Memorandum submitted by the Association of Welsh Community Health Councils
1. The Association of Welsh Community Health Councils welcomes the Draft NHS (Wales) Bill, and also the opportunity to comment on the content of the Bill to the Welsh Affairs Committee.
2. The support given by the National Assembly to retaining an effective, statutory and integrated voice for patients and the public is greatly appreciated. On behalf of the patients that they represent, CHCs in Wales wish to express their thanks that the requests they have made in the interests of the public have been listened to and accepted. The aim of the Bill to extend the rights of inspection and inquiry into primary care and other areas where NHS patients receive services; to provide patients with an independent complaints advocacy service, and to increase support to CHCs are all objectives which have been identified as necessary to enable the public to be properly represented in the NHS.
3. CHCs in Wales have been studying the Draft Bill over the last two weeks, and the comments below reflect the majority response. The contents of the Draft Bill are reproduced below, with our comments in italics for ease of reference, and any suggested change in the wording of the Draft Bill in bold italics.
DRAFT NHS (WALES) BILL
1. Community Health Councils in Wales
(1) (1) CHCs established in Wales are to continue in existence
(2) The National Assembly for Wales may by order
(a) provide for the Councils to be known by a different name;
(b) abolish a Council, alter the district for which a Council is established, or provide for the establishment of a new Council.
Agreed, but here we would wish to add "after consultation with the Public".
(3) In making an order the Assembly must ensure
(a) that every part of Wales is included in the district of a Council:
(b) that no part of a district is separated from the rest of it by a territory not included in the district.
4. Health Professions Wales
We believe this body should enable lay participation where appropriate, but it is difficult to identify where in the Draft Bill this could best be suggested. We should however like this be borne in mind when the Assembly makes provision as to the constitution of HPW.
Schedule 7a to be inserted in the NHS Act 1977
Further provisions about Councils under Section 20A
1. It is the duty of a Council continued in existence by section 20A or established under that section
(a) to represent the interests in the health service of the public in its district;
(b) to perform such other functions as may be conferred on it by regulations under paragraph 2.
2. The National Assembly for Wales may by regulations make provision about
(a) the membership of Councils (including the election by members of a Council of a chairman of the Council);
(b) the proceedings of Councils;
(c) the staff, premises and expenses of Councils;
(d) the consultation of Councils by Health Authorities, Local Health Boards, Strategic Health Authorities, Wales Centre for Health, Primary Care Trusts, Care Trusts and NHS Trusts with respect to such matters, and on such occasions, as may be prescribed;
we would like to consider here where and to whom unsatisfactory consultations should be referred, as this needs to be specified in writing, either in this Bill or in the regulations. Our preference is for CHCs to refer such consultations to the Minister for Health and Social Services of the National Assembly for Wales.
Here we would like to see the insertion of a new clause:
the furnishing of information to Councils by Health Authorities, Local Health Boards, NHS Trusts and other bodies who provide the NHS with services, whether directly or through contract; (a similar clause about NHS bodies having to provide information was included in the 1977 Act, but is not in the new draft NHS Billwe think it is still necessary)
(e) the consideration by Councils of matters relating to the operation of the health service within their districts, and the giving of advice by Councils to Health Authorities, Local Health Boards and other health organisations on such matters;
The aim of this inclusion is to ensure that other health organisations such as strategic partnerships or SHSCW are included in this clause.
(f) the preparation and publication of reports by Councils on such matters, and the furnishing and publication by Health Authorities and Local Health Boards of comments on the reports;
(g) the provision by Councils on behalf of the Assembly of the independent advocacy services required to be provided under section 19A of this Act;
This clause is particularly welcomed, as we believe it to be an essential service required by the public. CHCs have carried out this function to the best of their ability for many years without adequate resourcing, and are delighted that the Assembly intends to resource this task in future. The anonymised information derived from this essential function is invaluable in establishing the patient experience, and by feeding this into the clinical governance agenda it can assist in improving the quality of healthcare. CHCs use this data to ensure that their monitoring and representational role is as effective as it can be. This integration of roles is one of the main reasons why CHCs, properly supported, could be the most efficient and cost-effective ways of involving the public as envisaged by the National Assembly.
(h) the functions to be exercised by Councils in addition to those exercisable by them by virtue of paragraph 1(a) and of regulations made by virtue of sub-paragraphs (a) to (g).
3. (1) The Assembly may make regulations requiring
(c) Strategic Health Authorities;
(h) persons providing services under Part 2 of this Act or under arrangements under section 28C of this Act; or
(i) persons providing piloted services under pilot schemes established under section 28 of the Health and Social Care Act 2001 (c.15), or providing LP services under an LPS scheme established under Schedule 8A to this Act,
to allow members of a Council authorised by or under the regulations to enter and inspect for the purposes of any of the Council's functions, premises owned or controlled by those referred to in paragraphs (a) to (h).
We need a little more information on precisely what these clauses refer to as we have had insufficient time to establish this to datewe are assuming that they cover primary care and private care, but we will need clarification. As the majority of patients receive their healthcare through primary and community care we are delighted that the Bill seeks to improve our rights of access to premises and information in this area. We also need to ensure that any services relating to NHS patients contracted out to private providers are covered in this Bill.
(2) The Assembly may also make regulations requiring any other
person who owns or controls premises where services are provided as mentioned in sub-paragraph (1)(g) or (h) to allow members of a Council authorised by or under the regulations to enter and inspect the premises for the purposes of any of the Council's functions.
(3) The regulations may in particular make provision as to
(a) cases and circumstances in which access is to be permitted;
(b) limitations or conditions to which access is to be subject.
We appreciate that a number of issues that concern us will be the subject of regulations rather than primary legislation. We hope and expect that the Assembly will give us the same opportunity to comment on the regulations as we have had to comment on the wording of the Draft Bill. If this is the case then we need not dwell on the details that the regulations will cover in this paper.
4. The Assembly may by regulations
(a) provide for the establishment of a body
(i) to advise Councils with respect to the performance of their functions, and to assist Councils in the performance of their functions;
(ii) to perform such other functions as may be prescribed; and
(b) provide for the membership, proceedings, staff, premises and expenses of that body.
These are exactly the words used to provide for the establishment of ACHCEW in the last Act. As we anticipate that the aim of this clause is to provide CHCs in Wales with the same support that used to be supplied to CHCs by ACHCEW then we have no comment other than we welcome the intention to provide similar support to CHCs in Wales.
5. The Assembly may pay to members of Councils and any body established under paragraph 4 such travelling and other allowances (including compensation for loss of remunerative time) as it may determine.
Wales Centre for Health
6. The Assembly may by regulations make provision
(a) as to the appointment of members of the Centre, ensuring appropriate lay membership, (including any conditions to be fulfilled for appointment and provision about disqualification for membership);
Minor and consequential amendments
We are unsure as to where the following suggested amendment should correctly appear, and would be grateful for advice.
Additional Clause. In order to improve recruitment of members of the public, particularly those amongst the working population, we would very much like to have a new clause included in the Bill. The aim of such a clause is to recognise that Council Members sometimes need time off for public duties. If we wish to attract working members of the public it is not enough to ensure that they will be paid for any loss of earnings, as an employer could refuse them the time that they need to attend CHC business. There is a Section 50 (8) of the Employment Rights Act (1996) (Relevant Health Body) which lists the number of public bodies that employers have to give their employees time off to attend. CHCs are not included and we believe that they could be, so that employers would be obliged to give employees the necessary time .
10 May 2002