NHS Reform & Health Care Professions

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Mr. Burns: I am genuinely fascinated to know what line the Under-Secretary will take in her reply, because from 1993 to 1997 she was chair of the Salford community health council. No doubt she did a good job and came fully to appreciate what a valuable contribution that community health council made to the lives of the people of Salford by acting as an independent voice in health care provision and helping individuals in the community with their problems. It also played an important role in the local area in helping to advise, formulate and fulfil the provision of health care for Salford. At last, we have a Minister who knows something about the subject that she is debating, but she will have to behave like a juggler to repudiate the views that she held so deeply during that period.

I am not a cynical man, so I will not say that the hon. Lady loved and supported the proactive role of community health councils in 1993 to 1997, because the Government in those days were Conservative, not Labour. She saw the role of the community health council as emphasising the problems facing the health service at that time. If that had that a knock-on effect politically, it was all well and good for the Labour party.

During the prolonged debates that we had on the abolition of community health councils and the imposition of patients forums in the past six to nine months, I have noticed that this Government, who brook no opposition and hate the idea of any criticism, see community health councils as too successful, independent and determined to do their job properly in representing the interests of local people with regard to the provision of health care. I suspect that Ministers in the Department of Health petulantly decided that they would rid themselves of this ''troublesome priest.'' They came to the conclusion that it was not in their interest and did not fit in with the spin that they like to put on their policies for there to be an independent, free-thinking organisation doing to a tee the statutory duties that were imposed on community health councils at their inception.

To bolster the need for the amendments, one has only to consider the record of community health councils over the 27 years since their inception in 1974. You will know, Miss Widdecombe, that those councils were established as patient advocates in the NHS. By any criterion that one chooses, their success in being good, formidable patient advocates is beyond dispute.

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They have been at the forefront of ensuring that the patients' voices are heard and their complaints listened to.

Most recently, community health councils played a pivotal role in ensuring that Rodney Ledward was exposed and that the relatives of the victims of Harold Shipman were supported during a difficult time. I suspect that if hon. Members were honest, they would admit that such people have done a good job. The hon. Member for Crawley (Laura Moffatt) is a former state-registered nurse, so she will have first-hand experience from the other side of the excellence of the work of community health councils. If all members of the Committee examined their souls, they would know from their experience as constituency MPs—not as Ministers or poodles to the Government Whips Office, but as individual Members of Parliament representing their constituents—how good a job the community health councils do, by and large.

6.30 pm

Of course there is a case against the community health councils, as I am sure that they would be the first to admit. In some areas, they could be improved. Certain community health councils and some of their members may not be as efficient as others. There are grounds for improvements, but that does not necessarily mean that there are grounds for the abolition of an independent voice and its replacement by a poodle. The patients forums as envisaged by the Government are nothing more than a lapdog. They are an attempt to silence opposition to what is going on in the health service, and to deprive our constituents of an independent and powerful advocacy service on their behalf.

To put that in perspective, I would like to mention what the community health councils have done to justify their retention, albeit in a reformed format. On average, they assist around 30,000 people with complaints. A recent poll conducted by Health Which? found that 84 per cent. of those who had contacted their community health council at some point found the advice given very or fairly useful, which suggests an extremely high satisfaction rate.

A recent report, ''Hidden Volunteers'', conducted by the Community Service Volunteers estimated that community health council members contributed through their dedicated work about £7.9 million worth of free labour for the national health service. No one in the Room would underestimate their work—those who would must be extremely brave. People have devoted their time and effort to ensuring that the institutions that Parliament set up in 1974—according to research, the Labour party was in favour of it at the time—have more than fulfilled their potential, and continue to do so even as we discuss their future yet again tonight.

The trouble is that community health councils are a thorn in the Government's side. To be effective, they have to be a thorn in the side of every Government, regardless of their political persuasion. That is their role as an independent advocacy service. They are there when trusts and health authorities propose to close wards to save money. They have the real power

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to get such decisions called in to Ministers if they do not agree that they are in the best interests of local communities.

I will give the Under-Secretary an example that shows how the people of mid-Essex must be more than grateful in the end—it is sad that I have to say in the end—for the work of their community health council. The management of the Mid Essex Community and Mental health trust was fairly rotten until 18 months ago. In the end, it was replaced, and Ministers would be the first to accept that that was the right decision, certainly based on waiting list figures. The then management decided to close two wards in an attempt to save a little under £1 million to combat its financial problems. The way in which the proposals were implemented suggested that that money would not be saved because of the ensuing bed blocking, but the two wards would have been closed and all those acute care beds would have been lost.

In the end, the community health council stepped in and formally objected, which meant that the matter had to go to Ministers. It turned out that the community health council was absolutely right. The wrong decision had been taken—it would not achieve any savings or improve the provision of health care in any shape or form—and the community health council put a brake on the process. The trust abandoned the proposals; a decision that has been more than justified over the past 18 months. Without a community health council with those powers, those closures would have gone ahead and the situation for the provision of health care in mid-Essex would have been even worse than the trend suggested.

That shows the importance of community health councils and that is why it is important that the Government should think again and be prepared not to proceed with an idea that they cannot justify. During the debates on the Health and Social Care Act 2001 earlier this year, another place, thank heavens, through a combination of its Members' actions and the time scale of the general election, managed to stop this proposal from going ahead. Sadly, Ministers, almost as if they are feeling insulted that Parliament has stopped a proposal, however cock-eyed and difficult to justify, seem to believe it should be punished after the election by bringing back what is to all intents and purposes the same proposal.

No doubt the Under-Secretary will try to produce a fig leaf, not only for her own change of heart on the effectiveness of community health councils but for the proposals in this Bill, which are similar to those in the previous ones, although in some ways they are even worse.

The amendments would enable the Secretary of State to revise and extend existing regulations governing the operation of community health councils so that they might be retained and reformed in England. Of course, Miss Widdecombe, you will have noticed, as will any other perspicacious Member of this Committee, that community health councils will not be abolished in the Principality of Wales. It is a pity that the Under-Secretary of State for Wales, who has attended many of our Committee meetings, is not here.

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It would be interesting to hear his views as to why Wales is allowed to continue with the structure of community health councils, but England is not. [Interruption.] I thought that I heard ''devolution'' from an hon. Member on the Labour Benches; I have no doubt that that is the reason. Why is it that a devolved Assembly in Wales, which-unless my mathematics and my memory are wrong; the First Minister is a Labour politician-is run by the Labour party, has had the common sense to keep the community health councils in the Principality?

Dr. Harris: I do not know whether I am assisting the hon. Gentleman or the Labour party by pointing out that the Administration in Wales is a partnership between the Labour party and the Liberal Democrats. Who knows exactly who has taken which position, but it is likely that one of the conditions of that partnership government was that there was true democracy at local level in the community in the health service and that is why CHCs were saved.

Mr. Burns: If I understood that intervention correctly, the hon. Gentleman was claiming that because of conditions laid down by the Liberal Democrats community health councils are being retained in Wales. I am afraid that I have no way of verifying that fact. I hesitate to take it at face value, not simply because it is a Liberal Democrat claim, although that plays a role in my hesitation, but because the hon. Gentleman did not categorically say that that was the case. He said that he thought that that might be the case. Will he clarify the matter?

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Prepared 4 December 2001