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Session 2002 - 03
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Standing Committee Debates
Health (Wales) Bill

Health (Wales) Bill

Standing Committee B

Tuesday 10 December 2002

[Mr. Win Griffiths in the Chair]

Health (Wales) Bill

10.30 am

The Parliamentary Under-Secretary of State for Wales (Mr. Don Touhig): I beg to move,


    (1) during proceedings on the Health (Wales) Bill the Standing Committee, in addition to its first sitting on Tuesday 10th December at half-past 10 o'clock, do meet on that day at half-past 4 o'clock and on Thursday 12th December at five minutes to 9 o'clock and at half-past 2 o'clock;

    (2) the proceedings shall be taken in the following order, namely Clause 1, Schedule 1, Clause 2, Schedule 2, Clauses 3 to 7, Schedules 3 and 4, Clauses 8 to 10, New Clauses and New Schedules;

    (3) the proceedings on the Bill (so far as not previously concluded) shall be brought to a conclusion at Five o'clock on Thursday 12th December.

May I say how delighted I am that you are chairing the Committee, Mr. Griffiths? You were a distinguished Minister in the Welsh Office and achieved a great deal for the health service in Wales. I know that you have announced your intention not to seek re-election in the next general election, and that will be met with sadness in your constituency, as it will in this House. Over the years, you have made a major contribution to public life in Wales, as a Member of the European Parliament and of this House.

I know that the subject of this Bill is close to your heart, Mr. Griffiths; as a Wales Office Minister in 1997, one of the first things you did was to reiterate our commitment to reform and change and to the protection of our community health councils. I am indeed pleased to serve under your chairmanship and look forward to your guiding of these proceedings as expeditiously and successfully as possible.

Mr. Nigel Evans (Ribble Valley): I do not wish to detain the Committee long on this motion, which was keenly debated yesterday evening and received unanimous support.

I should like to add my and my party's delight that you are chairing the Committee, Mr. Griffiths. When you were a Minister in the Wales Office, improving the quality of the health service for all the people of Wales was at the forefront of your objectives. It was refreshing that you thought—and, sometimes, spoke—the unthinkable, when other colleagues were less frank. We are looking forward to two full days of debate on the Bill and I hope that our discussions will improve it.

The Chairman: I thank the Parliamentary Under-Secretary of State for Wales, the hon. Member for Islwyn (Mr. Touhig) and the hon. Member for Ribble Valley (Mr. Evans) for their kind words, though they will not affect the conduct of the Committee.

Question put and agreed to.

The Chairman: I remind the Committee that the Bill has a financial resolution, copies of which are available in this Room. Adequate notice should be given of

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amendments and, as a general rule, I do not intend to call starred amendments, including any reached during an afternoon sitting. I also remind everyone to switch off mobile phones.

Clause 1

Community Health Councils in Wales

Mr. Evans: I beg to move amendment No. 1, in

    clause 1, page 1, line 8, at end insert 'following a request by the Community Health Council or Councils affected;'.

The Chairman: With this it will be convenient to discuss the following:

Amendment No. 2, in

    clause 1, page 1, line 15, at end insert—

    '(c) that in abolishing a Council, altering the district in Wales for which a Council is established, or providing for the establishment of a new Council, it has the consent of the existing Councils in the area affected.'.

Amendment No. 15, in

    clause 1, page 1, line 15, at end insert—

    '(c) that due regard is paid to the boundaries of those health authorities which a Council is to scrutinise.'.

Mr. Evans: I am delighted to move these amendments. The Committee stage is important and, as I said earlier, we hope to improve the Bill, which we did not oppose on Second Reading. We have consulted widely and I greatly welcome the printing of the Bill first in draft form. I hope that that will become normal practice rather than an exception. Some of our amendments are based on the consultation that we carried out.

What is in a name? The Labour party—or new Labour, if it still is new Labour—has been re-branded because it thought that another name would be more consumer friendly. Indeed, that turned out to be the case. That was not wholly the reason why the Labour party achieved such a stunning victory in 1997—there may have been one or two other reasons for it—but the change was important. Plaid Cymru has gone through something of a re-branding in trying to make out that it is the party of Wales, so a name can be vital in projecting the right image.

Community health councils, or CHCs as they are commonly known, have an effective branding and are fairly well known. Indeed, we fought, struggled and lost in an attempt to retain CHCs in England. It was a valiant battle because CHCs were popular with patients and other people in England, but we lost that battle. I hope that in the Bill, which gives the Welsh Assembly power to retain CHCs, we will connect with the membership of CHCs in order to retain their name. Indeed, we could change the name only following consultation with the CHCs that would be affected.

Firms with popular names spend millions of pounds on research and analysis. They use expensive public relations companies and test out their ideas on focus groups. They do not always get it right, as we saw in the case of Consignia. It had a useful name that everyone recognised but after service levels were reduced, the Post Office decided to re-brand itself as Consignia. That failed dismally and after spending

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millions of pounds, it has now gone back to calling itself the Royal Mail.

We have seen that happen time and time again; for example in the case of British Airways, which decided to call itself BA, and British Telecom, which decided to call itself BT. Those companies changed their names for specific reasons because they were trying to connect with people globally. Therefore, even ditching the word ''British'' and replacing it with ''B'' was seen as important to the effectiveness of those organisations.

Community health councils are widely recognised throughout Wales. One can imagine that attempting to ditch the name, without consultation or a request from the CHCs involved, will be hugely expensive. That money will be diverted from the health service, which we all want to see improved. Some of the proposed changes may be expensive. They include not only changing notepaper but publishing advertisements and changing boards outside the premises where the councils currently have their offices. Even a publicity campaign will be required to tell patients that CHCs will be known as something else. That could dislocate the current connection between patients and patient groups and the CHCs that represent them.

Given the power to do so, the Welsh Assembly may agree to consult CHCs or to wait until it is asked to consider the matter, perhaps because insufficient people know what CHCs do and it is necessary to give them a more consumer friendly name. We must recognise, however, that CHCs are the patients' champion. They do a specific job on behalf of a group of people who receive services from the NHS. The majority of those people have no choice. They do not have private health care so they cannot go anywhere else, and they may not even be able to travel to neighbouring areas to get the health care that they need. They receive their health service from one monopoly supplier, so the role of the CHC is vital. It is the patients' watchdog and was established to ensure that the service is operating at its highest level for the person who cannot afford to go anywhere else.

I suspect that it is important for the patients who have no other choice about where they go—and vital to those who work in the national health service—for there to be a group of people who champion patients' rights and ensure that the quality of service at a health institution will be the best. If there is a deficiency, it will be exposed. That is not part of a blame culture, but is part of improving services generally.

It is right that CHCs are given the opportunity to enter an institution to find out where the inadequacies are and to make recommendations. As I said, it is not about blaming people for problems, for example, with waiting lists; we know that those problems exist in certain areas. I will not repeat the arguments made on Second Reading. We know that there are deficiencies in the health service in Wales in certain key areas, but it is right that the CHCs expose them.

It is right to allow CHCs to change their name if they, as the people's champion, decide that people do not know what they do and do not recognise them as community health councils. However, that demand should come from the CHCs themselves. I believe that

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I will be proved right when I say that CHCs would not seek to change their name if they were given that power, but would want to retain, or even add to, their brand name, so that all patients knew exactly what they did and how to get in touch with them.

One might say that all this talk about names is pedantic, and that what the CHCs do is far more important than what they are called. However, I believe that it is important for people, especially in an ageing population, to know who the patients' champion is and how to contact it. I remember, although not with fondness, our discussions on devolution during which we debated ad nauseam the name of the National Assembly for Wales. The debate continued for some time—it took up most of one sitting in the Chamber—on whether it should be the National Assembly of Wales or the National Assembly for Wales. We decided that we would call it the National Assembly for Wales, as it added a distinctive difference. Members of the Committee know that the vast majority of people in Wales call it the Welsh Assembly or, indeed, the Assembly.

During that debate, the right hon. Member for Swansea, East (Donald Anderson) intervened to say that the people of Wales had their own way of doing things and regularly shortened names; for example, the crematorium is known as ''the crem''. I made that wonderful joke about what the Assembly could be shortened to, which brought some light relief to the proceedings. The fact is that people will call it what they will, but it was important for us to get it right.

We also had great discussions about whether people holding portfolio posts should be called Secretaries or Ministers. In the end, after much discussion, we listened to what the Government had to say. They decided that they should be called Secretaries. One of the first things that the Welsh Assembly did was to change the change the name from Secretary to Minister, which is confusing. I avidly read about the Welsh Assembly every day in the Western Mail; I cannot think of anything better. Often, when they refer to a health Minister, I think of one person when they are talking about another. That is hugely confusing, and the Government are right that they should have been called Secretaries.

The main thrust behind amendment No. 1 is that we should widely consult the community health councils if we are going to give the Welsh Assembly the power to be able to change names, which will be significant. Indeed, I pay tribute to the community health councils themselves.

I turn now to amendments Nos. 2 and 15. One is an extension of the other. We are looking at the boundaries in which the community health councils operate. Amendment No. 2 would insert:

    ''that in abolishing a Council, altering the district in Wales for which a Council is established, or providing for the establishment of a new Council, it has the consent of the existing Councils in the area affected.''

10.45 pm

That is important, too. It goes back to the question of being the people's champion. The CHCs might be something of an irritant to the Welsh Assembly. After

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all they are there to ensure that the service is effective. If a CHC is doing its job efficiently, it is bound to find deficiencies and to expose them. However, the Health Secretary might find that irritating and take the criticism personally. The Health Secretary might wish to abolish that CHC, reconfigure it or do all manner of things to denude it of its recognised power in a local authority area.

I do not agree with the changes that have already been passed—they are coming in next year—that we should have 22 of these health boards. The whole thing will be hugely bureaucratic—there are problems already—and will lead to a fracturing of the current health service in Wales. I feel that the whole thing will be a disaster, but we know it will go ahead because it has already been passed. I will not rehearse all the arguments in this Committee, but if these health boards are to replicate local authority areas, let us at least have CHCs that cover each and every one of those areas. There should be coterminosity.

It is already confusing enough when people look to see who is covering them. Where does the buck stop in various levels of government and service? At the European level, we have one geographical boundary. We have five of them in Wales. If the European Parliament (Representation) Bill is passed this evening, we may go down to four. That will lead to another reconfiguration that is not based on the old European regions in Wales. That could easily be very confusing, at least for the people in a local authority area who have already gone through boundary changes. They are now getting used to their county areas. If a CHC replicates that local authority area, it may be easier for those involved to work out exactly what that area it is.

It is important that people know where the buck stops. If they have a problem in their area they will know that at least there is a CHC that covers the area, too. Amendment No. 15 would insert:

    ''that due regard is paid to the boundaries of those health authorities which a Council is to scrutinise.''

That is the coterminosity aspect, which would ease understanding. People would recognise the term CHC and know what it does. They know the area that it will cover and it will be one with which they are already familiar. The amendment is not a probing and certainly not a wrecking amendment. I am sure that the Minister will concede that all our amendments have the sole intention of improving the Bill. Improving the NHS should not be a party-political matter. We all wish to see the service improved for all the people of Wales.

The Government Whip will doubtless try to persuade Labour Members of the benefits of rejecting some of our amendments simply because they did not invent them. Rather than wasting time and waiting until the Bill goes to the House of Lords before the brilliance of our amendments is recognised—at which time the amendments will be slightly reconfigured before coming back to the House—why not accept them now and see them for

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what they are; something that will lead to an improved Bill?

I hope that some Labour Members will be independent, as I know one or two of them to be, and that they can come across with us during the Committee stage. I leave it to hon. Members to judge whether they fall into that category or whether they would prefer to be slavish to the Whip's will. They will know how independent they happen to be, but by speaking up for the CHCs they will be speaking up for all of their constituents. They will ensure that their constituents are properly represented by the CHCs; organisations they know and a name that they understand.


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Prepared 10 December 2002