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Mr. Roger Williams (Brecon and Radnorshire): I should like to comment from a Welsh point of view. I pay tribute to the hon. Members for Bridgend (Mr. Griffiths) and for Cardiff, Central (Mr. Jones) in whose name the amendment stands. They were both responsible for the delivery of health services in the Welsh Office, as it then was, and were very helpful to people in my constituency when we were making representations on health issues.
I was disappointed to see these amendments but rather glad to hear how they were interpreted by the hon. Gentlemen. I felt that the amendments went against the spirit of devolution in trying to tie the Assembly to a specific pattern for the health structure in Wales. That would have been unfortunate.
The coterminosity element is especially important in the delivery of social services. One of the main impediments to that delivery in Wales—as it is in England and Wales—has been the delayed departure of patients from hospital to their homes or to nursing homes. The system will work much better if there is full coterminosity between local health boards and local authorities.
I am pleased that the hon. Gentlemen are not going to press the amendment to a vote because the Assembly will certainly undertake further consultation and will take the results on board. The decisions reached by the Assembly will result in the most appropriate structure for Wales.
Mr. Heald: On a point of order, Mr. Speaker. We are not going to reach amendment No. 12 to clause 21. That clause was never discussed in Committee—nor were clauses 8 and 20—owing to lack of time. The timetable motion was hopelessly unrealistic. Would it be possible for you, Mr. Speaker, to consider whether there is some way in which you could use your offices to ensure that on a Bill of this sort we do not end up in the ludicrous position of being unable to debate three of its most important parts?
Mr. Speaker: By making a point of order the hon. Gentleman is taking time out of the debate. When I chair the proceedings, I take one amendment at a time. The fact that we shall not reach an amendment is not a matter for me to consider: I consider only what is before the House.
Hywel Williams (Caernarfon): I am glad to hear the hon. Member for Bridgend (Mr. Griffiths) plead for coterminosity. That is an extremely important point. However, the House should bear in mind the points made in an earlier debate by the right hon. Member for Llanelli (Denzil Davies). He pointed out that under the current proposals there are likely to be as many as 52 bodies concerned with the delivery of health in Wales, as well as the Welsh Assembly Government—the WAG—and its Committees. That presents the obvious dangers both of complexity and of the lottery in health care.
The proposal made by the hon. Member for Bridgend might, indeed, reduce the number of local health boards and that might be very useful in terms of critical mass—they might be more effective. It might also mean that we avoid some of the dangers that have become apparent since the reorganisation of local government brought in 22 small local authorities. Some of them cover small populations and are thus quite weak in respect of some of their powers and functions. However, the dangers of complexity and of a local lottery in health care would remain.
I support my party's policy on this matter: to establish an all-Wales commissioning body. That is a coherent policy which would avoid complexity and the threat of a health lottery. It is also plain common sense in a nation of only 3 million people.
The Secretary of State for Wales (Mr. Paul Murphy): In the short time left for the debate, I commend Government amendments Nos. 74, 84 and 85. They are technical amendments that will ensure clarity as regards local health boards.
My hon. Friends the Members for Bridgend (Mr. Griffiths) and for Cardiff, Central (Mr. Jones) were formerly Health Ministers at the Welsh Office. When Jane Hutt, the Minister for Health and Social Services in the National Assembly, reads our proceedings she will note their comments with great interest. I am sure that they and other Members who have spoken in this brief debate will agree that clause 6 refers to the establishment of local health boards by the National Assembly for Wales. It does not refer to a specific number of health boards. In other words, the principle of setting up local health boards is established by the House of Commons and by Parliament, but the Assembly, through the devolution settlement, agrees on the number.
I know that my hon. Friends agree with that principle because it is the principle of devolution. The hon. Members for Brecon and Radnorshire (Mr. Williams) and for Caernarfon (Hywel Williams) also know that the secondary legislation that will implement the setting up of those local health boards has quite properly been devolved.
After lots of consultation and debates in Committee, which my hon. Friend the Under–Secretary of State for
Wales attended on behalf of the Government, and in the plenary season of the National Assembly for Wales, it was agreed that it would be sensible to ensure that the local health boards coincided with the local authorities that deliver other services, such as social services, and deal with other public health matters. That makes eminent sense, and in this very short debate we have seen the partnership between Parliament and the assembly work to deliver the best possible health service for the people of Wales. There has been a long consultation process on this issue, which is important to Assembly Members because, at the end of the day, we represent the same people in Wales, irrespective of whether we are Members of Parliament or Assembly Members.
Mr. Jon Owen Jones: I agree with the Secretary of State when he says that the Welsh Assembly should take those final decisions, but will he tell the House whether he has been privy to the results of the consultation that has taken place and whether he can make the analysis of those results available to the House? It is very unsatisfactory to debate a Bill on Report when we still do not know the results of the analysis of the consultation on which that Bill was brought about.
Mr. Murphy: I am advised that that information has been placed in the Library and in the assembly's library. If that is not the case, I shall be happy to discuss the details of the results of that consultation with my hon. Friend and the Minister for Health and Social Services in Wales, but the point that I make is still valid. The way in which the restructuring will occur is the direct result of working with Members of Parliament and Assembly Members.
Of course, the House will recall that my hon. Friend the Member for Bridgend set up the local health boards when he was Minister with responsibility for health in Wales. So the structure was started some years ago by a Labour Government working under the pre-devolution structures, but the assembly has now decided that this is the way to proceed, and we, in turn, have debated such matters in Committee and on the Floor of the House. That bodes well for the people of Wales, and I commend the Government amendments and hope that my hon. Friend will withdraw the amendment.
Mr. Win Griffiths: I have already said that I wanted to place on the record my view that Wales could manage perfectly well with 14 local health boards. The Bill will empower the Minister for Health and Social Security and the assembly to create between one and 22 boards, but I hope that they will listen to the suggestion that there should be 14 of them. On that basis, I am happy to beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Amendment made: No. 75, in page 11, line 15, leave out "Trust" and insert "Board".—[Ms Blears.]
Clause 13
Amendments made: No. 29, in page 18, line 40, after "(db)", insert—
', or any functions equivalent to those under section 20(1)(c) prescribed under section 20(1)(e)'.
No. 30, in page 18, line 45, at end insert—
'( ) premises owned or controlled by a Local Health Board,'.
No. 31, in page 19, line 3, leave out—
'persons mentioned in paragraph (a) or (b) have'
and insert—
'an NHS body, a service provider or a Local Health Board has'.
No. 32, in page 19, line 6, after "20(7)", insert "(disregarding section 20(8)(b))".—[Mr. Hutton.]
Clause 15
Amendments made: No. 33, in page 20, line 22, at end insert—
'( ) If, in the course of exercising its functions, a Patients' Forum becomes aware of any matter which in its view should be considered by a relevant overview and scrutiny committee, the Forum may refer that matter to the committee.'.
No. 34, in page 20, line 45, at end insert—
' "relevant overview and scrutiny committee", in relation to a Patients' Forum, means any overview and scrutiny committee in relation to which the Primary Care Trust or NHS trust for which the Forum is established is a local NHS body by virtue of regulations made under section 7(4) of the Health and Social Care Act 2001 (including that provision as read with section 8(5) and as applied by section 10(2) of that Act),'.—[Mr. Hutton.]
Clause 17
Amendments made: No. 35, in page 21, line 40, leave out "the" and insert "each".
No. 36, in page 21, line 41, after "(i)", insert "any part of".
No. 37, in page 22, line 1, leave out from "(d)" to end of line 5 and insert—
'any relevant overview and scrutiny committee within the meaning given by section 15.'.—[Mr. Hutton.]
Clause 18
Amendments made: No. 38, in page 22, line 34, leave out—
'NHS trust or Primary Care Trust for which it is established'
and insert—
'Commission for Patient and Public Involvement in Health'.
No. 39, in page 22, line 43, at end insert—
'( ) the referral of matters by a Patients' Forum to a relevant overview and scrutiny committee (within the meaning given by section 15).'.—[Mr. Hutton.]
Clause 23
Amendments made: No. 76, in page 28, line 32, leave out "Part of this Act" and insert "group of sections".
No. 77, in page 29, line 19, leave out "In subsection (1),".—[Mr. Hutton.]
Clause 25
Amendment made: No. 40, in page 31, line 14, after "not)", insert—
'or by the Department of Health, Social Services and Public Safety in Northern Ireland'.—[Mr. Hutton.]
Clause 27
Amendments made: No. 41, in page 32, line 22, leave out paragraph (b).
No. 42, in page 32, line 43, leave out "22(4)" and insert "22".
No. 43, in page 32, line 44, leave out "of unacceptable professional conduct" and insert—
'referred to the Professional Conduct Committee'.
No. 44, in page 32, line 47, leave out "22(4)" and insert "22".
No. 45, in page 33, line 2, at end insert—
'(k) any corresponding measure taken in relation to a member of a profession regulated by the Professions Supplementary to Medicine Act 1960 (c.66) or, after the repeal of that Act by virtue of section 60(3) of the 1999 Act, by any such Order in Council under section 60 of the 1999 Act as is mentioned in section 23(3)(i).'.
No. 46, in page 33, line 8, after "visitor,", insert—
'or to any such person as is mentioned in subsection (1)(k)'.
No. 47, in page 33, line 12, leave out "(j)" and insert "(k)".—[Mr. Hutton.]
Clause 29
Amendments made: No. 48, in page 36, line 1, after "is", insert—
'(or if he were registered would be)'.
No. 49, in page 36, line 3, after "is", insert—
'(or if he were registered would be)'.
No. 50, in page 36, line 14, before "substitute", insert—
'(in the case of an appeal against a determination under section 27 above or a direction under section 28 above)'.
No. 51, in page 36, line 19, leave out "or the Health Committee" and insert—
', the Health Committee or the Continuing Professional Development Committee'.
No. 52, in page 36, line 21, after "above", insert—
'or Schedule 3A to this Act'.
No. 53, in page 36, line 40, at end insert—
'(5) In section 34A of the Dentists Act 1984 (c.24) (professional training and development requirements), in subsection (7)(b), for "to Her Majesty in Council" there is substituted "under section 29 above to the relevant court".
(6) Subsection (5) has effect—
(a) upon the coming into force of this section, if that happens after the coming into force of article 8 of the Dentists Act 1984 (Amendment) Order 2001 (S.I. 2001/3926) ("the Dentists Order") so far as that article effects the insertion into the Dentists Act 1984 (c.24) of the new section 34A(7)(b),
(b) otherwise, immediately after the coming into force to that extent of that article.
(7) If this section comes into force before article 10(3) of the Dentists Order—
(a) paragraphs (b), (c) and (d) of article 10(3) of that Order are revoked upon the coming into force of this section, and
(b) until the coming into force of the remainder of article 10(3) of that Order, section 29 of the Dentists Act 1984 (c.24) (as amended by this section) is to be read with the modifications set out in subsection (8).
(8) The modifications are that section 29 is to be read as if—
(a) in each of paragraphs (a) and (b) of subsection (1A), the words "(or if he were registered would be)" were omitted,
(b) in paragraph (c) of subsection (3), the words "(in the case of an appeal against a determination under section 27 above or a direction under section 28 above)" were omitted, and
(c) in paragraph (d) of subsection (3)—
(i) for the words ", the Health Committee or the Continuing Professional Development Committee" there were substituted "or the Health Committee", and
(ii) the words "or Schedule 3A to this Act" were omitted.'.—[Mr. Hutton.]
Clause 40
Amendments made: No. 78, in page 43, line 31, leave out "and".
No. 79, in page 43, line 33, leave out from beginning to end of line 36 and insert—
' "NHS trust" has the same meaning as in the 1977 Act.'.—[Mr. Hutton.]
Schedule 1
Amendments made: No. 80, in page 46, line 5, leave out "sections 11 to 17" and insert "preceding provisions".
No. 81, in page 47, line 42, leave out "Authority or" and insert "Authority,".—[Mr. Hutton.]
Amendments made: No. 54, in page 48, line 38, leave out sub-paragraph (2).
No. 55, in page 48, line 42, leave out—
'in paragraph 16 (in both places) and'.—[Mr. Hutton.]
Schedule 2
Amendment made: No. 82, in page 58, line 9, leave out "before "Health Authority"" and insert—
'after "Strategic Health Authority," (inserted by paragraph 28(d) of Schedule 1 to this Act)'.—[Mr. Hutton.]
It being 10 o'clock, Mr. Speaker then proceeded to put forthwith the Questions necessary for the disposal of the business to be concluded at that hour, pursuant to Order [20 November 2001].
Remaining Government amendments agreed to.
Motion made, and Question put, That the Bill be now read the Third time.
The House divided: Ayes 324, Noes 201.
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