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Baroness Hayman: I am grateful to the noble Lord for giving way. He is absolutely right. The recommendations from Greg Dyke on the current patient's charter and how we could move forward on the NHS charter are interesting. He makes the point that, while there are some basic values which he believes ought to be national standards, he very much feels that charters ought to be determined at local level. I did not refer to this in particular, although we intend to take forward those proposals and, before too long, issue suggestions for consultation throughout the service. Setting national standards is the responsibility of government, after proper consultation, rather than the responsibility, as this amendment would make it, of a standing conference.
Lord Clement-Jones: I thank the Minister. That was the most interesting of her responses. It demonstrated the direction from which the Government are approaching the matter. I look forward to consultation over the Greg Dyke proposals.
I agree that, when discussing rationing, there are difficult issues in relation to national bodies and whether there can be a consistent overall set of core healthcare treatments which form the NHS service. The Minister may have been thinking of Oregon, New Zealand and other such places as providing difficulties. If that is not to be the model that the Government wish to follow, the NHS charter model pursued by Greg Dyke must in a sense be the alternative approach: a broad set of values
are laid down by which health authorities and NHS trusts are expected to be guided. The indication from the Minister is that that is the direction in which the Government wish to go, subject to consultation. To that extent, this has been an interesting exchange. I beg leave to withdraw the amendment.Amendment, by leave, withdrawn.
Lord Lucas moved Amendment No. 131:
After Clause 18, insert the following new clause--
. The provisions of Part VA of the Local Government Act 1972 shall apply to a Primary Care Trust and to the Commission for Health Improvement as if in that Part any reference to a principal council included a reference to a Primary Care Trust and the Commission for Health Improvement.").
The noble Lord said: This is a purely probing amendment. I do not suggest that the Local Government Act 1972, or even a reference to it, belongs in this part of this Bill, but it is a useful model for deciding whether meetings of councils or public bodies should be open to the public. It seems to me a much better, more up-to-date and much more New Labour freedom-of-information model than that which is embedded in the Public Bodies (Admission to Meetings) Act 1960, which is an ancient piece of legislation applying principally to health authorities and parish councils. I believe that, if the department had had the opportunity to address itself de novo to how meetings of health authorities and the bodies referred to in the amendment should be made open to the public, it would not have set the provision in the following words:
That amounts to carte blanche to close meetings to the public. I hope that that is not what the noble Baroness contends should be the case with these bodies. I hope that she will be able to give me some comfort that in practice she would expect a much more open set of attitudes than would be permitted under the Bill as it now stands. I beg to move.
Baroness Hayman: I hope that I can give the noble Lord some reassurance on the issues which concern him. The Government are committed to openness and transparency of process and the principle that public bodies be accountable to the people they serve.
The noble Lord rightly points out that, while we have made provision in the Bill for primary care trusts and the commission for health improvement to hold their meetings in public, this is done by making them subject to the Public Bodies (Admission to Meetings) Act 1960, which is the Act that NHS bodies are generally committed to. It is our firm intention to extend this to primary care trusts, and we have done that in paragraph 1 of Schedule 4 to the Bill. I was interested to hear the
I suggest to the noble Lord that the commission for health improvement and primary care trusts are more like health authorities and trusts than they are like local government. They will not have a large and complex committee structure at which main decisions are taken. The majority of the business of the commission for health improvement is likely to be undertaken in main meetings. While there may be some sub-committees, they are likely to be on technical and administrative matters. To make such meetings open to the public would impose considerable administration and costs on the organisation. The document published last year, Quangos: opening the doors, which I hope he will recognise as showing our commitment to openness in the working of non-departmental public bodies, makes clear that there are costs involved in these matters.
We want to be as open as possible. We believe that meetings should generally be held in public. Both primary care trusts and the commission will hold open annual meetings at which members of the public will have an opportunity to question and gain greater understanding of the work of those bodies.
The noble Lord suggested that there was something rather sinister in the ability of those bodies to meet in private and not to make documents public when they thought that necessary. Given our earlier debate on confidentiality, Members of the Committee will be aware that both bodies are likely from time to time to deal with matters of a confidential nature and that at such times it is reasonable that the public should be asked to withdraw. The same arrangements to maintain confidentiality should apply to any papers made available to PCT boards and the commission. To complete the picture, I should add that, as we discussed earlier, specific provision is made in Clause 15(2) and paragraph 12 of the schedule for the commission to make its findings public and to issue an annual report.
In addition, the local NHS has a duty to consult widely where there are proposals for change in local services. There is already a requirement on NHS bodies to publish annual reports and to make available other information to the public concerning plans for health and healthcare. We do not wish to impose further administrative burdens and costs on the NHS. Earlier we had a debate about the importance of ensuring that maximum funding is directed at delivering and improving services for patients.
I hope that, in view of what I have said, the noble Lord will feel that not only is there already extensive provision as to public access to proceedings and reports of both the commission and primary care trusts but that there is absolutely no intention that those bodies should operate in any kind of shadow and that we are committed both to openness and transparency of process.
"A body may ... exclude the public from a meeting ... whenever publicity would be prejudicial to the public interest by reason of the confidential nature of the business to be transacted or for other special reasons ...
"A body may ... treat the need to receive or consider recommendations or advice from sources other than members, committees or sub-committees of the body as a special reason why publicity would be prejudicial".
9.15 p.m.
Lord Lucas: I am very grateful for the Minister's explanation but it does not go a very long way to address the basic question that I ask; namely, why these new bodies and existing health authorities are given a blanket permission to close meetings to the public, whereas local authorities are allowed to close meetings to the public in particular circumstances but are not given a blanket permission. The difference is that in the case of local authorities and other bodies certain circumstances will arise where it is right to close meetings to the public, but those circumstances are specified in the Act. Under this legislation and that which applies to existing health authorities--one asks why the opportunity is not being taken to revise the latter--these authorities are given blanket permission to close meetings to the public. The noble Baroness appears to believe that a formal annual general meeting every year--rather like some corporate bunfight--is sufficient to meet the obligation on health authorities to open their meetings to the public.
Baroness Hayman: If the noble Lord will forgive me for interrupting, I believe that he has misrepresented what I said. I did not say that I believed one annual meeting to be sufficient. I thought I had made it clear that the Government considered that these bodies, governed as they would be by the Public Bodies (Admission to Meetings) Act 1960, should hold their meetings in public. I take the noble Lord's point that these bodies will be governed by one piece of legislation that does not specify what is a confidential piece of business, and therefore the circumstances in which part of an agenda may be debated in closed session. But the noble Lord should not suggest that the Government consider that there should be only an annual meeting. I hope I have assured the noble Lord that, unless there are confidential matters on the agenda, the intention is that these bodies will meet in public.
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