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The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson): I congratulate the hon. Member for Wyre Forest (Dr. Taylor) on securing this debate. It is not a graveyard slot, even though the House is about to rise for the summer. I assure him that Ministers do not go on holiday quite as soon as ordinary MPs do; I seem to find myself at work next week.

Today, we set out our proposals for all the Department of Health's arm's length bodies. It is probably worth while running through some of the background.

The NHS plan 2000 heralded a period of investment and reform. I am glad that the hon. Gentleman recognised that that has significantly improved outcomes for patients. I am delighted to hear of his support for these changes. At a national level, the Department of Health has driven the reform. It has set a clear and ambitious framework for doing so. In addition, the arm's-length bodies from the Department—a national network of statutory organisations—have been deputed to regulate the system, improve standards, protect public welfare and support local services. These ALBs have contributed significantly to the pace of change described in "The NHS Improvement Plan", which was published last month.

The wider network of ALBs built up over the years has become too cumbersome in the context of devolution. The hon. Gentleman will recognise that quite a lot has changed. The ALB sector must recognise and reflect the shifting balance of power towards the front line and towards patients. Again, I welcome the hon. Gentleman's recognition of the shift that is taking place and the Government's vision and support for that.

The thinking that underlies the first thorough review of ALBs for many years reflects that. The ALB sector as a whole needs to remain coherent and fit for purpose. It needs also to enable itself to engage easily and efficiently with the service and the support that it gives to services.

Arm's length bodies have often been interventionist in their backgrounds and high profile. That has meant they have had a maximum impact in their areas of responsibility. That has been right while the momentum for change was being created, but the price has tended to be, as time has moved on, an increasing burden on the NHS, and has led to some poor co-ordination of agendas. We therefore took the view, entirely rightly, that ALBs need to be streamlined both in number and functions. I can reassure the hon. Gentleman that we are doing this not in response to anything that the Opposition are doing, but merely to reflect the fact that we are succeeding on the pace of change, reform and
 
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investment that we set ourselves. The results of that have moved forward significantly enough at this point to be able to reflect those factors in the changes that we are proposing and have outlined today.

The streamlining goes hand in hand with that. The lifting of burdens is linked with efficiency. The ALB review is a significant component of the Government's drive to make the public sector more efficient, and a key part of the implementation of the recommendations in the Gershon efficiency review.

In the report "Reconfiguring the Department of Health's Arm's Length Bodies", which we published today, we have described our plans for the future of all the Department's ALBs. There will be a reduction in their number by almost a half to 20. We are confident that the reduction will lead to savings that can be invested in front-line services of £0.5 billion by 2007–08. It is easy to lose sense of how much money that is, even in today's health service, and the advantages of reinvesting it in front-line services.

As our earlier written ministerial statement set out, the Commission for Patient and Public Involvement in Health will be abolished. Patients forums will remain the cornerstone of the arrangements that we have put in place to create opportunities for patients and the public to influence health services. Stronger, more efficient arrangements to provide administrative support, advice and training will be put in place after consultation. These will enable forums to concentrate on their core functions, maximising the resources available for spending on real involvement rather than on administration. These changes fit well within the overall objectives of the ALB review.

A clear quality framework for forum activities in monitoring and reviewing services will be established and will be communicated to forums. We are working closely with key stakeholders—forums in particular—to take this work forward and identify the best body to do that. The NHS Appointments Commission will become responsible for making appointments to patients forums. To pick up the hon. Gentleman's point about the search for members of the commission and non-executive directors, the commission has been a useful body in establishing the forums. However, another of its key tasks is to work with Government Departments to make sure that its work and the work of the patients forums is fully reflected in the cross-Government work on citizen engagement.

The timetable for implementation has not yet been set, and we will work closely with key stakeholders to ensure that there is minimum disruption for staff, people who support the forums and forum members themselves. I emphasise that our decision to abolish the commission was not borne out of concerns about its performance, nor does it indicate a reduction in our commitment to patient and public involvement. The Government share the hon. Gentleman's enthusiasm about empowering patients—I am an enthusiast myself—and there are many examples of that empowerment, not least the expert patient programme, which is a fantastic initiative that changes the emphasis of the doctor-patient relationship that he described. The commission's performance, particularly its achievement in setting up the forums and recruiting about 5,000 members within a tight time scale, is highly commendable. Our commitment to empowering
 
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patients and the public by providing opportunities to influence change and increasing care choices is a key theme of the NHS improvement plan and the continuing modernisation of the NHS.

We decided to abolish the commission and make better use of existing organisations to support, promote and implement patient and public involvement and ensure that it develops in the widest context possible. Effective involvement builds trust and confidence in public bodies, and helps public services to adapt to the needs and expectations of their users. The NHS Appointments Commission is the expert body that was set up to make public appointments, so it is logical that recruitment on the scale necessary to maintain forum numbers is carried out by an organisation that is expert in making appointments.

Patient and public involvement is not just about patients forums, although they are an important part of the arrangements that we have set up. The NHS is the key implementer of patient and public involvement, and it, too, needs advice and support to do so better and to learn from the experiences of others. It is not a statutory function of the commission to advise the NHS about patient and public involvement, and there should be a more strategic and joined-up approach to providing that advice to forums, the NHS and other organisations that provide health care so that patient and public involvement is embedded in their services. We will therefore ensure that those functions are covered for all providers as well as forums, and that work is developed with other bodies more generally involved in community engagement so that the lessons from patients forums and from NHS experience of public involvement are shared across sectors. Primary legislation will be required to abolish the commission, and it will be introduced in the usual way when parliamentary time allows. In the meantime, we will explore alternative options on the implementation of the decision.

Patients forums are currently supported by a wide range of local providers. There have been some difficulties with that approach, not least the inconsistencies in the support that forums receive. The hon. Gentleman mentioned the importance of consistent support, but inconsistencies are inevitable, given the large number of contracts. The problem must be addressed so that all forums can benefit from strong local support and carry out their functions as effectively as possible. By learning from the commission's experience we will ensure that forums all receive high quality support and can make even more of an impact.

The current budget for the commission is £33.3   million. There will be no cuts to that budget, I can assure the hon. Gentleman. We will invest more resources in patients forums, and any savings that
 
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accrue from the abolition of the commission will be invested in patients forums and in providing expert advice on patient and public involvement.

In the time remaining, I shall describe how patients forums will be affected. As I said, they are the cornerstone of patient and public involvement. They will not be abolished, nor will their independence be undermined. Rather, the support they receive is to be strengthened. It is key in the new arrangements that forums remain as independent as they currently are, so that they can continue to be responsive to the views of local people. That is the essence of what they are about.

The 5,000 current members of patients forums are beginning to get their work under way, so we are just beginning to see the results of that work. The all-party group on patient and public involvement hosted a reception for forum members earlier this month. The hon. Gentleman was in attendance on that occasion, I think.

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