NHS Reform & Health Care Professions Bill

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Ms Blears: This morning, I gave hon. Members the proposed implementation plans, which set out the time scale for developing guidance and consulting on regulations. I can assure the hon. Gentleman that had the documents to which he referred been ready, they would have been shared with the Committee. We envisage that guidance for the NHS will be published early next year, and that there will be discussion and consultation on that. My right hon. Friend the Minister of State did not promise to produce regulations that do not exist.

Mr. Heald: Will the Under-Secretary give way?

Ms Blears: This is tiresome.

Mr. Heald: It may be tiresome for the Under-Secretary, but it is our job to scrutinise. It is always tiresome for a Government to endure the scrutiny of an Opposition; in the past I felt much the same as she does.

In respect of the patient advocacy and liaison services, it is stated that guidance will be developed and issued in January 2002. Is the Under-Secretary seriously suggesting that no substantial, worked-on document exists on that subject? It is clear that work is on-going in respect of these matters. Why cannot a progress report be published, setting out what has been decided so far?

Ms Blears: I have tried to do as much as I can to share information on the proposed implementation plan, and I hope that I have answered many of the questions on how we envisage the system developing. I can promise the hon. Gentleman that there is no question whatever of our keeping up our sleeve drafting regulations and guidance in a deliberate attempt to avoid scrutiny. We are more than happy to be open and transparent, and to share as much information as we possibly can. I want not only patients and the public but hon. Members to be involved in this process, so that they feel they have a role in shaping how legislation develops.

Mr. Baron: Following on from the suggestion of my hon. Friend the Member for North-East Hertfordshire (Mr. Heald), it would have helped had we been given this information a few days earlier. I thank the Under-Secretary for producing the programme, and there is no doubt that it is useful, but it has given rise to questions—for example, on patients forums—that we might otherwise have considered. I, for one, would have wanted to know more about the progress of the agreed pilot projects, given the body that they are seeking to replace. Instead of providing such information on the day of discussion, it would be useful, if possible, to have at least a couple of days' notice. Given that the pilot projects have been agreed, the information could have been produced sooner, which would have helped the Committee in its deliberations.

Ms Blears: I am pleased that the hon. Gentleman is finding the document useful. It constitutes a gathering together of the progress on all the pieces of the jigsaw, so it has not been possible to share such information earlier. I wanted to gather together all parts of the system for the Committee's benefit, because I recognise that this is a complex issue. The greater the understanding, the more robust our proposals will be. I can assure members of the Committee that we have provided the information as soon as was possible.

On monitoring the duty on the NHS under section 11, the Commission for Patient and Public Involvement in Health will be responsible for reporting to the Secretary of State on how well all the public involvement mechanisms are working. There is provision in the Bill to check how well the NHS is performing the duty to consult. I am very keen to make certain that we have an audit process. In the past, no body has been able to monitor how well the system is working in different parts of the country, and there has been variation in standards. One hopes that the commission will provide that consistency across the board, so that people will have access to the same high standards that they have every right to expect, regardless of which part of the country they live in.

I turn to amendments Nos. 215 and 216, on the funding stream for patients forums, and the suggestion that that would be more logically contained within the remit of the Commission for Patient and Public Involvement in Health, rather than the trust. I take the point made by the hon. Member for Wyre Forest, and we have been considering the matter for some time. It may be more appropriate for the funding stream to be delivered in a different way and I undertake to consider the matter further with a view to introducing an amendment at a later stage. We are aware of the issue, we intend to address it and I assure the hon. Gentleman that we shall do so.

For all those reasons, I ask the Committee to resist the amendments, which are not appropriate in terms of the annual reports. We shall introduce the requirements by good practice rather than in the Bill and I undertake to look again at the funding stream for patients forums.

Amendment negatived.

Question proposed, That the clause stand part of the Bill.

Mr. Heald: It may be that the hon. Member for Wyre Forest did not want to withdraw the amendment, as one might have expected, but I hope that the Minister's assurance that she will look again at the matter, particularly the issues under clause 18, still stands; I am sure that it does. It may be possible for another way to be found to return to the matter on Report. I was going to raise one or two points but, after further thought, I shall leave them.

Clause 17 ordered to stand part of the Bill.

Clause 18


Dr. Harris: I beg to move amendment No. 217, in page 22, line 40, at end insert—

    '(mm) the referral of matters of a prescribed description to—

    (i) 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 1(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; and

    (ii) the relevant Strategic Health Authority.'.

The Chairman: With this it will be convenient to take the following amendments: No. 218, in page 22, line 42, leave out 'and'.

No. 219, in page 22, line 43, after 'Authorities', insert

    'and overview and scrutiny committees'.

No. 220, in page 23, line 7, at end insert—

    '(3A) Where an NHS trust provides significant services for patients resident in areas covered by more than one overview and scrutiny committee, the membership of the Forum for that Trust should be drawn proportionately from each of those areas.'.

New clause 3—Duty of overview and scrutiny committee to review and scrutinise—

    'In section 21 of the Local Government Act 2000 (c. 22) (overview and scrutiny committees), leave out paragraph (2)(f) and insert—

    ''(2A)Executive arrangements by a local authority must ensure that the overview and scrutiny committee or committees of an authority to which section 7 of the Health and Social Care Act 2001 applies, has a duty to review and scrutinise, in accordance with regulations under that section, matters relating to the health service (within the meaning of that section) in the authority's area, and to make reports and recommendations on such matters in accordance with the regulations.''.'.

New clause 4—Functions of overview and scrutiny committees: supplementary provisions—

    '(1) In line 1 of section 7(3) of the Health and Social Care Act 2001, leave out ''may'' and insert ''shall''.

    (2) In section 7(3) of the Health and Social Care Act 2001, there is inserted—

    ''(aa) as to matters relating to the health service in the authority's area which it must refer to the Secretary of State''.'.

New clause 5—Patient Forum representation on overview and scrutiny committees—

    'In section 21 of the Local Government Act 2000 (c. 22) (overview and scrutiny committees), there is inserted—

    ''(10A) When fulfilling its duty under subsection (2A) above, the overview and scrutiny committee of a local authority, or any sub-committee of such a committee, shall include at least one member of each Patients' Forum established for each NHS Trust and Primary Care Trust which provides services to the area of the local authority concerned.''.'.

Dr. Harris: This is an important group of amendments, designed to probe and to raise concerns that the current arrangements, particularly for oversight and scrutiny, are not as they might be. The Health and Social Care Act 2001 and the Local Government Act 2000 were predicated on a wider change. However, with the onset of the general election—on which we all look back with relief and pleasure—some aspects of legislation had to be dropped for the time being, so there may be omissions. I know that the Under-Secretary will have studied the matters carefully and I hope that she will be able to reassure hon. Members who share my views about them.

Amendment No. 217 would insert into the supplementary provisions in clause 18 an additional paragraph, and some of the words in the amendment are lifted from another part of the Bill. One of the important functions of community health councils is the ability to ensure that there is scrutiny of local decision-making. I will speak later with regard to whether overview and scrutiny committees have the relevant powers and duties to make the appropriate referrals. However, the first point I want to make explicit is that regulations should be provided for the referral of these matters to overview and scrutiny committees.

By misfortune rather than by design, I do not think that there is any problem in recognising which overview and scrutiny committee is relevant for each area. Indeed, there are arrangements for joint committees where required, and clearly some primary care trust patients forums will overlap more than one overview and scrutiny committee. That will not be a significant difficulty as regards the amendment.

The people already involved in the matter recognise that this amendment would allow patients forums to refer matters to relevant overview and scrutiny committees, and to strategic health authorities. As the Government would have it, patients forums would have first-hand knowledge of services, and should be able to put issues of concern on the agenda of overview and scrutiny committees. The second amendment in this group is amendment No. 219, which is consequential. Amendment No. 219 would insert into line 43 the need to have relevant regulations regarding membership. There may well be other members of the Committee who have strong views on those issues.

Amendment No. 220 again talks about membership. I am sure that the hon. Member for Wyre Forest will speak in his customary style, which is brief and to the point, on these matters.

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