NHS Reform and Health Care Professions Bill

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Mr. Heald: It is only right that I should plead guilty, because I drafted the amendments. Does my hon. Friend agree that the reason for choosing those particular stakeholders was because the Royal College of Nursing had said that it was worried about the time scale envisaged for the proposals, which talked about new organisations. It was concerned that the programme was ambitious and the BMA—the doctors—said much the same. It used the words ``ambitious timetable''. Those concerns came to us, but I accept that I may have drafted the amendment too narrowly.

Mr. Burns: My hon. Friend is right to draw attention to those important views from outside bodies whose members are working day after day in the health service and who have a far greater comprehension of what is going on than any politician.

Although the Minister was referring to PCTs, the precedent exists and we strongly believe, as does the hon. Member for Leigh in a wider way, that the same criteria for consultation, discussion and consent should apply to the SHAs before they are established. Given the power of our arguments, I hope that the Minister would be prepared to accept the pleading from his hon. Friend, and from us, and agree to the amendments as a halfway house, or building block, that can be improved on, enhanced and expanded by the Government on Report. The Government could use their majority to ensure that we improve the Bill in such a fashion.

Mr. Hutton: This has been a useful debate and I thank all hon. Members who have taken part. The hon. Member for West Chelmsford asked me to take into account the arguments of my hon. Friend the Member for Leigh, which I am prepared to do because he made a good case with good arguments. I should also say that I am grateful for that, just in case, with the Whip sitting next to him, I cause any problems, but I am not trying to encourage other hon. Friends. I want to put what I am saying on record because I do not want to be disingenuous to the hon. Member for North-East Hertfordshire who moved the amendment.

My hon. Friend is right. The architecture of the Bill includes a duty on the Secretary of State to set up SHAs, so we must be clear that the Bill will require him to do that anyway. He is right about the principle of consultation and the argument must take place in that context. We believe, and I hope that the Committee will endorse the view, that it should be a statutory duty to set them up. We could not pull the rug from under the Secretary of State and say that they cannot be set up under certain circumstances. The proposals are coherent.

SHAs should cover every part of England, but I accept the point made by my hon. Friend that the National Health Service Act 1977, or any other subsequent piece of legislation, which the Conservative had 20 years to change and amend, does not require consultation on the establishment of health authorities, and it never has done. Currently, the Secretary of State is required to establish health authorities under statute. My hon. Friend is right to draw attention to the fact that previous Governments, as well as this one, have operated the practice of consulting the public, professions in the NHS and groups outside on proposals to change the boundaries of health authorities; mergers are an example. We are in the middle of consultation now about the establishment of the new SHAs.

I could not accept the suggestion of the hon. Member for West Chelmsford that we should consult on the principle of establishing SHAs because we believe that that should be covered by an express duty on the Secretary of State. As suggested by my hon. Friend the Member for Leigh, there is scope for considering consultation processes under the Bill in respect of changing the name of health authorities and the boundaries and mergers of SHAs. I am prepared to reflect further on that and consider amendments on Report if necessary. The principle, to which my hon. Friend referred, is important and I am happy to consider it further.

I am prepared to reconsider how the proposals will affect SHAs in England, but I cannot accept the amendments as they would apply to Wales, for two reasons. First, those are devolved matters. This House has given responsibility for them to the National Assembly for Wales, and we should respect that devolution settlement, not seek to fetter the Assembly's powers in that way.

Secondly, more practically and perhaps importantly, the health authorities in Wales will be abolished by 2003 anyway. There seems little point in establishing such consultative proposals for bodies that will be scrapped in Wales in 18 months' time. With that caveat, and bearing in mind my hon. Friend's request to look at boundary changes and name changes, I can tell the hon. Member for North-East Hertfordshire that we will reflect further on the matter and table an amendment, if possible, on Report. I hope that, in that spirit, he will not press the amendment.

5.30 pm

Mr. Heald: The Minister's approach has been constructive. I join him in congratulating the hon. Member for Leigh. His viewpoint met us halfway and encouraged the Minister to move further as well.

The Minister has not gone the whole distance, as we would like him to. He says that he will consider placing consultation requirements in the Bill, which is welcome, and he mentioned consultation on names and boundaries. However, he did not agree to consultation on practical matters such as whether an SHA could deal locally with robust arrangements that were ready to be put in place, or whether the timing was right. Many concerns expressed have been on such matters as insufficient staff for PCTs and arrangements not being fully in place, as we have discussed, for a start in October or even in April 2003.

I should like to press the Minister further. Is he simply agreeing to consultation on names and boundaries with the wider group of people mentioned by the hon. Member for Leigh, or is he prepared to consider consultation on some of the more practical issues that I raised about whether local arrangements are ready for the changes to be implemented, whether staffing of PCTs is sorted out and so on? In other words, is he prepared to find out from doctors, nurses and local people whether the proposals can, practically, be implemented?

Mr. Hutton: I have probably gone as far as I can today in giving commitments to the Committee to re-examine the proposals. I shall certainly reflect on what the hon. Gentleman has said, but I repeat the point that I made at the outset: there will, I hope, be a statutory duty to establish SHAs, and I would treat with extreme caution any proposal from the hon. Gentleman that that should somehow be subject to caveats, or made conditional upon another range of circumstances. The Secretary of State will have to be satisfied that the SHAs are capable of delivering the functions that he has in mind for them. That is his responsibility, and he must discharge it. I have gone as far as I can on areas where we can look at amendments to the Bill.

Mr. Heald: We have seen some progress on the amendments, so, in that spirit, it would be right for me to withdraw them. I hope that the Minister will consider what the BMA and the RCN have said. Obviously, if the representative bodies of the two main health professions combine to say that they are worried about the time scale for arrangements being enforced, that is a matter for concern. We hoped that this consultation process would be a way, not of second-guessing the Minister, but of ensuring that local services do not collapse, with inadequate management, causing a deterioration and the delay of much of the progress that we hope to see during the coming years. I hope that the Minister will think further on the matter; he has said that he probably will. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Mr. Burns: I beg to move amendment No. 90, in page 2, line 33, at end insert—

    `(2A) Subsection 126(1) of the 1977 Act is amended by the insertion after the word ``Parliament'' of the words ``; save that no statutory instrument shall be made under section 8 above unless a draft of the instrument has been laid before, and approved by resolution of, each House of Parliament.''.'.

The amendment is very straightforward. As is patently obvious, we are seeking to reverse secondary legislation procedures that will set up SHAs. Unless I am mistaken, there are 58 separate order-making powers—[Interruption.] My hon. Friend the Member for North-East Hertfordshire tells me that it is slightly less than 58, but, in any event, the vast majority of the considerable number of order-making powers in this legislation are negative procedures.

At this point, I will offer to do a deal with the Minister. I will not mention issues that some of his right hon. Friends may have supported in 1983 or in 1987 if he agrees not to offer the bog-standard ministerial response that the Opposition did not do things in the way that I am suggesting when in government. Life has moved on and people have changed their views on certain issues. I shall explain why I have changed my views on the Bill after the Minister has intervened.

Mr. Hutton: Why is the hon. Gentleman so reluctant to talk about the record of his party in government? He is right to say that life has moved on; he is sitting on the Opposition Benches and we are sitting on the Government Benches.

Mr. Burns: I shall not digress, except to say that I was not talking about the Conservative Government. I said that I would do a deal with the Minister; unless he advances the hackneyed argument that most Ministers advance these days, I will not remind him that his right hon. Friend the Prime Minister fought the 1983 general election on CND's platform of withdrawal from Europe.

The Chairman: Order. CND has no relevance whatever to amendment No. 90, which is concerned with procedures for draft instruments.

 
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Prepared 27 November 2001