Mike
Penning: I thank the Minister. There are other aspects of
how the special administrators will operate. He might wish to intervene
on me, because he did not indicate where the cost burden of the special
administrators will fall. Certainly when turnaround teams went into the
constituency of my hon. Friend the Member for Orpington and mine, the
cost burden was taken up by the trust, although the contract for the
turnaround team had been agreed by the Department of Health and the
SHA. If the Minister cannot reply now, perhaps he will write to me. I
listened carefully to his comments, and I think he has taken on board
what hon. Members said. I beg to ask leave to withdraw the
amendment. Amendment,
by leave,
withdrawn.
Mike
Penning: I beg to move amendment 178, in
clause 15, page 12, line 10, at
end insert— ‘( ) the staff
of the
Trust.’.
The
Chairman: With this it will be convenient to discuss the
following: amendment 179, in clause 15, page 13,
line 5, at end
insert— ‘( ) the staff of
the
Trust.’. Amendment
180, in
clause 15, page 13, line 5, at
end insert— ‘( ) the
trustees, ( ) the board of
governors.’. Amendment
181, in
clause 17, page 18, line 5, at
end insert— ‘( ) the staff
of the
Trust.’.
Mike
Penning: This group of amendments addresses the fact that
there is no requirement in the Bill for staff to be consulted before
special administrators are appointed. The Government’s impact
assessment says that it should be a priority to ensure that staff are
engaged in the
process. Retaining staff and maintaining morale within an organisation
is crucial, but nothing in the Bill indicates that such consultation
would be required before a trust special administrator was appointed.
That is the reason behind these four amendments, and I hope that the
Minister will explain why such a requirement is missing from the
Bill.
Mr.
Mike O'Brien: The hon. Gentleman makes a good point. I
entirely agree that staff engagement is a central principle of such a
regime. When such intervention is triggered, it will understandably be
unsettling for staff, so we designed the process to produce a swift
resolution while ensuring that staff are engaged throughout. In Grand
Committee in the other place, my noble Friend Lord Darzi of Denham said
that staff should be engaged throughout the process, and that staff
engagement would be further strengthened by statutory guidance, which
we will produce. With that assurance, I hope that the hon. Gentleman
will withdraw his
amendment.
Mike
Penning: The assurance on the statutory guidance addresses
the point that it is important that staff have confidence in the
system, so I beg to ask leave to withdraw the amendment.
Amendment,
by leave,
withdrawn.
Mike
Penning: I beg to move amendment 93, in
clause 15, page 13, line 43, at
beginning, insert
‘Immediately’.
The
Chairman: With this it will be convenient to discuss the
following: amendment 95, in clause 15, page 15,
line 24, at beginning insert
‘Immediately’. Amendment
96, in
clause 17, page 19, line 7, at
beginning, insert
‘Immediately’. Amendment
97, in
clause 17, page 20, line 18, at
beginning insert
‘Immediately’.
Mike
Penning: I decided not to move amendments 182
and 101 to give me a bit of extra
time— [Interruption.] Just
joking. This
important group of amendments addresses the fact that the Secretary of
State is ultimately responsible to Parliament, and would require the
Secretary of State to place before Parliament the report on the failing
trust as soon as it was available. The report could be presented to
Parliament or to a scrutiny Committee, such as the Health
Committee. When
there are problems in the NHS, transparency is vital. I am sure that
you agree, Mr. Key, that it would not be right and proper
for the Secretary of State to have on his desk a trust special
administrator’s report on how bad a situation was when Members
of Parliament for the constituencies involved and, more importantly,
the public and local involvement networks did not have a copy of the
report. The amendments would require the Secretary of State to place
the report on a failing trust before the
House. 12.30
pm
Mr.
Mike O'Brien: In practice, we anticipate that the draft
report will be published and sent to the Secretary of State by the
trust special administrator simultaneously. The Secretary of State will
then lay it in Parliament as
soon as is reasonably practicable. The amendment would therefore be
problematic if, for example, the House was not sitting. There are
procedures, but they take some time. However, there would be no reason
in such circumstances for the Secretary of State to delay laying the
report before Parliament, because it will have been
published. The
TSA would need a good reason to send a draft report prior to
publication to the Secretary of State. For example, they might have to
intervene in a particular way if the Secretary of State needs to be
informed about something that need to be dealt with that could involve
confidential patient information. It might be possible to produce a
draft report, but the aim is for the trust administrator to publish a
broad report and for the Secretary of State to make it available to
Parliament at the earliest appropriate
opportunity.
Mike
Penning: I listened carefully to the Minister, and he has
now placed on record that the report will be published simultaneously.
I still have concerns about why a draft report will not be available
and under what circumstances the Secretary of State would hold it back
from public and parliamentary scrutiny. I said at the outset, however,
that because I would not move some amendments and I was going to listen
to the Secretary of State, I might return to some of my remaining
concerns at a later stage of the Bill. I emphasise again that there is
an absolute necessity for as much transparency as possible, and that
there is also a need for a regime. As yet, we still do not know how
much the special administrator will cost, but on the basis of the
Minister’s comments and reassurance, I beg to ask leave to
withdraw the
amendment. Amendment,
by leave, withdrawn.
Clause 15
ordered to stand part of the Bill.
Clause
16 ordered to stand part of the Bill.
Schedule 2
agreed
to.
Clause
17Trust
special administrators: Primary Care
Trusts Question
proposed, That the clause stand part of the
Bill.
Mr.
Andrew Turner (Isle of Wight) (Con): I should like to ask
the Minister to be clear about clause 17, because there are no
trusts—only primary care trusts—on the Isle of Wight.
Will he explain the
position?
Mr.
Mike O'Brien: I will write to the hon. Gentleman about the
problems and issues in relation to the Isle of Wight. I hope that he
will be satisfied with
that. Question
put and agreed to.
Clause 17
accordingly ordered to stand part of the Bill.
Clause
18 ordered to stand part of the
Bill.
Clause
19NHS
and other health appointments:
suspension
Mr.
Stephen O'Brien: I beg to move amendment 21, in
clause 19, page 23, line 15, at
end insert— ‘(1) The
Secretary of State may issue guidance on the suspension of NHS and
other health appointments. These may
include— (a) details of
appeals processes for suspended appointees;
and (b) details of
parliamentary
accountability.’. Let
me rein in the horse a little. We turn to suspension, but not the
suspension of one’s breath. The clause gives effect to schedule
3, which amends various enactments to provide for the suspension of
non-executive board members. To make it absolutely clear what we are
discussing, the Government already have the power to suspend NHS trust
and PCT non-executives. The clause will extend the power to strategic
health authority non-executives and those of other NHS bodies.
Paragraph 1 of the evidence base mentions social care, and I hope that
the Minister can tell me to which non-executive position that
applies. It
seems right that the power to suspend should be available as a halfway
house between keeping someone in post and firing them too hastily.
Equally, it must not be abused as a way of threatening a good person
whom the Department does not like or preserving unduly someone who
ought to be sacked. Given the almost pre-Runnymede powers the Bill
looks to bestow on the Secretary of State, amendment 19 would hold the
right hon. Gentleman more accountable for such decisions than the
current legislation
allows. The
first safeguard is that the suspended person be given details of
appeal, while the second safeguard would be that the Government bring
some parliamentary scrutiny into the process. Obviously, I worry about
their motives in that particular regard. As the explanatory notes make
clear, such action arises from events at the Maidstone and Tunbridge
Wells NHS Trust. In its summary, the regulatory impact assessment said
that the first key non-monetised benefit is maintaining public
confidence. The table at paragraph 12 states that the public perception
that nothing was being done could be damaging to the organisation and
that the first considered monetised cost is public
perception—somewhat tellingly, media handling. I put it to the
Committee that the Government are not legislating to save the blushes
of hospitals, but to help manage the process of public perception and
image for
themselves. As
the explanatory notes state at paragraph 35, the power to suspend will
rightly be devolved to the Appointments Commission. Will the Minister
clarify how the suspension process will, as a matter of practice, work?
Will suspension be on full pay? We must remember that the Appointments
Commission does not yet seem to have succeeded in getting appointments
without political bias. Last year, 8 per cent. of applicants were
affiliated to the Labour party, as were 10 per cent. of appointees,
whereas 4 per cent. of applicants affiliated to the Conservative party
resulted in only 2 per cent. of appointments. We had the whole rather
damning issue about the resignation of the former Minister of Health
from her post at the Department of Health over the appointment of Sir
David Henshaw. It would be somewhat
pejorative of me to read into the record the full quote of what she
said, as I dare say all members of the Committee remember it
well. According
to the submission to the Delegated Powers and Regulatory Reform
Committee, the powers fulfil—although that might be too strong a
word—a commitment in developing the NHS performance regime. The
document was a result of something of a struggle between David
Nicholson and Anna Walker. Baroness Young has now taken on the
responsibility as chairman of the Care Quality Commission, whether it
is the Department or, as it should be, the independent regulator who
has the responsibility for performance management. I hope that the
Minister will explain what role the CQC will have in the suspension
process.
Mr.
Mike O'Brien: As for suspension, we would have to be in a
position when there was an issue of considerable importance. The
Secretary of State would then delegate his powers of public appointment
to the Appointments Commission, an independent organisation accountable
to the Secretary of State. To ensure that the relevant bodies are ready
for implementation of the powers, the Appointments Commission’s
draft guidance was included in the consultation exercise when
introducing new powers of suspension, which ran from July to October
last year. An updated version was published with the
Government’s response in January this
year. The
guidance set out how the Appointments Commission will manage
resignations, termination of appointments and suspensions of
non-executives lawfully and in the best interests of the public, and
respecting the rights of the office holders. I was asked whether
suspension would be on full remuneration, and the answer is yes. I was
also asked about the process for suspending senior appointments. The
Secretary of State will delegate his power to the Appointments
Commission. Cases would usually be referred to the commission by the
person to whom the appointee is accountable for their duty in bringing
evidence to its attention. In the referrer’s opinion when it
does not lead to the suspension of the appointee from office, the
commission’s role will be to work with the referrer as necessary
to establish whether there is a case for suspension. In the case of a
vice-chair or other member, the referrer would usually be the chair of
the organisation. In the case of the chairperson, the commission would
have to take a view. We would expect any body with which the commission
is not involved to follow good
practice. Essentially,
the process of dealing with such suspensions has been published. We
want to ensure that the Appointments Commission is operating within the
procedures it has set down publicly. When difficulty arises, a key
requirement is that public confidence in the NHS must be maintained.
That confidence must always remain one of the key priorities for those
who run the NHS in ensuring that such issues are dealt with. In the
end, it is the taxpayer who funds the NHS and to whom the NHS is
ultimately responsible as taxpayers and
patients. The
CQC’s role will depend on whether there is a need for a quality
examination of the way in which the organisation involved operates. If
the issue is financial, the CQC’s involvement will be limited.
If it relates to patient care, as in a recent case, the role of the CQC
or its equivalent will be important.
I will write
to the hon. Gentleman about which organisations relate to social
care.
Mr.
Stephen O'Brien: I am grateful for those reassurances and
I beg to ask leave to withdraw the
amendment. Amendment,
by leave,
withdrawn. Clause
19 ordered to stand part of the
Bill.
Schedule
3NHS
and other health appointments:
suspension
| 
