Standing Committee A
Thursday 6 December 2001
[Mr. Alan Hurst in the Chair]
Entry and Inspection of Premises
Amendment moved [this day]: No. 156, in page 21, line 7, at end insert
''( ) Health Authorities,
( ) local authorities,''.[Ms Blears.]
The Chairman: I remind the Committee that with this we are taking Government amendment No. 157. I also remind hon. Members of my co-Chairman's ruling that there will not be a stand part debate on clause 16.
The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): I hope that the amendments will be straightforward. As I said this morning, amendment No. 156 does not represent a change in policy. We have always intended that patients forums should have a right to inspect any premises in England where patients go to receive health care. That includes premises owned or controlled by Welsh national health service bodies and local authority premises where services are provided under a section 31 agreement with the local authority.
Until the proposed structural changes to the NHS in Wales in the Bill were introduced, Welsh NHS bodies were covered by the original wording of the clause. After the changes, trusts will still be covered in Wales, but not the new health boards and health authorities that will be created. In the case of local authorities, provision is made under the duties of patients forums outlined in clause 15 to extend the forums' functions to services provided pursuant to a section 31 arrangement. Those services may be provided on local authority premises. The amendment puts right an omission by allowing the forums entry rights to such premises. The amendment as it relates to local authority premises has the agreement of the Local Government Association, which will be consulted on the finer detail of the regulations.
I turn to amendment No. 157. Under clause 15 the forums' functions extend to health-related services provided under section 31 arrangements with a local authority. Therefore, entry rights must properly be extended to cover such premises, to ensure consistency. ''Local authority'' must be given the same meaning there as in section 31 of the Health Act 1999. The amendments are designed to tidy up; they ensure that patients forums can have entry wherever NHS patients from England are being treated.
Mr. Oliver Heald (North-East Hertfordshire): For the sake of completeness, will the Under-Secretary explain what the reciprocal arrangements are? Will Welsh community health councils be able to come into English NHS trusts to do the same job of scrutiny in reverse, so that there are no gaps in the system?
Dr. Richard Taylor (Wyre Forest): Does the amendment include those special authorities that will still exist after the next reorganisation?
Ms Blears: The Welsh are still reviewing the roles of community health councils. They have decided to keep CHCs but are looking at extensive reform of their powers and duties so that they reflect the new make-up of the national health service. As far as I am aware, they have not yet resolved many of those issues, but it will be important to ensure that the system has no gaps where rights of entry are not provided. I understand that the functions of the CHCs, and the way in which they perform in Wales, will be included in the forthcoming NHS (Wales) Bill. I take the point that the hon. Member for North-East Hertfordshire (Mr. Heald) made about Wales.
Mr. Heald: Can the Under-Secretary give a commitment that community health councils in Wales, for as long as they exist, will have exactly the same rights as are set out in the clause?
Ms Blears: No, I am not in a position to make that commitment. Patients forums are being set up because they are being given new powers to follow the patient wherever the patient goes: into primary care premises, where CHCs currently do not go, and into the private sector by virtue of contracting provisions. It would not, therefore, be right for me to give a commitment that existing bodies could exercise what are, in effect, new powers to give patients forums rights of entry. However, the hon. Gentleman made a good point about proposals on how the scrutiny and inspection system will operate in relation to the Welsh organisations. The people of Wales must consider and decide for themselves how they want their system to operate. That is the effect of devolution.
Mr. Heald: There should be no weakening of the position in Wales simply because its people have decided, as they are entitled to, that they want community health councils to remain in place. It does not make much sense to say that a CHC in Wales will not be able to do what a patients forum can do in England as regards entering and inspecting premises. The Under-Secretary agreed that there should not be gaps in provision, especially given the cross-boundary issues. If a CHC in Wales is unhappy about the way in which a Welsh patient has been treated in an English hospital, it may feel that it should investigate that. Many such cases might arise along the border region. Why should not CHCs have the same powers as patients forums? Will the Under-Secretary give a commitment to take up the matter with her counterpart in the National Assembly for Wales to ensure that the Welsh are not disadvantaged in such circumstances?
Ms Blears: As the hon. Gentleman will understand, it would be entirely inappropriate for me to decide here what will happen to the organisation of patient and public involvement in Wales, because that is a matter to be decided in Wales. He made a good point about not wanting gaps to appear, and I can draw that to the attention of the people in Wales who will consider the matter, but it is not for me to say any more about it. The Bill is designed to cover the establishment of patients forums in respect of patients being treated by the NHS in England.
Mr. Heald: Can the Under-Secretary confirm that the Government's intention in moving the amendment is not to allow Westminster in any way to disadvantage Wales relative to England, which is arguably its effect, but to give Wales the opportunity to decide the issue?
I assume that it is necessary for the House to give the powers to the CHCs if they are to acquire them. If that is wrong and the matter can be dealt with and tidied up in Wales, I should be grateful to hear the Under-Secretary say that. I do not want the message to go out that Westminster is acting to the advantage of the English and the disadvantage of the Welsh. That is always a danger where devolution is concerned.
Ms Blears: With respect, the hon. Gentleman is making heavy weather of the matter. I have already said that it will be dealt with in the forthcoming NHS (Wales) Bill. The Government want to enhance and deepen patient and public involvement in the whole national health service, not reduce it, and we have no wish to create inequity. There will be local consultation in Wales with all the relevant stakeholders about the type of organisation and the functions that they want for CHCs operating in their country. They will consider the reforms in order to decide exactly how they might be incorporated, and the detail will be dealt with in the NHS (Wales) Bill.
Amendment agreed to.
Amendment made: No. 157, in page 21, line 25, at end add
''( )In subsection (1), ''local authorities'' has the same meaning as in section 31 of the 1999 Act (arrangements between NHS bodies and local authorities).''.[Ms Blears.]
Clause 16, as amended, ordered to stand part of the Bill.
Dr. Taylor: I beg to move amendment No. 212, in page 21, line 44, at end insert
''(e) the Members of the House of Commons representing constituencies in the relevant locality.''
It gives me great pleasure to move the amendment. I have not been here long, but I have achieved one or two ambitions. One of them was to see an amendment that had not necessarily been tabled by the Government achieve something. This amendment is a tremendous opportunity for that. It is supported not merely by the Opposition, but by meI would prefer to sit in the middle if there were a seat.
From the response to the listening exercise, ''Involving Patients and the Public in Healthcare'', one can see that the Government have accepted that the amendment is necessary. In paragraphs 3.21 and 3.28 on pages 10 and 11, they agree that local MPs should be the people to receive forum reports and the amendment seeks to enshrine that requirement in the Bill. It would show that the Government and the Under-Secretary are listeningas she promised that she wouldand taking action. I want to see those in my amendment added to the list of people who receive reports from forums.
Mr. Heald: I support the amendment. One strength of the community health council system has been the generous way in which CHCs have kept Members of Parliament informed by sending them agendas, reports and information on other proceedings. Earlier, I said that I had become aware of the problems of one of my local hospitals because the CHC had brought them to my attention through reports and minutes of meetings.
However, there are other ways in which the aim of the amendmentthat reports come into the possession of hon. Memberscould be achieved. Provision could be made for a report to be laid before Parliament. Another way would be to give the Secretary of State permission, or require him, to publish a report that he receives. I therefore want to check with the Under-Secretary that there is not already something in the Bill that would cause such reports to come into the possession of Members of Parliament.
Ms Blears: I understand the wish of the hon. Member for Wyre Forest (Dr. Taylor) to see the amendment enshrined in law. I am pleased that he acknowledged that the listening document was genuine. As he pointed out, paragraph 3.21 of our response to the document states that local MPs have a role to play in shaping their health services, as they have an important role in raising issues in Parliament. We shall ensure that they receive copies of patients forum reports from their constituency so that they are kept aware of important local issues. We must ensure that the information in those annual reports is widely available.
It is inappropriate to put a provision into primary legislation because it is a matter of good practice rather than statutory responsibility and requirement. It would set a strange precedent for legislation if we were to require copies of a document to be sent to individual Members of Parliament. We could, however, require copies of all reports in which Members of Parliament might have a legitimate interest to be sent to them individually.
As we said in the listening document, we shall ensure that Members of Parliament get copies of documents and that they are kept in the loop regarding events in their constituency. I certainly appreciate being kept informed by the patient groups, including the community health council, in my constituency. Members of Parliament should receive that information, but it is inappropriate for a requirement to be placed in the Bill in this way. The spirit of the suggestion made by the hon. Member for Wyre Forest is sensible and we will ensure that what he has suggested happens, but for those reasons we must resist his amendment.