| Previous Section | Back to Table of Contents | Lords Hansard Home Page |
Lord Warner moved Amendment No. 19:
- Page 4, line 16, at end insert—
The noble Lord said: I shall speak to Amendments Nos. 19 and 22. They arise because Scottish Ministers have asked for the amendments, which add details of the Scottish equivalents to the legislation already mentioned here. It will enable the HPA, NHS bodies and local authorities in Scotland to enter into agreements and to make and receive payments to and from each other. The powers provided by the amendment are not new. They are powers which NHS bodies currently have and which the Bill now also makes available to the HPA. The amendments are a straightforward tidying-up operation regarding the relationship between Scottish health authorities and the HPA. I beg to move.
Earl Howe: Amendment No. 20 is included in this group and I shall also talk about my Amendments Nos. 45 and 46, which have a bearing on the matter.
It would be remiss of the Committee to pass over subsections (7) and (8) of Clause 4 without comment, as they raise quite deep-seated questions about the extent to which the Health Protection Agency will really be able to operate at arm's length from Ministers and thereby give the Government and the public independent, authoritative and impartial advice. We
The power set out in subsection (7) appears to be broad. It does not seek to limit or qualify the degree to which Ministers will be able to direct the way in which the agency's functions are performed. So what kind of direction is envisaged here? I think it would be helpful if the Minister gave us some possible examples. The Government's memorandum to the Delegated Powers Committee says that the content of any direction is likely to relate to matters of operational detail. We understand that there need to be default powers built into the Bill. But how are we to ensure that default powers are not used as a more regular mechanism for resetting the priorities of the agency or diluting in some way the force or content of its advice?
We see the same thing in Schedule 1 where, in paragraphs 11 and 13, wide powers of direction are included to enable the Secretary of State to dictate how the agency should conduct its internal business, including such matters as the composition of committees and how much committee members should be paid. There may be circumstances in which the Secretary of State feels the need to take action of that kind, but it is surely generally undesirable. At the very least, we are entitled to ask why he should not be subject to parliamentary scrutiny if he does. The use of directions appears unnecessary in this context.
The main message is simple. The more that healthcare professionals, management and staff within the agency are made by Ministers to jump through hoops in order to meet politically-based objectives, the worse it will be for us all. If the agency is to be regarded as the champion of the health of the public it deserves to be left alone, as far as possible, to get on with that job.
Lord Clement-Jones: I rise briefly to support the noble Earl, Lord Howe. I share all of his misgivings about the two subsections. There may well be a half-way position on the matter. There are certainly circumstances which do not impugn the independence of the HPA if a direction is given. The Faculty of Public Health takes that view. There are perfectly legitimate circumstances where the HPA could be directed to carry out work in areas which the Secretary of State feels are currently neglected.
The trouble with the two subsections is that it is also possible for the Secretary of State to direct the HPA not to undertake work. That seems to be extremely dangerous. If the HPA believes that certain work needs to be carried out and the Secretary of State overrides that, that will damage the independence of the HPA and would certainly cause public concern of the kind that the noble Earl has mentioned. We will consider later the issue of publication of information,
Baroness Finlay of Llandaff: I rise briefly to support those comments and to underline that health protection services, both in England and Wales, are the responsibility of the Health Protection Agency and the National Public Health Service for Wales. There has to be an inter-relationship, but there must be openness in what the agency is asked to do or not to undertake.
Lord Warner: I had an uneasy feeling that we would have this debate when I was reading the papers. Some of my comments will be familiar to one or two noble Lords who joined me in the wee small hours on the Health and Social Care (Community Health and Standards) Act 2003.
The particular powers that would be deleted are pretty much a standard feature of legislation on many NHS and non-departmental public bodies. Essentially, the argument is that the appropriate authorities under the Bill need that power in relation to the HPA for reasons of accountability. The HPA, like many other bodies that carry out not dissimilar functions, will largely be funded by grant in aid from the appropriate authorities and in particular by the Department of Health, which currently provides over £120 million of public money for its predecessor bodies.
We are accountable to Parliament for ensuring that those funds are applied only to the extent and for the purposes authorised by Parliament. Most of us would agree that it is most unlikely that the HPA would propose to use public money for any purpose other than that for which Parliament had voted. Nevertheless, it is normal practice to have in place the mechanisms for dealing with such an eventuality if it were to arise. The devolved administrations have similar responsibilities to their Parliament or Assembly.
Having the powers of direction and exercising them are not necessarily the same. It does not mean that we shall make frequent use of it. The Department of Health has not stockpiled a long list of activities on which we are aching to give directions to the HPA. The provision is not about micro-managing the HPA. If people had any concerns about that, I hope that they were reassured by my comments at Second Reading about the reduction in the size of the Department of Health. Our capacity to micro-manage and direct agencies will not exist in the way it may have done in the past.
We are also doing no more in the provision than continuing the powers of direction that were available to Ministers in relation to the predecessor bodies. That applies not just to the National Radiological Protection Board, but bodies like the Public Health Laboratory Service and the Microbiological Research
Effectively, we took a different course in relation only to the Food Standards Authority and the Commission for Health Audit and Inspection. Their functions are quite different, and there were special circumstances in relation to both those bodies. We emphasised that those bodies, because of their nature, should not have these powers of direction in the exercise of their functions. They are different from the HPA, which is much more in line with the reserved powers of direction of other NDPBs carrying out similar functions. That is the basis for this; there is nothing sinister about it. We are continuing the previous practice and are in line with much legislation where there are NDPBs similar to the HPA.
We do not believe that Amendments Nos. 45 and 46 are appropriate. They would control the minutiae of some of the proceedings, which is not the kind of detail that needs to be controlled through the processes involved in those amendments.
Earl Howe: I am a little surprised to hear that, because there needs to be accountability to Parliament and because of the payment of grant in aid, there needs to be a broadly drawn power of direction in the Bill. One of the trumpeted virtues of foundation trusts was the absence of a power of direction; yet there was no suggestion that parliamentary accountability was absent in the case of those bodies. I do not think that that argument washes.
If anything, I am less concerned with the clear default power set out in subsection (8) than I am with the unfettered power of direction in subsection (7). I very much take on board the powerful point made by the noble Lord, Lord Clement-Jones, which, to be frank, I had not thought about in quite the terms in which he put it. Despite the Minister's resistance to the amendment, would he agree to consider whether the power of direction could be tightened up to ensure that it is deployed only when Ministers have a genuine concern that the agency may not be performing its functions properly; namely, that there is a real need for direct intervention? At the moment, it appears to be a carte blanche.
"(d) for the purposes of sections 13 (payments by NHS bodies towards certain local authority expenditure) and 14 (payments by local authorities towards expenditure by NHS bodies on prescribed functions) of the Community Care and Health (Scotland) Act 2002 (asp 5) as if it is an NHS body within the meaning of that Act;
(e) for the purposes of section 15 of that Act (delegation etc. between local authorities and NHS bodies) as if it is an NHS body within the meaning of that Act."
5.45 p.m.
Next Section
Back to Table of Contents
Lords Hansard Home Page