|Health and Social Care Bill
Mr. Denham: If I have been listening properly, there is broad agreement about what the proper outcome should be. We shall touch on similar issues when we debate clause 9 and related amendments. The Government's view is that the lead responsibility for the scrutiny process should lie with social services authorities, which is the intention underlying the Conservative amendment. However, we recognise that there is a case for involving district councils in the process.
New clause 9 will enable us to make regulations for the joint working between social services authorities that will sometimes be necessary. That might be relevant, for instance, in my neck of the woods, where Southampton is the social services authority for my constituency, and Hampshire covers the constituency of the hon. Member for New Forest, West. The provision would also cover the involvement of district councils. There will obviously be situations involving primary care trusts, reconfigurations and things of that sort, where a district council input to the scrutiny process would be essential. There is no need for amendment No. 245. The existing wording of the Bill reflects a common intention.
Amendment No. 226 puts district councils on the same basis as social services authorities. That is not our intention, and new clause 9, when we come to it, will, I hope, be seen to deal adequately with the point made by the hon. Member for Sutton and Cheam.
Mr. Burstow: We deliberately put the amendment that we tabled in that part of the Bill, because the clause is about regulations. I interpret the clause to mean that the way in which scrutiny will be performed can vary. Will the Minister tell us in what way the clause precludes differential treatment between different tiers of local government?
Mr. Denham: I believe that new clause 9 deals with the matter more adequately. My understanding is that accepting such an amendment to subsection (2) might imply an equivalence of approach. I hope that new clause 9 will deal with the question.
Mr. Swayne: I accept entirely the hon. Gentleman's point that the practical effect of our amendment is to achieve precisely what the clause, as currently drafted, achieves. However, I do not understand why he has chosen to achieve that by specifying the types of council rather than what it is about those types of council that makes it appropriate for them to undertake the scrutiny. There is an agenda for reform in local government, and there is a regional government agenda. The types of council that the Government have specified might not always discharge the responsibilities that they currently do.
Mr. Denham: The answer is perfectly reasonable. We chose the best default option for inclusion in the Bill. Choosing to specify the type of authority as opposed to specifying authorities in terms of social services provision avoids any other selection of authorities that would have overlaps and duplications. Should responsibility for social services be transferred elsewherewe have no intention of doing sowe will at least be left with a pattern of scrutiny that covers the country uniformly. If we had specified social services provision as a criterion, consequential changes would have been needed. We are getting into a hypothetical area of law-making. The effect of the measure is to provide a uniform pattern of scrutiny, and new clause 9 will allow district councils to be included in that pattern where appropriate.
Dr. Naysmith: This is a minor point, which is not really related to the amendment. We are talking about social services provision as being the determining factor in deciding the direction of the Bill. I should like to place on the record, and I am sure that the Minister will agree with me, that district councils, through their environmental health function, have an important part to play in public health. I would not like to think that the direction of the Bill was being determined by questions of social services provision.
Mr. Denham: My hon. Friend is right, and that is why the amendments and new clause 9, which we shall consider later, are important. We must not exclude district councils from the process altogether. However, a decision must be taken about where the lead responsibility should lie, and that is the judgment that we have made.
Mr. Swayne: The Minister has adequately explained the matter, and said what I would have said in my intervention. In consequence, I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Mr. Swayne: I beg to move amendment No. 242, in page 6, line 19, leave out `Regulations may' and insert
The Chairman: With this, it will be convenient to take the following amendments: No. 74, in page 6, line 19, leave out `may' and insert `shall'.
No. 26, in page 7, line 3, at end add
Mr. Swayne: Given the hour, I am sure that the amendments will not detain us for too long. One thing has become abundantly clear from our debates this morning: there is a huge amount of uncertainty as to what, precisely, the arrangements are, and how they will work and interact. The amendments are concerned with what, precisely, is under scrutiny, what will be the subject of the reports of the scrutiny committee, what the NHS must consult the committees about, what information the NHS must or must not provide to them, and who has to appear before them. The regulations must, not ``may'', tell us all that.
There is already sufficient uncertainty. If the regulations will not give us that information, what use will they be? We crave certainty as to precisely what the regulations will spell out.
Mr. Burstow: The amendment does nothing of what the hon. Gentleman mentioned, but limits the time in which the regulations can be published. The points that the hon. Gentleman talked about are tackled by amendments Nos. 74 and 26, which were tabled by my hon. Friend the Member for Isle of Wight and me.
I understand the concerns of the hon. Member for New Forest, West. We tabled the amendments for the same reason. We believe that the Secretary of State should have to take action, and that he should have to consult. Much of the Bill is being portrayed as having a spirit in which consultation is important, and a provision such as that in amendment No. 44 would enable the Government to give further assurances to those interested in the subject that, in relation to clause 7(3), they will meet the interests of patients and other groups.
Mr. Swayne: I do not want to get into a private row with the hon. Member for Sutton and Cheam, but I am sure that he will acknowledge that the effect of publishing regulations within 60 days will achieve the certainty for which we have asked. I accept that his amendments would achieve the same effect.
Mr. Burstow: We have common cause in wanting certainty, if in nothing else. I hope that the Minister will respond positively to the proposal that there should be consultation ahead of the publication of the regulations.
Mr. Denham: I may be wrong, but I shall assume that the amendments are probing amendments, designed to elicit assurances that there will be regulations and consultation on them with parties such as the Local Government Association and the NHS Confederation. Regulations will need to be in place before the overview and scrutiny committees can assume their functions. The regulations will be subject to scrutiny through the negative resolution procedure.
The process will be important. The scope of the powers of the scrutiny committee to consider, for example, major hospital reconfigurations, major service changes and so on will be set out in the regulations. Members of the Committee will be aware that some of the rights that CHCs enjoy derive not from primary legislation or regulation, but from a combination of guidance and judicial precedent. When moving to the new system, we clearly need to outline the appropriate powers for the scrutiny committee, so it will be necessary to raise issues on which we especially want to ensure that the committee plays an effective role.
The hon. Member for Sutton and Cheam mentioned health inequalities. We would want to consult on whether there would be an advantage in specifying the health improvement programme and its implementation as a key area for the scrutiny committee to examine. That is a way in which, through the regulations, it would be possible to institutionalise a focus for some of the issues with which he is concerned.
The matter is not for today. Regulations will be made, and we will consult.
Mr. Burstow: Will the Minister tell us whether the current Association of Community Health Councils for England and Wales will still exist when the regulations are published? We must be able to check that the precedents set through the courts are firmly established and bedded down in the new regulations.
Mr. Denham: In view of my earlier assurances about the need for a proper transition from the existing system to the new system, that is likely.
Mr. Swayne: I thank the Minister for his response. We believe that the publication of the regulations is urgently required, because the process of deciding how the arrangements will work is already under way. The Minister will be aware that the discussion between the Local Government Association and the NHS Confederation was about precisely how the arrangement worked, and several questions were raised that need certainty. However, I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Adjourned till this day at half-past Four o'clock.
Maxton, Mr. John (Chairman)
Foster, Mr. Michael Jabez
Stewart, Mr. Ian
Young, Sir George
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