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Earl Howe: I am grateful to the Minister for those very useful observations. I take the point about unannounced visits and the need to have flexibility through regulations, rather than tying ourselves down to the wording on the face of the Bill. Nevertheless, I am a little frustrated that we cannot find a way of doing both: guaranteeing a satisfactory assurance about the right of entry and leaving the way open for the modus operandi to be set down in regulations. However, I accept the Minister's assurances in the spirit in which they were given. I shall reflect carefully on what he has said. Meanwhile, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendment No. 101 not moved.]

Lord Hunt of Kings Heath moved Amendment No. 102:

(e) persons providing services under arrangements made under Schedule 8A to the 1977 Act or section 35,"

On Question, amendment agreed to.

[Amendments Nos. 103 to 106 not moved.]

Clause 14, as amended, agreed to.

Lord Astor of Hever moved Amendment No. 107:

    After Clause 14, insert the following new clause--

The Secretary of State shall establish for each Health Authority a body to be known as an Independent Local Advisory Forum."

The noble Lord said: This amendment establishes a framework within which the Secretary of State may set up an independent local advisory forum for every health authority. On page 94, the NHS plan states:

    "Patients and citizens have had too little influence at every level of the NHS. As a result of this plan, each health authority area will be required to establish an independent local advisory forum, chosen from residents of the area, to provide a sounding board for determining health priorities and policies, including the health improvement programme".

Those independent local advisory forums are conspicuous by their absence.

At Second Reading the Minister said:

    "the most important barrier which the Bill seeks to address is that between patients and the health service. The radical changes in this Bill will underpin the involvement of the patient and the wider public in the NHS, will give patients real influence in the way that the NHS is run, and ensure that there is independent support available when they need it".--[Official Report, 26/2/01; col. 988.]

19 Mar 2001 : Column 1277

Independent local advisory forums were to be the conduit for this wider involvement in the NHS. They, we believed, were to be the body to represent the wider community. Why, unlike patients' councils, patients' forums, PALS and all the other bodies feeding into the health service provisions established within the statutory framework, have these forums not been included? Without a statutory framework it is not certain that they will be established. Moreover, they may be established only sporadically and may operate to varying standards and responsibilities. I beg to move.

Lord Clement-Jones: I rise to support the amendment of the noble Lord, Lord Astor. In the Bill we have had to get used to a whole range of new creatures--ILAFs, PALS, patients' councils and patients' forums, and the list goes on. Some are statutory and some are not. Therefore, some are susceptible to abolition at the will of the Secretary of State and others are not.

The noble Lord, Lord Harris, said earlier how awkward CHCs could and indeed should be on occasion. I am sure that the temptation to abolish one's CHC may have been fairly strong in some health authorities, if only they were able to do so. Therefore, I should very much like to hear from the Minister why the interesting distinction has been drawn between ILAFs and, for example, patients' forums and why ILAFs do not appear on the face of the Bill. Certainly Amendment No. 107 is designed to elicit that response.

The Earl of Listowel: Perhaps the Minister in his response will elaborate on how these ILAFs will work; what their membership will be; how they will be facilitated; and, what is their agenda?

Lord Hunt of Kings Heath: ILAFs are a useful mechanism for helping health authorities obtain views from citizens about strategic decisions that they have to make. The reason that ILAFs are not on the face of the Bill is simply that they do not have to be because they can be set up through guidance that we can give to the health service. Secondly, we very much want ILAFs to evolve and develop locally. We do not want to be too prescriptive about how they should develop.

19 Mar 2001 : Column 1278

Their function will be to help with the HImP and strategic planning process. The intent is that they might have a core panel of patients and citizens, some representatives of the patients' forums and, perhaps, a wider group of people from the locality involved. We know that some health authorities have developed citizens' juries as a way of getting public involvement and views about the overall strategic direction of the local health service. That technique could be used by ILAFs. Many health authorities have developed well-planned techniques for involving the public. They are not called ILAFs, but we can certainly build on that. We will certainly encourage health authorities to share and develop best practice.

I can reassure the noble Lord, Lord Clement-Jones, that the Secretary of State will be issuing directions to each health authority requiring the establishment of ILAFs and ensuring that appropriate mechanisms are in place to ensure effective and meaningful public involvement. We do not believe that we need to be prescriptive about how that should happen.

Lord Astor of Hever: I am grateful for the Minister's response, and even more grateful for the support from the noble Lord, Lord Clement-Jones. We are disappointed that the Minister is not prepared to put ILAFs on the face of the Bill. We feel that would have ensured that all health authorities would have them. Placing responsibility for establishing them with the Secretary of State means that health authorities will not be able to decide how effective they want the voice of the local community to be in this matter. However, I shall read carefully Hansard. In the meantime, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Lord Burlison: I beg to move that the House do now resume.

Moved accordingly, and, on Question, Motion agreed to.

House resumed.

        House adjourned at fourteen minutes before eleven o'clock.

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