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Lord McKenzie of Luton moved Amendment No. 440:
The noble Lord said: My Lords, I shall speak also to Amendments Nos. 441 and 442. Amendment No. 440 is designed to address a problem raised in Grand Committee by the noble Lord, Lord Hodgson, on behalf of the Law Society. References in the clause to a company's shares currently exclude any shares held as Treasury shares. The effect is to prevent companies being able to discover who had an interest in any of the past three years in those of their shares which they now hold as Treasury shares. The amendment would remove that unnecessary exemption of treasury shares from Clause 595.
Amendments Nos. 441 and 442 address further points raised by the noble Lord, Lord Hodgson. He tabled an amendment in Grand Committee which sought to clarify the time limit in respect of the requirements of Clause 605(3). Amendments Nos. 441 and 442 achieve that clarification by moving the time limit to subsection (2), so that it applies to the basic
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entry of information on the register of interests disclosed, which must now be made within three days of receipt.
Before we leave Part 21, I take this opportunity to advise noble Lords that we undertake to table at Third Reading further amendments to Clauses 859 to 861, which currently appear in Part 33 and which implement the transparency directive in UK law. I am happy to expand on that if noble Lords press me, but I take this opportunity to put them on notice. In the mean time, I beg to move.
On Question, amendment agreed to.
Clause 605 [Register of interests disclosed]:
Lord McKenzie of Luton moved Amendments Nos. 441 and 442:
Page 296, line 13, leave out from beginning to "enter" and insert "A company which receives any such information must, within three days of the receipt,"
On Question, amendments agreed to.
Lord McKenzie of Luton: My Lords, I beg to move that further consideration on Report be now adjourned.
Moved accordingly, and, on Question, Motion agreed to.
NHS: Primary Care Trusts and Ambulance Trusts
5.17 pm
The Minister of State, Department of Health (Lord Warner): My Lords, with the leave of the House, I shall now repeat a Statement made in another place.
"With permission, Mr Speaker, and in the unavoidable absence of my right honourable friend, I should like to make a Statement on primary care trusts and NHS ambulance trusts. Detailed information for each area has, for the convenience of honourable Members, been placed on the Board since 1 pm.
"In my right honourable friend the Secretary of State's Written Statement of 18 October 2005, she explained that strategic health authorities had been invited to submit proposals to the Department of Health on how to streamline SHAs and strengthen primary care trusts. Four clear criteria underpinned this exercise: the need to improve health and reduce inequalities; to strengthen the PCTs' commissioning function; to improve co-ordination with social services through greater coterminosity between PCT and local authority boundaries; and to deliver at least a 15 per cent reduction in management and administrative costs.
"In the intervening period, strategic health authorities have consulted local people, staff and clinicians, partners in local government and a range of other local bodies on the proposals for SHAs, PCTs and ambulance trusts. Many right honourable
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and honourable Members on both sides of the House have offered their views. I am very grateful to them.
"After local consultations, SHAs submitted their reports and recommendations to the department. The external panel, established to advise Ministers on the proposals, has since met to consider each proposal for PCTs and SHAs in detail. After its advice, we announced on 12 April that the numbers of SHAs would reduce from 28 to 10.
"Ministers have now considered the recommendations and the panel's advice on PCTs. I can inform the House that the number of PCTs will fall from 303 to 152, with the new organisations established on 1 October 2006. The population covered by each PCT will rise from an average of around 165,000 at present to an average of just below 330,000. Just over 70 per cent of the new PCTs will be coterminous with the boundaries of local authorities with social services responsibilities. This compares with about 44 per cent of PCTs that are currently coterminous.
"In some areas concerns have been expressed that larger PCTs could lose a locality focus and divert resources away from deprived areas, or that smaller PCTs could lack commissioning power. We acknowledge the concerns and have sought to strike a careful balance between these conflicting demands.
"In response, we are proposing that four general conditions be applied: one, that all PCTs must retain and build on current partnership arrangements; two, that a strong locality focus must be retained, and where necessary that locality structures should be put in place; three, that all PCTs must deliver their share of the 15 per cent management cost savings, strengthen commissioning and ensure robust management of financial balance and risk; and, four, that the new PCTs and SHAs should consider how any further conditions, on issues that arose during the consultation, could be applied.
"In some areas the new proposals do differ from those suggested by the SHA and the external panel. In these circumstances, having taken into account all the evidence and, wherever possible, sought local consensus, we have judged that the alternatives could better satisfy the Commissioning a Patient-led NHS criteria and have the best possible chance of success.
"On PCTs as providers of services, let me restate the Secretary of State's clear commitment to the House on 25 October 2005:
'district nurses, health visitors and other staff who deliver clinical services . . . will continue to be employed by the PCT unless and until it decides otherwise'.—[Official Report, Commons, 25/10/05; col. 152.]
"Our aim in making these changes is to benefit both patients and taxpayers. Fewer, more strategic PCTs will be better placed to ensure effective commissioning of services for patients and to support the development of practice-based commissioning
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among GPs and other primary care staff. Patients will receive the right care and treatment, in the right place, at the right time.
"The taxpayer will see the release of £250 million savings annually—by merging back office functions and reducing administrative costs—for reinvestment in frontline services from 2008-09. This could pay for, for example, roughly 50,000 heart operations or major improvements in services for people with long-term conditions, especially older people. The changes will also build stronger partnerships between the NHS and local government.
"The reconfiguration of PCTs is the first stage in strengthening their commissioning function. The next stage is a development programme for all PCTs which will ensure that they are strong, confident organisations, fit for driving forward the NHS reforms that we are implementing.
"Let me now turn to ambulance trust reorganisation. In June 2005, the Government accepted the recommendations set out in the review by Peter Bradley, our national ambulance adviser, called Taking Healthcare to the Patient: Transforming NHS Ambulance Services. The report set out a vision for ambulance services. In future, they will provide more care in the home and more treatment at the scene, give better advice to patients over the telephone and ensure faster response times to save more lives.
"The review made it clear that, in order to ensure ambulance trusts have the right strategic capacity, infrastructure and staff to deliver these improvements to patient care, there should be fewer, larger ambulance trusts in future. These changes will enable standards within the new trusts to be levelled up to those of the best.
"In her Written Statement of 14 December 2005, my right honourable friend set out our intention to consult and to ensure that the benefits outlined in the ambulance review could be fully realised. Following this consultation, the Secretary of State has now decided that, from 1 July 2006, most of the existing 29 NHS ambulance trusts will merge into 12, with separate management arrangements for the Isle of Wight. For now, Staffordshire ambulance service will remain a separate trust, working in partnership with the new West Midlands ambulance service, but eventually merging later.
"Feedback for most areas was supportive of our proposals. However, in order to address public concern that local responsiveness and flexibility could be lost through having larger trusts, we have decided to address this by requiring ambulance trusts to ensure that their services are meeting the needs of all localities and populations within their boundaries.
"These changes should mean more investment in frontline services as trusts identify savings in backroom functions; improved patient care by providing an opportunity to raise the standards of services provided by all trusts to the level of the best; better emergency planning with greater capacity
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and capability to respond to major incidents of all kinds; and more integrated services and better career opportunities for staff.
"Changes of this kind are inevitably difficult. We have not sought to impose a single blueprint on the NHS, but instead have listened carefully to representations from all honourable Members, local communities and organisations. Wherever possible, we have responded positively to them. They have one aim above all—to deliver better healthcare to patients".
My Lords, that concludes the statement.
5.26 pm
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