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Health and Social Care (Community Health and Standards) Bill

2.26 p.m.

A message was brought from the Commons, That they insist on their disagreement with your Lordships in an amendment to the Health and Social Care (Community Health and Standards) Bill on which the Lords insisted but have made a consequential amendment to the Bill to which they desire the agreement of your Lordships. They insist on their disagreement with your Lordships in another amendment on which your Lordships have insisted but have made amendments to the words so restored to the Bill to which they desire the agreement of your Lordships.

The Parliamentary Under-Secretary of State, Department of Health (Lord Warner): My Lords, I beg to move that the Commons message be considered forthwith.

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

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[The page and line refer to the HL Bill 94 as first printed for the Lords.]

1CClause 1, page 105, line 33, leave out "Parts 1" and insert "Part 1 (except section 1 and Schedule 1) and Parts 2"

Lord Warner: My Lords, I beg to move that the House do not insist on its Amendment No. 1 to which the Commons have disagreed and do agree with the Commons in their Amendment No. 1C.

Noble Lords will notice that the amendment to Clause 1 deals with commencement and enables the Bill to continue to be discussed. The amendment to Schedule 1 was required, but it increases the minimum number of staff representatives on the board of governors to three. That was something that noble Lords on the Liberal Democrat Benches sought in Committee and on Report. The amendment effectively provides for the amendment that they tabled on Report.

There is little point in my repeating the arguments in favour of NHS foundation trusts at this stage of the proceedings. I am afraid that those on the Benches opposite decline to listen to the arguments. Instead, I remind the House that we have spent nine days considering the Bill since Second Reading. During that time, the Government have moved or accepted many, many amendments. Over 200 amendments have been approved here and in the other place, 90 of which relate to NHS foundation trusts. That demonstrates how much the Government have listened and responded to the concerns expressed in all parts of the House.

On top of that, my right honourable friend the Secretary of State has made it clear that, after the 2004 wave of foundation trusts comes into existence—around the autumn of 2004—he is happy to review that experience. That is something that those on the Benches opposite have asked for all along; but now, it seems, it is brushed aside as inconsequential. That review could cover all aspects of the governance arrangements and the effect of NHS foundation trusts on local health economies. The review would involve the Commission for Healthcare Audit and Inspection, and the report would be available to Parliament and could be debated in Parliament. The Secretary of State has even agreed to defer approving any more NHS foundation trusts after the 2004 wave until the review process is complete.

Yet, after all the listening and positive responses, with the House of Lords doing its rightful job of scrutiny and revision, all we got from the Benches opposite yesterday were lengthy and synthetic speeches about the alleged inadequacies of the Bill. The reality is that they have

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simply refused to use the nine days in Committee, on Report and at Third Reading to move amendments that would modify the Bill as they think necessary.

Perhaps I may give one example. On Third Reading, the Benches opposite successfully moved three relatively minor amendments that were comprehensively defeated in the other place with majorities of well over 100. The truth is that this House has had plenty of opportunity to revise the Bill, but all that the Benches opposite want is to pursue wrecking amendments and to divide the will of the elected Chamber.

No one is fooled by their behaviour. The two opposition Benches in this House are marching to the drumbeat of their colleagues in another place. I feel rather sorry for the noble Earl and the noble Lord, Lord Clement-Jones, who I suspect are more discomforted than they let on about the position in which they are placed. I am sure that noble Lords from other parts of the House, who may have thought that it was a good idea to vote with them yesterday, may need to reflect a little on what is going on.

The Bill has gone back to the other place twice, where it has been thought through twice. The Bill has been returned twice, with Clause 1 and Schedule 1 restored. As my right honourable friend the Minister of State said in the final debate early this morning in the other place, the House of Commons has had the debate on Part 1 of the Bill on five separate occasions. I understated it yesterday, as is my normal approach in these matters. On five separate occasions, the House of Commons has debated Part 1 and on each occasion has approved it.

We know what is the will of the elected Chamber, which, incidentally, returned the Bill this time with the disagreement to the Lords amendment on Clause 1 carried by a majority of 41. I can remember a previous administration when those on the Benches opposite were in power; they would have cut off their right arms for that kind of majority.

The other place has thought about National Health Service foundation trusts repeatedly. It has decided that they should proceed. As I made clear yesterday, the Government will not give in. They will keep sending the Bill back with Clause 1 and Schedule 1 restored. They will not bow to an unelected Chamber thwarting the reform of the NHS. All that those on the Benches opposite are doing is delaying prorogation, jeopardising the Bill, and usurping the role of the other place. I beg to move that this House do not disagree with the Commons amendment.

Moved, That the House do not insist on its Amendment No. 1 to which the Commons have disagreed and do agree with the Commons in their Amendment No. 1C.—(Lord Warner.)

2.30 p.m.

1DEarl Howe had given notice of his intention to move, as an amendment to the Motion that the House do not insist on its Amendment No. 1 in respect of which the Commons have insisted on their disagreement, and do agree with the Commons in their Amendment No. 1C, leave out from "House" to end and insert "do insist on its amendment 1".

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The noble Earl said: My Lords, the events of yesterday evening and the results of the two Divisions in this House will have weighed heavily with many of your Lordships during the past few hours, as they have with me. I hope that, on reflection, those on the Government Benches will consider that the adjournment of the House last night has proved helpful in enabling all parties to consider the way forward.

It cannot have escaped the notice of the Government that the majority achieved in this House last night on both the Conservative and the Liberal Democrat amendments was greater than the corresponding majority on Report. That very remarkable fact demonstrates to the Minister how the majority of your Lordships viewed the constitutional arguments advanced by Benches opposite in the preceding debate.

There is a real and widespread hostility against Part 1, which Ministers will not or cannot acknowledge. The warnings issued by the Minister yesterday that the Bill as a whole was at risk unless this House bowed to the will of the Commons will not have been lost on any of your Lordships. But that was a threat which was perhaps all of a piece with the arm-twisting tactics we have witnessed during the past few days.

It was also disingenuous. The Government know well that it would be possible to agree to the removal of Part 1 of the Bill, allowing Parts 2 to 6 to proceed without further ado. That offer was made to the Government yesterday; the offer was rejected. On one level, the rejection of the offer may not be surprising given the Government's unreasonably obdurate frame of mind. On another level, it has caused me total astonishment.

Yesterday evening an e-mail was sent by Julia Hickling, head of the NHS Foundation Trust Implementation Branch, to all chairs and chief executives of the first wave applicant foundation trusts. It began:

    "I attach a copy of the Secretary of State's statement to Parliament following the decision not to pass the NHS foundation trust part of the Health and Social Care Bill. The Secretary of State will be writing to you personally tomorrow. As you will see, the statement refers to the Government's intention to use existing powers to give extra freedoms to applicant Trusts who meet the criteria for approval as NHSFTs. We plan to use the Chief Executives and Chairs meeting on Tuesday to discuss how we can move forward on this basis".

The message was later retracted, but it had already gone out.

It tells us that, in very large measure, Part 1 is not needed at all in order for the Government to proceed with their plans to confer additional freedoms on the health service. It also tells us something more about the cocksure mentality of Ministers; they feel perfectly comfortable in proceeding with de facto foundation status regardless of Parliament having rejected Part 1 under the assumption used in the e-mail.

So, to the sins of obduracy and self-righteousness by Ministers, can be added cynicism and disingenuousness as well. Perhaps I may say that I do not think that the Government have emerged with any credit from the events of the past 24 hours.

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However, of necessity, we must return to what I suggest is the issue today; that is, the constitutional position. Late last night, or early this morning, the other place reinstated Clause 1 and Schedule 1 with a considerably increased majority. I believe that this House was right to send an emphatic message to the Government yesterday in rejecting those parts of the Bill. However, like it or not—I do not—this House has a duty to recognise the validity and strength of the decision of the other place. On a matter of this kind, which is essentially an issue of policy rather than constitutional principle, it is not for your Lordships to continue to resist the will of the elected House any further. I therefore do not propose to move my amendment.

[Amendment not moved.]

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