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Lord Renton: I hope that my recollection is not wrong. The Minister will, I am sure, from her experience--which was also in another place--correct me if I am wrong, but I hope that she will confirm that the Public Accounts Committee had, as of right, the opportunity to look at the public accounts of any body appointed by statute. If we start to say that, by statute, a particular body may have its accounts so scrutinised, we may get into an unfortunate situation. If that were done too often, and then there is no mention of public accounts being available for scrutiny by the Public Accounts Committee, they could not be so. Therefore, I think that we have to be very careful about Amendment No. 89. I really do not see the need for it.
As regards the other amendments in this group, I do not think that the noble Lord has developed those to any great extent. At the moment, I have no comment to make on them.
Baroness Hayman: Perhaps I may look at the general intention behind this series of amendments and say to
the noble Lord, Lord Clement-Jones, that I recognise that intention. Indeed, I share it, if it is to ensure that the commission, as an executive non-departmental body, operates in a fully open and accountable way. We are determined that that shall be so.However, I believe that we have already made adequate provision for that within the Bill. Clause 15 makes clear that the commission will make reports on the exercise of its functions. The Explanatory Notes also clearly state the intention to make those available to the organisations involved and to the Secretary of State, and to make provision for their publication.
The commission will be able to report on its findings. Importantly, it must be recognised that, in doing so, the commission will provide an external and independent assessment of NHS arrangements to improve quality. Thus, Clause 15(2)(d) allows for the Secretary of State to make regulations as to when and how the commission publishes its reports.
A key aim will be to ensure that the Secretary of State may make provision for the commission's recommendations to be published quickly after a review or investigation so that the organisations involved may act on the report as soon as possible and that others may learn from it.
Where the Secretary of State asks the commission to report to him on the exercise of its functions, the Secretary of State will decide on the arrangements for publication. In doing so, he will have due regard to the Code of Practice on Access to Government Information. I have to say that it would be our intention that such reports should be made public. They are obviously of general interest. However, equally I have to say to the noble Lord that the Secretary of State might ask for something much more run-of-the-mill in terms of a publication and that to have a general duty to publish everything might not be sensible.
Amendment No. 89 seeks to ensure that the commission's annual report be sent to the Public Accounts Committee. I believe that on this point the noble Lord, Lord Renton, is absolutely right in terms of the role of the Public Accounts Committee. We do not need to list it on the face of the Bill to ensure that it would have a role over a non-departmental public body. However, it is certainly the intention, as far as the annual report is concerned, that it would be sent to that committee as well as being made generally available as a public document.
Schedule 2 also makes clear that the annual report will not be the only means by which the commission is to be held to account to the public and to Parliament. It will be subject to the Parliamentary Commissioner for Administration, and members of the commission may be called before the Select Committee on Health and, indeed, the Public Accounts Committee of another place.
These provisions in the Bill demonstrate a commitment to openness, greater transparency and accountability both to the public and to Parliament. It would not be sensible to put on the face of the Bill provisions to ensure that everything on which the commission reports is automatically made public. It is
sensible for the Secretary of State to have some discretion in this matter, particularly having regard to the delicacy and confidentiality of some of the subject matter that might possibly be involved.However, I hope that I can reassure the noble Lord that, as far as the generality of reporting arrangements is concerned, we would wish the commission to operate in a transparent way.
Lord Clement-Jones: I thank the Minister for that helpful explanation of how the Government see the reports being published in what she describes as a fully open and accountable way. We shall certainly look at what she says with great care. However I believe that much of what she said was reassuring.
Before I seek leave to withdraw the amendment, perhaps the Minister could clarify one matter. I believe that she mentioned that the commission for health improvement was to be treated as a non-departmental public body in terms of its relationship with the Public Accounts Committee. Can she direct me to where that appears? Is it in the Explanatory Notes? I cannot see, on the face of the Bill, as regards CHI, or CHIMP, as others like to call it, that that is so. However, if that is the case, I am more than happy with the relationship that it will have with the Public Accounts Committee. If the Minister wishes to write to me on that point, I would be more than happy.
Baroness Hayman: I shall certainly write to the noble Lord, giving chapter and verse. Implicit in the need for the body to be set up statutorily is the fact that CHIMP is to be independent. The national institute for clinical excellence is being set up as a special health authority. That shows the distinction between the two. However, perhaps I may write to the noble Lord with the details.
6 p.m.
Lord Clement-Jones: I thank the Minister for that reply. It is precisely because of the issue of the status of the commission for health improvement that we have asked about publication and the relationship with the Public Accounts Committee. We want the body to be independent. At Second Reading I referred to the way in which Her Majesty's Inspector of Prisons has a particular status relative to the Home Office so that he can go about his business entirely independently. The commission must operate in that way. I shall be most interested to see the Minister's reply but, in the meantime, I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
[Amendments Nos. 90 to 93 not moved.]
Clause 15 [Functions of the Commission]:
[Amendments Nos. 94 and 95 not moved.]
Lord Harris of Haringey moved Amendment No. 96:
The noble Lord said: This clause sets out the functions of the commission for health improvement. Within those functions, it is clear that the commission is intended to provide an independent scrutiny of local efforts to improve quality. It will seek to ensure that serious problems are addressed and will be able to spot check quality standards.
Amendment No. 96 seeks to give community health councils a role which would effectively enable them to act as trigger mechanisms for the commission. Given that community health councils have extensive local knowledge of health provision and are often aware of where problems lie, that seems a helpful mechanism to ensure that the commission pursues issues relevant to local communities.
Community health councils assist complainants with some 30,000 NHS complaints each year. That work provides them with an unrivalled source of information about where the problems in service delivery may lie. Again, that seems an excellent qualification for enabling them to assist the commission.
I recall that in 1992 the Association of Community Health Councils and Action for Victims of Medical Accidents (AVMA) drew up proposals for a health standards inspectorate. In many ways, CHIMP bears some resemblance to those proposals. I should have thought that the commission would want to use the expertise of local community health councils and bodies such as AVMA to identify patients' complaints in order to guide its investigations.
Amendment No. 101, which is grouped with Amendment No. 96, refers to the commission's report and suggests that such reports should automatically be made available to community health councils to assist them in monitoring the commission's progress. It may seem self-evident that reports should be provided in that way--one would certainly expect the commission's reports to be made public--but it is perhaps worth stating that, in the interests of freedom of information, it is important that the commission's reports are published and made available to the public who have a right to know about the standards and quality of care being provided to them. In the event of a failure of standards, it would be even more important that such information should be made available to the public to avoid any fears of a cover-up and so that the accountability can be seen properly to be exercised. Where mistakes or accidents have occurred in service delivery, it is particularly upsetting for the patients and their relatives to be left without any clear idea of what went wrong. It is probable that at some time in the future the commission will have to investigate such sensitive and difficult cases.
I should have thought that requiring the commission to make its reports available to CHCs would increase public confidence in the work of the commission and enable the CHCs to monitor the progress made with regard to any of the commission's recommendations. I beg to move.
Page 11, line 29, at beginning insert ("giving due consideration to any concerns of the relevant community health council,").
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