”

LORD PATEL

LORD KAKKAR

243

Page 83, line 13, leave out “may” and insert “must”

BARONESS CUMBERLEGE

243ZA

Page 83, line 16, at end insert “, and the extent to which their detailed merits, powers and programmes of work are clear and avoid any duplication or gaps in comparison with other healthcare organisations.”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

243A

Page 83, line 16, at end insert—

“( ) The report must include statements on the following matters—

(a) progress toward reducing relevant inequalities;

(b) integration of services;

(c) waiting time performance;

(d) health outcome performance;

(e) other matter prescribed in regulations.”

Clause 50

LORD WARNER

LORD PATEL

BARONESS MURPHY

BARONESS PITKEATHLEY

244

Page 83, line 23, at end insert “and its integrated working with adult social care services”

LORD RIX

LORD WIGLEY

BARONESS HOLLINS

245

Page 83, line 25, at end insert—

“( ) The Secretary of State must include in any report progress on tackling health inequalities for people with a disability.”

Clause 51

BARONESS FINLAY OF LLANDAFF

 

Baroness Finlay of Llandaff gives notice of her intention to oppose the Question that Clause 51 stand part of the Bill.

Schedule 4

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

245ZA

Page 289, line 30, leave out paragraph 1

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

245A

Page 289, line 35, at end insert—

“( ) This general power does not affect Chapter 1 of Part 7 (pharmaceutical services).”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

245B

Page 294, line 13, at end insert—

“( ) add “Board and Clinical Commissioning Groups””

245C

Page 294, line 16, at end insert—

“( ) add “Board and Clinical Commissioning Groups””

EARL HOWE

246

Page 294, line 33, after “Board,” insert—

“(hb) a subsidiary of a company which is formed under that section and wholly owned by the Secretary of State,”

247

Page 294, line 37, leave out “(ha)” and insert “(hb)”

248

Page 294, line 42, after “(ha)” insert “or (hb)”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

248A

Page 299, line 21, at end insert—

“(2B) Prior to the Board concluding any arrangements for the provision of primary medical services by any person under subsection (2), including any contractual arrangements with any person other than a general medical services contract under section 84 of this Act, the Board shall—

(a) disclose the nature of the proposed arrangements for the provision of primary medical services to each of the Health and Wellbeing Boards for the area in which the primary medical services are due to be provided under the proposed arrangements (referred in this section as a “relevant Health and Wellbeing Board”);

(b) provide any further information in relation to the proposed arrangements which is sought in writing by each relevant Health and Wellbeing Board;

(c) obtain the written consent from each relevant Health and Wellbeing Board to the proposed arrangements;

(2C) In the event that the Secretary of State certifies that in his or her opinion consent for the arrangements is being unreasonably withheld or refused by any relevant Health and Wellbeing Board, the Secretary of State shall be entitled to give a direction to the Board to enter into arrangements notwithstanding the absence of consent by the relevant Health and Wellbeing Board.

(2D) The direction making power under subsection (2C) shall not be delegated by the Secretary of State to any person apart from a Minister of State.

(2E) Unless the Board considers that it is necessary to make interim arrangements to provide short term emergency primary medical services in a particular area or the Secretary of State has given a direction under subsection (2C), no primary care medical services shall be provided by any person under subsection (2) until each relevant Health and Wellbeing Board has provided its consent to the proposed arrangements.”

BARONESS FINLAY OF LLANDAFF

248B*

Page 301, line 19, after “Board” insert “and an appropriate local clinical commissioning group”

EARL HOWE

248C

Page 311, line 30, leave out “57 to 61” and insert “69 to 76”

248D

Page 312, line 8, at end insert “, and

( ) in sub-paragraph (5), omit “in its area””

248E

Page 312, line 25, leave out “62” and insert “77”

249

Page 316, line 3, at end insert—

“In section 216 (application of trust property: further provisions), in subsection (3), after “or 214” insert “of this Act or section 294 or 296 of the Health and Social Care Act 2011”.”

250

Page 316, line 21, at end insert—

“In section 220 (trust property previously held for general hospital purposes), in subsection (2), after “or 214” insert “of this Act or section 294 or 296 of the Health and Social Care Act 2011”.”

LORD ROOKER

251

Page 317, line 27, at end insert—

“In section 234(2)(1) for “Primary Care Trust” substitute “Clinical commissioning groups”.”

252

Page 317, line 27, at end insert—

“In section 234(2)(1)(a) for “Primary Care Trust” substitute “Clinical commissioning groups”.”

253

Page 317, line 27, at end insert—

“In section 234(2)(2) for “Primary Care Trust” substitute “Clinical commissioning groups”.”

Schedule 5

EARL HOWE

253A

Page 326, line 42, leave out “paragraphs 46 and 49” and insert “paragraph 46”

253B

Page 327, line 27, after “(1)” insert “—

(a) omit paragraph 49 of Schedule 2 to the National Health Service Reform and Health Care Professions Act 2002, and

(b) ”

LORD LUCAS

254

Page 338, line 30, at end insert—

“( ) Section 77 of the Freedom of Information Act 2000 (offence of altering etc. records with intent to prevent disclosure) is amended as follows.

( ) In subsection (1), after the words “held by the public authority” insert “or by a service provider”.

( ) In subsection (2), after the words “public authority” in each place it appears insert “or service provider”.

( ) After subsection (4) insert—

“(5) “Service provider” means a person providing, or a person who has provided, services under a contract with the National Health Service Commissioning Board established under section 1E of the National Health Service Act 2006 or with a clinical commissioning group established under section 1F of that Act.””

EARL HOWE

255

Page 351, line 2, at beginning insert “In section 123 of”

256

Page 351, line 2, leave out from “2009” to “(partner” in line 18

Clause 53

257

[Withdrawn]

LORD WARNER

LORD PATEL

LORD TURNBERG

[In substitution for Amendment 257]

257ZA

Page 84, line 15, at end insert—

“( ) On the abolition of the Health Protection Agency, the Secretary of State will allocate their functions and any others he or she considers appropriate to an Executive Agency with its own chief executive as accounting officer with a management board with an independent chairman and at least three non-Executive Directors with expertise in its functions selected by the Department’s Chief Scientific Adviser.

( ) In allocating these functions the Secretary of State shall ensure that staff of the Executive Agency should have freedom to secure and discharge external research contracts.”

LORD BEECHAM

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

 

The above-named Lords give notice of their intention to oppose the Question that Clause 53 stand part of the Bill.

Clause 54

EARL HOWE

257A

Page 85, line 2, at end insert—

“( ) Any function conferred on the appropriate authority by this section may be performed by either the Secretary of State or the Department of Health, Social Services and Public Safety in Northern Ireland acting alone or both of them acting jointly (and references in this section to the appropriate authority are to be construed accordingly).”

257B

Page 85, leave out lines 4 to 6

After Clause 57

LORD WILLIS OF KNARESBOROUGH

LORD PATEL

LORD KAKKAR

LORD WARNER

258

Insert the following new Clause—

“The Health Research Authority

(1) There shall be a body corporate called the Health Research Authority (referred to as “the HRA”).

(2) The Secretary of State shall make all necessary regulations to establish the HRA within 12 months of the Act receiving Royal Assent.

(3) The HRA shall manage a co-ordinated process for all aspects of the approval of health research involving human participants or their data, including—

(a) the provision of ethics committee opinions and other approvals,

(b) with the National Institute for Health Research and NHS trusts, delivering a consistent, efficient process for obtaining permission for research carried out under the scope of the Research Governance Framework for Health and Social Care (referred to as “NHS R&D permissions”),

(c) with the Medicines and Healthcare Products Regulatory Authority, improving the regulation of clinical trials of medicinal products, and

(d) other such functions as may be specified in regulations including those currently being undertaken by organisations which will cease to function following the implementation of future legislation.

(4) The HRA shall have the following general functions—

(a) providing general oversight and guidance as it considers appropriate in relation to activities within its remit,

(b) publishing annual metrics and indicators on all research approvals within its remit,

(c) working with relevant bodies across England, Wales, Scotland and Northern Ireland to address differences in practice and legislation, and providing supporting guidance or codes of practice that apply across the UK,

(d) superintending compliance with requirements imposed by legislation relevant to its remit,

(e) monitoring developments relating to activities within its remit, and

(f) facilitating and promoting health research involving human participants or their data.

(5) The HRA must carry out its functions effectively, efficiently and economically.

(6) In carrying out its functions, the HRA must, so far as relevant, have regard to the principles of best regulatory practice (including the principles under which regulatory activities should be transparent, accountable, proportionate, consistent and targeted only at cases in which action is needed).

(7) The Special Health Authority known as the Health Research Agency is abolished and its functions transferred to the HRA.”

LORD PATEL

LORD WARNER

BARONESS CUMBERLEGE

259

Insert the following new Clause—

“Employment conditions for public health specialists

Any registered public health specialist or other person employed in the exercise of public health functions by a local authority or in an executive agency of the Department of Health shall be employed on terms and conditions of service no less favourable than those of persons in equivalent employment in the National Health Service.”

LORD PATEL

BARONESS FINLAY OF LLANDAFF

LORD WARNER

260

Insert the following new Clause—

“Public Health England

(1) There is to be a special health authority known as Public Health England, with the function of assisting the Secretary of State in the delivery of his or her public health functions.

(2) Section 44 of this Act shall not apply to this authority.”

LORD WILLIS OF KNARESBOROUGH

LORD PATEL

BARONESS FINLAY OF LLANDAFF

260A

Insert the following new Clause—

“The Health Research Authority: approval functions

The following functions are transferred to the Health Research Authority—

(a) advising the Secretary of State on applications for support to process confidential patient information under section 251 of the NHS Act 2006,

(b) functions of the Human Tissue Authority in relation to the scheduled purpose of research in connection with disorders, or the functioning, of the human body,

(c) functions of the Human Fertilisation and Embryology Authority in relation to the provision of licences for research, and

(d) advising Health Ministers on the certification of doctors and dentists wishing to administer radioactive medicinal products to humans for research under the Medicines (Administration of Radioactive Substances) Regulations 1978.”

260B

Insert the following new Clause—

“The Health Research Authority: duty of co-operation with MHRA

The Health Research Authority and the Medicines and Healthcare products Regulatory Agency (MHRA) must co-operate with each other in the exercise of their respective functions to develop a co-ordinated process for the approval of clinical trials of medicinal products and to deliver improvements to the regulation of these trials.”

260C

Insert the following new Clause—

“The Health Research Authority: National Research Governance Service

(1) A component of the Health Research Authority, known as the National Research Governance Service, shall lead a streamlined common service for obtaining permission for research carried out under the scope of the Research Governance Framework for Health and Social Care (referred to as “NHS R&D permissions”).

(2) The National Research Governance Service will have the following general functions—

(a) undertaking all study-wide NHS research governance checks, ensuring consistent national standards,

(b) recommending research projects as suitable for undertaking in the NHS, subject to local assessment of feasibility and delivery by NHS trusts,

(c) managing the process requiring NHS trusts to determine local feasibility within 20 working days,

(d) maintaining records on NHS staff to confirm their competence to conduct research, and

(e) providing in relation to activities within its remit general oversight and guidance as it considers appropriate.

(3) The National Research Governance Service and NHS trusts must have regard to the National Institute of Health Research’s Research Support Services standard procedures, framework of good practice and benchmarks for performance.”

LORD WARNER

LORD PATEL

BARONESS MURPHY

BARONESS PITKEATHLEY

260D

Insert the following new Clause—

“PART Standards of adult social care

Secretary of State’s duty as to standards of adult social care

(1) The Secretary of State shall, after appropriate consultation, make regulations governing the eligibility and assessment of individuals for adult social services on a consistent basis throughout England, including—

(a) portability of assessments between areas,

(b) the charging arrangements for services provided,

(c) the assessment of carers’ needs, and

(d) the integration of such assessments with those for continuing care under the NHS.

(2) Regulations made under subsection (1) shall be—

(a) made by statutory instrument subject to an affirmative resolution in both Houses of Parliament;

(b) laid within 3 years of this Act being given Royal Assent; and

(c) kept under review.

(3) In this section “integration” means integration of the assessment and delivery of health and social care and services to individuals that benefit their treatment and care.”

LORD FOWLER

BARONESS GOULD OF POTTERNEWTON

BARONESS MASHAM OF ILTON

260E

Insert the following new Clause—

“Charges to overseas visitors

(1) The National Health Service (Charges to Overseas Visitors) Regulations 2011 (S.I. 2011/1556) is amended as follows.

(2) In regulation 6 (services exempted from charges) for paragraph (e) substitute—

“(e) the diagnostic test for evidence of infection with the Human Immunodeficiency Virus (HIV) and counselling associated with that test and its result;

(ea) all other services for the treatment of HIV provided to an overseas visitor who has been present in the United Kingdom for a period of not less than six months preceding the time when services are provided;

(eb) treatment for sexually transmitted infections other than HIV;”.”

Clause 58

BARONESS THORNTON

LORD BEECHAM

260EA*

Page 87, line 9, at end insert—

“(c) is to continue as regulator of NHS Foundation Trusts as set out in Chapter 5 of Part 2 of the National Health Service Act 2006”

260EB*

Page 87, line 9, at end insert—

“(d) is to take on the further duties as set out in this Act in relation to authorising through licensing any person who provides health care services for the purposes of the NHS as set out in Chapter 3 of this Act.”

Schedule 8

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

260F

Page 361, line 24, at end insert—

“( ) The first Chief Executive of Monitor is to be appointed by the Secretary of State.”

260G

Page 361, line 25, leave out “The chief executive and”

260H

Page 364, line 26, at end insert—

“Provision of information to Secretary of State

(1) The Secretary of State may require Monitor to provide the Secretary of State with such information as the Secretary of State considers it necessary to have.

(2) The information must be provided in such form, and at such time or within such period, as the Secretary of State may require.”

Clause 59

BARONESS THORNTON

LORD BEECHAM

261

Page 87, line 12, leave out subsection (1) and insert—

“(1) The main duty of Monitor is to exercise its functions to support the duties of the Secretary of State as set out in section 1 of this Act as provided for in regulations.

(1A) Monitor must exercise its functions to protect and preserve the interest of those who use, or may use, health care services, and to maintain or improve the quality of those services, and the outcomes achieved by those services.”

BARONESS BAKEWELL

261A

Page 87, line 13, after “services” insert “and adult social care services”

261B

Page 87, line 14, after “services” insert “and adult social care services”

BARONESS WARNOCK

LORD PATEL

262

Page 87, line 15, after “effective” insert “as demonstrated through regular published comparable financial and performance information”

BARONESS THORNTON

LORD BEECHAM

263

Page 87, line 16, at end insert—

“( ) The role of Monitor as the Independent Regulator of Foundation Trusts shall continue.”

BARONESS MURPHY

264

Page 87, line 17, after “must” insert—

“(a) operate economically, efficiently and effectively, and

(b)”

BARONESS BAKEWELL

264A

Page 87, line 18, at end insert “and adult social care services”

BARONESS THORNTON

LORD BEECHAM

265

Page 87, line 19, leave out subsection (3)

265ZZA*

Page 87, line 19, leave out subsection (3) and insert—

“( ) Monitor shall be under a duty (known as the “duty of cooperation”) to ensure that any provider organisation which is regulated by it shall both plan to provide and shall provide its services in ways that promote efficient and effective cooperation between providers of health care services as part of health services provided under this Act, and in particular shall both plan and provide services that further the objectives of—

(a) improving the quality of services for patients from all providers under subsection 1A;

(b) reducing inequalities between persons with respect to their ability to access those health care services;

(c) reducing inequalities between persons with respect to of health outcomes.

( ) The Secretary of State shall publish guidance to Monitor and providers if NHS services regarding the exercise of the duty of cooperation, and where such guidance is published, NHS providers and Monitor shall pay due regard to the guidance in the discharge of their functions.

( ) Regulations may require NHS providers to take such steps as are prescribed as part of the duty of cooperation.”

BARONESS FINLAY OF LLANDAFF

BARONESS HOLLINS

265ZA

Page 87, line 19, after “to” insert “promoting collaboration and”

LORD WHITTY

265A

Page 87, line 19, leave out “anti-competitive”

BARONESS BAKEWELL

265B

Page 87, line 20, after “services” insert “and adult social care services”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD CLEMENT-JONES

BARONESS JOLLY

265C

Page 87, line 20, leave out from “services” to end of line 22 and insert “where it considers that preventing such behaviour would—

(a) improve—

(i) the quality of those services, including the outcomes that are achieved from their provision, or

(ii) the efficacy of the provision of those services;

(b) reduce inequalities between persons with respect to their ability to access those services;

(c) reduce inequalities between persons with respect to the outcomes achieved from them by the provision of those services”

LORD WARNER

LORD PATEL

266

Page 87, line 21, at end insert “and in discharging this duty will conduct and publish within one year of Royal Assent a review of the anti-competitive barriers that restrict NHS patients from benefiting from new or existing organisations providing new or extended NHS services that defined quality standards, together with their proposals for removing these barriers”

BARONESS BAKEWELL

266A

Page 87, line 22, at end insert “and adult social care services”

BARONESS THORNTON

LORD BEECHAM

267

Page 87, line 31, leave out “enabling” and insert “promoting”

BARONESS BAKEWELL

267ZA

Page 87, line 32, after “services” insert “and adult social care services”

267ZB

Page 87, line 35, after “services” insert “and adult social care services”

267ZC

Page 87, line 39, after “services” insert “and adult social care services”

267ZD

Page 87, line 41, at end insert “and adult social care services”

BARONESS THORNTON

LORD BEECHAM

267ZDA*

Page 87, line 41, at end insert—

“( ) In subsections (4) and (5), integration should be interpreted to mean that health-related and social care services are provided in such a manner that individuals will experience services—

(a) which provide them with care which they experience as being independent of organisational barriers;

(b) which offer them, their families and carers, the most appropriate involvement in their care choices;

(c) which reduce to a minimum the need for separate assessments; and

(d) which result in a care plan for the individual which covers all aspects of their care.”

BARONESS BAKEWELL

267ZE

Page 88, line 7, after “services” insert “and adult social care services”

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

267ZF

Page 88, line 10, at end insert “and Monitor must obtain advice from Healthwatch England for enabling if effectively to discharge that function”

LORD KENNEDY OF SOUTHWARK

BARONESS YOUNG OF OLD SCONE

LORD COLLINS OF HIGHBURY

BARONESS MASHAM OF ILTON

267A

Page 88, line 12, after “from” insert “persons or organisations with expertise in the experience of patients and from”

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

267B

Page 88, line 15, after “2006),” insert—

“(aa) public and patient involvement,”

BARONESS FINLAY OF LLANDAFF

BARONESS HOLLINS

267C

Page 88, line 16, at end insert—

“( ) the management of a wide range of complex clinical conditions”

BARONESS THORNTON

LORD BEECHAM

268

Page 88, line 20, leave out subsection (10)

BARONESS BAKEWELL

268ZA

Page 88, line 21, after “services” insert “and adult social care services”

LORD KENNEDY OF SOUTHWARK

BARONESS YOUNG OF OLD SCONE

LORD COLLINS OF HIGHBURY

BARONESS MASHAM OF ILTON

268A

Page 88, line 26, at end insert—

“( ) Every annual report of Monitor must include a statement of the steps it has taken in the financial year to which the report relates to comply with the duty under subsection (7).”

BARONESS FINLAY OF LLANDAFF

268B

Page 88, line 26, at end insert—

“( ) Monitor must report annually to the Secretary of State on how it has discharged its duty to promote integration.”

Clause 60

BARONESS THORNTON

LORD BEECHAM

LORD WHITTY

269

Page 88, line 35, leave out subsection (2)

Clause 61

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

269A

Page 89, line 21, at end insert—

“(5) The regulations under this section must not be made unless a draft of the statutory instrument containing them has been laid before Parliament and approved by a resolution of each House of Parliament.”

BARONESS THORNTON

LORD BEECHAM

 

The above-named Lords give notice of their intention to oppose the Question that Clause 61 stand part of the Bill.

Clause 62

BARONESS MURPHY

270

Page 89, line 25, leave out paragraphs (b) and (c)

EARL HOWE

270A

Page 89, line 26, after “services” insert “provided”

BARONESS THORNTON

LORD BEECHAM

270B*

Page 89, line 30, leave out paragraphs (d) to (f)

BARONESS MURPHY

271

Page 89, line 31, leave out from “that” to end of line 32 and insert “people who require health care services for those purposes are provided with fair access to them.”

272

Page 89, line 33, leave out paragraph (e)

273

Page 89, line 37, leave out from “for” to end of line and insert “operate economically, efficiently and effectively”

274

Page 89, line 38, leave out paragraph (g) and insert—

“(g) the need for commissioners and providers to cooperate to improve services and deliver seamless and sustainable care to patients”

BARONESS THORNTON

LORD BEECHAM

274ZZZA*

Page 89, line 41, leave out paragraphs (h) to (j)

BARONESS FINLAY OF LLANDAFF

274ZZA

Page 89, line 45, at end insert—

“( ) the need to secure and protect the education and training of the future healthcare workforce,”

Clause 63

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

274ZA

Page 90, line 16, at end insert “with a paramount duty towards the safety of people who use health care services”

BARONESS FINLAY OF LLANDAFF

274ZAA

Page 90, line 16, at end insert “and imposes the least burden on providers”

BARONESS THORNTON

LORD BEECHAM

274ZAB*

Page 90, line 17, leave out from “act” to end of line 25 and insert “through appropriate organisational arrangements to separate its functions in paragraphs (c) and (d) of section 58.”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD CLEMENT-JONES

LORD PATEL

274ZB

Page 90, line 26, leave out subsection (3)

LORD WHITTY

274A

Page 90, line 28, leave out paragraph (a)

BARONESS THORNTON

LORD BEECHAM

274XAA*

Page 90, line 29, leave out paragraph (b)

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD CLEMENT-JONES

LORD PATEL

274AA

Page 90, line 35, at end insert—

“(4A) Where Monitor concludes that it is unable to secure the resolution of a conflict it must publish a statement setting out—

(a) the nature of the conflict;

(b) the matters which it considers to be significant to its resolution; and

(c) the reasons why it has been unable to resolve the conflict.”

LORD KENNEDY OF SOUTHWARK

BARONESS YOUNG OF OLD SCONE

LORD COLLINS OF HIGHBURY

BARONESS MASHAM OF ILTON

274B

Page 90, line 45, at end insert—

“( ) a matter likely to have a significant impact on the integration of services”

BARONESS FINLAY OF LLANDAFF

274BA

Page 90, line 45, at end insert—

“( ) a matter likely to have significant impact on the need to secure and protect the education and training of the future healthcare workforce or the need for high standards in the education and training of healthcare professionals who provide services for the purposes of the NHS”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD CLEMENT-JONES

LORD PATEL

274C

Page 90, line 46, after “(4)” insert “or (4A)”

274D

Page 91, line 1, after “(4)” insert “or (4A)”

274E

Page 91, line 2, at end insert—

“(7A) Where Monitor is required to publish a statement under subsection (4A), it must submit the statement to the Secretary of State for resolution of the conflict.

(7B) Where the Secretary of State has received a statement under subsection (7A), the Secretary of State must direct Monitor as to how to resolve the conflict and must publish a statement giving notice of his or her direction as soon as is reasonably practicable.”

Clause 65

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD CLEMENT-JONES

LORD PATEL

275

Page 92, line 13, leave out subsection (2)

Clause 66

LORD MARKS OF HENLEY-ON-THAMES

BARONESS WILLIAMS OF CROSBY

276

Page 93, line 8, after “functions’ insert “other than the personal medical records of patients”

Clause 67

LORD MARKS OF HENLEY-ON-THAMES

BARONESS WILLIAMS OF CROSBY

277

Page 93, line 20, leave out subsection (3)

Before Clause 68

BARONESS THORNTON

LORD BEECHAM

277A*

Insert the following new Clause—

“CHAPTER 2 Co-operation and competition

Co-operation and competition

(1) Regulations must make provision as to the services specified in the national tariff designating which services are to be commissioned through specified forms of competition and which services may be commissioned by specified other means.

(2) These regulations shall be known as the Principles and Rules of Co-operation and Competition in the NHS and at the commencement of this Part of the Act, the current regulations shall continue to apply.

(3) Changes to these regulations may only be made through the mandate to the Board using the process as set out in section 20 of this Act.

(4) The Co-operation and Competition Panel (CCP) shall continue as an independent, arms length agency.

(5) The CCP will continue to support the delivery of patients and taxpayers of the benefits of cooperation and where appropriate of competition by investigating and advising the Department of Health and Monitor on potential breaches of the Principles and Rules of Co-operation and Competition.”

277B*

Insert the following new Clause—

“Duty as to continuous improvement

(1) Regulations must provide that commissioners have a duty to make arrangements to secure continuous improvement in the way in which their functions are exercised, having regard to a combination of economy, efficiency and effectiveness.

(2) Such continuous improvement is to involve—

(a) consideration of costs,

(b) making the most of money spent, and

(c) making sure that services meet the needs of patients, communities and the priorities agreed in any Health and Wellbeing Strategy.

(3) For the purpose of deciding how to fulfill the duty, commissioners must consult the relevant Health and Wellbeing Boards, patients and public, as provided in the regulations.

(4) Commissioners must conduct reviews of the services commissioned in accordance with the regulations, and publish the results.

(5) In conducting a review a commissioner—

(a) shall aim to improve the way in which its commissioning of services is exercised, having regard to a combination of economy, efficiency and effectiveness, and

(b) shall have regard to any guidance issued by the Secretary of State under this section.

(6) Regulations may specify matters which commissioners must include in a review of a service under this section, and in particular may require a commissioner—

(a) to consider whether the current providers of the service were meeting all reasonable requirements;

(b) to consider the extent to which competition for the provision of the service may or may not be appropriate;

(c) to consider its objectives in relation to commissioning the service;

(d) to assess its performance as regards the commissioning of the current provider;

(e) to consider the outcome of consultation with relevant persons and bodies as specified in the regulations.

(7) Regulations may specify the circumstances for use of tenders as a result of a service review in order to sustain continuous improvement.

(8) These regulations may include—

(a) single tender actions,

(b) restricted tenders,

(c) open market tenders.”

Clause 68

LORD WHITTY

BARONESS THORNTON

LORD BEECHAM

 

The above-named Lords give notice of their intention to oppose the Question that Clause 68 stand part of the Bill.

Clause 69

LORD WHITTY

BARONESS THORNTON

LORD BEECHAM

 

The above-named Lords give notice of their intention to oppose the Question that Clause 69 stand part of the Bill.

Clause 70

BARONESS THORNTON

LORD BEECHAM

277C*

Page 95, line 33, at end insert—

“( ) Before taking any action in relation to functions under section 68 or 69, Monitor must—

(a) have regard to any regulations made by the Secretary of State, including the Principles and Rules for Co-operation and Competition,

(b) consult the relevant clinical commissioning groups and Health and Wellbeing boards,

(c) obtain the consent of the Secretary of State for the proposed action.”

LORD WHITTY

BARONESS THORNTON

LORD BEECHAM

 

The above-named Lords give notice of their intention to oppose the Question that Clause 70 stand part of the Bill.

Clause 71

BARONESS THORNTON

LORD BEECHAM

277D*

Page 95, line 35, leave out subsections (1) to (3) and insert—

“(1) Subject to subsection (2) below, regulations, to be known as the Principles and Rules for Co-operation and Competition, will impose requirements on the National Health Service Commissioning Board and clinical commissioning groups for the purpose of securing that, in commissioning health care services for the purposes of the NHS, they—

(a) adhere to good practice in relation to procurement of healthcare services;

(b) protect and promote the right of patients to make appropriate choices with respect to treatment or other health care services provided for the purposes of the NHS;

(c) do not engage in anti-competitive behaviour which is demonstrated to be against the interests of patients generally who use such services.

(2) Regulations under subsection (1) shall—

(a) require the National Health Service Commissioning Board or clinical commissioning groups where appropriate to undertake procurement exercises only where the administrative cost of undertaking such an exercise is—

(i) likely to be justified by any improvements in a service anticipated as a result of such an exercise; and

(ii) is affordable having regard to the other calls upon the resources of the National Health Service Commissioning Board or clinical commissioning groups;

(b) require the National Health Service Commissioning Board or clinical commissioning groups to discharge their functions in such a way as to promote cooperation between providers in the discharge of services to patients and to balance the desirability of competition between providers with the duty to promote cooperation between providers where this has the potential to benefit patients;

(c) not entitle or require the National Health Service Commissioning Board or clinical commissioning groups to undertake procurement exercises in order to replace an existing provider which is delivering services pursuant to a contract or an NHS contract in a form approved by the Secretary of State unless that contract or NHS contract has been lawfully terminated by reason of a breach by the provider.”

BARONESS FINLAY OF LLANDAFF

277E*

Page 95, line 40, leave out paragraph (b)

LORD PATEL

LORD WARNER

278

Page 95, line 41, after “treatment” insert “including integrated healthcare”

LORD WHITTY

278A

Page 95, line 43, leave out “anti-competitive”

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD CLEMENT-JONES

LORD PATEL

278B

Page 95, line 44, at end insert—

“(d) ensure that health services are integrated where that is in the interests of people who use such services.”

LORD RIBEIRO

278BA

Page 95, line 44, at end insert—

“(d) ensure consistent healthcare provision through the quality assurance of education and training, a requirement to follow the NHS Outcomes Framework, utilisation and support of medical research and innovation and the adoption of professional guidelines in the event of complications following treatment.”

Clause 72

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD CLEMENT-JONES

LORD PATEL

278C

Page 96, line 19, at end insert “or (d)”

BARONESS THORNTON

LORD BEECHAM

 

The above-named Lords give notice of their intention to oppose the Question that Clause 72 stand part of the Bill.

Clause 73

BARONESS THORNTON

LORD BEECHAM

 

The above-named Lords give notice of their intention to oppose the Question that Clause 73 stand part of the Bill.

Schedule 9

EARL HOWE

278D

Page 368, line 12, leave out from “contains” to the end of line 14 and insert “information which it is satisfied is—

(a) commercial information the disclosure of which would, or might, significantly harm the legitimate business interests of the person to whom it relates;

(b) information relating to the private affairs of an individual the disclosure of which would, or might, significantly harm that person’s interests.”

Clause 74

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD CLEMENT-JONES

LORD PATEL

278E

Page 98, line 7, after “(1)(a)” insert “, (1)(b) or revised guidance under subsection (4)”

278F

Page 98, line 10, after “(b)” insert “or revised guidance under subsection (4)”

Clause 75

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

278G

Page 98, line 25, at end insert—

“( ) The cases referred to in subsections (2) and (3) shall be (in so far they would not otherwise be) “relevant merger situations” for the purposes of Part 3 of the Enterprise Act 2002.”

BARONESS THORNTON

LORD BEECHAM

 

The above-named Lords give notice of their intention to oppose the Question that Clause 75 stand part of the Bill.

After Clause 75

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

278H

Insert the following new Clause—

“Public interest consideration

In section 58 of the Enterprise Act 2002 (specified considerations), after subsection (2C) insert—

“(2D) The interest of the promotion in the United Kingdom of a comprehensive health service is specified in this section.

(2E) For the purposes of subsection (2D) a “comprehensive health service” means a health service—

(a) designed to secure the improvements set out in section 1(1) of the National Health Service Act 2006; and

(b) that is free of charge at the point of delivery except as specified in section 1(3) of that Act.””

Clause 76

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD CLEMENT-JONES

LORD PATEL

278J

Page 98, line 28, leave out “development” and insert “occurrence”

278K

Page 99, line 2, at end insert—

“( ) Healthwatch England.”

LORD WHITTY

BARONESS THORNTON

LORD BEECHAM

 

The above-named Lords give notice of their intention to oppose the Question that Clause 76 stand part of the Bill.

Clause 77

LORD WHITTY

 

Lord Whitty gives notice of his intention to oppose the Question that Clause 77 stand part of the Bill.

Clause 78

EARL HOWE

278L

Page 101, line 10, after “considers” insert “would or”

LORD WHITTY

 

Lord Whitty gives notice of his intention to oppose the Question that Clause 78 stand part of the Bill.

Clause 80

BARONESS THORNTON

LORD BEECHAM

279

Page 101, line 29, after “service” insert “, including a primary medical service,”

279A*

Page 101, line 29, after “service” insert “including a service under a PMS contract”

After Clause 80

BARONESS GREENGROSS

LORD LOW OF DALSTON

280

Insert the following new Clause—

“Provision of health care to be public function

(1) A person (‘P’) who provides a health care service for the purposes of the NHS under arrangements made with P under the relevant statutory provisions is to be taken to be exercising a function of a public nature for the purposes of subsection (3)(b) of section 6 of the Human Rights Act 1998 (acts of public authorities) in doing so.

(2) The “relevant statutory provisions” are—

(a) section 3A of the National Health Service Act 2006 as amended;

(b) section 3B of the National Health Service Act 2006 as amended;

(c) section 4 of the National Health Service Act 2006 as amended;

(d) section 5 of the National Health Service Act 2006 as amended.”

Clause 82

LORD PATEL

LORD WARNER

LORD HARRIS OF HARINGEY

281

Page 102, line 31, leave out “its Healthwatch England Committee” and insert—

“( ) Healthwatch England”

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

281A

Page 102, line 39, leave out “28” and insert “90”

BARONESS THORNTON

LORD BEECHAM

 

The above-named Lords give notice of their intention to oppose the Question that Clause 82 stand part of the Bill.

Clause 83

LORD PATEL

LORD WARNER

LORD HARRIS OF HARINGEY

282

Page 103, line 33, leave out “its Healthwatch England Committee” and insert—

“( ) Healthwatch England”

Clause 88

BARONESS THORNTON

LORD BEECHAM

282A*

Page 105, line 7, at end insert—

“(2) In the case of an NHS Foundation Trust or NHS Trust, Monitor must consult the Secretary of State.

(3) The Secretary of State may veto the revocation of a licence under this section if the Secretary of State deems it not to be in patients’ and taxpayers’ interests.”

Clause 93

BARONESS THORNTON

LORD BEECHAM

282B*

Page 106, line 27, leave out subsection (1) and insert—

“( ) Regulations must provide guidance as to the conditions to be included, and Monitor must have regard to the regulations and determine and publish the conditions to be included, in a licence under this Chapter (referred to in this Chapter as “the standard conditions”).”

283

Page 106, line 29, at end insert—

“( ) The standard conditions must set out—

(a) minimum standards for governance structures, including the management of conflicts of interests,

(b) minimum standards as regards meeting in public when decisions are taken and the disclosure of all relevant information,

(c) minimum standards as to employment conditions, workforce training and development,

(d) minimum standards around capitalisation debt ratios and other significant funding and financial factors,

(e) co-operate fully with the relevant local authority overview and scrutiny functions.”

283A*

Page 106, line 37, leave out subsections (4) to (6)

LORD WALTON OF DETCHANT

LORD PATEL

THE EARL OF LISTOWEL

284

Page 107, line 7, at end insert—

“( ) Requirement 3 is that the licensee must promote and engage in education and training of the health care workforce.”

EARL HOWE

284A

Page 107, line 13, leave out “National Health Service Commissioning Board” and insert “NHS Commissioning Board Authority”

284B

Page 107, line 14, leave out “clinical commissioning group” and insert “Primary Care Trust”

284C

Page 107, line 15, leave out “and its Healthwatch England committee”

LORD PATEL

LORD WARNER

LORD HARRIS OF HARINGEY

285

Page 107, line 15, leave out “its Healthwatch England committee” and insert—

“( ) Healthwatch England”

BARONESS FINLAY OF LLANDAFF

BARONESS HOLLINS

285ZA

Page 107, line 20, at end insert “which must—

“( ) state services to be provided by primary medical services,

( ) include a duty of collaboration across all health and social care providers,

( ) facilitate staff involvement in local and national work for the wider benefit of healthcare services and patients,

( ) promote education and training, at undergraduate and postgraduate level, relevant to the service provided”

EARL HOWE

285A

Page 107, line 22, at end insert—

“( ) If, at the time Monitor discharges the function under subsection (7), the day specified by the Secretary of State for the purposes of section 14A of the National Health Service Act 2006 has passed or section 6 or 178 has come into force—

(a) in the case of section 14A of the National Health Service Act 2006, the reference in subsection (8)(c) to every Primary Care Trust is to be read as a reference to every clinical commissioning group;

(b) in the case of section 6, the reference in subsection (8)(b) to the NHS Commissioning Board Authority is to be read as a reference to the National Health Service Commissioning Board;

(c) in the case of section 178, the reference in subsection (8)(d) to the Care Quality Commission is to be read as including a reference to its Healthwatch England committee.”

Clause 94

LORD PATEL

LORD WARNER

LORD HARRIS OF HARINGEY

286

Page 107, line 36, leave out “its Healthwatch England committee” and insert—

“( ) Healthwatch England”

Clause 95

BARONESS THORNTON

LORD BEECHAM

286ZA*

Page 108, line 15, leave out paragraphs (a) and (b)

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD CLEMENT-JONES

LORD PATEL

286A

Page 108, line 16, at end insert—

“( ) for the purpose of encouraging the integration of services where such integration is in the interest of people who use such services;”

EARL HOWE

286B

Page 108, line 21, at end insert “provided for the purposes of the NHS”

LORD PATEL

LORD WARNER

287

Page 108, line 22, after second “of” insert “integrated”

BARONESS THORNTON

LORD BEECHAM

287ZA*

Page 108, line 26, leave out paragraph (f)

287ZB*

Page 108, line 33, leave out subsection (3)

Clause 96

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD CLEMENT-JONES

LORD PATEL

287A

Page 108, line 42, at end insert—

“( ) requiring the licence holder to abide by the seven general principles of public life set out in the First Report of the Committee on Standards in Public Life (Cm 2850),

( ) requiring the declaration of any financial interest the licence holder may have in a commissioning decision by a clinical commissioning group,”

BARONESS FINLAY OF LLANDAFF

287AA

Page 108, line 42, at end insert—

“( ) requiring the licence holder to hold indemnity, for the services provided, which will remain valid for the lifetime of patients treated,

( ) requiring the licence holder to have registered competencies in the service being provided,”

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

287B

Page 109, line 9, at end insert “ orfor the purposes of encouraging the integration of services in the interest of people who use such services”

BARONESS THORNTON

LORD BEECHAM

287BA*

Page 109, line 19, leave out paragraphs (g) and (h)

EARL HOWE

287C

Page 109, line 38, after “NHS” insert “in order to ensure the continued provision of one or more of the health care services that the licence holder provides for those purposes”

287D

Page 109, line 40, at end insert “in order to ensure the continued provision of one or more of the health care services that the licence holder provides for those purposes”

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

287E

Page 109, line 42, leave out subsection (3)

Clause 97

BARONESS THORNTON

LORD BEECHAM

287F*

Page 110, line 17, at end insert—

“( ) co-operating with the scrutiny functions of any relevant local authority as set out in section 244 of the National Health Service Act 2006, as amended by this Act”

Clause 98

LORD PATEL

LORD WARNER

LORD HARRIS OF HARINGEY

288

Page 111, line 4, leave out “its Healthwatch England Committee” and insert—

“( ) Healthwatch England”

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

288ZA

Page 111, line 12, leave out “28” and insert “90”

BARONESS THORNTON

LORD BEECHAM

288ZB*

Page 111, line 14, leave out subsections (6) to (11) and insert—

“( ) Monitor must consider any representations and must publish its response.

( ) No modification can be effective without the consent of the Secretary of State.”

Clause 99

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

 

The above-named Lords give notice of their intention to oppose the Question that Clause 99 stand part of the Bill.

Schedule 10

EARL HOWE

288A

Page 372, line 26, after “are” insert “not”

288B

Page 373, line 26, after “considers” insert “would or”

288C

Page 373, line 29, after “considers” insert “would or”

Clause 100

BARONESS THORNTON

LORD BEECHAM

 

The above-named Lords give notice of their intention to oppose the Question that Clause 100 stand part of the Bill.

Clause 101

EARL HOWE

288D

Page 115, line 10, at end insert “or the conditions of a particular licence”

Clause 104

BARONESS THORNTON

LORD BEECHAM

288DA*

Page 117, line 17, at end insert—

“( ) Regulations may specify that any enforcement action against a particular category of provider which may otherwise result in a fine of any form, can only take place with the consent of the Secretary of State.”

Schedule 11

EARL HOWE

288E

Page 378, line 35, leave out from “contains” to the end of line 37 and insert “information which it is satisfied is—

(a) commercial information the disclosure of which would, or might, significantly harm the legitimate business interests of the person to whom it relates;

(b) information relating to the private affairs of an individual the disclosure of which would, or might, significantly harm that person’s interests.”

Clause 106

BARONESS THORNTON

LORD BEECHAM

288EA*

Page 117, line 39, at end insert—

“( ) any regulations made under section 104 of this Act”

Clause 107

EARL HOWE

288F

Page 118, line 5, leave out from “include” to the end of line 7 and insert “information which it is satisfied is—

(a) commercial information the disclosure of which would, or might, significantly harm the legitimate business interests of the person to whom it relates;

(b) information relating to the private affairs of an individual the disclosure of which would, or might, significantly harm that person’s interests.”

Clause 109

BARONESS JOLLY

LORD CLEMENT-JONES

BARONESS BARKER

BARONESS TYLER OF ENFIELD

288G

Page 118, line 31, leave out subsection (2)

BARONESS THORNTON

LORD BEECHAM

288GA*

Page 119, line 20, leave out subsection (10)

Clause 110

BARONESS THORNTON

LORD BEECHAM

 

The above-named Lords give notice of their intention to oppose the Question that Clause 110 stand part of the Bill.

Clause 111

BARONESS THORNTON

LORD BEECHAM

 

The above-named Lords give notice of their intention to oppose the Question that Clause 111 stand part of the Bill.

Clause 112

BARONESS THORNTON

LORD BEECHAM

 

The above-named Lords give notice of their intention to oppose the Question that Clause 112 stand part of the Bill.

Clause 113

LORD NEWTON OF BRAINTREE

LORD BUTLER OF BROCKWELL

LORD TURNBERG

288H

Page 122, line 8, at end insert—

“( ) If a health care service is awaiting inclusion in the national tariff, the provider of the health care service can apply to the National Commissioning Board for the service to be included within the innovation tariff in accordance with section 114(1)(e).”

Clause 114

BARONESS THORNTON

LORD BEECHAM

289

Page 122, line 14, leave out “Monitor” and insert “The Secretary of State”

LORD WARNER

LORD PATEL

BARONESS MURPHY

BARONESS PITKEATHLEY

290

Page 122, line 19, at end insert—

“( ) the scope for paying providers incentives to integrate service delivery to individuals both within the NHS and with social care, especially to reduce unnecessary use of hospital inpatient services and by paying for periods of care rather than individual episodes,”

LORD PATEL

LORD KAKKAR

291

Page 122, line 19, at end insert—

“( ) that the national tariff reflects patient care pathways,”

LORD NEWTON OF BRAINTREE

LORD BUTLER OF BROCKWELL

LORD TURNBERG

291A

Page 122, line 22, at end insert—

“(e) the method of deciding whether a health care service can be included within the innovation tariff.”

LORD PATEL

292

Page 122, line 25, after “vary” insert “provided that this does not affect patient outcomes”

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

292ZA

Page 122, line 27, at end insert—

“( ) The national tariff must also—

( ) specify variations to the national price for a service by reference to the circumstances relating to individuals who experience disadvantage or who have complex needs,

( ) specify variations to the national price for a service by reference to circumstances in which the service is provided or other factors relevant to the provision of the service,

( ) provide for rules for determining the price payable for the provision for the purposes of the NHS of health care services and health-related services which are not specified under subsection (1)(a).”

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

LORD CLEMENT-JONES

292ZB

Page 122, line 33, at end insert—

“( ) In exercising its functions under this Chapter, Monitor and the National Commissioning Board must have regard to the latter’s Board’s duties under section 13M of the National Health Service Act 2006 and clinical commissioning groups’ duties under section 14Y of that Act.”

BARONESS GOULD OF POTTERNEWTON

292A

Page 123, line 24, leave out subsection (11)

Clause 115

LORD PATEL

LORD WARNER

293

Page 123, line 41, at end insert—

“(d) specifying it by reference to clinical and social care pathways.”

294

Page 124, line 4, at end insert—

“( ) if it is specified in accordance with subsection (1)(d), specify a national price for the health and social care in its entirety.”

EARL HOWE

294A

Page 124, line 14, leave out subsection (4)

Clause 116

LORD WARNER

LORD DARZI OF DENHAM

LORD PATEL

294AA

Page 124, line 38, after “holder,” insert—

“( ) relevant clinical groups,”

EARL HOWE

294B

Page 125, line 26, leave out “guidance” and insert “such guidance as Monitor proposes to provide for in the national tariff”

Clause 117

BARONESS FINLAY OF LLANDAFF

294BZA*

Page 126, line 38, leave out “116” and insert “114”

Clause 118

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

294BA

Page 127, line 15, leave out “Competition Commission” and insert “Secretary of State”

LORD WARNER

LORD DARZI OF DENHAM

LORD PATEL

294BAA

Page 127, line 28, after “holders” insert “undertaking work of comparable complexity”

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

294BB

Page 127, line 31, leave out “Competition Commission” and insert “Secretary of State”

294BC

Page 127, line 34, leave out subsection (5)

Schedule 12

EARL HOWE

294C

Page 380, line 5, leave out from “each” to end of line 6 and insert “objector”

294D

Page 380, line 7, at end insert—

“( ) In this Schedule, “objector” means—

(a) in relation to a reference made where the condition in section 118(2)(a) is not met, each clinical commissioning group who objected to the proposed method to which the reference relates, and

(b) in relation to a reference made where the condition in section 118(2)(b) or (c) is not met, each licence holder who objected to that proposed method.”

294E

Page 382, line 8, at end insert—

“( ) The Competition Commission must give notice to each objector who has made representations in accordance with paragraph 2 of the time and place at which an oral hearing is to be held.”

294F

Page 382, line 22, leave out “entitled to give evidence at the hearing” and insert “present at the hearing and comes within sub-paragraph (5)”

294G

Page 382, line 24, leave out second “is not” and insert “cannot be”

294H

Page 382, line 26, leave out from “not” to “, and” in line 27 and insert “obliged to require the person to attend the hearing”

Clause 119

EARL HOWE

294J

Page 128, line 4, after “by” insert “clinical commissioning groups or”

294K

Page 128, line 38, after “such” insert “clinical commissioning groups or”

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

 

The above-named Lords give notice of their intention to oppose the Question that Clause 119 stand part of the Bill.

Clause 120

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

 

The above-named Lords give notice of their intention to oppose the Question that Clause 120 stand part of the Bill.

Clause 121

EARL HOWE

294L

Page 129, line 28, after “are” insert “not”

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

 

The above-named Lords give notice of their intention to oppose the Question that Clause 121 stand part of the Bill.

Clause 122

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

294M

Page 130, line 23, at end insert “and ensure that all providers licensed under Chapter 3 and operating in relevant clinical commissioning groups are paid the same price for the provision of the service”

Clause 125

BARONESS FINLAY OF LLANDAFF

294N*

Page 132, line 7, at end insert—

“(1A) A relevant provider does not include one for whom the majority of its staff are entitled to NHS terms and conditions under The Transfer of Undertakings (Protection of Employment) Regulations, or the Cabinet Office Statement of Practice on Transfers.”

BARONESS THORNTON

LORD BEECHAM

295

Page 132, line 21, at end insert—

“( ) protect the interests of patients,”

Clause 127

EARL HOWE

295A

Page 134, line 46, at end insert “or (b)”

Clause 131

EARL HOWE

295B

Page 136, line 40, after “provider” insert “of health care services for the purposes of the NHS (referred to in this Chapter as “a provider”)”

Clause 135

EARL HOWE

295C

Page 139, line 44, at end insert “(but for this not to affect any other method of recovery)”

BARONESS FINLAY OF LLANDAFF

295CA*

Page 140, line 8, at end insert—

“(c) each clinical commissioning group, and (d) such other persons as it considers appropriate.”

Clause 136

BARONESS FINLAY OF LLANDAFF

295CB*

Page 140, line 34, at end insert—

“(6) In determining the rate of any levy on a provider or providers, Monitor must have regard to the impact this may have on the provider or providers’ financial stability, particularly where a provider has been identified as in distress.”

Clause 138

EARL HOWE

295D

Page 141, line 6, leave out second “that” and insert “the current financial year”

295E

Page 141, line 25, leave out “the rate of levy” and insert “those factors”

Clause 140

EARL HOWE

295F

Page 143, line 38, at end insert “(but this does not affect any other method of recovery)”

Clause 144

BARONESS THORNTON

LORD BEECHAM

 

The above-named Lords give notice of their intention to oppose the Question that Clause 144 stand part of the Bill.

Clause 148

LORD MARKS OF HENLEY-ON-THAMES

BARONESS WILLIAMS OF CROSBY

296

Page 148, line 11, leave out subsection (2) and insert—

“(2) For paragraph 9(3) of that Schedule (requirement for at least one member of council governors to be appointed by PCT) substitute—

“(3) At least one member of the council of governors must be appointed by the NHS Commissioning Board.””

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

296A

Page 148, line 34, at end insert—

“( ) After paragraph 10C of that Schedule insert—

“10D The governors shall be notified of and have the right to attend all meetings of the Board and its sub-committees and have access to all relevant documents and papers.

10E For this purpose, governors will be required to acknowledge their duty to protect confidentiality.””

Clause 149

LORD MARKS OF HENLEY-ON-THAMES

BARONESS WILLIAMS OF CROSBY

297

Page 149, line 20, after “whole” insert “for the purposes of the National Health Service”

Clause 151

LORD WARNER

LORD PATEL

BARONESS MURPHY

298

Page 151, line 6, at end insert “having full regard to the recommendations of the independent body established by section 13D of this Act”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

298A

Page 151, line 6, at end insert—

“(1B) The accounts so produced must identify separately the income and expenditure which relates to any private income business, and the audit of such accounts must include assurance that all costs which relate to private income business have been properly calculated or recorded (or both).”

Clause 156

LORD PATEL

LORD BEECHAM

299

Page 154, line 19, after “the” insert “national”

Clause 161

BARONESS JOLLY

LORD CLEMENT-JONES

BARONESS BARKER

BARONESS TYLER OF ENFIELD

299A

Page 159, line 16, at end insert—

“( ) before “purpose” insert “exclusive”,

( ) at the end insert “as detailed in an annual plan presented to and approved by its council of governors””

Clause 162

LORD PHILLIPS OF SUDBURY

BARONESS FINLAY OF LLANDAFF

LORD KAKKAR

LORD DARZI OF DENHAM

299B

Page 159, line 33, at end insert—

“( ) An NHS Foundation Trust may provide private health treatment and care but not so that its provision is to any significant extent detrimental to that provided for the purposes of the health service save that that shall not restrict accommodation and services not available within the health service nor restrict treatment or care where that is not a clinical priority.”

BARONESS FINLAY OF LLANDAFF

299C

Page 159, line 35, at end insert—

“( ) NHS services must not use NHS business to recruit private patient business.

( ) NHS services must ensure that the availability of NICE approved treatments is not decreased by private service provision.”

Clause 165

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD PATEL

BARONESS FINLAY OF LLANDAFF

300

Page 160, line 32, after first “of” insert—

“(a)”

301

Page 160, line 33, at end insert “; and

(b) the Secretary of State”

Clause 167

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

LORD PATEL

BARONESS FINLAY OF LLANDAFF

302

Page 161, line 36, after first “of” insert—

“(a)”

303

Page 161, line 37, at end insert “; and

(b) the Secretary of State”

Clause 170

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

 

The above-named Lords give notice of their intention to oppose the Question that Clause 170 stand part of the Bill.

Clause 171

LORD WARNER

LORD PATEL

BARONESS MURPHY

304

Page 164, line 28, at end insert—

“(4) Where the regulator considers that the conditions for making such an order are likely to exist within a year, the regulator shall, after consultation with the National Commissioning Board, appoint an independent panel of no more than six people with expertise in health and social care, to make proposals to the regulator and Board, within an agreed timetable, for the reconfiguration of services in the health economy within which the trust operates that would provide sustainable services for patients in the area affected.

(5) Recommendations from the Panel shall be subject to public consultation within a timescale specified by Monitor.

(6) Monitor shall, after consulting the National Commissioning Board, determine the service reconfiguration required to achieve clinical and financial sustainability of services unless the Secretary of State notified Parliament of his or her reasons for replacing those arrangements with alternative ways of achieving sustainable health services in the area.

(7) Where matters become so serious that the regulator is required to act under section 3(1) and (2), the Regulator shall incorporate the work of any such panel in any order or report made under section 5(5) and (6) as conditions to which the trust special administrator must have full regard in discharging his or her responsibilities.”

Clause 172

BARONESS FINLAY OF LLANDAFF

304A*

Page 166, line 13, at end insert—

“( ) the current and future requirements for the provision of medical education and training”

304B*

Page 166, line 22, after “Board” insert “, in conjunction with commissioners,”

Clause 176

BARONESS FINLAY OF LLANDAFF

304C*

Page 174, line 5, at end insert—

“(2A) This section and section 165 will come into force by order of the Secretary of State after consultation with Monitor, the NHS Commissioning, and the Care Quality Commission no earlier than on 1 April 2020.”

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

 

The above-named Lords give notice of their intention to oppose the Question that Clause 176 stand part of the Bill.

Clause 177

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

 

The above-named Lords give notice of their intention to oppose the Question that Clause 177 stand part of the Bill.

Clause 178

LORD HARRIS OF HARINGEY

BARONESS WHEELER

305

Page 175, leave out from line 16 to end of line 8 on page 178 and insert—

“(1) There shall be a body corporate known as Healthwatch England.

(2) Healthwatch England shall have the following functions—

(a) to establish a Local Healthwatch organisation for each local authority area,

(b) to provide each Local Healthwatch organisation with such resources as may be agreed by Healthwatch England,

(c) to provide Local Healthwatch organisations with advice on and assistance in relation to their functions and on such other matters that Healthwatch England may determine,

(d) to provide relevant persons with information and advice on—

(i) the views of people who use health and social care services and of other members of the public on their needs for and experiences of health and social care services, and

(ii) the views of Local Healthwatch organisations and of other persons on the standard of provision of health and social care services and on whether or how the standard could or should be improved.

(3) Relevant persons referred to in subsection (2)(d) are—

(a) the Secretary of State;

(b) the National Health Service Commissioning Board;

(c) the Care Quality Commission;

(d) Monitor; and

(e) English local authorities.

(4) A person provided with advice under subsection (2)(d) must inform Healthwatch England in writing of its response or proposed response to the advice.

(5) Healthwatch England must publish details of arrangements it makes under this section, including details of payments of remuneration or other amounts.

(6) In performing functions under this section, Healthwatch England must have regard to such aspects of government policy as the Secretary of State may direct.

(7) As soon as possible after the end of each financial year, Healthwatch England must publish a report on the way in which it has exercised its functions during the year.

(8) Healthwatch England must—

(a) lay before Parliament a copy of each report made under subsection (7), and

(b) send a copy of each such report to the Secretary of State.

(9) Healthwatch England may publish other reports at such times, and on such matters relating to health or social care, as it deems appropriate.

(10) Before publishing a report under subsection (7) or (9), Healthwatch England must, so far as practicable, exclude any matter which relates to the private affairs of an individual, the publication of which, in its opinion, would or might seriously and prejudicially affect that individual’s interests.

(11) In this section, “financial year” means—

(a) the period beginning with the date on which Healthwatch England is appointed and ending with the following 31 March, and

(b) each successive period of 12 months ending with 31 March.

(12) The first Chair and members of Healthwatch England shall be appointed by the Secretary of State for a period that shall expire no more than twelve months after Local Healthwatch organisations have been established.

(13) Prior to appointing the first Chair and members of Healthwatch England, the Secretary of State shall consult, and must have regard to the views of, such organisations that seem to him or her to represent the interests of users of health and social care provision.

(14) The first Chair and members of Healthwatch England shall make arrangements for their successors to be elected by local Healthwatch organisations on such a basis as shall be determined by Healthwatch England.”

LORD PATEL

LORD WARNER

306

Page 175, line 17, leave out subsections (2) and (3) and insert—

“(2) Healthwatch England is to be appointed in accordance with regulations made by the Secretary of State.”

LORD ROOKER

LORD HARRIS OF HARINGEY

307

Page 175, line 20, leave out “appointed” and insert “elected from local Healthwatch organisations”

BARONESS CUMBERLEGE

307A

Page 175, line 21, at end insert—

“( ) The majority of the members of the Healthwatch England committee shall not be members of the Commission.”

LORD ROOKER

LORD HARRIS OF HARINGEY

308

Page 175, line 24, after “assistance” insert “and make recommendations”

BARONESS CUMBERLEGE

308A

Page 175, line 25, at end insert—

“( ) The provision that must be made by virtue of sub-paragraph (1A) includes provision as to—

(a) the majority membership of Healthwatch England committee being elected from representatives of Local Healthwatch organisations, and

(b) the manner in which those representatives are elected, the term which they must serve and the role that they must fulfil.”

308B

Page 175, line 29, at end insert—

“( ) In sub-paragraph (2) after “advisory committee” insert “or the Healthwatch England committee, as the case may be,”.”

LORD ROOKER

LORD HARRIS OF HARINGEY

309

Page 176, line 9, after “information” insert “, recommendations”

BARONESS MASSEY OF DARWEN

BARONESS FINLAY OF LLANDAFF

LORD WARNER

BARONESS TYLER OF ENFIELD

310

Page 176, line 10, after “people” insert “, including children,”

311

Page 176, line 11, after “public” insert “, including children,”

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

311ZA

Page 176, line 12, after “services” insert “including services directly commissioned by the NHS Commissioning Board at a regional or national level”

LORD WHITTY

311A

Page 176, line 20, at end insert—

“( ) Care Quality Commission;”

LORD ROOKER

LORD HARRIS OF HARINGEY

312

Page 176, line 22, after “advice” insert “or recommendations”

LORD WHITTY

312A

Page 176, line 23, leave out “committee”

LORD ROOKER

LORD HARRIS OF HARINGEY

313

Page 176, line 24, at end insert “or recommendations and any action it intends to take”

LORD WHITTY

313A

Page 176, line 25, leave out subsection (6)

LORD ROOKER

LORD HARRIS OF HARINGEY

314

Page 176, line 25, leave out “may” and insert “must”

315

Page 176, line 26, after “advice” insert “or recommendations”

316

Page 176, line 28, at end insert “and recommendations and any actions it intends to take”

LORD WHITTY

316A

Page 176, line 29, leave out “The Commission” and insert “Healthwatch England”

316B

Page 176, line 34, leave out “committee”

316C

Page 176, line 37, leave out second “the”

316D

Page 176, line 38, leave out “committee”

316E

Page 176, line 39, leave out “Commission” and insert “Secretary of State”

316F

Page 176, line 44, leave out “The committee” and insert “Healthwatch England”

LORD ROOKER

LORD HARRIS OF HARINGEY

317

Page 176, line 47, at end insert—

“( ) send a copy of each such report to all local Healthwatch organisations”

LORD WHITTY

317A

Page 177, line 1, leave out “The committee” and insert “Healthwatch England”

317B

Page 177, line 5, leave out “The committee’s” and insert “Healthwatch England’s”

LORD ROOKER

LORD HARRIS OF HARINGEY

318

Page 177, line 20, at end insert—

“( ) The Secretary of State shall consult local Healthwatch organisations before issuing such directions.”

LORD WHITTY

318A

Page 177, line 21, leave out from beginning to end of line 8 on page 178

318B

Leave out Clause 178 and insert the following new Clause—

“Healthwatch England

(1) There is to be established a body corporate called Healthwatch England.

(2) The primary duty of Healthwatch England shall be to represent the interests of patients and users of national health services and social care services (hereafter known as “patients and users”) in relation to providers and to regulators and the Secretary of State.

(3) Healthcare England shall be independent of any provider of national health or social care services or of any Regulator of health or social care or of any other body established by this Act or otherwise.

(4) The Board of Healthwatch England shall consist of a chair appointed by the Secretary of State and no more than sixteen members to be appointed by the Secretary of State of whom eight shall be chosen from nominations obtained from Local Healthwatch organisations as constituted under section 179 and terms and conditions of appointment of the chair and members of the Board of Healthwatch England shall be determined by the Secretary of State.

(5) The Chief Executive of Healthcare England shall be appointed in the first instance by the Secretary of State and thereafter by the Board of Healthwatch England and shall be an employee of the Board of Healthwatch England and of no other National Health Service provider or any body established under this Act and terms and conditions of the chief executive officer shall be determined by the Secretary of State.

(6) The Board of Healthwatch England shall appoint such other staff on terms and conditions as it considers appropriate and such staff shall be employees of the Board of Healthwatch England and no of other health service provider or of any body established under this Act.”

Clause 179

LORD WHITTY

318BA

Page 178, line 22, at end insert—

“( ) In section 221 (health services and social services: local involvement networks) for subsection (1) substitute—

“(1) The Local Healthwatch organisation established under section 220A shall carry out the activities mentioned in subsection (2) in such manner as it deems fit, subject to any directions from Healthwatch England.””

318BB

Page 178, line 36, leave out subsection (9)

318BC

Page 179, line 8, leave out subsection (12)

After Clause 179

LORD WHITTY

318C

Insert the following new Clause—

“Powers of Healthwatch England

(1) Healthwatch England shall have powers of investigation as prescribed in subsections (2) and (3) and powers to require disclosure of information as prescribed in subsection (4).

(2) Healthwatch England may investigate—

(a) a complaint made by or on behalf of a patient or user or a local Healthwatch organisation which appears to the Board to raise one or more issues of general relevance; and

(b) any matter which appears to the Board of Healthwatch UK to be or be related to a problem which affects or may affect patients or users generally or patients or users of a particular description.

(3) For the purpose of subsection (3) a complaint raises an issue of general relevance if it raises—

(a) a novel issue which affects or may affect patients or users in general or patients or users of a particular description, or

(b) any other issue which has or may have an important effect on patients or users generally or patients or users of a particular description.

(4) Healthwatch England may by notice require a person within subsection (5) to supply it with such information as is specified or described in the notice within a reasonable period as is so specified and the information so specified or described must be information that Healthwatch England requires for the purpose of exercising its function.

(5) The persons referred to in subsection (4) are—

(a) any provider of health or social care services licensed by the Care Quality Commission and Monitor under the provisions of this Act;

(b) the National Health Service Commissioning Board;

(c) Monitor;

(d) Care Quality Commission;

(e) any other person specified or of a description specified by the Secretary of State.

(6) If a person within subsection (5) fails to comply with a notice under subsection (4) the person must if so required give notice to Healthwatch England of the reason for the failure and if that reason for failure is not acceptable to the Board of Healthwatch England then the Board of Healthwatch England may take steps to publish the notice and the reasons for failure provided or to seek enforcement of the said notice through the courts.”

318D

Insert the following new Clause—

“Functions of Healthwatch England

(1) The Board of Healthwatch England shall take steps to ensure the organisation can perform the following functions—

(a) an information function to acquire information on matters of concern to patients and users,

(b) a research function to analyse such information and produce reports, and

(c) a representation function to where appropriate make representations to persons prescribed in subsection (2).

(2) Persons prescribed for the purposes of subsection (1)(c) are—

(a) any person supplying services to the National Health Service or social care services,

(b) Monitor,

(c) Care Quality Commission,

(d) any other person specified or of a description specified by the Secretary of State,

(e) the Secretary of State.”

Schedule 15

LORD ROOKER

LORD HARRIS OF HARINGEY

319

Page 399, line 26, after “appointment” insert “and election”

Clause 180

BARONESS MASSEY OF DARWEN

BARONESS FINLAY OF LLANDAFF

LORD WARNER

BARONESS TYLER OF ENFIELD

320

Page 179, line 14, at end insert—

“(1A) In subsection (2)(a), (b) and (c) after “people” insert “, including children,”

BARONESS CUMBERLEGE

320ZA

Page 179, line 14, at end insert—

“( ) For subsection (1) substitute—

“(1) Unless a Local Healthwatch organisation decides to make its own arrangements, A must make arrangements for securing that the Local Healthwatch organisation for its area has the services, staff and accommodation, including such administration, maintenance, cleaning and other services as may be necessary for such accommodation, as may be necessary to enable it to perform its functions effectively.

(1A) A shall, in respect of each financial year, pay to the Local Healthwatch organisation for its area sums equal to the amounts which it has approved as the amounts of expenditure which it considers may reasonably be incurred by the Local Healthwatch organisation in that year for the purpose of performing its functions.”

( ) In subsection (2) for “activities” substitute “functions of a Local Healthwatch organisation”.”

LORD WHITTY

320A

Page 179, line 16, leave out “the”

320B

Page 179, line 17, leave out “committee of the Care Quality Commission”

320C

Page 179, line 23, leave out “the”

320D

Page 179, line 24, leave out “committee of the Care Quality Commission”

320E

Page 179, line 25, leave out “that committee” and insert “Healthwatch England”

320F

Page 179, line 29, leave out “that committee” and insert “Healthwatch England”

LORD ROOKER

LORD HARRIS OF HARINGEY

321

Page 179, line 39, at end insert—

“( ) The Secretary of State shall by regulations make provision requiring Healthwatch England to make arrangements under this section for members of local Healthwatch to have indemnity cover against the risk of a claim arising out of the carrying out of their duties in local Healthwatch organisations.”

Clause 181

LORD WHITTY

321A

Page 179, line 41, leave out subsection (1) and insert—

“(1) Omit section 222 of the Local Government and Public Involvement in Health Act 2007.”

321B

Page 180, line 1, leave out subsections (2) to (11)

BARONESS CUMBERLEGE

321C

Page 180, line 4, leave out “activities” and insert “its functions”

LORD ROOKER

LORD HARRIS OF HARINGEY

322

Page 180, line 16, at end insert—

“( ) Local Healthwatch is not to be regarded as a servant or agent of A”

BARONESS CUMBERLEGE

322A

Page 180, line 23, leave out paragraphs (a) and (b) and insert—

“(a) after “which” insert “include—

(a) prescribed provision relating to the way in which certain decisions of a local authority in relation to the arrangements are to be taken; and

(b) provision that arrangements made under section 221(1) (local authority arrangements) must—

(i) include prescribed provision, or

(ii) require prescribed provision to be included in local Healthwatch organisation arrangements.”;

(b) for “local involvement network arrangements” substitute “Local Healthwatch organisation arrangements”.”

Clause 182

LORD ROOKER

LORD HARRIS OF HARINGEY

323

Page 181, line 4, after “appropriate” insert “in relation to the needs of people”

LORD RIX

LORD WIGLEY

324

Page 181, line 5, at end insert “ensuring that there is no upper limit on the length and type of advocacy support that may be provided”

LORD ROOKER

LORD HARRIS OF HARINGEY

325

Page 181, line 12, at end insert—

“( ) a complaint under section 114(1) and (2) of the Health and Social Care Act (Community Care and Standards) 2003”

326

Page 181, line 26, leave out subsection (4)

Clause 183

LORD ROOKER

LORD HARRIS OF HARINGEY

327

Page 183, line 7, at end insert—

“(4A) In section 224(2)(c) of the Local Government and Public Involvement Act for “Primary Care Trusts” substitute “Clinical Commissioning groups”.”

Clause 184

LORD WHITTY

327ZA

Page 183, line 31, leave out “and a local authority”

After Clause 186

BARONESS BAKEWELL

327ZB

Insert the following new Clause—

“Commissioner for older people

Commissioner for older people

(1) The Secretary of State shall, by order, establish an Office of Commissioner for Older People in England.

(2) The general functions of the Commissioner shall be to consult with and garner the opinions of older people, and to represent those opinions in all arenas of public discourse including Parliament.

(3) Particular functions of the Commissioner shall be to—

(a) monitor, on behalf of older people, all law, policy and practice relating to their health and social care;

(b) commission and publish research into the provision of health and social care services to older people;

(c) commission and publish research into health and social care outcomes for older people in comparison with other sectors of society;

(d) act on behalf of older people in promoting best practice by providers of health and social care services.

(4) The Commissioner must encourage the involvement of older people in the work of the Commissioner.

(5) The Commissioner must, in particular, take reasonable steps to—

(a) ensure that older people are made aware of the functions of the Commissioner and how the Commissioner may be contacted;

(b) consult older people on the work to be undertaken by the Commissioner; and

(c) consult organisations working with and for older people on the work to be undertaken by the Commissioner.”

Clause 189

BARONESS FINLAY OF LLANDAFF

327A

Page 190, line 19, at end insert—

“( ) involve allied health professionals who work in that area;”

LORD RAMSBOTHAM

BARONESS WILKINS

BARONESS HOWE OF IDLICOTE

327B

Page 190, line 20, at end insert—

“( ) consult and work with education or children’s services;”

327C

Page 190, line 24, leave out from “group” to end of line 25 and insert “must consult with persons with experience of delivering relevant health services giving particular regard to health professionals who work with children or vulnerable adults”

Clause 190

BARONESS FINLAY OF LLANDAFF

LORD BROOKE OF ALVERTHORPE

LORD WIGLEY

BARONESS HOLLINS

328

Page 190, line 44, at end insert—

“( ) The assessment must include an examination of the levels of hazardous, harmful and dependent alcohol use in the local population.”

BARONESS FINLAY OF LLANDAFF

328A

Page 191, line 20, after “authority,” insert—

“( ) involve allied health professionals who work in that area,”

BARONESS TYLER OF ENFIELD

BARONESS JOLLY

BARONESS BARKER

LORD CLEMENT-JONES

328B

Page 191, line 20, after “authority,” insert—

“(aa) have regard to the assessment of housing needs undertaken by the local planning authority,”

BARONESS FINLAY OF LLANDAFF

LORD BROOKE OF ALVERTHORPE

LORD WIGLEY

BARONESS HOLLINS

329

Page 191, line 21, at end insert—

“( ) involve representatives from alcohol services”

LORD RAMSBOTHAM

BARONESS WILKINS

BARONESS HOWE OF IDLICOTE

329A

Page 191, line 21, at end insert—

“( ) consult and work with education or children’s services”

BARONESS MASSEY OF DARWEN

BARONESS FINLAY OF LLANDAFF

THE EARL OF LISTOWEL

330

Page 191, line 25, leave out “may” and insert “must”

BARONESS FINLAY OF LLANDAFF

330ZA

Page 191, line 29, at end insert “, including how such integration could be supported by the involvement of allied health professionals”

BARONESS TYLER OF ENFIELD

BARONESS JOLLY

BARONESS BARKER

LORD CLEMENT-JONES

330ZAA

Page 191, line 44, after “functions,” insert—

“( ) an assessment of the needs of areas of disadvantage and of inequalities which exist,”

Clause 191

BARONESS WILKINS

BARONESS FINLAY OF LLANDAFF

LORD LOW OF DALSTON

330A

Page 192, line 20, at end insert—

“( ) a representative of education providers for persons resident in the area of the local authority, including maintained schools, city technology colleges, city college for technology or the arts, and Academy schools”

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

330B

Page 192, line 21, at end insert—

“( ) a representative of community pharmacy”

LORD RAMSBOTHAM

330C

Page 192, line 21, at end insert—

“( ) a representative of the probation service,

( ) a representative of the police,”

BARONESS FINLAY OF LLANDAFF

330D

Page 192, line 21, at end insert—

“( ) a representative of an allied health professional organisation,”

330E

[Withdrawn]

LORD CLEMENT-JONES

BARONESS JOLLY

BARONESS BARKER

BARONESS TYLER OF ENFIELD

330F*

Page 192, line 21, at end insert—

“( ) at least one representative of a community organisation which delivers opportunities for physical activity”

BARONESS FINLAY OF LLANDAFF

LORD BROOKE OF ALVERTHORPE

LORD WIGLEY

BARONESS HOLLINS

331

Page 192, line 23, at end insert—

“( ) a representative from alcohol and drugs service”

LORD BEECHAM

BARONESS THORNTON

331A

Page 192, line 23, at end insert—

“( ) in the case of two-tier local government areas, a representative of district councils”

BARONESS JOLLY

BARONESS TYLER OF ENFIELD

BARONESS BARKER

LORD CLEMENT-JONES

331AA

Page 192, line 23, at end insert—

“(h) a representative of designated health professionals for safeguarding”

Clause 192

BARONESS JOLLY

BARONESS TYLER OF ENFIELD

BARONESS BARKER

LORD CLEMENT-JONES

331AB

Page 193, line 30, leave out “encourage” and insert “mandate”

BARONESS FINLAY OF LLANDAFF

331B

Page 193, line 31, after “services” insert “, including allied health professionals,”

LORD RAMSBOTHAM

BARONESS WILKINS

BARONESS HOWE OF IDLICOTE

331C

Page 193, line 31, after “services” insert “and education or children’s services”

LORD WARNER

LORD PATEL

BARONESS MURPHY

BARONESS PITKEATHLEY

332

Page 193, line 31, leave out “an integrated manner” and insert “a manner that integrates the delivery of services to individuals”

BARONESS MASSEY OF DARWEN

BARONESS FINLAY OF LLANDAFF

333

Page 193, line 37, leave out “may” and insert “must”

BARONESS FINLAY OF LLANDAFF

333A

Page 193, line 38, after “services” insert “, including allied health professionals,”

LORD RAMSBOTHAM

BARONESS WILKINS

BARONESS HOWE OF IDLICOTE

333B

Page 193, line 38, after “services” insert “or education or children’s services”

BARONESS MASSEY OF DARWEN

BARONESS FINLAY OF LLANDAFF

334

Page 193, line 40, leave out “may” and insert “must”

BARONESS FINLAY OF LLANDAFF

334A

Page 193, line 41, after “services” insert “, including allied health professionals,”

LORD WARNER

LORD PATEL

BARONESS MURPHY

335

Page 194, line 7, at end insert—

““integration” means the integration of the assessment and delivery of health and social care services to individuals that benefits their treatment and care;”

Clause 193

LORD WARNER

BARONESS MURPHY

BARONESS THORNTON

LORD PATEL

336

Page 194, line 17, at end insert—

“( ) A local authority may agree with the National Commissioning Board that a Health and Wellbeing Board that the authority has established may assume responsibility for some or all of the functions (and associated funding) of a clinical commissioning group where such a group agrees that this is in the best interests of patients, particularly where it improves the integration of service delivery for individuals.”

LORD BEECHAM

BARONESS WHEELER

336A

Page 194, line 22, at end insert—

“(5) A Health and Wellbeing Board shall be entitled to make a referral for investigation relating to any services which have been provided as part of the health service under this Act related to any who is or has been person in the area for which a Health and Wellbeing Board functions or which services, in the opinion of the Health and Wellbeing Board ought to be provided as part of the health service under this Act.

(6) A referral for investigation shall be made by a Health and Wellbeing Board to the body that they understand is the commissioner of the relevant services or would commission the services if provided as part of the health service under this Act.

(7) Where a commissioner of health services receives a referral under subsection (5), the commissioner shall undertake a prompt and comprehensive investigation into all matters which are relevant to the referral and shall report its findings in writing to the relevant Health and Wellbeing Board within 28 days or within such longer period as shall be agreed by the Health and Wellbeing Board.

(8) In the event that the commissioner of health services to whom a referral has been made under subsection (5) hereof is not the commissioner of all or part of the services relevant to the referral, the commissioner of health services to whom the referral has been made shall pass all relevant details of the referral to such other commissioner of health services as it considers is the appropriate commissioner of health services, whereupon that commissioner of health services shall be obliged to investigate and report to the Health and Wellbeing Board within 28 days of receiving the referral or within such longer period as shall be agreed by the Health and Wellbeing Board.

(9) In this section “commissioner of services” shall mean the Board, Clinical Commissioning Group or other body under this Act which has made or would make arrangements for the relevant services to be provided or, if there is no such body which has made arrangements, is the body which will meet all or part of the cost of the provision of the said services.

(10) Subject to subsection (11), all reports provided under subsection (7) shall be published by the Health and Wellbeing Board in such a manner as the Health and Wellbeing Board consider appropriate.

(11) All publicly available copies of reports provided under subsection (7) hereof shall have details of individual patients anonymised in such a way as the commissioner of services considers appropriate to protect the confidentiality of any patient who desires to maintain confidentiality, and shall also have the details of any other person anonymised where this is necessary to protect a legal right to confidentiality.”

After Clause 198

BARONESS FINLAY OF LLANDAFF

LORD WALTON OF DETCHANT

LORD WIGLEY

337

Insert the following new Clause—

“Health Service Ombudsman for England and Health Service Ombudsman for Wales

All patients receiving care from an organisation that receives any funding from the NHS shall have the right of complaint to the relevant health service ombudsman.”

Clause 205

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

 

The above-named Lords give notice of their intention to oppose the Question that Clause 205 stand part of the Bill.

After Clause 205

BARONESS EMERTON

LORD PATEL

LORD WARNER

BARONESS MASHAM OF ILTON

338

Insert the following new Clause—

“Power to regulate health care support workers in England

(1) The Nursing and Midwifery Order 2001 (S.I. 2002/253) shall be amended to provide that all health care support workers in England shall be registered by the Nursing and Midwifery Council and regulated in accordance with the terms of that order.

(2) For the purposes of subsection (1), a health care support worker shall be an individual whose work is routinely delegated to them by a registered nurse or midwife or has a qualification in health and social care at level one (or higher) of the Qualifications and Credit Framework, in England.”

After Clause 217

LORD PATEL

BARONESS FINLAY OF LLANDAFF

LORD WARNER

BARONESS CUMBERLEGE

339

Insert the following new Clause—

“Public health specialists

(1) In section 25 of the National Health Service Reform and Health Care Professions Act 2002, in subsection 3 (regulatory bodies regulated by the Council for the regulation of health care professionals), insert—

“(k) those statutory bodies responisible for the regulation of public health specialists including those from backgrounds other than medicine;

(l) where a statutory register for public health specialists from backgrounds other than medicine does not exist, such a register shall be established by the Health Professions Council.”

(2) In this Act “registered public health specialists” means a person recognised as such on a register maintained by those statutory bodies responsible for the regulation of public health specialists, including those from backgrounds other than medicine.”

Clause 225

BARONESS MASHAM OF ILTON

339A

Page 224, line 46, leave out “voluntary”

339B

Page 224, line 47, leave out “voluntary”

339C

Page 225, line 26, leave out “voluntary”

339D

Page 225, line 29, leave out “voluntary”

339E

Page 226, line 14, leave out “Voluntary”

339F

Page 226, line 25, leave out “voluntary”

BARONESS EMERTON

LORD PATEL

340

Page 226, line 42, at end insert—

“(c) to which section 205A(2) does not apply”

BARONESS MASHAM OF ILTON

340A

Page 227, line 17, leave out “voluntary”

Clause 226

BARONESS MASHAM OF ILTON

340B

Page 227, line 39, leave out “voluntary”

340C

Page 227, line 40, leave out “voluntary”

340D

Page 228, line 9, leave out “voluntary”

340E

Page 228, line 15, leave out “voluntary”

340F

Page 228, line 24, leave out “Voluntary”

340G

Page 228, line 25, leave out “voluntary”

340H

Page 229, line 4, leave out “voluntary”

340J

Page 229, line 9, leave out “voluntary”

340K

Page 229, line 10, leave out “voluntary”

340L

Page 229, line 13, leave out “voluntary”

340M

Page 229, line 14, leave out “voluntary”

340N

Page 229, line 17, leave out “voluntary”

340P

Page 229, line 19, leave out “voluntary”

340Q

Page 229, line 20, leave out “voluntary”

340R

Page 229, line 25, leave out “voluntary”

340S

Page 229, line 27, leave out “voluntary”

340T

Page 229, line 31, leave out “voluntary”

340U

Page 229, line 37, leave out “voluntary”

340V

Page 230, line 27, leave out “voluntary”

Clause 230

LORD PATEL

LORD WARNER

341

Page 231, line 36, leave out “the desirability of”

Clause 231

LORD WARNER

LORD PATEL

342

Page 232, line 11, leave out “may direct NICE to prepare statements of standards” and insert “shall each year agree with NICE a programme of clinical quality standards to be completed or revised”

LORD PATEL

LORD WARNER

343

Page 232, line 13, at end insert “including for patients with long term conditions,”

BARONESS ROYALL OF BLAISDON

BARONESS THORNTON

343A

Page 232, line 16, at end insert—

“( ) NICE must prepare those quality standards that it has been directed to do so by the relevant commissioner at the date of the passing of this Act within 6 months and no later than 1 October 2012.”

BARONESS BARKER

BARONESS JOLLY

LORD CLEMENT-JONES

BARONESS TYLER OF ENFIELD

343B*

Page 232, line 16, at end insert—

“( ) NICE must prepare those quality standards that it has been directed to do so by the relevant commissioner at the date of the passing of this Act within 6 months and no later than 1 October 2012.”

Clause 234

LORD WARNER

LORD PATEL

BARONESS THORNTON

344

Page 234, line 8, at end insert—

“( ) The Secretary of State shall by regulations continue the responsibility of NICE to assess the cost-effectiveness to the health service of new pharmaceutical products until this matter is incorporated in a system of quality standards as provided for in section 231.”

Clause 236

LORD PATEL

LORD WARNER

 

The above-named Lords give notice of their intention to oppose the Question that Clause 236 stand part of the Bill.

Clause 247

LORD PATEL

LORD WARNER

345

Page 240, line 7, leave out “may” and insert “shall”

LORD WARNER

LORD PATEL

346

Page 240, line 7, leave out “may prepare and” and insert “shall”

347

Page 240, line 8, at end insert “governing the collection, processing and dissemination of information.”

347A

Page 240, line 10, leave out “in relation to the processing of information” and insert “for the efficient and effective collection, processing and dissemination of information that benefits the commissioning and provision of health and adult social care services, helps improve public health and wellbeing, enables the public to be informed about the quality and performance of those services and to exercise informed choice by ensuring maximum transparency of dissemination”

Clause 250

LORD WARNER

LORD PATEL

348

Page 241, line 33, at end insert—

“( ) the need for a publicly available independent audit of their processes in each 3 year period.”

Clause 255

LORD KENNEDY OF SOUTHWARK

BARONESS YOUNG OF OLD SCONE

LORD COLLINS OF HIGHBURY

BARONESS MASHAM OF ILTON

348A

Page 244, line 31, at end insert—

“(c) require any person mentioned in subsection (2) to provide it with any information necessary for the national clinical audits”

LORD WALTON OF DETCHANT

348B

Page 245, line 14, at end insert—

“(9) The powers under this section do not apply to information which falls within Section 256(2)(b).”

Clause 274

BARONESS FINLAY OF LLANDAFF

348C

Page 252, line 20, at end insert—

“( ) The National Information Governance Committee shall appoint a chairman from within its membership who shall report to the Information Commissioner.”

Clause 275

LORD HUNT OF KINGS HEATH

BARONESS THORNTON

 

The above named Lords give notice of their intention to oppose the Question that Clause 275 stand part of the Bill.

Before Clause 278

BARONESS MURPHY

349

Insert the following new Clause—

“Mental Health Act: members of Parliament

Repeal of section 141 of the Mental Health Act 1983

Section 141 of the Mental Health Act 1983 (members of Parliament suffering from mental illness) is repealed.”

Clause 285

LORD MARKS OF HENLEY-ON-THAMES

BARONESS WILLIAMS OF CROSBY

350

Page 259, line 42, after “duty” insert “or are otherwise in conflict with each other or at significant risk of being in conflict with each other”

351

Page 260, line 22, at end insert “or may require one or more of the bodies concerned to exercise specified functions in a specified manner”

BARONESS FINLAY OF LLANDAFF

 

Baroness Finlay of Llandaff gives notice of her intention to oppose the Question that Clause 285 stand part of the Bill.

Clause 294

BARONESS FINLAY OF LLANDAFF

351A*

Page 264, line 43, leave out “transfer” and insert “occupation”

351B*

Page 265, line 4, leave out first “transfer” and insert “occupation”

351C*

Page 265, line 4, leave out “transfer from” and insert “occupation of any property by”

351D*

Page 265, line 5, leave out from “23” to second “a” in line 7 and insert “or”

351E*

Page 265, line 15, leave out first “transfer” and insert “occupation”

EARL HOWE

352

Page 265, line 28, after “means” insert “—

(a) ”

353

Page 265, line 30, at end insert “, or

(b) a subsidiary of a company which is formed under that section and wholly owned by the Secretary of State.”

Clause 300

BARONESS THORNTON

LORD HUNT OF KINGS HEATH

353ZA

Page 270, line 34, at end insert—

“( ) Section 30 comes into force in accordance with section 30(3).”

Clause 301

BARONESS MASHAM OF ILTON

353A

Page 272, line 1, leave out “voluntary”

353B

Page 272, line 3, leave out “voluntary”

After Clause 301

LORD KAKKAR

LORD PATEL

354

Insert the following new Clause—

“Review of the operation of the Act

(1) Annually, the Secretary of State shall review the operation of this Act, publish a report on the review and lay the report before Parliament.

(2) If required by a Committee of either House, the Secretary of State must make available to both Houses of Parliament information necessary for the operation of this Act to be scrutinised.”

Prepared 25th November 2011