Health and Social Care Bill

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Mr. Denham: As I said this morning, we are sympathetic to the idea that there needs to be some form of national body to reflect patients' views. That is why we funded the first part of a study proposed by the College of Health, the Long-Term Medical Conditions Alliance and the patients forum, to which we have given £20,000 in the first instance. One of its aims is to identify the options for a national patient body.

The research brief states that

    ``a number of the demands arising from''

the Government's

    ``proposals are best supported on a national basis. For example, support for the recruitment, appointment and development of patient and public representatives; national guidance to ensure that work is properly undertaken. There are also questions about how best to pull-together and roll-up local information to ensure influence on regional and national services and policy developments. Fundamentally, there is a need to be confident that the new arrangements will ensure the system for involvement in the NHS is being strengthened''.

That is part of the brief that we are supporting.

The scoping study is regarded as the first stage in two subsequent studies on, first, the detailed design of a national patient involvement organisation, and, secondly, plans for its implementation. That study is already being supported. Among the aspects that it will examine are the scope for a new national body, its main roles and functions, the models of good practice and current capability that it should draw on and what, if any, formal powers and authority it would require. We are moving broadly in the direction suggested in the amendments, but I would not want to tie us to the specific models implied in the amendments. There is no need for the national body to be set up on a statutory basis, as has been agreed by some of the organisations that are taking part in the study. We are considering the issues that underlie the amendments.

Dr. Doug Naysmith (Bristol, North-West): Has my hon. Friend the Minister any idea how long the study will take and when we can expect results?

Mr. Denham: We hope to receive the results of the scoping study by 31 March, when we shall be able to move on to the other studies that I have mentioned.

Dr. Brand: I am in no way persuaded by the Minister, which is unusual, because he usually makes a strong case. I do not understand why we need research or a consultant to establish the scope for a national body. Perhaps he wants to be absolutely certain that a national body will be tied to ministerial restrictions, so that it restricts itself to comments on matters on which the Minister is prepared to receive representations. If we are to have a national body representing patients forums, it is for those patients forums collectively to determine the agenda of that body. The only study that the Minister must do is into how to fund it. Spending £20,000 on calculating how much it might cost to duplicate ACHCEW seems a waste of Government money. We are being presented with £20,000-worth of buying time and paying off organisations that recognise a need for a national presence on the matter.

Mr. Swayne: The Minister said that the first of the studies would be received by 31 March. That strikes me as taking the Government out of any significant danger in relation to the Bill in Committee and, indeed, the House, although perhaps not so with respect to its passage in another place. We shall consider carefully what the Minister has said, and we shall consult outside bodies with a view to returning to this matter, or it may receive further scrutiny in the other place.

I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Amendments made: No. 191, in page 8, line 23, leave out

    `by regulations made by the Secretary of State'.

No. 192, in page 8, line 33, at end insert `and the trust'.

No. 193, in page 8, line 35, at end insert `and the trust'

No. 194, in page 8, line 41, leave out

    `(within the meaning of the 1977 Act)'.

No. 195, in page 8, line 43, leave out from `of' to `, and' in line 44 and insert

    `section 31 arrangements in relation to the exercise of health-related functions of a local authority'.

No. 196, in page 9, line 1, leave out `in pursuance of such' and insert

    `(and not as part of the health service in England) in pursuance of section 31'.

No. 197, in page 9, line 3, leave out `subsections (2) and (3)' and insert

    `this section--

    ``the health service'' has the same meaning as in the 1977 Act;

    ``patient'' includes (as well as a patient within the meaning of that Act) a person who receives services provided in pursuance of section 31 arrangements in relation to the exercise of health-related functions of a local authority;

    ``prescribed'' means prescribed by regulations made by the Secretary of State;'.

No. 198, in page 9, line 5, at end insert—

` ``section 31 arrangements'' means arrangements under regulations under section 31 of the Health Act 1999 (arrangements between NHS bodies and local authorities).'. —[Mr. Denham.]

Clause 10, as amended, ordered to stand part of the Bill.

Clause 11

Patients' Forums: Entry and Inspection of Premises

Mr. Hammond: I beg to move amendment No. 250, in page 9, line 6, leave out subsection (1) and insert—

    `(1) Authorised members of a Patients' Forum shall be permitted (subject to subsection 2 below) to enter and inspect, for the purposes of any of the Patients' Forum's functions, premises owned or controlled by—

    (a) a Health Authority, or

    (b) a Primary Care Trust, or

    (c) an NHS Trust, or

    (d) a person providing services under Part II of the 1977 Act or under arrangements under section 28C of that Act.'.

The Chairman: With this we may discuss the following amendments:

No. 83 in page 9, line 6, leave out `may' and insert `shall'.

No. 84 in page 9, line 13, after `inspect', insert `by arrangement and unannounced'.

No. 251, in page 9, line 15, after `The', insert

    `Secretary of State shall make regulations in relation to the powers granted under subsection (1) above, and the'.

No. 238, in page 9, line 16, leave out `cases and' and insert `exceptional cases or exceptional'.

No. 239, in page 9, line 16, after `is', insert `not'.

No. 252 in page 9, line 17, at end add—

    `(3) The Secretary of State shall make regulations providing for—

    (a) publication of a report of any inspection carried out under this section;

    (b) submission of any such report to the body controlling the premises inspected; and

(c) publication of a response from the body controlling the premises inspected.'.

Clause stand part.

    No. 86, in clause 12, page 9, line 22, at end insert—

    `(1A) Every Patients' Forum shall also—

    (a) prepare reports on matters arising from premises visited within 60 days and send the same to the relevant Trust, overview and scrutiny committee, ILAF, and Health Authority, which bodies shall be required to respond; and

    (b) have the right to refer any matters to the Secretary of State for action in the event that it is dissatisfied with the response from the above bodies'.

Mr. Hammond: Amendments Nos. 250 and 251 would change slightly the architecture of this clause. Instead of ``allowing'' the Secretary of State to make regulations'', it would state that the Secretary ``may'' make regulations. The amendments would insert in the Bill the requirement to allow authorised members of a patients forum the right to enter the premises of certain health bodies—thus enshrining that right in primary legislation—and would require the Secretary of State to make the necessary regulations to govern the way in which that arrangement is to work.

We think that the right of patients forums to enter the premises of designated NHS bodies is so absolutely fundamental to the performance of their function that it must be written into the Bill, and not left as something the Secretary of State may do by regulations. We fully accept that there will have to be arrangements governing the exercise of those powers, which will have to be preserved in regulation-making powers by the Secretary of State.

Every member of the Committee will be familiar with the Casualty Watch bulletins produced by community health councils. One of the high profile and very important functions of community health councils is to monitor what is actually going on in hospitals. A picture speaks a thousand words, and a snapshot that Casualty Watch can provide over a 24-hour period often gives us a clearer view of what is really going on in an NHS organisation than all the statistics published--or not published--by the Department of Health. I will judge the Government's motive in making these changes to the NHS's overview and scrutiny arrangements by the output of the new bodies.

If we do not continue to see a regular flow of often very embarrassing Casualty Watch reports, which contradict assurances that Ministers give to the public and to the House, and if we do not see these new organisations blowing the whistle on scandals or irregular practices occurring around the country, then we will know that the Government, in making these changes, have not improved the scrutiny and oversight of the NHS: they have diminished it.

For that reason, we believe that the right of entry must be enshrined in the Bill. It must, of course, be properly hedged around by regulations to ensure that the exercise of those powers does not damage the clinical effectiveness of the premises being visited. We see no reason to delegate this to a regulation-making power that the Secretary of State may or may not exercise.

Amendment No. 252 enables the Secretary of State to make regulations providing for the publication of reports of inspections carried out under clause 11, the submission of those reports to the NHS body concerned and the publication of the NHS body's response to those reports. Anything less than that will not provide effective public scrutiny or enable the patients forums to perform their function effectively.

6.45 pm

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