Draft National Health Service (Wales) Bill

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Mr. Llwyd: On a point of order, Mr. Griffiths. Why has two thirds of the Welsh Labour party disappeared from the Committee? This is an important Bill.

The Chairman: That is not a point of order. I call Lembit Öpik.

12.31 pm

Lembit Öpik (Montgomeryshire): One hundred per cent. of the Welsh Liberal Democrats are currently represented here, so one party of Welsh government is present in its entirety.

This is a landmark event, because it gives us the opportunity to show that the Welsh Grand Committee can make mature and constructive contributions to the drafting of legislation. For many of us, this process has been long overdue, but we welcome it because, assuming that we can prove our ability to contribute constructively to the development of legislation, this might be the beginning of something that we have long awaited—observing a listening Government taking on board serious and sensible recommendations when legislation is still flexible enough to be positively influenced by them.

I feel particularly qualified to talk about the health service because it saved my life in 1998 after I had had a serious accident. I fell 30 m when the paraglider that I was attempting to fly deflated above my head. Llanidloes hospital was largely responsible for initially stabilising my condition, and Royal Shrewsbury hospital got me through the critical hours that I spent hovering between life and death. Thereafter, Gobowen hospital, which is probably one of the world's leading orthopaedic institutions, helped me to get back on my feet. After the accident, Glyn Davies, a Conservative Assembly Member, saw me hobbling around Newtown and said, with visible disappointment, ''Ah, Lembit, you were 10 feet short of a by-election.'' I have never forgotten that.

The lesson that I learned at that time was that all the elements of the health service perform exceptionally well in the great majority of life-or-death crises. Its emergency provision is not absolutely perfect, but the overwhelming majority of the Welsh public feel that it does not make a drama out of a crisis, and that it does all that it possibly can to help people. Therefore, this Bill offers us an opportunity to improve a health service that, by and large, works extremely hard. It might be starved of resources, but the members of its professions are very committed. It would be hard to believe that many of them work in the health service for the money; they work for it because they love what they do.

The Liberal Democrats welcome the Bill. As currently drafted, it covers sensibly and strategically the evolution of the Association of Welsh Community

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Health Councils, the Wales Centre for Health, and the Health Professions Wales organisation. I suspect that the Bill would not exist in its current form if the Welsh Assembly had not come into being. One reason why this draft Bill is so important is that it is beginning to show the evolution of a realistic partnership among the Welsh Assembly, Welsh health professionals and Westminster, which is seeking to design health provision that specifically fits the needs of Wales, although I will mention one potential consequence of divergence in Welsh Assembly and Westminster policy.

It is wholly constructive that Westminster now shows its genuine commitment to working with and listening to the needs of Wales as outlined by the Welsh Assembly and others. In that sense, as we look through the Bill, it is important that we make constructive and specific recommendations for improvement. Should he catch your eye, Mr. Griffiths, my hon. Friend the Member for Brecon and Radnorshire (Mr. Williams), who is a member of the Welsh Affairs Committee, will make specific suggestions. Some of those come from Liz Hewitt of the Royal College of Nursing, who very helpfully gave us some specific guidelines.

Mr. Martyn Jones: I wanted to interrupt the hon. Gentleman's speech before he finished, which is difficult to judge. I tried unsuccessfully to intervene on the hon. Member for Caernarfon. Although I accept that they may wish to add some of their own recommendations, do the Liberal Democrats support each of the 22 in our report? I should have liked to put that question to the hon. Member for Caernarfon, who spoke for Plaid Cymru.

Lembit Öpik: We broadly agree with most of the recommendations, although we have specific issues with one of them. My hon. Friend the Member for Brecon and Radnorshire will discuss that in detail, and the hon. Member for Clwyd, South may wish to intervene at that point. I do not pretend to share the knowledge of members of the Select Committee because this is not an opportunity for us to grandstand and provide our perspective on issues about which we may not necessarily be as well qualified to talk. I hope that the hon. Gentleman will understand that it is more appropriate for me to leave it to my hon. Friend to talk in detail about such issues.

On coterminosity, we have, as hon. Members know, more than one community health council in Powys. We believe that a degree of flexibility is necessary so that community health councils naturally cover the geographical flow of patients to their local provision. In our view, therefore, it would be dogmatic to insist on coterminosity based on obvious but not necessarily appropriate boundaries. That is a matter for further discussion.

It is extremely important that we ensure that the health professional representatives are on board at all points between now and the evolution of the final Bill. In fairness, that has already taken place to a large extent, thanks to the way in which the Select Committee conducted its activities. It becomes really important when we discuss the detail. We sometimes generate unintended consequences. In examining the

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way in which the three particular bodies are designed, we must not build in any restriction or limit what the Health Professions Wales can do to ensure that regulation is effective.

By the same token, it is important that the Wales Centre for Health embraces a cross-Wales brief. In large part it will be geographically connected to the Welsh Assembly. However, with modern technology, there is no reason why any part of Wales should feel excluded from the centre's activities. Liz Hewitt told me that she imagined that the centre would largely be a virtual Wales Centre for Health, using modern technology to ensure that nobody is excluded. As far as they go, the provisions make that possible. However, it may be necessary to state that intention more explicitly in the final Bill, and include some of the mechanisms that one would expect to be needed.

Community health councils are perhaps the most obvious example of potential divergence between England and Wales. To the credit of the Government and those who have framed the Bill, representations from people throughout Wales have been listened to. It will be interesting to contrast the operation of community health councils in Wales with activities in England, and compare like with like to see which is more effective. If we are effective in implementing the Bill expeditiously, there will be pressure and an assumption that we will get better value for money from the health service in Wales than we have in the past.

Plaid Cymru Members have asked questions and read a long line of statistics that imply that Welsh health is not performing well. Let us remember that there is no quick fix to issues that require long-term investment. The obvious reason why waiting lists are so long in Wales is that we cannot physically recruit and train sufficient staff quickly enough to turn round the problems that we have observed during many decades in which there was underfunding of the health service. We should have realistic expectations of what the Bill can and cannot do. It is not an alternative to proper resourcing.

By the same token, even if we create a more efficient health service, we are unlikely to create a less expensive one because, as life expectancy increases, the significant expenditure that occurs toward the end of a person's life will be shunted to a higher age. It would be wrong to pretend that health care will become less expensive in Wales, although it might be more effective. Life expectancy and the incidence of disease might be more meaningful measures than the cost of treating an individual from cradle to grave.

If the system of feedback on draft Bills is to work, we must recognise what the hon. Member for Gower (Mr. Caton) said about taking a Select Committee approach rather than a party political approach. I am not convinced that simply reeling off the health service's problems is useful feedback to civil servants and Ministers while we are considering a clearly focused and specific Bill to which we should contribute.

A constructive approach is not necessarily one in which there are no differences of opinion. On 7 May in

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the Assembly, a motion moved by Plaid Cymru generated much debate about the health service and the Barnett formula. The Assembly divided on several issues, and Liberal Democrats opposed the motion. We felt that what Plaid Cymru Assembly Members said about the NHS with regard to consequentials was too restrictive.

Mr. Llwyd: May I briefly deal with that point?

The Chairman: As long as it is not a point of order.

Mr. Llwyd: It is not a point of order. The matter arose yesterday during a debate on the radio. The hon. Member for Montgomeryshire (Lembit Öpik) said that he was looking for a needs-based formula, and I said that that was unfortunate because his colleagues voted against that on 7 May. Liberal Democrats say one thing in Wales and another in Westminster. It is the same old story.

Lembit Öpik: In my clever way, I have managed to prompt the comment from the hon. Gentleman for which I had hoped. We had a private discussion after a debate yesterday, and I shall address the point for 30 seconds before I conclude my comments.

The motion on 7 May addressed three things: the Barnett formula, the NHS and European funding. As the hon. Gentleman well knows, Liberal Democrats proposed an amendment to the motion, which was defeated. We felt obliged to vote against the motion because we disagreed with parts 2 and 3 of it. I told the hon. Gentleman that I would publicly apologise if he could show that we voted against the Barnett formula. I hope that he will understand in the spirit of our conversation that we voted against other parts of the motion but not those that related to the Barnett formula. The hon. Gentleman is a grown-up politician who understands how things work, and I hope that I have clarified the point to his satisfaction, although he was perfectly entitled to raise it.

As I have said, there is a risk of divergence between Westminster and Cardiff, which I believe will happen. If this process is successful and repeated in future, Members of Parliament who represent Wales will be drawn into discussions that will often be sponsored and promoted by the Welsh Assembly and that lead us away from policies that will apply to England and occasionally Scotland.

That is a healthy consequence of devolution, but we must recognise that if that happens we shall increasingly be required to regard politics as a competition, not a war, and we must be able to tolerate the fact that different solutions will fit different regions of the United Kingdom. That is a different way of looking at politics. It will provide us with both the opportunity for better solutions for Wales and a hostage to fortune, as there will be a danger of our acting hypocritically by condemning different solutions.

If we are serious about devolution, we must always consider the outcomes that we intend rather than the cheap shots that may be presented to us in the short term. The latter are boomerang issues; if we try to

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score short-term gains, sooner or later we shall be found out. I therefore hope that a consequence of the consultation is the same as one of the consequences of devolution: a more mature approach to policy making in both Westminster and Wales.

12.46 pm

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Prepared 16 July 2002