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27 Nov 2002 : Column 408—continued

Mr. Jon Owen Jones: My hon. Friend makes an interesting point about how effective specialist care could be best managed in different areas. I am sure that community health councils will be able to play a role, but surely the most effective way to develop that is to have a national audit across the United Kingdom comparing best systems and how they work. An independent database helps local people know what is the best available care.

Mr. Havard: I share some of my hon. Friend's views on the audit process, but I shall not go into detail about it. He has made the point that he wanted to make.

Setting up the Wales Centre for Health is a very important step. It will have to work alongside and co-operate with many other health institutions, for example, the National Institute for Clinical Excellence, whose remit will still apply in Wales. It will be important to judge how that arrangement works.

I have a problem that I am trying to resolve. I have decided that I may be banging my head against the existing bureaucracy, even though I have the Chancellor of the Exchequer on my side, apparently, in doing so. So, I have turned the problem the other way around and said that what is really important is what the patients understand. I welcome the CHCs and the advocacy services. I want the informed debate that I am told should take place between clinicians and patients regarding what is the standard and the care that they should expect. I hope that these bodies will help empower patients so that they know what to ask for—very often they do not know unless someone tells them what care is available.

I am involved with a free magazine for cancer patients. It is in the Library of the House, and it provides a forum for debate so that patients can understand what could and should be available to them. In that way, they are empowered and can make the health service their health service. If these proposals help that process, I shall be very pleased—if they do not, I shall be less pleased, because those are my tests to measure their success.

I once saw a campaigner wearing a huge badge that said, XWearing badges is not enough"; nor is changing institutions. We have to have the right intentions; we have to listen to the response when it comes, and act on it. We will confront the issue about money at some point, although it will not be in our gift here at Westminster, of course, because we will have given that opportunity away. It is called devolution. Nevertheless, we will have an important view and there need be no worry that it will be properly put.

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I welcome the fact that some of the institutions in the Bill will help make change. They will test one or two of the old boys' clubs current in the bureaucracy surrounding the health service. If we say what standards we require, people will say exactly what they want. Wales is the appropriate place for those institutions to carry out the Government's intentions in practice, given that it was the place that designed and achieved the national health service, as my hon. Friend the Member for Aberavon (Dr. Francis) articulated earlier.

9.13 pm

Ian Lucas (Wrexham): This has been a long and interesting debate. Right hon. and hon. Members have been almost unanimous in welcoming the Bill. Part of the reason that the Bill has been so widely welcomed is the procedure that has been followed to bring us to this point. The scrutiny that has taken place has ironed out some of the differences between the various parties and the Government have in many respects already addressed the smaller issues that were raised during the process. However, the Bill is largely uncontroversial and I therefore caution against the inference that the procedure that has been followed for this Bill is the best possible when considering legislation for Wales.

I want to say, at the outset, that the onset of draft legislation—a tremendous innovation by the Government—gives us a great opportunity to forge a working relationship with the National Assembly for Wales. Within the context of draft legislation, we can begin to deal with the major constitutional challenges brought by the establishment of the Assembly.

The Government decided that a draft Bill for Wales should first be looked at by the Welsh Affairs Committee. That was a useful experiment, but I am not a member of the Welsh Affairs Committee, and I have an interest in, and experience of, the health field, and I should have liked to contribute to the Bill at an earlier stage than now. The fact that the Welsh Affairs Committee is a territorial Committee is relevant in the context of draft legislation. One of the great benefits of the Select Committee system is that it enables Members to develop specific expertise, which they can bring to bear in consideration of any Bill that relates to the individual topic. The Welsh Affairs Committee does not have the same merits as a departmental Select Committee in that respect.

My view is that a special Committee should be set up to look at draft legislation of this type. As I have said before, I believe that that Committee should be made up of Members of this House and Members of the National Assembly for Wales. I am pleased that, today, the Chairman of the Welsh Affairs Committee has adopted my suggestion and appears to be following the course that I have set out previously. It is important that we follow that course for two main reasons. First, it would mean that a thread would run from the inception of any policy in the Assembly through to the passing of the Bill in the UK Parliament. Assembly Members would be present at the beginning of the Bill when the ideas were brought forward, and, at the onset of draft legislation, they would become members of a Committee with Members of this House and would work together to improve the Bill.

At that stage, once the preliminary consideration of the draft legislation had taken place, the Bill would be shifted up to Westminster, and the Committee members

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from Westminster who had been looking at the Bill could pass on the information, experience and arguments of Assembly Members to this House. That would ensure a rigorous line of scrutiny from inception of ideas through to passing of legislation. That is a sensible framework that at least deserves to be tried. The test will come when we have a contentious piece of legislation. The Select Committee format is very positive, and as a new Member I have been impressed by the way in which Select Committees operate and relationships develop, even with Members from Opposition parties.

Mr. Deputy Speaker: Order. I am not sure that this is the most apt occasion for a constitutional essay. I hope that the hon. Gentleman will come to the Bill in a moment.

Ian Lucas: I am obliged, Mr. Deputy Speaker. I am coming to the Bill now.

The issue on which I want to focus is the retention of community health councils. My experience of community health councils comes from a different perspective, which has not been mentioned in the debate so far. Before I came to the House, between 1997 and 2001, I was a non-executive director of the Robert Jones and Agnes Hunt hospital at Gobowen. It is an unusual hospital. It is two miles from the border with Wales and provides a great deal of help, expertise and care to people from north Wales, mid-Wales, Shropshire and the surrounding area.

In my role as a non-executive director, I was also complaints convenor and had much experience of dealing with members of the CHC. It played an extremely valuable role in putting together submissions on behalf of people who would not usually be able to put together submissions themselves. It presented complaints in a NHS procedure that is, in my experience, the most complex one that anyone making a complaint could encounter. The procedure is bedazzling to all those who deal with it, including me as a trained lawyer.

Gareth Thomas: I know that my hon. Friend has an interest in this subject. He has not only been involved in health service management but is a lawyer who has experience of clinical negligence claims. He will recall that I chaired a seminar on clinical negligence in the House. Does he think that there is a role for CHCs and the Wales Centre for Health in trying to bring about a more effective complaints system? Such a complaints system would offer the patient a quicker and more transparent explanation of what had gone on in an adverse incident, as it is termed by doctors. It would also have the ability and power to make small awards and compensation without recourse to the long-winded procedure in the courts.

Ian Lucas: There is, indeed, an essential role for the CHCs. In my role as a member of the board of a hospital that provided health care to people in north Wales, I knew that the submissions and complaints made by patients were a valuable management tool for the hospital. They helped to improve the standard of care that was delivered. One of the major challenges that the NHS faces is to find a system that responds to the

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concerns and complaints of patients and does so in an environment that does not threaten the providers of the care—whether they are doctors or nurses. The CHCs need to develop a partnership role with hospitals so that information can be presented in a uniform way as far as possible. That information would then be a valuable management tool for the hospital.

I must confess that another aspect of the Bill causes me concern, and it relates to cross-border care. I represent Wrexham, which is a border town. Health care is supplied to it by the Countess of Chester hospital, Wrexham Maelor hospital and the Robert Jones and Agnes Hunt hospital near Oswestry that I have already mentioned. More specialist care is provided in Liverpool and Manchester. However, the Bill does not appear to be clear on the important question of whether the CHCs in north Wales, which will continue, will have the investigatory powers to examine matters in England. I hope that my hon. Friend the Minister will clarify that point when he winds up. Many of my constituents who see me about health care problems tell me that they have been treated across the border and want to pursue their case just as readily as they could if the hospital were in Wales.

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