NHS Reform & Health Care Professions Bill

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Mr. Baron: I thank the Under-Secretary for her modest clarification of funding. I apologise if I missed the answer, but my question was about where the funding will come from. If patients forums are to be truly independent, funding should not come from the budgets of primary care trusts. We rely on patients forums to ensure that the service meets the public's requirements. If forums are funded by local primary care trusts, there could be a conflict of interest.

Ms Blears: I dealt partially with that when we discussed earlier amendments on the requirement to ensure that the funding stream came through the commission and not the trusts, so that there would be an element of independence. I told the hon. Member for Oxford, West and Abingdon that I had identified the issue as important and that we would table an amendment to strengthen independence in that regard.

The hon. Member for North-East Hertfordshire raised two other issues, the first relating to the position of CHC staff. I said on Tuesday that I went to the staff conference a couple of weeks ago. We launched a human resources framework document that was directed specifically at CHC staff. We have already given a commitment that they will be treated like all the other health service staff who are going through structural and organisational change as the balance of power is shifted. They must go to clearing houses and look at vacancies to see where their new role will be in the system. We want to ensure that CHC staff, including the staff of ACHCEW, have the same opportunities to find their way through the new system.

I understand Mr. Tester's point that the commitment is to ensure that staff in the NHS as a whole have a job for at least 12 months from 2002, which is when the main functions in ''Shifting the Balance of Power within the NHS'' come in. CHC staff are looking for a similar guarantee beyond 2003, which is the timetable proposed in the implementation plan. I understand that that matter is still being discussed among officials and representatives of the staff's trade union. I understand their point. We will endeavour to give them as much protection as we can, but we do not want one group of staff in the health service to be treated differently from the other staff. We want to provide equity, but we are conscious of the need to ensure that people find, where they want it, a new role in the new system.

Finally, I shall deal with the point raised by the hon. Member for Westbury about ensuring that people bring a range of skills to patients forums, including people with disabilities. I commend to him the campaign currently being conducted by Scope, an excellent organisation. I learned about what it calls its ''missing persons'' campaign recently at a conference. The organisation is identifying people with a range of disabilities and the campaign's theme is, ''Have you seen this missing person—as a magistrate? Have you seen them as a school governor, or in your health service?'' It is a marvellous campaign and it brought home to me that we hardly ever see people with disabilities shaping our civil society. That is a key issue for us. Such material helps to put it on the agenda, and we intend to operate a lot of missing persons campaigns. It is time that missing people had a say in our health service.

4.30 pm

Mr. Heald: I echo the Under-Secretary's remarks. Disabled people should be given more prominence in all spheres. Scope does a great job. However, I should like to take the Committee back to the money, if I may. It is obvious that more needs to be spent on the new bodies than was spent on the community health councils. The estimates are £35.6 million for the commission, £32.5 million for patients forums and about £12 million for the advocacy service.

The Under-Secretary says that she wants to look at the matter in the round. Does she agree, first, that more money needs to be spent than was originally spent on the community health councils? Does she also agree with Mr. Tester, who, as she said, thinks that the proposals are better than the original ones but who also says that although the proposed system has the potential to be dynamic, it will also depend on being adequately resourced?

If the Under-Secretary cannot even say that the same amount of money—£23 million—that was spent on community health councils will be available for patients forums, which is about £10 million less than the estimate of what is actually required, does that not suggest that the Government are thinking of not adequately resourcing the measures? Considering the figure of £32.5 million, which is a low estimate anyway—as I said, the Audit Commission has estimated £60 million—will the Minister at least say that the Government are committed to providing the £23 million, and might even do better?

Ms Blears: I have said everything that I want to say about finance. I have said that the system will be adequately resourced, and that remains my position.

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

The Committee divided: Ayes 7, Noes 3.

Division No. 9]

AYES
Blears, Ms Hazel
Fitzpatrick, Jim
Hall, Mr. Mike
Hutton, Mr. John
Moffatt, Laura
Taylor, Dr. Richard
Ward, Ms Claire

NOES
Baron, Mr. John
Heald, Mr. Oliver
Murrison, Dr. Andrew

Question accordingly agreed to.

Clause 18 ordered to stand part of the Bill.

Clause 19

The commission for patient and public involvement in health

Dr. Harris: I beg to move amendment No. 221, in page 24, line 8, at end insert—

''(3A) It is also the function of the Commission to monitor the performance by NHS bodies of their duty of public involvement and consultation as specified in section 11 of the Health and Social Care Act 2001 (public involvement and consultation).''.

The Chairman: With this it will be convenient to discuss the following amendments: No. 222, in page 24, line 27, at end insert—

''(c) the Secretary of State''.

No. 223, in page 24, line 35, after ''Forum'', insert

''those persons specified in section 16(1)(d) and (e) and in section 16(2)''.

Dr. Harris: I shall be brief because some of us harbour hopes of discussing later clauses.

The purpose of the 2001 Act was to place on NHS bodies a duty to ensure adequate public involvement. It seems appropriate that that duty should be monitored, as other things in the health service are. It is also reasonable to say that the commission, which is set up with that duty in mind, is best placed to carry out the monitoring of the requirement to involve and consult patients and public on

''(a) the planning of the provision of those services,

(b) the development and consideration of proposals for changes in the way those services are provided, and

(c) decisions to be made by that body affecting the operation of those services.''

As happened with CHCs, there is a danger that people in the health service will think that that covers the public involvement element and that the issue need no longer concern them. The Under-Secretary will probably state with as much passion as she has so far demonstrated that that is not the intention. The amendment would serve her purpose well and I hope that she considers it satisfactory.

Amendment No. 222 inserts the Secretary of State into the list of bodies to whom the Commission for Patient and Public Involvement might report concerns about the safety and welfare of patients, if they are not satisfied about the way in which matters are being dealt with. It is reasonable that a line of report to the Secretary of State should exist. I understand the need for the commission to maintain independence, but we must be concerned about the safety and welfare of patients.

Amendment No. 223 would broaden the groups of bodies, or persons, who should provide the commission with information so as to include primary care practitioners and participants in local pharmaceutical services, pilot schemes and so on. Those people are referred to in clause 16(1)(d) and (e), and subsection (2). The amendment would also include people who own or control premises where services are provided. If the commission seeks information under its NHS duties, it is reasonable that everyone who will provide NHS services should be covered by provisions under the Bill.

Those are reasonable amendments and we ask the Under-Secretary to accept the lead amendment or give a reassurance that NHS bodies will be adequately monitored.

Dr. Richard Taylor: I shall be even briefer. The Under-Secretary has already assured us that promotion of public involvement will take place. We want to substitute the word ''monitoring'' to ensure that that happens. She has partly reassured me on amendment No. 222, which would ensure that there was a mechanism for a statutory body to refer to the Secretary of State. She has referred to that, but I am not clear in my mind which body it will end up being, so I would like a further reassurance that there will be such a body.

Ms Blears: Three amendments refer to the functions of the commission and reporting arrangements. I do not think that they are necessary because sufficient powers exist, but that is not to say that the amendments are not important. Amendment No. 221 would give performance-management responsibility for the duty on the NHS to consult and involve the public. The commission's responsibility is to work with the local community and trusts to help them to deliver their responsibilities under section 11 of the 2001 Act. To ask them to help to deliver and to performance-manage would put the commission in an invidious position. The way in which the NHS carries out its duties in accordance with the rest of its organisational provisions needs to be performance-managed. We envisage that strategic health authorities will be the performance management bodies, and that they will ascertain how well the NHS is fulfilling a variety of its duties. However, it would be wrong for the Commission for Patient and Public Involvement in Health—

 

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Prepared 6 December 2001