Previous Section Back to Table of Contents Lords Hansard Home Page

Lord Warner: At the heart of this amendment is the issue of the clarity of accountability. I suspect that the noble Baroness will agree that the accounting arrangements need to reflect that NHS foundation trusts are public sector bodies ultimately accountable to the public. That is why we have provided in Schedule 1 for each foundation trust to make its accounts available to the public and the National Audit Office and to lay the accounts before Parliament. Therefore, the Bill provides more than adequate provision for public and parliamentary scrutiny of the financial arrangements for NHS trusts.

It is not normal practice for regulators to come along and try to provide summaries of the accounts of the bodies that they regulate. It is important that those who exercise freedoms—we are expecting NHS foundation trusts to do that; that is one of the main purposes of this legislation—should be accountable for the results of their actions. The requirement for an

13 Oct 2003 : Column 622

independent regulator to prepare summarised accounts is an unnecessary burden and is potentially misleading, which is perhaps the more serious argument. The presentation of accounts to Parliament would normally be carried out by an accounting officer who was responsible for the expenditure reflected in those accounts. Although the independent regulator sets the accounting requirements and borrowing limits for NHS foundation trusts, he is not accountable for an NHS foundation trust's expenditure or its operational management.

Of course, no one is arguing that the regulator should not assist Parliament when required to do so. Indeed, as has already been said, the regulator will make a report to Parliament on the discharge of his functions and the content of that report is a matter for him in the light of the way that he has discharged those functions. He could also assist Parliament by preparing summaries of financial information relating to NHS foundation trusts if requested to do so—by a parliamentary committee, for example. However, if there were a legislative requirement for him to act as this amendment suggests, the implication is that he is the accounting officer for the information contained therein. As I have tried to explain we believe that that would be quite inappropriate.

Baroness Carnegy of Lour: I see the Minister's argument about the regulator. I know that he does not like my questions because he does not always expect them. However, will there be a summarised account of foundation trusts anywhere? The difference between the costs of foundation trusts and other trusts will be of great interest throughout government. It will also be of interest to the Scots Parliament because, with the Barnett formula, its funding is dependent on what England spends. This change will therefore be very important to the Scots Parliament. Will it be possible to see the summarised accounts anywhere under the arrangements in the Bill?

Lord Warner: Let me make it clear: I very much enjoy questions from the noble Baroness and I am not in any way affronted by her question. Ministers usually learn not to try to forecast the future—at least those who have managed to survive in office a reasonable amount of time—so I am not going to attempt to do that. I expect that, as is often the case, if the regulator is asked to provide information by a parliamentary committee, he will try to respond positively—as most of us do when put in that position. I think we will just have to wait and see.

Baroness Carnegy of Lour: I hope that the Minister will go on enjoying my questions because that is a great encouragement to me. It was extremely nice of him to say that. However, I am asking whether there will be a summarised account anywhere of the cost of foundation trusts. A Select Committee could ask the regulator for one but, leaving the regulator out of this

13 Oct 2003 : Column 623

for a moment, will there be a summary account anywhere in the volume that my noble friend Lady Noakes showed us and which made my heart sink?

Lord Warner: We will have to wait and see. We do not want to anticipate doing anything that damages the clear accountability framework for NHS foundation trusts that we have set out in this legislation.

Baroness Noakes: I thank the Minister for his reply and my noble friend Lady Carnegy for her insightful intervention. As usual, she puts her finger on the issue. There will be a lack of information after this Bill and a whole area of the NHS about which we will not be able to get a financial overview, which is an important matter. I completely accept the Minister's concerns that to summarise might imply accounting officer responsibility, but that should not stand in the way of creating this important source of information.

I do not believe that, in moving from NHS to foundation trust status, people will understand it if an important source of summarised information disappears. It is strange that we will have to wait for a parliamentary committee to request a summary when it is perfectly plain and obvious that something is disappearing from the arrangements and needs to be replaced to allow information to be available. I will consider carefully what the Minister has said about not implying accountability alongside the provision of information, but I feel sure that we can get around that and I look forward to debating the matter again on Report. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendment No. 107 not moved.]

Lord Clement-Jones moved Amendment No. 108:

    Page 115, line 4, at end insert—

"8 The regulator must report in person to any Committee of either House of Parliament, or a Committee of both Houses, which requests information on the discharge by the regulator of his functions."

The noble Lord said: Paragraph 7 of Schedule 2 is something of a curiosity. It states:

    "The regulator must respond in writing to any recommendation which . . . is made by a Committee of either House of Parliament, or a Committee of both Houses, and . . . relates to the exercise by the regulator of his functions."

It is not immediately clear why paragraph 7 is written in that way. Certainly, written evidence given by a regulatory body is perfectly usual in these cases, but oral evidence is also perfectly usual and acceptable. Indeed, it is often very important that oral evidence is given to a Select Committee. In practice of course, the Health Select Committee would be the one most likely to be involved. As currently drafted, does the fact that the paragraph refers only to written evidence—it states "respond in writing"—mean that the intention is to have the regulator respond only in writing? Is there some hidden intention? Is it possible for the Select Committee to call the regulator to give oral evidence?

13 Oct 2003 : Column 624

It is not clear whether the provision in the schedule is explanatory, limiting or whatever. The bare fact is—this is the reason for the amendment—that the ability of a Select Committee to take oral evidence is an important part of the accountability of a regulator to Parliament. I look forward to hearing what the Minister says. I beg to move.

4 p.m.

Baroness Finlay of Llandaff: I have added my name to the amendment. Like the noble Lord, Lord Clement-Jones, I have a concern about the ability of Parliament to drill down in depth into information that may be provided in the report. We should allow Parliament the capacity to scrutinise beyond the boundary of the items that are included in the report, to allow any destabilisation in the health economy to be detected in questioning.

Baroness Cumberlege: I support the amendment. Noble Lords who have a good memory may remember that, at the beginning of the Committee stage, I proposed six clauses that would have established an agency that would be responsible for the day-to-day running of the NHS. I hope that, in a year or two, that will come about. I see some of the proposals in the Bill as paving mechanisms to prepare the ground for an agency in the future.

In proposing those clauses, I was keen to try to get a different relationship between Parliament, Ministers, the Department of Health and the NHS and to get the politics in their rightful place. A crucial element of that was safeguarding the independence of the agency—in this case, it is the independence of the regulator—and ensuring that the accountability was to Parliament. Having heard through the media the oral evidence that is being submitted to the Hutton inquiry, I find it interesting to see how, when people have to respond immediately to incisive questions, they reveal information that they would not reveal in a written report, in which it would be easier to get away with some weasel words.

It is a good amendment, and I hope that the Minister will agree to it.

Baroness Andrews: I can reassure the Committee that there is nothing sinister about the fact that paragraph 7 of Schedule 2 specifies that the regulator should respond in writing. The provision is there to make it clear that the independent regulator must submit a report to Parliament and must respond in writing to any parliamentary committee with regard to the exercise of his functions. However, that is hardly the limit of his accountability to Parliament.

The fact that it is specified that the regulator must respond in writing does not rule out the fact that he will be available to any Select Committee of either House that wants to scrutinise his activities. The regulator's activities will be subject to the scrutiny of any parliamentary committee, including the Select Committee on Health and the Public Accounts Committee, before which he is summoned to give evidence. We know that Select Committees have the

13 Oct 2003 : Column 625

power to order people to attend to give evidence, but we do not expect that they will have to exercise those powers with regard to the independent regulator, who will have a public office with public responsibilities.

In recent months, we have seen the Select Committees, with their formidable reputation, making a strong impact on the public consciousness and on the workings of government. I would not have thought that we needed to provide powers to require the regulator to respond to order. Select Committees have amply demonstrated in recent months the fact that a simple invitation to attend will suffice. If and when that invitation comes, the regulator will surely be pleased to give evidence to the committees.

Next Section Back to Table of Contents Lords Hansard Home Page