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Lord Hunt of Kings Heath: I am grateful to the noble Lord, Lord Clement-Jones, for giving way. I do not disagree with him when he says that it is right and, indeed, a duty for the Government to set the strategic framework in which HIMPs are developed. That is what we seek to do in the planning priorities guidance that we issue to the health service. That attempts to give a strong steer to the health service on the core priorities it needs to develop. I said earlier that Members of this place can raise a matter which they feel is important—we all agree that eye services are important—but the cumulative effect of treating every service with the same degree of priority would be to end up with a situation in which the health service is presented with 300 different priorities. As we have already discussed in our debates on Clause 1, that would mean ending up with a situation in which there are no priorities.

Lord Clement-Jones: I entirely accept that. I have read all the previous public health White Papers and Green Papers and know about the four key areas of government concentrations and so forth. The argument is not about setting priorities in those terms but about how many targets we set to try to get those priorities implemented. That is where some of the argument about micro-management is concerned. The setting of broad priorities for action is entirely satisfactory. Perhaps the essence of the argument today in terms of low-vision services is to try to push them higher up the agenda in the health service. That is an appropriate way to proceed. I detect that in the second half of his response the Minister accepted some of the argument in that respect.

Therefore, it is not inappropriate to consider that health improvement plans should address that issue. We believe that they should cover a wide range of matters. Expecting them to cover this matter without stating the way in which they should deal with it or the priority it should be accorded is perfectly proper and an entirely strategic way to approach the matter.

I turn to more positive ground. I believe that the Minister gave quite a lot of encouragement in response to the gentle prodding point raised by the noble Earl,

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Lord Howe. It would be inconsistent of those on this side of the House to expect PCTs, on top of all the other matters with which they have to deal—we have dealt with that in earlier parts of the Bill—to be over-prodded at this stage in terms of those services. However, I welcome the Minister's commitment that at the end of the 18-month evaluation period by the implementation group there will be a review to see how those services are developing, to see whether the voluntary approach has worked, and then to report back. It is important that the six-monthly progress reports are published and that there is proper dialogue with all the groups to which I have previously referred. That is a fairly formidable coalition. It is highly significant that that has now been formed.

I take encouragement from the Minister. However, I believe that we may well need to return to the matter, depending on the evaluation that takes place after that period. We can always guarantee that there will be a health Bill passing through this place again. Even if we do not return to the matter on Report, we may well return to it in a future Bill. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 22 agreed to.

Baroness Noakes moved Amendment No. 86:

After Clause 22, insert the following new clause—

"REPORT ON BODIES ACCOUNTABLE TO THE SECRETARY OF STATE
(1) The Secretary of State shall prepare each year in relation to the bodies set out in subsection (2) a report dealing with the matters set out in subsection (3) and shall lay a copy before both Houses of Parliament.
(2) The bodies referred to in subsection (1) are any body—
(a) over which the Secretary of State has powers of appointment;
(b) for which he provides the majority of its funding;
(c) which he may direct as to the conduct of its business,
but shall not include Health Authorities, NHS trusts or Primary Care Trusts.
(3) The report shall contain in relation to each of the bodies referred to in subsection (2)—
(a) its name;
(b) the nature of the Secretary of State's relationship with the body;
(c) details of the exercise of any of the Secretary of State's powers during the previous year;
(d) the amounts provided to the body;
(e) how the annual report and accounts of the body may be obtained; and
(f) the Secretary of State's opinion as to the continued need for the body or, if he is of the opinion that the body is no longer needed, how he plans to proceed."

The noble Baroness said: Amendment No. 86 inserts a new clause after Clause 22 dealing with the various bodies for which the Secretary of State has responsibility.

At Second Reading, the noble Lord, Lord Walton of Detchant, who I am sorry is not in his place, spoke about the Government suffering from "quangoitis" and being determined to convert the NHS into a "quangocracy". It seems that the Government's

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instinctive reaction to any problem is to set up one or more new bodies. Since 1997 they have created a long list of bodies: the Human Genetics Commission; the Genetics and Insurance Committee; the NHS Information Authority; the Commission for Health Improvement; the National Institute for Clinical Excellence; the Health Development Agency; the NHS Purchasing and Supply Agency; the NHS Logistics Authority; the General Social Care Council and its equivalents in Scotland, Wales and Northern Ireland; the National Care Standards Commission; and the National Patient Safety Agency. There are probably others which I have missed.

In this Bill alone we have a multitude of patients forums, far more than the CHCs which they will replace. We have the Commission for Patient and Public Involvement in Health and the council for the regulation of health care professionals. Since the Bill has been published, the Government have announced, in their response to the Bristol report, the setting up of a council for quality of healthcare. In January, the Chief Medical Officer announced a new national infection control and health protection agency. Only a week or so ago the Secretary of State announced a new board of patient choice trustees. There is no sign that the Government's zeal for new quangos is diminishing.

I am not seeking to debate the merits of any of those bodies individually. The amendment merely asks for an annual report setting out who the bodies are, their relationship with the Secretary of State, the money provided to them and where their annual report and accounts may be obtained. Importantly, the report should also give the Secretary of State's opinion as to the continued need for the body. If nothing else, it would be an opportunity for the Secretary of State to reflect on the size and nature of his quango empire. It would also give both Houses of Parliament the opportunity to consider the issue too.

I am aware that much of this information is already available in other places, for example, in an annex to the Department of Health's explanatory plans and information on the Cabinet Office website. The aim of the amendment is to bring together all relevant information relating to the Department of Health once a year and, crucially, to ask the Secretary of State to give his views as to the continued need for the bodies. That, in turn, would approve the accountability of the Secretary of State for the bodies that he has created. I hope that the Minister is in favour of increased accountability and will support the amendment. I beg to move.

Baroness Masham of Ilton: I support the amendment as it is an exceedingly good idea. I went to the launch of a new body last night. It was launched most eloquently by the Minister. It was to do with safety, but I cannot remember the full title.

Lord Hunt of Kings Heath: It is the National Patient Safety Agency.

Baroness Masham of Ilton: That is a most important issue and I am sure that the agency will grow. It would

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be useful to have a list of quangos, as it is useful to know how important they are. On matters such as the control of infections in hospitals, for example, we could see how they were doing and the progress on all sorts of issues such as food and so on. The amendment is an excellent idea which I hope the Government will support.

Baroness Pitkeathley: I cannot see the need for this information because it is already available. I was not sure whether the noble Baroness wanted more information, different information or more information in a different form.

I currently chair a non-departmental public body which is sponsored by the DCMS, and I am the former chair of a Department of Health-sponsored body—the GSCC. My experience is that NDPBs and all other bodies already produce huge amounts of information, all of which is available to the public. They are required by the Secretary of State to produce strategic plans, business plans, annual reviews and they must meet all kinds of performance targets, including administration costs.

Clearly they are responsible to Parliament through the Secretary of State. Their boards are appointed through open advertisements by an independent panel and then approved by the Secretary of State. In terms of justifying their continued need, I believe that adequate information structures and systems already exist. I am reluctant to see further requirements being imposed on them, so that they have to spend more time reporting than doing the job that they were set up to do.

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