Draft National Health Service (Wales) Bill

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Mr. Wayne David (Caerphilly): Like other hon. Members, I warmly welcome the draft Bill and the process in which we are currently engaged. I echo the comments of several hon. Members who said that we were making a small part of history in our deliberations today. During the past few weeks, the Welsh Affairs Committee considered the draft Bill in some detail and prepared an excellent report, which is extremely readable and reaches succinct and apposite conclusions. The deliberations of the Welsh Affairs Committee are part of a pre-legislative scrutiny process, which is of constitutional significance.

I am pleased that there has been good co-operation with the National Assembly for Wales. I was interested in the comments by my hon. Friend the Member for Cardiff, North on the participation of Members from this House and from the National Assembly's Health and Social Services Committee. I am also pleased to read in the report that the Under-Secretary of State for Wales and Jane Hutt, a Minister from the National Assembly, gave evidence in a joint session. All those

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activities are most commendable and show that devolution is working.

Today we have this very important debate in the Welsh Grand Committee. I say that it is very important because I want to underline the fact that primary legislative powers remain with Westminster under the devolution settlement. However, devolution is essentially a partnership between the Administrations in London and Cardiff. Therefore, as Members of this House, we must ensure that we play a proactive role. We are just as important in the legislative process as are the Members of the National Assembly, and we can only demonstrate that by our participation in deliberations such as these.

As we have heard, the draft Bill essentially consists of three parts: the first is about maintaining and enhancing community health councils in Wales, the second creates the Wales Centre for Health and the third establishes Health Professions Wales. In my brief contribution, I want to concentrate on the first element—community health councils. I am a keen advocate of CHCs as a result of my practical experience as the Member for Caerphilly for the past 12 months. All my contact with the Gwent CHC has been very positive. I am delighted with the support that I get as an elected Member but, more important, I am very pleased with the support that the CHC gives to my constituents.

Gwent CHC consists of some 60 members, who are drawn from a wide range of backgrounds and experience. I believe that, by and large, there is a high degree of commitment to the work of the CHC. However, I am glad that the draft legislation is not just about maintaining CHCs and developing a model that is different from England's but about improving the work of CHCs. I am especially pleased that there will be an elaboration of two aspects of the work of CHCs. The first concerns the extension of their remit into primary care and nursing homes—at least, that is what I believe the draft Bill advocates. I say that because I read the text of the draft Bill not once but twice and three times. To a layperson such as myself it is not entirely clear. There is no better way to demonstrate that than by quoting the draft Bill. It states that the Assembly may make regulations requiring

    (g) persons providing services under Part 2 of this Act or under arrangements under section 28C of this Act; or

    (h) persons providing piloted services under pilot schemes established under section 28 of the Health and Social Care Act 2001 (c.15), or providing LP services under an LPS scheme established under Schedule 8A to this Act,

    to allow members of a Council authorised by or under the regulations to enter and inspect, for the purposes of any of the Council's functions, premises owned or controlled by those referred to in paragraphs (a) to (h).

The Chairman: Very clear. Well read.

Mr. David: I am delighted that hon. Members are able to comprehend the linguistic idiosyncrasies of the text to a greater extent than me. I am reliably informed by several sources that, basically, there will be an extension of the work of the CHCs into the two sectors to which I referred: the community sector and the

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private sector. I welcome that, because my experience of private nursing homes has not been entirely good.

Without naming names, I am strongly of the view that standards could be much higher in some private nursing homes. That is not to say that CHCs can replace the work of professional services. Nevertheless, they can play an important role in ensuring that higher standards are maintained and that there is greater external vigilance. The extension of CHCs into that area is a positive step forward, and I am glad that the CHCs themselves welcome and recognise the important development.

It is also important to state that the draft Bill provides recognition of the advocacy services provided by CHCs. Much work already goes on. I can once again cite my own work with regard to my constituency efforts in which I have learned that CHCs provide a valuable service. However, we must recognise that that type of advocacy support is not uniform throughout Wales. We need a higher standard and a degree of consistency. I am therefore pleased that the National Assembly has indicated that—as recorded in the regulatory impact assessment—extra resources of some £481,000 per year will be provided to develop the work of some of the services that already exist. The services that I hope will be developed, and from which lessons can be learned, include the pathfinder advocacy schemes in Cardiff and Gwent.

I am sure that with their new powers and additional resources, CHCs throughout Wales will develop a coherent and comprehensive system of advocacy services. However, we should also recognise that they will not be operating in isolation. Of necessity, they will have to work with others in the field and I hope that there will be close co-operation with the Children's Commissioner for Wales and other bodies.

In conclusion, although modest in size, the draft Bill is a significant step forward in terms of the development of the national health service in Wales. It is also a step forward in constitutional terms. I hope that in his winding-up speech, the Under-Secretary will not only respond and give clarification to some of the points in the draft Bill, but will tell us whether he believes that the excellent deliberations that have taken place so far have set a precedent for future legislation. I hope that that will be the case. The lessons to be learned from such an experience are positive and they will ensure that devolution works not only in theory but in practice.

5.5 pm

Huw Irranca-Davies: As someone who wishes devolution to prosper and succeed in Wales, I welcome our historic proceedings and the modest but important Bill for the future of the health service in Wales, as my hon. Friend the Member for Caerphilly (Mr. David) described it. The Bill is a landmark in the process of devolution; it will strengthen communication between the National Assembly for Wales and Westminster during the pre-legislative process. I am quietly confident that it will be successful and I am sure that it highlights an

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appropriate way forward for improved legislation for our constituents.

It has been useful to examine the process with a fresh pair of eyes. The Bill and I have travelled down varying, strange paths to arrive here together in Committee Room 16.

Mr. Elfyn Llwyd (Meirionnydd Nant Conwy): Committee Room 14.

Huw Irranca-Davies: I thank the hon. Gentleman for correcting me. I hope that it is the only correction that I shall face today.

The Bill began as an announcement in the Queen's Speech in June 2001, when I was a prospective parliamentary candidate for Brecon and Radnorshire. In November it was given further wings and a boost, when I was still recovering from contesting that by-election in the largest seat geographically in Wales. The Select Committee pointed out that the pre-legislative scrutiny period fell two months short of the usual consultation period. However, after the excellent scrutiny, the Bill and I have arrived here together in Committee Room 14.

I shall now discuss the meat of the Bill. The retention and enhancement of the CHCs and the creation of a Wales Centre for Health and a new statutory body, Health Professions Wales, have sparked little controversy. In fact, to date, they have attracted great agreement. My hon. Friend the Member for Cardiff, North complimented members of the Committee on their willingness to concentrate, rightly, on the detail of the legislation rather than on political differences. However, I do not rule out the fact that political differences have yet to emerge and that Opposition Members may just be keeping their powder dry and stored away tightly.

The CHCs have a crucial role to play in giving a local voice to people and influencing health outcomes in Wales. The great challenges in respect of health improvement and delivering a good health service have been mentioned today. The picture is not all bleak, but neither is it uniformly good. Great challenges are ahead. The Association of Welsh Community Health Councils—unfortunately, if I say the acronym quickly, it sounds like ''Ouch''—can provide a national, strategic voice in the NHS in Wales.

Historical variations in the role and performance of CHCs were dealt with in the report and at the evidence-taking stage. Enhanced CHCs with a new, extended role will need to have consistently high standards. In short, the Bill provides CHCs and the AWCHC with greater potential to effect positive change in the lives and health of people in Wales. The Welsh public in constituencies in Ogmore, Wrexham and Powys, although not necessarily in the Ribble Valley, will expect them to perform.

The CHCs and the AWCHC will fulfil specific duties. In line with the practice of other organisations from which people absent themselves to carry out duties for the public good, employees should be allowed limited time off work with appropriate remuneration, too. That is particularly important in order to encourage a different and wide variety of

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people to take part in such duties. If we want the CHCs to be truly representative, let us give people the time off work and give them the remuneration to go with it. I take the point made by the hon. Member for Ribble Valley; ways have to be explored to achieve that and difficulties for small businesses must be examined.

In addition, I can reiterate the views expressed by my hon. Friend the Member for Gower and others this morning. They identified the need to allow the possibility of extending the remit of inspection visits to prisons and other establishments in which people are detained for physical and psychological health reasons. Although that will not be a substitute for the regular lay visits that are carried out by other organisations, the concentration on health needs and well-being will usefully complement their focus.

In any area and region of Wales it is often too easy to point the finger at deficiencies within the health service—to say, frequently on the basis of anecdotal evidence, that this proves that the NHS is in crisis, or that that proves that it is on the verge of meltdown. During the Ogmore by-election, the Princess of Wales hospital in Bridgend—which is my local district general hospital—was pilloried by the Opposition parties for poor standards of cleanliness and catering. That is when the CHCs came in. However, the Opposition parties neglected to point out that the problems that they had newly discovered in the by-election had been flagged up by the joint staff and management board—an innovation in employee relations that was brought forward by a Labour Government—or that the hospital was working to put them right. They also neglected to point out that the staff deficiencies that were identified were the result of chronic underfunding over two decades. I pay tribute to the staff of that hospital. I also state that one of the important things about CHCs is the fact that they, as well as the boards of the hospitals, can flag up such issues and thereby identify the challenges that lie ahead and show the way forward.

A picture has been painted today of the poor standard of some parts of the NHS, which is relevant to the Bill. However, that is in sharp contrast to what has happened at the Maesteg community hospital, and I am sure that the hon. Member for Brecon and Radnorshire (Mr. Williams) would say the same about Ystradgynlais community hospital, where the standards are very good, the morale is very high, and the staff are well received—even treasured—by the community.

I briefly turn to the cross-boundary working of the CHCs. There has been much discussion about the need to avoid overlapping enclaves of CHCs, which could lead to omission by default or duplication of effort. It must also be recognised that CHCs that represent contiguous areas will often need to work together, because they will find common causes or concerns. The hon. Member for Brecon and Radnorshire will remember an instance that is relevant to that point; two years ago, on a blustery evening in a packed hall in Ystradgynlais, more than 500 people gathered to protest against potential bed closures in the community hospital. I should declare an interest in

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this matter, because my wife works part-time at the hospital—to escape the clutches of my children, I think. The closure of those beds would have affected the hon. Gentleman's constituents in Powys, and those of my right hon. Friend the Member for Neath (Peter Hain). Two trusts, two constituencies and two boundaries were involved; that highlights why CHCs will increasingly need to work effectively together, particularly as they will have these enhanced roles and responsibilities.

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Prepared 16 July 2002