Health and Social Care Bill

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

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.”

Page 83, line 12, at end insert—

“( ) Healthwatch England”

Page 83, line 12, at end insert—

“( ) Clinical Commissioning Groups”

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.”

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

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.”

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.”

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

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.”

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

Page 289, line 30, leave out paragraph 1

Page 289, line 35, at end insert—

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

Page 294, line 8, leave out paragraphs 16 to 19

Page 294, line 13, at end insert—

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

Page 294, line 16, at end insert—

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

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,”

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

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

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.”

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

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

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

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

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

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”.”

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”.”

Page 317, line 27, at end insert—

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

Page 317, line 27, at end insert—

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

Page 317, line 27, at end insert—

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

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

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) ”

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.””

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

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

Page 357, line 7, at end insert—

“(1A) During the initial period, unless an arrangement has been made with a clinical commissioning group to exercise its functions, each Primary Care Trust must have its own governance structure.

(1B) For the avoidance of doubt, sub-paragraph (1A) shall apply where clusters of Primary Care Trusts have already been established.”

[Withdrawn]

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.”

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

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).”

Page 85, leave out lines 4 to 6

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.”

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.”

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.”

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.”

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.”

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.”

[Withdrawn]

Insert the following new Clause—

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

(1) The Secretary of State shall have a duty to secure the continuous improvement in the quality of adult social care services through local social services authorities and qualified service providers registered by the Care Quality Commission.

(2) In discharging this duty, the Secretary of State must ensure—

(a) the establishment of a fair and sustainable partnership between individuals and the state for funding adult social care that—

(i) secures adequate funding of these services,

(ii) provides access to these services for those of limited means,

(iii) caps the financial liabilities of those with excessive and unusually high lifetime care costs,

(iv) delivers safe services, and

(v) minimises the impact on the demand for NHS services;

(b) that the assessment of the needs of individuals and their carers for services is undertaken on a basis of standardised published criteria for eligibility to services and liability to pay for services that apply throughout England;

(c) continuous efforts are made to reduce barriers to the delivery of integrated health and adult social care to individuals through the conduct of commissioners and providers of both health and social care services.

(3) The Secretary of State shall, after such consultations as he or she considers appropriate, make regulations governing the assessment, eligibility and charging for adult social care to individuals and their carers in England, together with such other matters as he or she considers relevant to the discharging of his or her duty under subsections (1) and (2).

(4) Regulations made under this section—

(a) shall be made within the term of this Parliament;

(b) be subject to an affirmative resolution in both Houses of Parliament; and

(c) be kept under review.

(5) In this section and other relevant parts of this Act, the term “integration” means the integration of the commissioning, assessment of entitlement and the provision of health and adult social care to individuals that benefits their treatment and care.”

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;”.”

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”

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.”

Page 361, line 15, at end insert—

“( ) The chair and the chief executive must be separate roles, and cannot be held by the same person.”

Page 361, line 24, at end insert—

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

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

Page 364, line 26, at end insert—

“( ) Monitor must meet in public.”

Page 364, line 26, at end insert—

(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.”

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.”

[Withdrawn]

[Withdrawn]

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

Page 87, line 15, at end insert—

“( ) is based on the principles of universality and social solidarity”

Page 87, line 16, at end insert—

“(1A) The role of Monitor as the Independent Regulator of Foundation Trusts shall continue.”

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

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

(b)”

[Withdrawn]

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

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.”

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

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

[Withdrawn]

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”

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”

[Withdrawn]

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

[Withdrawn]

[Withdrawn]

[Withdrawn]

[Withdrawn]

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.”

[Withdrawn]

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

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

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

“(aa) public and patient involvement,”

Page 88, line 16, at end insert—

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

Page 88, line 19, at end insert—

“( ) Monitor must have regard to the Mandate in the exercise of its functions.”

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

[Withdrawn]

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).”

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.”

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

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.”

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

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

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

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

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.”

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

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

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”

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

Page 89, line 45, at end insert—

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

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

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

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.”

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

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

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

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.”

Page 90, line 45, at end insert—

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

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”

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

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

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.”

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

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

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

Insert the following new Clause—

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 (the “CCP”) shall continue as an independent, arms length agency.

(5) The CCP will continue to support the delivery to 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.”

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.”

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

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

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.”

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

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

“(1) Subject to subsection (2), 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.”

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

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

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

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.”

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.”

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

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

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

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.”

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

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

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.”

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

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.””

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

Page 99, line 2, at end insert—

“( ) Healthwatch England.”

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

The above-named Lords give notice of their intention to oppose the Question that Clause 77 stand part of the Bill.

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

The above-named Lords give notice of their intention to oppose the Question that Clause 78 stand part of the Bill.

The above-named Lords give notice of their intention to oppose the Question that Clause 79 stand part of the Bill.

[Withdrawn]

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

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.”

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

“( ) Healthwatch England”

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

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

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

“( ) Healthwatch England”

Page 104, line 11, at end insert—

“( ) Such criteria must include the requirement, at regular intervals, for all licensees to supply Monitor with financial information, in the interests of meeting standards of financial stability and probity.”

Page 104, line 14, at end insert—

“( ) A criterion for a person or organisation to be granted a licence must be that that person demonstrates a commitment to education, training and research.”

Page 104, line 14, at end insert—

“( ) A criterion for a person or organisation to be granted a licence must be that that person or organisation demonstrates a commitment to education, training and research.”

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.”

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”).”

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.”

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

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.”

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

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

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

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

“( ) Healthwatch England”

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”

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.”

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

“( ) Healthwatch England”

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

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;”

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

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

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

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

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,”

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,”

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”

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

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”

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”

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

Page 110, line 8, at end insert—

“( ) The standard or special conditions of a licence under this Chapter must include a condition limiting—

(a) the licence holder’s revenue to be derived from treating private patients as a percentage of the licence holder’s total revenue, and

(b) the number of private patients treated by the licence holder as a percentage of the total number of patients treated by the licence holder

( ) To such percentage, being less that 50 per cent, as the licence holder may agree with Monitor.”

Page 110, line 8, at end insert—

“( ) The standard or special conditions of a licence under this Chapter must include conditions—

(a) that any income derived by the licence holder from treating private patients shall exceed the costs of providing such treatment, after capital, labour, supplies and training costs are taken into account;

(b) that no less that one half of any surplus income derived by the licence holder from treating private patients, after capital, labour, supplies and training costs are taken into account, shall be applied for the benefit of NHS patients.”

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”

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

“( ) Healthwatch England”

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

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.”

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

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

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

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

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

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

The above-named Lords give notice of their intention to oppose the Question that Clause 101 stand part of the Bill.

Page 116, line 22, at end insert—

“( ) Powers under this section may only be applied with consent of the Secretary of State in each case.

( ) A monetary penalty against a provider must be held by a local clinical commissioning group for investment in services in that area.”

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.”

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.”

Page 117, line 39, at end insert—

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

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.”

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

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

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

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

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

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).”

Page 122, line 14, at beginning insert “Regulations must provide and”

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

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,”

Page 122, line 19, at end insert—

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

Page 122, line 22, at end insert—

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

Page 122, line 22, at end insert—

“( ) The regulations must be accompanied by a full statement of how the various prices and methods were determined.

( ) Regulations must also set out how any proposal for a change to any national price of for a method to be used will be subject to proper evaluation and testing, with the results being published, prior to any implementation.

( ) Before publishing any regulations under this section the Secretary of State must consult with Monitor, and publish his response.”

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

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).”

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.”

Page 123, line 15, leave out subsections (9) and (10)

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

Page 123, line 41, at end insert—

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

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.”

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

Page 124, line 23, leave out subsections (5) and (6)

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

“( ) relevant clinical groups,”

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

The above-named Lords give notice of their intention to oppose the Question that Clause 116 stand part of the Bill.

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

The above-named Lords give notice of their intention to oppose the Question that Clause 117 stand part of the Bill.

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

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

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

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

The above-named Lords give notice of their intention to oppose the Question that Clause 118 stand part of the Bill.

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

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.”

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.”

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)”

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

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

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

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

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

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

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

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

Page 130, line 3, at end insert—

“( ) Regulations must provide guidance on the circumstances in which there can be any agreement to a local variation in the price payable as set out in the national tariff to the provider of a health care service.”

Page 130, line 13, at end insert “and the Board”

Page 130, line 22, at end insert “Health and Wellbeing Boards,”

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”

Page 130, line 34, after “may” insert “with the consent of the Board”

Page 131, line 16, leave out subsection (9) and insert—

“(9) No modification shall have effect without the consent of the Secretary of State.”

Insert the following new Clause—

“Health special administration

(1) The National Health Service Act 2006 (appointment of trust special administrator) is amended as follows.

(a) in section 65B(4), leave out paragraph (b) and insert—

“(ba) the Board and all relevant clinical commissioning groups and Health and Wellbeing Boards”;

(b) in section 65D(4), leave out paragraph (b) and insert—

“(ba) the Board and all relevant clinical commissioning groups and Health and Wellbeing Boards”;

(c) in section 65F(2), leave out paragraph (a) and insert—

“(aa) the Board and all relevant clinical commissioning groups and Health and Wellbeing Boards”.

(2) The provisions of section 18 of the Health Act 2009 (appointed day for provisions relating to trust special administrators) not already in effect shall have effect on the day this Act is passed.”

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.”

Page 132, line 21, at end insert—

“( ) protect the interests of patients,”

The above-named Lords give notice of their intention to oppose the Question that Clause 125 stand part of the Bill.

The above-named Lords give notice of their intention to oppose the Question that Clause 126 stand part of the Bill.

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

The above-named Lords give notice of their intention to oppose the Question that Clause 127 stand part of the Bill.

The above-named Lords give notice of their intention to oppose the Question that Clause 128 stand part of the Bill.

The above-named Lords give notice of their intention to oppose the Question that Clause 129 stand part of the Bill.

The above-named Lords give notice of their intention to oppose the Question that Clause 130 stand part of the Bill.

Insert the following new Clause—

“Prior actions to health special administration orders

(1) Monitor shall produce annually a report to the National Commissioning Board setting out those trusts and their associated health economies where it considers that, on the evidence available, trusts are at serious risk of Monitor seeking a health special administration order unless urgent action is taken to review existing services and agree reconfiguration of those services to ensure their clinical and financial sustainability and this report shall be made available promptly to the Secretary of State, Parliament and the relevant clinical commissioning groups and health and wellbeing boards.

(2) It shall be the responsibility of the National Commissioning Board, in consultation with the relevant clinical commissioning groups and health and wellbeing boards, to establish a mechanism for producing a response to Monitor within six months of the annual report’s publication on how the services in specified areas can be made clinically and financially sustainable and the extent to which these proposals are agreed by local organisations on behalf of the public.

(3) It shall be for Monitor to decide whether the Board’s response is adequate to secure clinical and financial sustainability in particular areas and, after informing the Secretary of State, to publish its decisions on proposed changes and should the Secretary of State decline to accept Monitor’s decision in a particular case he or she should inform Parliament with his or her reasons, together with his or her alternative proposals for securing clinical and financial sustainability in the particular health economy.

(4) It shall be open to Monitor, by agreement with the Secretary of State and the National Commissioning Board, to establish a panel of independent people with appropriate expertise to assist with securing local agreement on the reconfiguration of services required to secure clinical and financial sustainability.”

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”)”

The above-named Lords give notice of their intention to oppose the Question that Clause 131 stand part of the Bill.

The above-named Lords give notice of their intention to oppose the Question that Clause 132 stand part of the Bill.

The above-named Lords give notice of their intention to oppose the Question that Clause 133 stand part of the Bill.

The above-named Lords give notice of their intention to oppose the Question that Clause 134 stand part of the Bill.

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

Page 140, line 8, at end insert—

“(c) each clinical commissioning group, and

(d) such other persons as it considers appropriate.”

The above-named Lords give notice of their intention to oppose the Question that Clause 135 stand part of the Bill.

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.”

The above-named Lords give notice of their intention to oppose the Question that Clause 136 stand part of the Bill.

The above-named Lords give notice of their intention to oppose the Question that Clause 137 stand part of the Bill.

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

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

The above-named Lords give notice of their intention to oppose the Question that Clause 138 stand part of the Bill.

The above-named Lords give notice of their intention to oppose the Question that Clause 139 stand part of the Bill.

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

The above-named Lords give notice of their intention to oppose the Question that Clause 140 stand part of the Bill.

The above-named Lords give notice of their intention to oppose the Question that Clause 141 stand part of the Bill.

The above-named Lords give notice of their intention to oppose the Question that Clause 142 stand part of the Bill.

The above-named Lords give notice of their intention to oppose the Question that Clause 143 stand part of the Bill.

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

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.””

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.””

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

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

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).”

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

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””

Page 159, line 27, leave out paragraph (a)

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.”

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.”

Page 160, line 32, after first “of” insert—

“(a)”

Page 160, line 33, at end insert “; and

(b) the Secretary of State”

Page 161, line 36, after first “of” insert—

“(a)”

Page 161, line 37, at end insert “; and

(b) the Secretary of State”

The above-named Lords give notice of their intention to oppose the Question that Clause 170 stand part of the Bill.

Insert the following new Clause—

“Remedial action

( ) Where the Secretary of State under paragraph 65B(1) of the NHS Act 2006, or the regulator under section 65D of that Act, considers that the conditions for making an order or notice are likely to exist within the year, the Secretary of State or 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, with 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.

( ) Recommendations from the panel shall be subject to public consultation within a timescale specified by Monitor.

( ) 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 has notified Parliament of his or her reasons for replacing those arrangements with alternative ways of achieving sustainable health service in the area.

( ) Where matters become so serious that the regulator is required to act under inserted subsections (1) and (2) of section 65D of the NHS Act 2006, the regulator shall incorporate the work of any such panel in any order or report made under inserted subsections (5) and (6) of that section as conditions to which the trust special administrator must have full regard in discharging his or her responsibilities.”

Insert the following new Clause—

“Reconfiguration of NHS services

( ) Regulations shall provide for the process to be followed in the consideration of reconfiguration of NHS services.

( ) Such regulations must cover how reconfiguration is to be governed by—

(a) the legislative obligations of sections 242 and 244 of the NHS Act 2006,

(b) guidance published in 2003, 2008, and 2009 requiring NHS organisations to involve, work more effectively with and be more locally accountable to local people and communities through—

(i) Health Overview and Scrutiny Guidance (2003),

(ii) Leading Local Change and Changing for the Better: Guidance when Undertaking Major Changes to NHS Services (May 2008),

(iii) Real Involvement—Working with People to Improve Health services (October 2008),

(iv) Real Accountability—demonstrating responsiveness and accountability (November 2009), and

(v) Code of Practice on Consultation—BIS Guidance on consultations (2009)

(c) the Carruthers review—Service Improvement: Quality Assurance of Major Changes to Service Provision (2007), and

(d) any guidance issued through the Department of Health covering reconfiguration process requirements.

( ) The regulations must set out the roles of the Board, Clinical Senates and Networks, clinical commissioning groups and Health and Wellbeing Boards.

( ) The regulations shall set out indicative timescales to be followed in considering and implementing reconfigurations.”

Page 164, line 11, leave out subsection (1)

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.”

Page 166, line 13, at end insert—

“( ) the current and future requirements for the provision of medical education and training,”

Page 166, line 22, after “Board” insert “, in conjunction with commissioners,”

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.”

The above-named Lords give notice of their intention to oppose the Question that Clause 176 stand part of the Bill.

The above-named Lords give notice of their intention to oppose the Question that Clause 177 stand part of the Bill.

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.”

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.”

Page 175, line 20, leave out “appointed” and insert “elected from local Healthwatch organisations”

Page 175, line 21, at end insert—

“( ) The majority of the members of the Healthwatch England committee shall not be members of the Commission.”

Page 175, line 24, after “assistance” insert “and make recommendations”

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.”

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,”.”

Page 176, line 9, after “information” insert “, recommendations”

Page 176, line 10, after “people” insert “, including children,”

Page 176, line 11, after “public” insert “, including children,”

Page 176, line 12, after “services” insert “including services directly commissioned by the NHS Commissioning Board at a regional or national level”

Page 176, line 20, at end insert—

“( ) Care Quality Commission;”

Page 176, line 22, after “advice” insert “or recommendations”

Page 176, line 23, leave out “committee”

Page 176, line 24, at end insert “or recommendations and any action it intends to take”

Page 176, line 25, leave out subsection (6)

Page 176, line 25, leave out “may” and insert “must”

Page 176, line 26, after “advice” insert “or recommendations”

Page 176, line 28, at end insert “and recommendations and any actions it intends to take”

Page 176, line 29, leave out “The Commission” and insert “Healthwatch England”

Page 176, line 34, leave out “committee”

Page 176, line 37, leave out second “the”

Page 176, line 38, leave out “committee”

Page 176, line 39, leave out “Commission” and insert “Secretary of State”

Page 176, line 44, leave out “The committee” and insert “Healthwatch England”

Page 176, line 47, at end insert—

“( ) send a copy of each such report to all local Healthwatch organisations”

Page 177, line 1, leave out “The committee” and insert “Healthwatch England”

Page 177, line 5, leave out “The committee’s” and insert “Healthwatch England’s”

Page 177, line 20, at end insert—

“( ) The Secretary of State shall consult local Healthwatch organisations before issuing such directions.”

Page 177, line 21, leave out from beginning to end of line 8 on page 178

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.”

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.””

Page 178, line 36, leave out subsection (9)

Page 179, line 8, leave out subsection (12)

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.”

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.”

Insert the following new Clause—

“Opinion of Local Healthwatch organisations on commissioning plans

(1) A relevant local Healthwatch organisation—

(a) must give the NHS Commissioning Board its opinion on whether a plan published by a clinical commissioning group under section 14Z9(4) or 14Z10(2) of the National Health Service Act 2006 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.”

Page 399, line 26, after “appointment” insert “and election”

Page 179, line 14, at end insert—

“(1A) In subsection (2)(a), (b) and (c) after “people” insert “, including children,”

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”.”

Page 179, line 16, leave out “the”

Page 179, line 17, leave out “committee of the Care Quality Commission”

Page 179, line 23, leave out “the”

Page 179, line 24, leave out “committee of the Care Quality Commission”

Page 179, line 25, leave out “that committee” and insert “Healthwatch England”

Page 179, line 29, leave out “that committee” and insert “Healthwatch England”

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.”

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.”

Page 180, line 1, leave out subsections (2) to (11)

Page 180, line 4, leave out “activities” and insert “its functions”

Page 180, line 16, at end insert—

“( ) Local Healthwatch is not to be regarded as a servant or agent of A”

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”.”

Page 181, line 4, after “appropriate” insert “in relation to the needs of people”

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”

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”

Page 181, line 26, leave out subsection (4)

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”.”

Page 183, line 31, leave out “and a local authority”

Insert the following new Clause—

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.”

Page 190, line 19, at end insert—

“( ) involve allied health professionals who work in that area;”

Page 190, line 20, at end insert—

“( ) consult and work with education or children’s services;”

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”

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.”

Page 191, line 20, after “authority,” insert—

“( ) involve allied health professionals who work in that area,”

Page 191, line 20, after “authority,” insert—

“(aa) have regard to the assessment of housing needs undertaken by the local planning authority,”

Page 191, line 21, at end insert—

“( ) involve representatives from alcohol services”

Page 191, line 21, at end insert—

“( ) consult and work with education or children’s services”

Page 191, line 25, leave out “may” and insert “must”

Page 191, line 29, at end insert “, including how such integration could be supported by the involvement of allied health professionals”

Page 191, line 44, after “functions,” insert—

“( ) an assessment of the needs of areas of disadvantage and of inequalities which exist,”

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”

Page 192, line 21, at end insert—

“( ) a representative of community pharmacy”

Page 192, line 21, at end insert—

“( ) a representative of the probation service,

( ) a representative of the police,”

Page 192, line 21, at end insert—

“( ) a representative of an allied health professional organisation,”

[Withdrawn]

Page 192, line 21, at end insert—

“( ) at least one representative of a community organisation which delivers opportunities for physical activity,”

Page 192, line 23, at end insert—

“( ) a representative from alcohol and drugs service”

Page 192, line 23, at end insert—

“( ) in the case of two-tier local government areas, a representative of district councils”

Page 192, line 23, at end insert—

“(h) a representative of designated health professionals for safeguarding”

Page 193, line 30, leave out “encourage” and insert “mandate”

Page 193, line 31, after “services” insert “, including allied health professionals,”

Page 193, line 31, after “services” insert “and education or children’s services”

Page 193, line 31, leave out “an integrated manner” and insert “a manner that integrates the delivery of services to individuals”

Page 193, line 37, leave out “may” and insert “must”

Page 193, line 38, after “services” insert “, including allied health professionals,”

Page 193, line 38, after “services” insert “or education or children’s services”

Page 193, line 40, leave out “may” and insert “must”

Page 193, line 41, after “services” insert “, including allied health professionals,”

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;”

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.”

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.”

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.”

Insert the following new Clause—

“Power to regulate pharmacists

(1) The Medicines Act 1968 is amended as follows.

(2) After section 58(6) there is inserted—

“(7) Subsection (2)(a) does not apply to the sale or supply of a medicinal product by a person lawfully conducting retail pharmacy business where the sale or supply is in accordance with a prescription and, having exercised all due diligence, believes on reasonable grounds that those requirements have been fulfilled.

(8) The activity under subsection (7) shall be regulated by the General Pharmaceutical Council.

(9) The General Pharmaceutical Council may take what steps it considers necessary under section 6(1) of The Pharmacy Order 2010 (S.I. 2010/231) in relation to a person who performs an activity referred to in subsection (7).”

(3) After section 64(5)(b) there is inserted—

“(6) Subsection (1) does not apply to the sale or supply of a medicinal product by a person lawfully conducting retail pharmacy business where the sale or supply is in accordance with a prescription and that person selling or supplying the product, having exercised all due diligence, believes on reasonable grounds that those requirements have been fulfilled.

(7) The activity under subsection (6) shall be regulated by the General Pharmaceutical Council.

(8) The General Pharmaceutical Council may take what steps it considers necessary under section 6(1) of The Pharmacy Order 2010 (S.I. 2010/231) in relation to a person who performs an activity referred to in subsection (6).”

(4) After section 85(5) there is inserted—

“(6) Subsection (1)(a) to (c) does not apply to the sale or supply of a medicinal product by a person lawfully conducting retail pharmacy business where the sale or supply is in accordance with a prescription and that person selling or supplying the product, having exercised all due diligence, believes on reasonable grounds that those requirements have been fulfilled.

(7) The activity under subsection (1) shall be regulated by the General Pharmaceutical Council.

(8) The General Pharmaceutical Council may take what steps it considers necessary under section 6(1) of The Pharmacy Order 2010 (SI 2010/231) in relation to a person who performs an activity referred to in subsection (6).””

The above-named Lords give notice of their intention to oppose the Question that Clause 205 stand part of the Bill.

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.”

Insert the following new Clause—

“Power to regulate clinical psychologists in England

(1) Section 60 of the Health Act 1999 (regulation of health care professions) is amended as follows.

(2) In subsection (1) after paragraph (b) insert—

“(ba) regulating the clinical psychology profession in England,”.

(3) In that section, after paragraph (bb) insert—

“(bc) regulating clinical psychologists in England who appear to require regulation in pursuance of this section,”.”

Insert the following new Clause—

“Requirement for clinical psychologists in England to be registered

(1) The Health Professions Council is required to keep a register of clinical psychologists in England.

(2) A person may not practise as a clinical psychologist in England unless the person is registered in that part of the register maintained by the Health Professions Council.”

Lord Hunt of Kings Heath gives notice of his intention to oppose the Question that Clause 206 stand part of the Bill.

Lord Hunt of Kings Heath gives notice of his intention to oppose the Question that Clause 208 stand part of the Bill.

Lord Hunt of Kings Heath gives notice of his intention to oppose the Question that Clause 209 stand part of the Bill.

Lord Hunt of Kings Heath gives notice of his intention to oppose the Question that Clause 210 stand part of the Bill.

Page 210, line 29, leave out “Care” and insert “Social Worker”

Lord Hunt of Kings Heath gives notice of his intention to oppose the Question that Clause 211 stand part of the Bill.

Insert the following new Clause—

“Establishment by the Health Professions Council of the Social Worker Professions Committee

(1) The Council shall establish a statutory committee to be known as the Social Worker Professions Committee.

(2) The functions of the Committee will be to oversee the work of the Council in relation to the regulation of social worker professions.

(3) The Secretary of State may by order confer further functions on the Social Worker Professions Committee.”

Insert the following new Clause—

“Appointment by the Health Professions Council of Director of Social Worker Professions Regulation

(1) The Council shall appoint a Director of Social Worker Professions Regulator who shall hold office for such period and on such terms as the Council may determine.

(2) The Director shall have such functions as may be conferred by order.

(3) The Director shall have such other functions as the Council may determine.”

Insert the following new Clause—

“Appointment to the Health Professions Council of social workers

The Secretary of State shall appoint at least two registered social workers to the Council.”

[Withdrawn]

Page 211, line 7, at end insert—

“(viii) the regulation of clinical psychology in England, and

(ix) the provision, supervision or management of services of persons engaged in clinical psychology in England.”

Lord Hunt of Kings Heath gives notice of his intention to oppose the Question that Clause 212 stand part of the Bill.

Lord Hunt of Kings Heath gives notice of his intention to oppose the Question that Clause 213 stand part of the Bill.

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.”

Insert the following new Clause—

“Statutory registration

(1) The Health Professions Council shall establish a statutory register of Physicians’ Assistants (Anaesthesia) and other healthcare professional as the Secretary of State may by order specify.

(2) In this Act “registered Physicians’ Assistant (Anaesthesia)” means a person recognised as such on a register maintained by the statutory body responsible for the regulation of Physicians’ Assistants (Anaesthesia).”

Insert the following new Clause—

“Regulation of clinical psychologists

(1) The Health Professions Order 2011 (S.I. 2002/254) is amended as follows.

(2) In Schedule 3 (interpretation), in paragraph 1, in the definition of “relevant professions”, at the appropriate place insert “clinical psychologists in England”.

(3) In that paragraph, at the appropriate place insert—

““Clinical psychologist in England” means a member of the clinical psychology profession in England and references to clinical psychology in England are to be construed accordingly.””

Lord Hunt of Kings Heath gives notice of his intention to oppose the Question that Clause 218 stand part of the Bill.

Lord Hunt of Kings Heath gives notice of his intention to oppose the Question that Clause 219 stand part of the Bill.

Lord Hunt of Kings Heath gives notice of his intention to oppose the Question that Clause 220 stand part of the Bill.

Page 224, line 46, leave out “voluntary”

Page 224, line 47, leave out “voluntary”

Page 225, line 17, leave out from “regulates” to end of line 18

Page 225, line 26, leave out “voluntary”

Page 225, line 29, leave out “voluntary”

Page 225, line 42, leave out from “body” to end of line 43

Page 226, line 14, leave out “Voluntary”

Page 226, line 25, leave out “voluntary”

Page 226, line 42, at end insert—

“(c) to which section 205A(2) does not apply”

Page 227, line 17, leave out “voluntary”

Page 227, line 39, leave out “voluntary”

Page 227, line 40, leave out “voluntary”

Page 228, line 9, leave out “voluntary”

Page 228, line 15, leave out “voluntary”

Page 228, line 24, leave out “Voluntary”

Page 228, line 25, leave out “voluntary”

[Withdrawn]

[Withdrawn]

[Withdrawn]

Page 229, line 4, leave out “voluntary”

Page 229, line 9, leave out “voluntary”

Page 229, line 10, leave out “voluntary”

Page 229, line 13, leave out “voluntary”

Page 229, line 14, leave out “voluntary”

Page 229, line 17, leave out “voluntary”

Page 229, line 19, leave out “voluntary”

Page 229, line 20, leave out “voluntary”

Page 229, line 25, leave out “voluntary”

Page 229, line 27, leave out “voluntary”

Page 229, line 31, leave out “voluntary”

Page 229, line 37, leave out “voluntary”

Page 230, line 27, leave out “voluntary”

Page 231, line 36, leave out “the desirability of”

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”

Page 232, line 13, at end insert “including for patients with long term conditions,”

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.”

[Withdrawn]

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.”

The above-named Lords give notice of their intention to oppose the Question that Clause 236 stand part of the Bill.

Page 240, line 7, leave out “may” and insert “shall”

Page 240, line 7, leave out “may prepare and” and insert “shall”

Page 240, line 8, at end insert “governing the collection, processing and dissemination of information.”

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”

Page 241, line 33, at end insert—

“( ) the need for a publicly available independent audit of their processes in each 3 year period.”

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”

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).”

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.”

The above-named Lords give notice of their intention to oppose the Question that Clause 275 stand part of the Bill.

Insert the following new Clause—

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.”

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”

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 gives notice of her intention to oppose the Question that Clause 285 stand part of the Bill.

Page 264, line 43, leave out “transfer” and insert “occupation”

Page 265, line 4, leave out first “transfer” and insert “occupation”

Page 265, line 4, leave out “transfer from” and insert “occupation of any property by”

Page 265, line 5, leave out from “23” to second “a” in line 7 and insert “or”

Page 265, line 15, leave out first “transfer” and insert “occupation”

Page 265, line 28, after “means” insert “—

(a) ”

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.”

Page 270, line 24, at end insert—

“( ) section (health special administration);”

Page 270, line 34, at end insert—

“( ) Section 30 comes into force in accordance with section 30(3).”

Page 272, line 1, leave out “voluntary”

Page 272, line 3, leave out “voluntary”

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.”