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Lord Roberts of Conwy: I detect a slight note of discord between us, because I believe that the amendment is important.

CHCs have a dual duty:

"(a) to represent the interests in the health service of the public in its district; and

(b) to perform such other functions as may be conferred on it by regulations under paragraph 2".

I want to add, as a third requirement, the duty to present an annual report.

There seems a general agreement that bodies of this kind should report, especially when they represent a public interest, as these bodies clearly do. I should have thought that they would wish to report, in any case. If we look at the schedule, we see that the,

"National Assembly for Wales may by regulations make provision about"—

and there follow sub-paragraphs all the way from (a) to (n), containing a long list of activities of CHCs that will be subject to regulation.

The Minister's performance is normally impeccable, but I could not fail to notice that he leapt over sub-paragraph (i). He referred to sub-paragraph (h), which mentions,

"the preparation and publication of reports by Councils",

but he skipped sub-paragraph (i), which states that there can be regulations regarding,

"matters to be included in any such report".

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The CHCs may produce reports, but they are regulated reports. They will be told by regulation by the Assembly—very clearly, I should imagine—exactly what can be put into such reports and what shape those reports can have.

The noble Baroness, Lady Finlay, said that other bodies would have an interest in providing health services. However, the CHCs are particularly responsible for representing,

"the interests in the health service of the public",

and that is what they will report on. They will not necessarily report on the level of the service, but the public interest in the service. I do not necessarily see a clash of interests between the providers of health services and the CHCs. Of course there can be a clash if the CHCs think that the providers are defective or lacking, but it is just as well that the public should know. I fear that the CHCs will be too constrained by regulation and the public's knowledge of how they are discharging their duties will be limited.

I shall withdraw the amendment in a moment, although we may wish to come back to the issue on Report.

4.30 p.m.

Lord Hunt of Kings Heath: The noble Lord should not attribute too much significance to the fact that I did not mention sub-paragraph (i). It could be argued that his amendment would constrain the ability of a CHC to report, because it would set out in primary legislation what CHCs should report on. However, leaving that aside, his question goes wider. He is talking about the independence of community health councils. I agree that that is important. My understanding is that the Assembly has no desire to compromise the independence of CHCs and fully intends to safeguard that independence. That will be reflected in the way the Assembly responds to its power in the schedule to make regulations. The Assembly will seek to strike a balance between setting out in detail the requirements and duties to be placed on CHCs and the need to ensure that CHCs represent patients consistently across Wales. That is important. The experience so far is that the performance of CHCs has been patchy. Good CHCs can be marvellous, but the interests of those who live in an area where the CHC is poor are not properly served. I suspect that the point of sub-paragraph (i) is to try to encourage greater consistency across community health councils. I am assured that in striking a balance between setting out—potentially in too much detail—the requirements and duties on CHCs and the need to ensure that they represent patients consistently, the National Assembly for Wales clearly feels that it is very important to preserve the independence of CHCs.

Lord Roberts of Conwy: I am grateful to the Minister for those reassurances, particularly about the independence of CHCs. However, CHCs must demonstrate that independence. Laying a duty on them to produce an annual report on how they have

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discharged their duties would make that independence abundantly clear, not only to them but to the public whom they serve. I hope that the Minister's assurances about the views of the Assembly are correct and will be implemented in practice. I shall give the issue further consideration and may return to it on Report. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Lord Roberts of Conwy moved Amendment No. 7:

Page 7, line 45, at end insert ", which shall present an annual report on its activities to the Assembly"

The noble Lord said: This amendment also relates to the production of an annual report. The background is that, under paragraph 4, the Assembly will establish a national body to advise and assist CHCs in the performance of their functions. It will probably be akin to the association of CHCs, but it will be established by the Assembly. There is some ground for concern about its independence. From the Assembly government's point of view, there is everything to be said for having all these bodies well and truly buttoned up, if not straitjacketed, so that they cannot cause embarrassment, such as the revelation a fortnight ago that some health authority chief executives in Wales were drawing scandalously high salaries, well in excess of £100,000 a year. In a democracy such as ours, the truth usually emerges one way or another.

One way of safeguarding the integrity of an institution or body, such as the one proposed to advise and assist CHCs, is to impose a duty on it to produce an annual report on its activities so that the public can read about them. I would have thought that the Assembly, as well as the public, would welcome that, because such an account would help in the constant process of assessment of the value of the body.

Most bodies established by statute are obliged to produce an annual report, which is laid before Parliament. There should be a similar obligation on the body proposed here to report annually to the Assembly and, in so doing, to report to the public. I beg to move.

Lord Hunt of Kings Heath: In some ways, this is a rerun of our previous debate. My main response is that the Bill gives the Assembly sufficient discretion to ensure that if it so wishes the new body can make an annual report to the Assembly on its activities. Of course I accept the principle that such bodies ought to report on their activities. I am sure that we all agree with that, but it is for the Assembly to decide. My understanding is that the intended establishment of a statutory all-Wales body for CHCs is seen as a way of increasing the standard and quality of work of community health councils and ensuring consistency of service provision. The Assembly sees the body as a powerful strategic influence for patient representation at an all-Wales level.

The role and responsibilities of the body are currently the subject of consultation with CHCs, but it is likely that its duties will include supporting and advising individual CHCs, providing support for personnel and training, payroll and financial support,

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budget allocation and distribution, the maintenance and review of CHC standards and, importantly, performance monitoring, advice and support.

I mention performance monitoring because one of the great weaknesses of CHCs over the past 25 years is that there has been very little external monitoring of how well they work. That is why we have seen such a variation in performance between excellent CHCs and very poor ones. The new body will have a key role in helping each CHC to improve its work.

The noble Lord also raised the issue of independence. The other major function envisaged for the new body is to provide an all-Wales voice for patient and public representation. I understand that the current association of Welsh CHCs undertakes that role, but it is not considered to be adequately resourced. In placing the association's successor body on a statutory footing, the Assembly is turning it from an informal support organisation into one that will have a much greater ability to monitor performance, set standards, develop best practice and provide an all-Wales voice for patient and public representation. That is to be commended. The Bill gives the Assembly plenty of discretion to require such a body, when it is established, to report as it thinks fit. We should have confidence in the Assembly on that.

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