NHS Reform & Health Care Professions

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The Chairman: Order. I am sorry to interrupt the hon. Gentleman, but several conversations are taking place and it makes life difficult for the Hansard writers.

Dr. Harris: The Under-Secretary must explain why the existing structure, with all its powers and the enthusiasm of those of whom she spoke so warmly when she talked about the notional new volunteers, cannot be channelled towards the kind of functions that she wishes to see. The amendments include the duty to ensure that the views of patients, carers and the wider communities are obtained. That would not make the reformed CHCs empty shells.

The commissioning and delivery of independent advocacy services by CHCs in their areas is an important function, and not one that would be found in an empty shell. The preparation of reports on the operation of the independent advisory service that would be provided to the Secretary of State, the Commission for Patient and Public Involvement in Health, the overview and scrutiny committee, strategic health authorities and trusts is an important role and not that of an empty shell.

It is also the function of community health councils, as reformed, to promote the involvement of members of the public in their area in consultations or processes leading, or potentially leading, to decisions by those mentioned in clause 19(4)

    ''or the formulation of policies by them, which would or might affect (whether directly or not) the health of those members of the public''

and to co-operate with the Commission for Patient and Public Involvement in Health to carry out that function. That is in the Bill, so the Under-Secretary cannot simply dismiss the amendments for not addressing points on which she waxed extremely lyrical. Those features are in the proposals that I am recommending. They set out important duties, before

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a decision is made. The roles that the Under-Secretary said were so important are proactive. I believe that she sincerely believes in the importance of duties such as

    ''the discharge of any function of a council by a committee of the Council or a joint committee appointed with another council''

    ''representations by Councils of the views of members of the public in its area about matters affecting their health to persons and bodies which exercise functions in a Council's area''.

The amendments show, if one accepts drafting errors, that such duties can be achieved through the current system.

Much has been said about the refusal of people in the other place and the outside world to accept reform, and about how unreasonable they were when the previous Bill had its passage. I suspend judgment on that because, at the time, I was not doing my current job or involved in negotiations, although I studied the debate. However, the surreal quality of our debate and the Under-Secretary's refusal to explain why the existing system could not be amended to provide for the nirvana of volunteering that she described makes me believe that, if anything, people in the other place were too willing to meet the Government halfway. Perhaps they will still be willing to do so. The Under-Secretary will have to do a better job of persuading them and me why the existing functions are not important.

The Under-Secretary mentioned the importance of making a real difference and described how people in the community could do so. She veered off to dismiss all the work that members of community health councils have done to date. Even the people whom she does not believe to have done their job properly have worked hard. Then she veered toward the other danger of being patronising to people who fulfil that role, which she will be keen not to do. I urge her to exercise caution. If the Under-Secretary lifts her ambition and understands that people do not require their roles to be abolished or to be kicked in the face to achieve her aims, we have a real opportunity. I am prepared to accept PALS and Liberal Democrats have accepted overview and scrutiny committees and the need for patient involvement at board level in primary care trusts and in other areas. Negotiations are the order of the day, but the starting point must be to amend the existing system. That is the rational way in which to make law and structures and to approach reform. Unless the hon. Lady shows that she is prepared to examine the matter wider, I intend to press the amendments to a vote.

Ms Blears: I shall deal with the hon. Gentleman's points briefly. I did not say that the functions that he proposed for his councils were unimportant. All the functions are vital and will be carried out by either patients forums or the commission. The hon. Gentleman's amendments would jumble up and blur the boundaries between the functions of the patients forums and the commission. Each function that he outlined is extremely important and is totally covered

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by either the patients forums or the commission. I do not say that the functions need not be carried out or supported.

I made an explicit point that the proposals build on the best of work done by community health councils and, especially, their members. I went out of my way to recognise the years of excellent voluntary commitment that people have given to community health councils. I know many such people personally, and it is wrong for the hon. Gentleman to say that I patronised them or dismissed their contributions. I wish to find a transition through which staff and members may find new roles within the new organisations. We have gone out of our way to do so and to ensure that people will be helped if they require extra support and training to take a new and enhanced role in the new system. The Society of Community Health Council Staff welcomed the proposals. I attended its annual conference three weeks ago, and 150 members were present. Following my presentation I did not know how what reception to expect, knowing how controversial the proposals were last year, but I was received extremely generously.

I received a testimonial, which I shall not read out, from the chairman of the society, Tony Tester, to say that the society welcomes the proposals from the point of view of community health council staff. Every effort has been made to ensure that we draw in the best ideas of the CHCs and of members. We will set up a transition advisory board to ensure that members in the system see a key role for themselves in future and can take on new responsibilities.

I want to respond to the points made by the hon. Members for Wyre Forest and for Westbury. To the hon. Member for Wyre Forest I say that it will be important to provide proper signposting to the new parts of the system that are designed to involve patients and the public; the patient advocacy and liaison services system will be on the spot in the trusts, more visible and accessible to everyone than community health councils.

We shall arrange for NHS Direct to provide a signposting facility so that anyone who telephones with a query needing independent complaints and advocacy services will be pointed in the right direction. If they need PALS, or want the commission to help them in taking part in a public consultation they will be able to get in touch with them. We want to make the system as accessible as possible.

We want to ensure that members will be appointed at local level by the commission and draw on people to take part in the patients forums who would not automatically reply to an advertisement in The Guardian, for example, and go through a formal process. We want rigorous criteria and selection procedures, but we also want to make them flexible enough to draw in groups that have not been well represented in the past.

In response to the hon. Member for Westbury, I am not sure that most community health councils would like to be described as a pair of old carpet slippers. Many of their members are forward-looking, progressive, imaginative and creative people who put a great deal of work and energy into drawing people into

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public consultation and involvement. People take time to get used to institutions but I hope that in the new system they will find a range of mechanisms in a rigorous system that enables them to get properly involved and to influence the shape of health services, rather than a comfortable pair of old carpet slippers.

Dr. Murrison: The Under-Secretary is being meddlesome. She knows full well that my comments about carpet slippers were made in the best possible sense and were to do with familiarity, which is important for the public in such matters.

Question put, That the amendment be made:—

The Committee divided: Ayes 5, Noes 8.

Division No. 7]

AYES
Burns, Mr. Simon
Harris, Dr. Evan
Heald, Mr. Oliver
Murrison, Dr. Andrew
Taylor, Dr. Richard

Column Number: 256

NOES
Blears, Ms Hazel
Challen, Mr. Colin
Fitzpatrick, Mr. Jim
Hall, Mr. Mike
Havard, Mr. Dai
Hutton, Mr. John
Moffat, Laura
Thomas, Gareth

Question accordingly negatived.

Motion made, and Question put, That the clause stand part of the Bill:—

The Committee divided: Ayes 8, Noes 5.

Division No. 8]

AYES
Blears, Ms Hazel
Challen, Mr. Colin
Fitzpatrick, Jim
Hall, Mr. Mike
Havard, Mr Dai
Hutton, Mr. John
Moffat, Laura
Thomas, Gareth

NOES
Burns, Mr. Simon
Harris, Dr. Evan
Heald, Mr. Oliver
Murrison Dr. Andrew
Taylor, Dr. Richard

Question accordingly agreed to.

Clause 15 ordered to stand part of the Bill.

Further consideration adjourned.—[Mr. Fitzpatrick.]

Adjourned accordingly at half-past Seven o'clock till Thursday 6 December at half-past Nine o'clock.

The following Members attended the Committee:
Hurst, Mr. Alan (Chairman)
Atkinson, Mr. Peter
Blears, Ms
Burnham, Andy
Burns, Mr.
Challen, Mr.
Fitzpatrick, Jim
Hall, Mr. Mike
Harris, Dr. Evan
Havard, Mr.
Heald, Mr.
Hutton, Mr.
Moffatt, Laura
Murrison, Dr.
Taylor, Dr. Richard
Thomas, Gareth

 
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Prepared 4 December 2001