National Health Service Reform and Health Care Professions Bill

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Dr. Andrew Murrison (Westbury): Many of us are from Essex, either by birth or election: I add my name to that list, and I know that one of my hon. Friends sitting to my right will also do so in due course. Let us hope that that reflects the quality of the Act that ultimately emerges.

I am concerned about the haste with which such an important Bill is being rushed through. As someone who has worked in the NHS, it is dear to my heart. The Bill will fundamentally change the way in which the NHS operates; it is not, by any means, merely tweaking. Therefore, the sort of programme that we have concerns me. The issues need to be adequately exposed; in particular, we need to have the comments of outside bodies.

Only this morning I received a representation from the Local Government Association, and I am sure that many hon. Members have received the same one. Such representations seem to be arriving daily, but I am told that the normal experience is that they usually come in dribs and drabs during the Committee stage. We cannot assume that outside bodies are sufficiently organised to pass their representations to us in good time. They expect Committee stage to last a reasonable length of time so that they can comment as it proceeds. I am rather concerned that supportive outside bodies on which the Committee should rely quite heavily will not have that opportunity.

There are substantial concerns about the Bill, especially as it relates to community health councils—a subject that we shall debate in due course. Somewhat to my surprise, my postbag has been flooded with expressions of concern about community health councils. The strategic health authorities are also causing considerable concern among the general public, although that is largely the result of some misunderstandings about the way they are to be put together.

In short, I urge that we are given more time in which to debate this important Bill. I am sure that the quality of the legislation will be markedly improved as a result.

Amendment agreed to.

Main Question, as amended, put:—

The Committee divided: Ayes 13, Noes 5.

Division No. 1]

AYES
Blears, Ms Hazel
Burnham, Andy
Challen, Mr. Colin
Fitzpatrick, Jim
Hall, Mr. Mike
Harris, Dr. Evan
Havard, Mr. Dai
Hutton, Mr. John
Moffatt, Laura
Taylor, Dr. Richard
Thomas, Gareth
Touhig, Mr. Don
Ward, Ms Claire

NOES
Atkinson, Mr. Peter
Baron, Mr. John
Burns, Mr. Simon
Heald, Mr. Oliver
Murrison, Dr. Andrew

Question accordingly agreed to.

Resolved,

    That—

    (1) during proceedings on the National Health Service Reform and Health Care Professions Bill the Standing Committee do meet on Tuesdays at half-past Ten o'clock and at half past Four o'clock, and on Thursdays at half-past Nine o'clock and at half-past Two o'clock;

    (2) 14 sittings in all shall be allotted to the consideration of the Bill by the Committee;

    (3) the proceedings to be taken on the sittings shall be as shown in the second column of the Table below and shall be taken in the order so shown;

    (4) the proceedings which under paragraph (3) are to be taken on any sitting shall (so far as not previously concluded) be brought to a conclusion at the time specified in the third column of the Table;

    (5) paragraph (3) does not prevent proceedings being taken (in the order shown in the second column of the Table) at any earlier sitting than that provided for under paragraph (3) if previous proceedings have already been concluded;

    (6) provided that Clauses 7 and 8 shall be taken at the morning sitting on Thursday 29th November at half-past Nine o'clock and be concluded by twenty-five minutes past Eleven o'clock.

    TABLE

    Sitting ProceedingsTime for conclusion of proceedings
    27th NovemberClause 1, Schedule 1; Clause 2, Schedule 2; Clauses 3 and 4, Schedule 3; Clauses 5 and Clause 6, Schedules 4 and 5; Clause 22; Clauses 7 to 10.      —
    27th NovemberClause 1, Schedule 1; Clause 2, Schedule 2; Clauses 3 and 4, Schedule 3; Clauses 5 and Clause 6, Schedules 4 and 5; Clause 22; Clauses 7 to 10.      —
    29th NovemberClause 1, Schedule 1; Clause 2, Schedule 2; Clauses 3 and 4, Schedule 3; Clauses 5 and Clause 6, Schedules 4 and 5; Clause 22; Clauses 7 to 10.      —
    29th NovemberClause 1, Schedule 1; Clause 2, Schedule 2; Clauses 3 and 4, Schedule 3; Clauses 5 and Clause 6, Schedules 4 and 5; Clause 22; Clauses 7 to 10.      5 p.m.
    4th DecemberClauses 11 to 19, Schedule 6; Clauses 20 and 21; new Clauses and new Schedules relating to Part 1.      —
    4th DecemberClauses 11 to 19, Schedule 6; Clauses 20 and 21; new Clauses and new Schedules relating to Part 1.      —
    6th DecemberClauses 11 to 19, Schedule 6; Clauses 20 and 21; new Clauses and new Schedules relating to Part 1.      —
    6th DecemberClauses 11 to 19, Schedule 6; Clauses 20 and 21; new Clauses and new Schedules relating to Part 1.      5 p.m.
    11th DecemberClause 23, Schedule 7; Clauses 24 to 33; new Clauses and new Schedules relating to Part 2.      —
    11th DecemberClause 23, Schedule 7; Clauses 24 to 33; new Clauses and new Schedules relating to Part 2.      —
    13th DecemberClause 23, Schedule 7; Clauses 24 to 33; new Clauses and new Schedules relating to Part 2.      —
    13th DecemberClause 23, Schedule 7; Clauses 24 to 33; new Clauses and new Schedules relating to Part 2.      5 p.m.
    18th DecemberClauses 34 and 35, Schedules 8 and 9; Clauses 36 to 40; remaining new Clauses and new Schedules.      —
    18th DecemberClauses 34 and 35, Schedules 8 and 9; Clauses 36 to 40; remaining new Clauses and new Schedules.      7 p.m.

The Chairman : We now move to preliminary business. Copies of the financial resolution that has been tabled are in the Room. I remind members of the Committee to provide adequate notice of amendments. As a general rule my co-Chairman and I do not intend to call starred amendments.

Clause 1

English health authorities: change of name

Mr. Burns : I beg to move amendment No. 1, page 1, line 5, leave out from `(1)' to `Health' and insert `From 1st April 2003'.

    The first amendment is very straightforward. If accepted by the Government, it would change subsection (1) by saying that the proposed change of name of the health authority would have the knock-on effect of postponing implementation of the wide-ranging changes to 1 April 2003.

In ``Shifting the Balance'' the Government outlined a time scale for changes to PCTs, for the creation of strategic health authorities and for the abolition, in effect, of health authorities in England. According to that document, consultation on the proposed strategic health authorities will last from September to November, and the chairmen and chief executives designate will be appointed in November. That is cutting things fine. One presumes that the consultation period has been established so that the Government can properly analyse, assess and digest the results, but their intention to appoint the chairmen and chief executives in the same month as it ends —should they keep to the proposed time scale —adds to our fears that the measure is being rushed. I genuinely believe that a deadline of November 2001 for designated appointments and one of April 2002 for the establishment of the new strategic health authorities and the disestablishment of existing health authorities leaves too short a time.

With that in mind, the purpose of the amendment is twofold. First, it is designed to find out whether the Government are indeed keeping to the time scale outlined in ``Shifting the Balance'', what progress they are making in terms of the April 2002 target date, the way in which interested parties responded to the consultation process, and what consideration the Government have given to those responses. Apart from probing, the amendment has a second and more defined purpose, which is to advise the Government to think again about rushing in, and to accept the amendment so that strategic health authorities will not be set up until a year this April.

If the amendment were accepted, there would be a knock-on effect on consistency, clarity and the way in which the system works. I appreciate that the Government have put together a package and that therefore many elements rely on others. If the introduction of SHAs is postponed for 12 months to April 2003, it is logical to postpone changes to the functions and establishment of 100 per cent. of PCTs. They come as a package, and the one cannot work without the other. I accept, therefore, that however innocuous and helpful to the Government the amendment might be, it would have a wide-ranging knock-on effect on the first five clauses.

I urge the Minister not to reject the amendment out of hand. As I have said, it is intended to be helpful. It is not the Minister's intention to introduce botched or rushed legislation; he, like any other hon. Member—or, in his case, right hon. Member—wants the best possible legislation. On that basis, I anticipate his appreciating the fact that we are doing the Government a service by tabling an amendment that errs on the side of caution to ensure that there is no headlong rush that will cause considerable confusion and might destabilise the position.

There are approximately 104 health authorities in England and Wales. When the SHAs are set up, they will reduce dramatically the number of bodies at what is, for all intents and purposes, the health authority level of the NHS: fewer SHAs will cover larger areas and populations. In the context of the Government's aims, I understand the logic of their proposals. However, health authorities are currently the purchasers of health care for our constituents.

Dr. Harris: Language is important. The Government have done little to change the so-called internal market, but they have changed the language. We no longer talk about purchasing; instead, we talk about commissioning. I fear that I am on the hon. Gentleman's side when I say that the change is only a change of language; it is not the sort of change that it was purported to be.

 
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Prepared 27 November 2001