|NHS Reform and Health Care Professions Bill
Mr. Heald: I beg to move amendment No. 227, in page 74, leave out line 16.
This is a probing amendment designed to raise the question of the extent to which it is proposed that work should be undertaken in house, or contracted out. Its effect would be to require all work to be contracted out, which I do not suppose the Government would wish to do, but we would like to know what work the Government envisage would be outsourced. Would it be investigative work or opinion research? Will the Minister also explain whether a regulatory body could be asked to help investigate another?
Page 74, line 16, states:
11 (1) The Council may arrange for the discharge of any of its functions by —
(a) a committee, sub-committee, member or employees of the Council, or
(b) any other person.''
I have chosen to delete line 16, but I could equally have deleted line 17. What I really want to get at is what the Council—in the Government's view—will do in terms of the delegation of the discharge of its functions. What sort of work would ''any other person'' be expected to do?
Mr. Hutton: I take it from the hon. Gentleman's remarks that this is essentially a probing amendment, and he is trying to extract from me an assessment of under what circumstances the powers of delegation would be exercised. Let me explain why I think we need this provision in the Bill in the first place. It is a pretty standard provision in relation to bodies of this kind, which allows the council to exercise its discretion as to what work it might want to delegate to others within the organisation and outside. It clearly allows the council to go about its business efficiently and effectively, taking advantage of that type of opportunity when it thinks it appropriate. We therefore want to give the council the powers, tools and opportunities to go about its business effectively that we would give to any similar body. It is for the council to decide if, when and how its powers are used, and I would not want to take that freedom away.
The answer to the question put by the hon. Member for North-East Hertfordshire is that this is a matter for the council to decide. We have had a long argument about independence from the Government, and he is asking me to say when the council might want to exercise its discretion to delegate. Hello? We cannot join those arguments together and present them as a whole. The important point is for the council to have discretion as to when and under what circumstances it might want to exercise that power. It would be for the council to decide who, what, when and how such a power was exercised. ''Who?'' might include, for example, academic bodies with expertise in this area from which the council will want to commission pieces of research.
The issue of committees and sub-committees relates to the good management of the council. Many regulatory bodies have committees to which they delegate responsibilities and powers, and those are matters for the council to decide. I cannot give the hon. Gentleman anything more concrete than that, given that we expect the council to act at an arm's length distance from Ministers.
Mr. Heald: Will the Minister deal with two points of detail? First, would it be possible for the council to say to one of the bodies that it is regulating, for example the chiropractors: ''We should like you to help us investigate this complaint against the nurses''? In the case of the police, the use of one police force to investigate another has always been subject to criticism. I was wondering whether the provision would allow bodies to be used in that way. Secondly, will it be possible to use outside investigators such as private inquiry agents to assist in a complaint investigation?
Mr. Hutton: The hon. Gentleman is describing fitness-to-practice issues, which are not within the council's remit because of clause 24(3). The council would not have the powers to investigate individual fitness-to-practice cases. [Interruption.] Under clause 26, the Secretary of State would have the opportunity to establish a scheme whereby the council could deal with maladministration complaints through regulations, and this issue might arise in that context. These are, however, matters for the council to determine.
Mr. Burns: May I seek some information from the Minister? I notice that in schedule 7, paragraph 11(1)(b)—''any other person''—allows the council to commission work from outside bodies and individuals, which will, if one examines paragraph 11(2), have to be paid for. The Secretary of State will provide funding for the body, but would there be a problem if funding goes to the private sector to commission work, which does not necessarily come cheaply? The budget will presumably be fixed, not elastic. Does the Minister envisage the workings of the council's being hampered by its inability to commission an adequate amount of work from ''any other person'' because of its financial constraints?
Mr. Hutton: There is no such thing as a free lunch. All public bodies must operate within the resources that have been allocated to them. Yes, it is not cheap to commission pieces of specialist work from private sector bodies, or indeed any bodies outside government. It is right—I wish that I had referred to this point when the hon. Member for Westbury asked about the council's costs—to draw the Committee's attention to our intention to fund the council through the Department of Health, which will not entail passing on costs to the GMC, the General Dental Council or the General Optical Council. The council will be funded centrally, and it must operate within its budget. The way in which it chooses to discharge its functions or delegate and commission outside work must be compatible with its budget. There is no blank cheque, but by the same token the council must be properly resourced so that it can go about its jobs effectively. Like all of us in our daily lives, it must balance what it would like with what it has to spend. The council will be properly resourced, but how it decides to use its resources will be its concern, which accords with the spirit of operating at arm's length from the Government.
Mr. Heald: It seems that clause 26, which the Minister mentioned, provides the council with an investigatory role. It will, for example, be making payments to persons in connection with investigations. It is right that such investigations are into administrative matters rather than fitness-to-practice issues. Given that people will be doing investigatory work, the amendment is designed to find out who could do that work and whether it is right that one of the regulatory bodies, such as the chiropractors, could be asked to investigate maladministration by, for example, the Nursing and Midwifery Council. Will outside inquiry agents be used? Alternatively, am I missing the point and something else is being thought of here?
Mr. Hutton: With respect to the hon. Gentleman, he is asking me to put myself in the council's position and tell the Committee how it will delegate its powers to outside bodies, which is not a position that I want to occupy, and I therefore decline to give him an answer. The hypothetical situation of the council asking the chiropractors to investigate complaints about the nurses strikes me as slightly eccentric, and I am unsure whether there is sense or logic behind that proposition. In principle, these issues are a matter for the council, which will have the widest possible powers of delegation. That is compatible with the way in which other bodies have been set up in the past. If the hon. Gentleman would like a note explaining how, if at all, similar bodies have used these powers, I am happy to provide that for him.
Mr. Burns: To return to my earlier intervention, will the Minister clarify his valid point that all of us, including the Government, the Department of Health and the council, must live within our means? On the question that I raised about ''any other person'', I have suddenly realised that the Secretary of State can make loans to the council. Does that not undermine the Minister's claim that the council will be stuck within strict limits for its finances? If it needs more money to commission outside work, it can presumably go the Secretary of State for a loan.
Mr. Hutton: The hon. Gentleman must have unique access to non-repayable loans, and he must tell me where he gets them.
The Chairman: Order. Debates on finance will be better conducted under the next group of amendments. We are now on amendment No. 227. May I ask the Minister, and any other hon. Members who intervene, to direct themselves to that amendment?
Mr. Hutton: I am very grateful for that definition. I was looking forward to discussing with the hon. Gentleman whether loans are repayable—of course they are—and whether they must be paid from existing budgets. However, we shall return to that point in a moment. I am grateful for your indulgence, Miss Widdecombe, and I shall not try your patience any longer. This would probably be a good time for me to sit down.
Mr. Heald: I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Mr. Heald: I beg to move amendment No. 228, in page 74, line 30, leave out
The Chairman: With this it will be convenient to discuss the following amendments: No. 229, in page 74, line 32, leave out sub-paragraph (2).
No. 230, in page 74, line 37, leave out sub-paragraph (4).
No. 231, in page 74, line 41, leave out 'and (4)'.
No. 232, in page 75, line 1, leave out sub-paragraphs (7), (8) and (9).
Mr. Heald: The purpose of the amendment is to remove the power of the Secretary of State to attach conditions to the payments that he makes to the council. The amendment is probing. What is the purpose of the conditions that are referred to in the schedule? The amendment would make the council as independent and undirected by the Secretary of State as possible. I should be grateful if the Minister would explain exactly what conditions he has in mind in relation to money for the council.
Amendment No. 229 is another probing amendment and would delete paragraph 13(2) from the schedule. Why is it necessary for an appropriate authority, such as the National Assembly for Wales, to have the power to give money to the council, subject to conditions? The appropriate authorities are the National Assembly for Wales, Scottish Ministers and the Department of Health, Social Services and Public Safety in Northern Ireland.
Amendments Nos. 230 and 231 would delete paragraph 13(4), which relates to loans that may be determined by the various authorities; the amendments are directed at the conditional nature of the loans. Amendment No. 232 deletes sub-paragraphs (7), (8) and (9). Sub-paragraph (7) gives the Secretary of State the power to give directions as to the applications of funds, (8) gives the appropriate authority the power to give directions as to the application of funds and (9) requires the council to comply with those directions.
Do such conditions simply relate to the repayment of money and the way in which the Bill broadly applies so as to ensure no impropriety, or are they a direction that may have an impact on the council's independence? I am interested to hear what the Minister has in mind in respect of conditionality.
|©Parliamentary copyright 2001||Prepared 11 December 2001|