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Amendment made: No. 23, in page 2, line 25, at end insert
'(4A) The Secretary of State may make regulations containing requirements as to consultation which must be complied with before he makes an order under this section which relates to a Strategic Health Authority, and if he does make such regulations he shall not make such an order unless such of those requirements (if any) as are applicable have been complied with.
(4B) Consultation requirements contained in regulations under subsection (4A) are in addition to, and not in substitution for, any other consultation requirements which may apply.'.[Mr. Hutton.]
Amendments made: No. 24, in page 2, line 41, leave out "is amended as follows" and insert
'(which provides for the establishment of Primary Care Trusts) is amended as provided in subsections (2) and (3)'.
No. 25, in page 3, line 4, at end insert
'( ) Schedule 5A to the 1977 Act (which makes further provision about Primary Care Trusts) is amended as follows
(a) in paragraph 2(3)
(i) for "the Health Authority in whose area a Primary Care Trust is established to meet the costs" there is substituted "a Strategic Health Authority whose area includes any part of the area of a Primary Care Trust to meet costs", and
(ii) in paragraph (b), after "meet" there is inserted "(or to contribute towards its meeting)",
(b) in paragraph 2(4), for "the Health Authority in whose area a Primary Care Trust is established" there is substituted "a Strategic Health Authority whose area includes any part of the area of a Primary Care Trust",
(c) in paragraph 16(1), for "the Health Authority within whose area the trust's area falls" there is substituted "each Strategic Health Authority whose area includes any part of the trust's area", and
(d) in paragraph 16(3), for "the Health Authority within whose area the trust's area falls" there is substituted "any Strategic Health Authority whose area includes any part of the trust's area".'.[Mr. Hutton.]
Amendments made: No. 26, in page 3, line 17, after "Trust", insert "any part of".
No. 74, in page 3, line 38, leave out from "under" to end of line 39 and insert
'preceding provisions), in subsection (1A)
(a) "or" is inserted after paragraph (a),
Amendments made: No. 27, in page 5, line 24, leave out
'by the Strategic Health Authority whose area includes the area of the Primary Care Trust'.
No. 28, in page 5, line 31, leave out
'by the Strategic Health Authority whose area includes the area of the Primary Care Trust'.[Mr. Hutton.]
'(c) by both of the following: NHS trusts and Local Health Boards.'. No. 20, in clause 9, page 10, line 30, at end insert
(c) sums required, on application by Local Health Boards, to deal with major health emergencies.'. No. 10, in page 10, line 39, at end insert
'(2A) In determining the amount to be allotted to a Health Board, the National Assembly for Wales shall have regard to the health needs of the population served by that Board'. Government amendments Nos. 75, 84 and 85.
Mr. Griffiths: I want to devote some time in the Chamber to a brief discussion of the number of health boards that will be needed in Wales to ensure that an effective health service works in co-operation with local government. There is no need to press the amendment to a vote, as the Bill is flexible enough to allow the National Assembly for Wales to decide how many health boards are needed. The maximum number possible is 22, as that is the number of local government units in Wales. I have no problem with the principle that the units of government for the health service in Wales should be organised in the same way as the units of local government there. Where I differ with the National Assembly is that I believe that we should look at the degree of coterminosity between the health service and local government in Wales from the point of view of the health service, rather than of local government. Jane Hutt, the Minister for Health and Social Services in Wales, feels that it would be best to have 22 local health boards, which would work alongside the trusts in Wales. I believe that it would be better if the local health boards were to mirror the trusts in Wales, although I accept that in a few places it could be argued that the trusts are too large to have only one local health board.
Julie Morgan (Cardiff, North): Does not my hon. Friend agree that the advantage of exact coterminosity between health boards and local authorities is that preventive and primary care would be given the highest priority as a result of the authority's involvement with housing, the environment, transport and so on? Those issues are vital to health, and it would be bound to be to the advantage of the health of local people if they were the primary concern of a coterminous local authority.
Mr. Griffiths: I beg to disagree with my hon. Friend on this issue. In the Bro Morgannwg trust that covers my local authority area, there are two local authorities. One health board would have representatives of both local authorities. I believe that they would be able to negotiate better on that basis than if there were two separate local health boards. However, that is a matter of opinion. I believe that 14 would provide sufficient flexibility for one or two larger trusts to have more than one local health board. I hope that these issues will be considered seriously in Cardiff. As the person who had the honour of having responsibility for the health service in Wales immediately after the 1997 election, I created the local health boardsor groups, as they then werebecause I wanted coterminosity between local government and the health service in Wales. In terms of their responsibilities, the local health boards will be mini health authorities. We will have much better local health boards if we have to staff 14 rather than 22. We do not have time to go into all the other arguments that I would like to makeI will put those privately to the Minister for Health and Social Services in Wales. However, I wanted to flag up this issue because it is important in delivering a more effective and efficient health service while still ensuring strong co-operation between the health service and local government in Wales.
Mr. Jon Owen Jones (Cardiff, Central): I shall be very brief because there is hardly any time left. I agree with my hon. Friend the Member for Bridgend (Mr. Griffiths) that the number of health boards proposed is excessive. I believe that they are likely to be expensive and too bureaucratic. There is room in the Bill to reduce the number of boards so that we can maintain the coterminosity that my hon. Friend mentioned, while retaining a degree of efficiency and flexibility in the delivery of the health service in Wales.
The majority of those working in the health service in Wales who were consulted and replied to the consultation also agreed that the number of bodies suggested in the new structure would be unwieldy. Unfortunately, the House has never been given proper access to an analysis of that consultation procedure, perhaps because the results would prove to be opposed to the proposals.
There is sufficient flexibility in the Bill, as my hon. Friend has said. I ask the Welsh Assembly to retain coterminosity but to reduce the number of boards so that we can have an efficient system that delivers health care to people in Wales without tying them down to the over-bureaucratic and wasteful system that 22 boards would create.