Draft National Health Service (Wales) Bill

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Mr. Evans: Does the hon. Gentleman therefore see a role for associations of CHCs in supervising such matters? For instance, there are very few specialists in Wales who deal with myalgic encephalomyelitis, and associations might take evidence from all of the CHCs and say, ''Something needs to be done to provide more specialists in this area.''

Huw Irranca-Davies: I thank the hon. Gentleman for that intervention. There is a significant strategic role to be performed in identifying such particular needs across regions throughout Wales. However, I am currently addressing cross-boundary working, which is very much a local issue. It is easy to set down arbitrary boundaries that are based on good practice and the existing formation of local health groups and so on, but it will not necessarily always be the case that that is the best way to work over particular problems and challenges. However, I take on board the hon. Gentleman's point that there is a strategic role to be performed.

In conclusion, I turn to the process of devolution that we are currently engaged in. It was not easy for Wales to win devolution, but it was won, and I understand that even the Conservatives in Wales—an elusive breed—have recently become convinced that it is here, and that it must be made to work. That is a triumph indeed. [Interruption.] The hon. Gentleman has disappeared; that cannot be the result of anything that I said. The process of devolution is also not easy. A new institution is finding its feet and determining its role. That process is not easy for Members of Parliament either. We slave over matters such as policing, defence, foreign affairs, international aid, pensions and welfare—not forgetting the Barnett-plus plus settlement that we have received today with over £15 billion of devolved and non-devolved funding for Wales. Labour leads that with a little help and encouragement from its friends—the Liberal Democrats in Wales. However, like a parent who has seen his teenage son cut off and leave home for the first time to make his own way in the world, we look on with a little bit of jealousy and longing.

This meeting of the Committee and the historic humble draft Bill are innovative ways of strengthening the bond between the mother of Parliaments and the potential-filled offspring in Wales. Through dialogue on primary and secondary legislation, we have begun to communicate more effectively for the benefit of Wales and its people. In legislative and other terms, we must keep that dialogue going. I commend the draft Bill and the historic process of which it is part.

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Mr. Huw Edwards (Monmouth): I apologise to you and other members of the Committee for missing the start of this afternoon's sitting, Mr. Griffiths. I was in a meeting with a Minister about the United Kingdom Passport Agency and an issue that I raised on the Floor of the House a few weeks ago.

I welcome this Committee's examination of the draft Bill following the publication of the report of the investigation by the Select Committee on Welsh Affairs. Before last year, I was a member of that Committee, which was a great privilege, and I am pleased that a new hon. Member has taken my place. It is a pleasure to follow my hon. Friend the Member for Ogmore (Huw Irranca-Davies), who speaks so fluently on behalf of his constituency and on issues that affect the Ogmore valley.

The subject demonstrates the continuing relevance of our Welsh parliamentary forums with regard to examining contemporary issues that relate to Wales. It is a prime example of the House of Commons undertaking pre-legislative scrutiny and shows the value of the Welsh Affairs Committee examining primary legislation that relates to Wales. As hon. Members have said, the draft Bill aims to retain and enhance the role of community health councils, to establish the Wales Centre for Health as a multidisciplinary body to monitor public health and influence decision making, and to create Health Professions Wales as a statutory body that is accountable to the National Assembly for Wales.

As hon. Members have said, it is unlikely that we would have the Bill if we did not have the National Assembly for Wales, and I greatly welcome that development. The Bill is a testimony to the fact that democratic devolution and the National Assembly are addressing the people of Wales in a manner that recognises Wales' distinct problems and characteristics.

I have had an interest in the subject for some time. I have served on a community health council in Coventry, and before my election I was a university lecturer specialising in social policy and involved with the education and training of many people who later worked in the health care field and related social services.

With respect to devolution and health, I believe that there is scope for a distinctly Welsh approach to Wales' health needs. For example, the National Assembly is committed to addressing health inequalities as part of its strategy to combat social exclusion. In addition, the Welsh population, especially in valley communities, have a poorer health status than the population of England—for example, the people of Blaenau Gwent are served by Nevill Hall hospital, which is the general hospital in my constituency. Of course, there are specific health problems in rural areas. My constituency of Monmouthshire is one of Wales' rural areas. It is a great credit to Jane Hutt, the National Assembly's Minister for Health and Social Services, that she was persuaded to retain community health councils in Wales with an enhanced role. The Bill is a testimony to

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the representations that were made to her and the wise decisions that she took.

I was a member of the Welsh Affairs Committee when it conducted its short inquiry on women who are imprisoned in Wales—there are no prisons for women in Wales. My constituency contains Usk prison and Prescoed young offenders institution. The health needs of the prison population have been mentioned during my visits to the institutions, and I welcome moves to ensure that the prison health service comes within the remit of the national health service. I am sure that that will improve standards. Members of the Committee—including my hon. Friends the Members for Cardiff, North, and for Gower—and I visited the women in that prison in Gloucestershire. We were stunned by the concerns about mental health provision for the prison population.

Like other members of the Committee, I should like to pay tribute to all those who serve on community health councils. I was in regular contact with the North Gwent and South Gwent CHCs, which have now been amalgamated into Gwent community health council. I pay tribute to Bob Hall, who was the chairman of the Gwent CHC and gave evidence to the Select Committee. Gwent CHC has a new structure and is now coterminous with the Gwent Healthcare NHS trust and a system of area committees that reflect the size of Gwent. The chairman of the Monmouthshire committee is Sylvia Gilbert, who has long campaigned on behalf of public sector workers, especially those who are on low pay. I am grateful for the correspondence that I have had with her about some of the issues that concern the CHC in Monmouthshire.

The Gwent CHC recently investigated a problem concerning Monmouth's ambulance service that may concern other hon. Members representing the Gwent area. Ambulances are tied up at Royal Gwent hospital for hours, waiting to discharge patients to admission wards. Some hon. Members and I have made representations about that. The CHC has given support to the new health and social care facility proposed for Monmouth. That pioneering new establishment will recognise the essential interrelationship between health and social care. That important new development has recently been given full approval and will now go ahead.

The community health council has also held investigations into cleanliness and hygiene standards in local hospitals, bed blocking, and hospital car parking provision. It has also considered the particularly controversial ''patientline'' service, whereby patients are required to pay for television and telephone access at what I consider to be extortionate rates, especially for those on low incomes and those who are in hospital for a long time.

There has also been a particularly important investigation into dental services. I raised that matter in Committee this morning. In Monmouth and Abergavenny, no one could get access to an NHS dentist unless they were, for example, on benefits. People expect there to be dentists who will give them NHS treatment, because the cost of private treatment can be prohibitive for many people. I am pleased that,

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following representations, the National Assembly and the Gwent health authority addressed the problem, so there will be NHS dental provision in future.

However, I reiterate what I said this morning: there is concern that dentists are attracted to an area by grants to establish or expand a practice, and they give the impression that they will provide NHS cover. Then, in due course, they write to most or all of their patients and say, ''We're not going to do this any more. We invite you to join Denplan, a private insurance dental service.'' Many of my constituents have taken exception to that. They believed that they were signing up to be treated by a dentist on NHS terms and not to a private health insurance system. I hope that the relevant bodies will investigate that issue.

I support the Select Committee's recommendations that CHC members should be given time off for their public duties, and that CHCs should have access to information that covers areas of their remit, and should have the power to commission other bodies to undertake independent advocacy services. I hope that the other bodies that will be established as a result of the Bill—the Wales Centre for Health and Health Professions Wales—can consider some of the other issues that affect Wales, and particularly my constituency. One of them has been the scarcity of consultant neurologists in Wales, which has been drawn to my attention by representatives of the Parkinson's Disease Society and those who represent patients with epilepsy. A new consultant has been appointed at Nevill Hall, but I believe that she works only part-time, in conjunction with her work in Cardiff.

As other Members said, we need to consider ME and its recognition by the health care field. There is great variation in how ME is dealt with. I speak as a patron, along with my hon. Friend the Member for Blaenau Gwent (Llew Smith), of the Gwent ME Society.

I hope that the bodies involved will be able to consider the issue of new consultants' contracts. That has been a welcome development on the part of the Minister, Jane Hutt, and Ministers in England. It is important that consultants trained by the national health service work exclusively for the national health service, and they deserve to be rewarded for their dedication.

Finally, I welcome the Select Committee's inquiry. I pay tribute to all those who work in the national health service and related social services. It has been a great pleasure for me to make representations on behalf of my constituents about problems that affect the health service. I hope that the Bill is passed without difficulty and that health provision in Wales will improve as a result of it.

5.26 pm

 
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Prepared 16 July 2002