Health (Wales) Bill

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The Chairman: I have noted the hon. Gentleman's comments.

Mr. Wiggin: It is nice to see the Liberal Democrats torn between crying their normal cries that they are the Opposition and being supine about everything Welsh and waiting to have their tummies tickled by the Government.

On coterminosity, one of the great concerns about community health councils is that people who need to contact them must not be allowed to fall through the cracks between geographical boundaries. There can be nothing more frustrating for patients with serious problems than to be told that they are addressing the wrong CHC and to be moved from pillar to post when what they really need is to get their points across quickly and effectively. I recognise the geographical constraints in Wales—the areas are huge and the infrastructure makes it difficult for people to move

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around—but that is a good reason for ensuring that patients do not fall between two community health councils in a geographical sense.

Although I am a critic of the Welsh Assembly, none of the amendments seeks to prevent it from reflecting the feelings and wishes of the Welsh people. However, we should try to have consensus about things that affect patients. I should like to see that reflected in the Bill, so several of the amendments aim to ensure that CHCs consult with one another so that there is no overlap.

The hon. Member for Brecon and Radnorshire (Mr. Williams) made the point that if there were a benefit from some of the proposed changes to names or boundaries, they would proceed without consultation. Surely if there were a benefit to be had, the consultation would take place and it would be agreed. Therefore, his criticism of the amendment was unfair; we all want to see benefits brought out rather than suppressed.

I felt strongly about the wording of subsection (2), which lists a variety of words:

    ''Supplementary, incidental, consequential, transitory, transitional or saving provision''.

Some of those cause me confusion; not because I do not understand them but because I am sure that others might struggle with them in this part of the Bill. One of the tasks of the Committee is to make legislation easy to understand, rather than more complicated. I hope that the Government will take note and comment at length about why they agree with us on the amendment, which would remove that confusing subsection.

Mr. Touhig: I hope to share much with the Committee, apart from my cold, which I am just getting over. We have had an interesting debate and before responding to the comments that have been made about amendments, I shall touch on the broad thrust of clause 1, which allows us to reform and strengthen community health councils in Wales. It recognises their importance and provides them with a sound legislative foundation to strengthen the voice of the patient and the public.

Community health councils are ideally placed to represent patients, but until now they have not had the opportunity to fulfil their potential. This clause seeks to do that by doing a number of things. It allows for the continued independence of CHCs—to which this House and the Assembly are fully committed—and it encourages movement towards more open membership of CHCs, including the creation of new opportunities for other people, especially groups who are under-represented in Wales, to take part in the work of CHCs.

The clause will allow CHCs to provide, on behalf of the Assembly, an independent advocacy service for people who wish to complain about the national health service. It will give CHCs the right to enter and inspect any premises where NHS care is provided. That includes health bodies, providers of family health services such as GPs, dentists and opticians, and other premises, such as nursing homes, where primary care is provided. It also allows the inspection of premises

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situated in England and mirrors the powers of patients' forums in England to inspect premises in Wales.

Chris Grayling: The Minister talked about the ability of different groups to participate in CHCs, but does he accept that many of the powers of those communities are vested in the Assembly, not directly in CHCs? Does he further accept that several of the amendments are designed to ensure simply that the voice in the creation, structure and operation of CHCs that is vested in communities is not controlled by politicians and can, in some cases, be exercised directly?

Mr. Touhig: No, I do not agree with anything that the hon. Gentleman says. As we shall see when we discuss other clauses, the Conservative party wants to restrict the opportunities of people who are not politicians to become involved in the management of the health service.

The clause allows for the creation of an all-Wales body to support CHCs and sets standards for them to follow. You will remember, Mr. Griffiths, the commitment that you gave to strengthening, reforming and improving the work of CHCs when you were first a Minister in the Wales Office. We are taking forward that agenda.

I shall now deal with the amendment tabled by the hon. Member for Ribble Valley; not one to hide his light under a bushel, he described the amendment as ''brilliant''. I thank him and all the other Opposition parties for their support and co-operation in the extensive pre-legislative scrutiny of the Bill, but it is still important for the Committee to scrutinise the Bill as thoroughly as possible because we should not undermine the duties of Members of Parliament.

Amendment No. 1 would prevent the Assembly from changing the name of CHCs, except in the event that groups or councils asked for such a change. That could have bizarre consequences. The hon. Member for Ribble Valley asked what was in a name; we could, perhaps, foresee that Morgannwg community health council, which covers the great city of Swansea—the hon. Gentleman's home town—might decide to call itself the Nigel Evans Morgannwg community health council. That would be bizarre.

Mr. Evans: I can understand why it might want to do that. [Laughter.] It is obviously attractive to the Committee that it should be allowed to do so. However, if the council wanted to do that, it would tell the Welsh Assembly, which would see the benefit of the name change and allow it. At least the request would come from the CHC, as opposed to the Welsh Assembly deciding to rename a CHC the Don Touhig CHC.

Mr. Touhig: This gets more attractive every minute, but the hon. Gentleman contradicts what he said earlier. He spoke previously about the effective branding of CHCs but he now seems to be suggesting something else.

The amendment would prevent the Assembly from renaming all CHCs to give them greater visibility and better corporate identity in Wales unless the CHCs

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unanimously asked for that change to be made. The Bill provides that the Assembly must seek, by agreement, to discuss any name change with CHCs. However, the amendment would shift the onus for a name change to CHCs, which would then have to instigate the whole process. A single identity and name is important. The Assembly would consult widely on any proposal to change the names of CHCs, and I am sure that hon. Members on both sides of the House are aware that the Assembly has groundbreaking processes for widespread consultation on any changes that it plans to make. I do not share the fear expressed by Opposition Members that the Assembly would not take full account of the views of the wider community and CHCs if it decided to propose a change to the name of CHCs. Members should be reassured.

11.15 am

Chris Grayling: Does the Minister accept that the fundamental principle underlying this issue is the nature of the CHCs? They are supposed to be an independent scrutineer of the performance of the national health service in Wales, which in turn is administered by the National Assembly. The importance of dividing the two bodies and leaving accountability with the independent body is as much about the relationship that should exist between the two as it is about devolution.

Mr. Touhig: I agree in part with the hon. Gentleman. I know that the hon. Member for Brecon and Radnorshire had some doubts about the Assembly's record on consultation and in defending the independence of bodies like CHCs. Devolution does not end in Cardiff and goes much further; more people should be involved in the taking of decisions that affect their lives. That is why we proposed reforms to the health service in Wales and created local health boards under a Bill in the last Session. It is important to protect that independence, but it is also necessary to give the Assembly powers whereby it can decide, following consultation, that CHCs will be called by another name if it is thought to be more appropriate. That would be done only after the fullest of consultation.

Amendment No. 2 relates to the abolition of CHCs. If it were passed, it would prevent the Assembly from abolishing CHCs, changing the boundary of a community health council or establishing new CHCs. Only if it retains this power will the Assembly be able to ensure that we have a network of strong CHCs throughout Wales, covering the relevant geographical areas and operating standard practice. Allowing the Assembly to make changes to a council or councils only at the consent of the councils concerned would restrict its ability to pursue the changes that it wants to make in the interests of patients.

Throughout Wales, we have seen the benefits of CHCs forming federations. That made sense. The situation was not prescribed; it evolved, and has benefited the operation of CHCs and the people whom we seek to serve. There is no intention of changing the boundaries of CHCs in the short term. The National Assembly Minister for Health and Social Services, Jane Hutt, made it abundantly clear that she does not

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believe it to be appropriate to start examining the boundaries of CHCs. That may happen later, but will depend on further discussion between the Assembly and CHCs.

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Prepared 10 December 2002