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Mr. Touhig: Does the hon. Gentleman not accept that that happens now? When CHCs find that there is a problem with the delivery of the health service in their areas, and if there is a case for immediate action, they act. If the matter has to be referred to in a report, they produce a report. CHCs address such matters; they do not need to be covered by the Bill. Mr. Evans: The Minister says that they do not need to be in the Bill. Why, then, do we need:
in paragraph 1 of new schedule 7A? He agreed when I drew his attention to it earlier because it was important. We take it for granted; that is what they do now. We could say, ''That is what they do now, so why put it in the Bill?'' It is important for it to be in the Bill because it reminds everybody of the obligation of each CHC. Chris Grayling: I have been listening to my hon. Friend's comments, and those of the Minister, with great interest. He will have read paragraphs 2(h) and 2(i) of schedule 7A, which allow the National Assembly to make provision about
and the
Does he share my understanding that the National Assembly ultimately has legislative powers to decide what the CHCs can report on and how they do it? His amendment would provide one element of the reporting process outside the control of the National Assembly, which is, after all, the body being scrutinised. Mr. Evans: My hon. Friend has hit the nub of why we tabled the amendment—[Interruption.] Hon. Members say that I have spent 20 minutes talking about it. [Hon. Members: ''Thirty.''] It is just as well that I spent 30 minutes and that I had my hon. Friend the Member for Epsom and Ewell with me to bring some light into the darkness that shrouds the minds of Labour members. Just now, after half an hour of hearing my explanation, the Minister said, ''Why put it in the Bill? It is what the CHCs do anyway.'' As my hon. Friend has reminded the Committee, the provisions in paragraph 2 of new schedule 7A are the problem. Under sub-paragraphs (h) and (i), the Assembly has power to direct and restrict. We are not taking that out; that is important in cases in which the Assembly decides that something should be emphasised and the CHCs are not doing it. We read in the newspapers that there are many AIDS patients throughout the United Kingdom. The number is increasing, and, no doubt, Wales has its fair percentage of AIDS sufferers. Because AIDS is on the increase—I do not know whether that has to do with immigration into the United Kingdom; that is what Column Number: 35 the newspapers are saying—the Assembly might say that it would like a report on the matter. It is important for the Assembly to be able to consider that for a number of reasons, particularly the provision of drugs, which are expensive, and the availability of expertise, and for there to be a report on that.Mr. Williams: Does the hon. Gentleman agree that the effect of the amendment would be to place a duty on CHCs that would take up valuable resources in terms of personnel and money? As they are independent—as the hon. Gentleman keeps emphasising—should they not be able to decide whether to spend their resources on the annual report or on something that they believe would be more productive for the health of the people whom they serve? [Interruption.] Mr. Evans: I may have heard the Minister saying, ''Spot on'' to the hon. Member for Brecon and Radnorshire. The Liberal Democrats and the Labour party are hand in hand yet again, working together— Mr. Touhig: Common sense is common sense. Mr. Evans: Common sense is common sense, and I just wish that the Minister and the hon. Member for Brecon and Radnorshire had some. It is clear why we have tabled the amendment. We are told that CHCs are ''doing it anyway'', but now the hon. Member for Brecon and Radnorshire says that perhaps they will not want to do it and will want to spend their money on something else. Can the hon. Gentlemen make their minds up, or at least meet before this Committee sits in order to work out a line that they can both follow, so that there is some coherence in their argument? Ms Dari Taylor (Stockton, South): Cynical. Mr. Evans: Cynical with good cause. The nub of our amendment is that we wish to see the provision included in paragraph 1 of new schedule 7A. As my hon. Friend the Member for Epsom and Ewell said, we are placing an obligation on them to reinforce the provision under paragraph 1(a) that requires them to do their job by publishing an annual report, which the hon. Member for Cardiff, North says they do in any event. However, we must ensure that they can carry on doing that with the independence that we want them to have—even if the Assembly says that they should not—and, as the hon. Member for Brecon and Radnorshire says, even if they may be too busy and want to spend their money elsewhere. It is important to concentrate on areas where there are deficiencies and to give the patients' champion body the right to expose deficiencies where they exist; not as part of a blame culture, but to improve the quality of services in a particular CHC area. The Chairman: I make a technical point that there are no wrecking amendments on the amendment paper; they are rooted out beforehand. Mr. Jones: I was not going to refer to the amendment as a wrecking amendment. I want briefly—extremely briefly compared with other hon. Members—to argue why the amendment should not Column Number: 36 be accepted. CHCs are not adequately resourced to assess the level or quality of health care in their area. They can make a useful contribution to any assessment, but they are not resourced to take objective decisions. The newly strengthened Audit Commission will make those assessments, although the position in Wales is not clear.I do not want the amendment to be accepted. It is not up to the task, and I do not want to give any comfort to anyone who might argue that there was no need for a proper audit body to make an independent and objective comparison between health care providers in the United Kingdom. I do not want to give anyone the excuse that we do not need such a body because the CHCs will do that job. Mr. Evans: I respect the hon. Gentleman's views. He spoke about insufficient resources. Does he agree that it would be far better to ensure that proper resources were made available to those bodies? I understand all the other obligations that are placed on them. If one were to press the matter further, one might say that, under paragraph (2)(h) and (i) of new schedule 7A, they do not have the proper resources even to make the reports that the Assembly may ask them to make. Surely it is better to ensure that they have the resources to fulfil the obligations that we place on them. Mr. Jones: No. There will be 22 committees and 22 health boards. Healthcare resources should be concentrated on delivering patient care, not on duplicating resources for a huge number of committees. That is all I have to say. Julie Morgan rose—
Mr. Jones: I have finished the point that I wanted to make. If others want to make other points, they may do so. Julie Morgan: I had not intended to speak, but the point that I wanted to make was made by my hon. Friend the Member for Cardiff, Central. However, it would not be practicable for the CHCs to do what the hon. Member for Ribble Valley said and make an overall report on the trend of AIDS or HIV in Wales. They are ill equipped to do that sort of work, and it would not be part of their role. As my hon. Friend the Member for Cardiff, Central said, there are 22 community health bodies, whose role would be completely different from that of examining the overall trends of AIDS or HIV in Wales, where, incidentally, a report has recently been published.
12.45 pmMr. Touhig: We have had quite a debate, with a long contribution from the hon. Member for Ribble Valley. I do not chastise him for that, because we should scrutinise legislation as thoroughly as possible. However, I am grateful to the hon. Member for Epsom and Ewell for bringing things to a conclusion a little earlier than might have been the case otherwise. I thought that the winter was going to be shortened, if nothing else. I understand why the hon. Member for Ribble Valley tabled the amendment, but I hope to persuade him that it is not necessary. If we considered it Column Number: 37 appropriate for CHCs to publish an annual report, we would have put that in the Bill ourselves after all the widespread consultation that we had undertaken. The amendment would place in the Bill an additional and unwanted burden for CHCs. Such an ill-defined duty as in the amendment would surely go against giving CHCs the freedom to scrutinise as they saw fit—he talked about such freedoms earlier—by prescribing that they produce an annual report.Moreover, the amendment would require CHCs to duplicate work already undertaken by national health service organisations that report regularly on the quality and level of services through annual reports, directories and so on. Earlier, my hon. Friend the Member for Cardiff, Central referred to the fact that further legislation would be introduced on inspection of the health service in England and Wales. The Opposition will doubtless want to give that their full support, so that we have the most open and transparent system of monitoring and inspection of the NHS. The provision of information to patients and the public on how local health care services perform is an essential part of building such services around the needs of the people who want to use them. Placing a requirement on CHCs would duplicate much of the good work that is already done and will be done as a result of future legislation. We would expect CHCs to share information about visits that they conduct and complaints that they have to handle with regard to any of the NHS organisations that they monitor in their areas. That would be in the public domain as a result of any report or activity in which they are engaged. CHCs already publish annual reports on their activities—visits and other problems that they encounter during a year—and NHS bodies also publish reports annually on the level and quality of services. Were we to accept the amendment, we would put another tier and burden on to CHCs that was not necessary. The work is already well provided for in many other areas.
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| ©Parliamentary copyright 2002 | Prepared 10 December 2002 |
