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Baroness Gardner of Parkes: My Lords, I do not accept the Minister's statement that this is the first reform in dentistry; it is a matter of how one looks at it. There have been many reforms over the years and the last new contract was, I think, in 1991. Is it not correct that under the new contract the original proposal was to give dentists more time for preventive work, as the Minister said, but new targets have now been imposed whereby the dentist must carry out 90 per cent of the courses of treatment that he carried out before and at least 5 per cent of those must be on new patients? Is it not the case that unless the dentist matches those requirements, which means no less
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workstill on the treadmill as he was in the pastthe promised guaranteed income for three years will not apply?
Baroness Andrews: My Lords, when I referred to reform I was talking about a much more significant reform in terms of the structure of payments in relation to the traditional ways in which dentists have been paid and getting away from the treadmill of "drill and fill" and unnecessary recalls and so on. That is what I meant.
Regarding the noble Baroness's second point, we all have to understand that when we make an income guarantee over three years we must be able to quantify what the NHS gets for that, because we have serious under-capacity in NHS dentistry. That is why over the past year, as discussions have proceeded, this matter has come into the frame in a more focused way. I believe that as a result of that we will obtain value for money; dentists will know what they are able to and want to do; and essentially NHS patients will have better access to NHS care. Surely, that is what we all want to see.
Lord Grocott: My Lords, my noble friend Lord Bach has already referred to the fact that there will be a Statement on defence later today. For clarity, that Statement will take place after the Second Reading of the Public Services Ombudsman (Wales) Bill, and it will be entitled, "Future infantry structure".
The legislation that currently provides for three separate ombudsmen is out of date. The three offices are the Commission for Local Administration in Wales, the Health Service Commissioner for Wales and the Welsh Administration Ombudsman. The current legislation does not allow the ombudsmen to deliver the efficient and effective service to which people in Wales are entitled.
The legislation was enacted at a time when it was assumed that a particular service would be the particular, or even exclusive, responsibility of local or central government or the National Health Service. But that is no longer true. There is increasing emphasis now on the provision of services for people through partnerships between different public bodies. In the fields of health and social care, for example, a person's case may be dealt with by a health body working together with a local authority's social services department. But if that person is not happy with some
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aspect of a service provided, it may not be easy to identify which of several public bodies is responsible and, therefore, to which ombudsman a complaint should be submitted. We need to remedy that.
However, differences in the legislation applying to each office inhibit the development of a coherent and effective ombudsman's service in Wales that reflects the ways in which public sector service delivery is evolving. The Bill will address that and will allow a properly integrated ombudsman's service to be created.
I shall explain briefly how this Bill has been carefully developed over the past two years. In March 2001, the then Secretary of State for Wales and the Assembly's First Minister jointly announced that there would be a review of public sector ombudsmen services in Wales. Their provisional view was that all of the offices in Wales should be held by the same person. This reflected a recommendation made by the National Assembly Advisory Group in 1998. In December 2002 the Wales Office, working jointly with the Welsh Assembly Government, published Ombudsmen's Services In Wales: Time for change?, a consultation on the principle of bringing these offices together into a unified service led by one person.
That proposal received unanimous support from a wide range of consultees. It was also endorsed by all parties in the Assembly in plenary debate. So, in October 2003, a second round of consultation on the detailed powers and jurisdiction of the new office, entitled A Public Services Ombudsman for Wales: Powers and Jurisdiction, was initiated. I have both documents here and I shall arrange for every noble Lord who takes part in this debate to receive copies of them before the next stage of the Bill.
Meanwhile, as an interim step to achieving the longer term objective of a unified office, the Regulatory Reform (Local Commissioner for Wales) Order 2004 removed a restriction in the Local Government Act 1974, the effect of which was to prevent one person simultaneously holding the three existing offices in Wales. As a result, Mr Adam Peat holds those three offices now.
But as I have said, to create a properly integrated office, the legislation applicable to the three offices needs to be rationalised and brought together into a coherent whole if the benefits of a unified office are to be achieved. That is what the Bill seeks to achieve. It will bring together the offices of the Commission for Local Administration in Wales, colloquially known as the local government ombudsman, the Health Service Commissioner for Wales, the Welsh Administration Ombudsman and finally, when established in 2005, the Social Housing Ombudsman for Wales into a unified jurisdiction led by one personthe Public Services Ombudsman for Wales.
We believe that the Bill's effect will be cost neutral; this is a Bill about creating a coherent jurisdiction, administered by a team which is already working increasingly effectively together, but which now needs the backing of a sound legislative framework. The Bill will provide a modern, flexible and accessible service
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for members of the public who wish to complain about most public service providers operating in relation to Wales.
I said "most public service providers", because services delivered under the auspices of the UK Governmentfor example, social securitywill remain subject to the jurisdiction of the Parliamentary Commissioner. But that is an exception to the general principle that, in respect of public services on which people rely in their daily lives, the new ombudsman's office will provide a single channel for receipt and investigation of complaints.
So, local government, within which we include community councils, health bodies, the Assembly itself, and its sponsored public bodies, will all be within, or may be brought within, the new ombudsman's jurisdiction. The Bill provides powers for the National Assembly to amend the list of bodies within the ombudsman's jurisdiction, to reflect changes in the structures of government in Wales. The Bill gives the ombudsman important powers of investigation in his own right, but it also allows him to seek to resolve disputes between complainants and the relevant public bodies without the need for a formal investigation. This is a new provision for Welsh ombudsmen, but it is one that I hope your Lordships will welcome.
The Bill also provides powers to permit the ombudsman to work jointly with other ombudsmen, including the Parliamentary Commissioner and the Health Service Commissioner for England, for the investigation of cross-jurisdictional or cross-border complaints. As noble Lords will know, cross-border provision of services, particularly in health, is not at all uncommon between Wales and England. The Government have sought to facilitate joint ombudsman investigations to cover precisely that situation.
I give notice now that the Government may wish to table a limited number of amendments. We want to consider, in particular, whether the Bill can be improved by express provision to ensure that, in health and social care, the ombudsman can look across the scene at complaints about the consequences of decisions made by social care professionals who are working alongside clinical colleagues. The Bill may also require minor drafting changes. Naturally, I will keep the House informed of that and give the House as much notice as possible of any changes to be made.
I look forward to listening to noble Lords' views on the Bill. If the Bill is enacted, Wales will have a first-class ombudsman service, fit for the 21st century. It is an aspiration that we can all share. I undertake to give the most careful consideration to suggestions for improving the Bill. I would welcome suggestions from all sides of the House.
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