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Lord Rea: I wish to thank the noble Baroness for her remarks. In fact, these amendments, as she realises, were exploratory in intent and followed the suggestions that were in the Wilson Report and also the suggestions by the National Consumer Council that perhaps there should be a national complaints commission. Of course, the noble Baroness is right. For that commission to administer all the complaints procedures throughout the country would be a bureaucratic and an impossible task. We were suggesting that there should be an independent authority—possibly a commission, to use another term—to oversee the complaints panels of the different health authorities and trusts throughout the country in order to keep standards up.

As the noble Baroness intimated, complaints need not necessarily be bad, although if more bunches of flowers were offered quickly enough perhaps there would be

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fewer complaints. However, a well handled complaint can be beneficial in that it can lead to adjustments of local practices and to improvements in the future. However, that is not to say that I do not think that many of the complaints now coming before panels are due to the delays and frustrations that people are experiencing directly as a result of the fact that the money does not follow the patient. There is not so much patient choice as there used to be and, inevitably, disappointments and inconveniences occur.

However, it is not my intention to press this amendment. I wish to thank all Members of the Committee who have spoken. We will read what the Minister said because I believe it is the first time that the Government's intentions, outlined in Acting on Complaints, have been announced on the Floor of the Chamber. While thanking everyone for their contributions I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Baroness Jay of Paddington moved Amendment No. 10:

Insert the following new clause:

("Health Authorities: public meetings

. A Health Authority established in accordance with the provisions of this Act shall each year hold at least the same number of public meetings as was held by an authority which it replaces.").

The noble Baroness said: In moving this amendment I wish to speak also to Amendment No. 26. The purpose of these amendments is to ensure that the new health authorities hold open public meetings at least as frequently as do the existing district health authorities and family health services authorities. It seems to us that this Bill provides an ideal opportunity to ensure that the new purchasing bodies are at least as open and accountable as their predecessors, if indeed not more so.

Throughout debates on this Bill, both here and in another place, Ministers and others who have spoken on all sides of the Chamber have emphasised the need for openness in the health service. Again, that was referred to in the previous amendment. People believe that an independent and open organisation is very important in establishing public confidence.

I understand that the National Health Service Executive code of practice consultation—that word again—on the holding of meetings has been concluded but not yet released. Therefore, this is a good opportunity to explore the necessity for putting this minimal amendment on the face of the Bill to guarantee in practice that matters will not get worse under the new arrangements for health authorities.

There is considerable evidence, much of it anecdotal but also some that is authoritative from community health councils and organisations such as the research body Community Rights, that health authorities are not as open and public in their meetings as they were previously and that this has become a closed area of government. I know from my own experience of matters which could well be discussed in open session being discussed in closed session, often for no better reason than that there might be embarrassment to executive directors required to answer rather tricky questions.

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There is also a tendency among health authorities to use the so-called seminar procedure to debate many important policy issues which can then be brought to the public meeting almost for rubber stamping. The real discussion and exchange of opinion goes on behind closed doors at the seminar and the debate on the subject matter in the open meeting is almost rehearsed. That is partly due to the fact that health authorities operate under the Public Bodies (Admission to Meetings) Act which, I was fascinated to discover, had been a Private Member's Bill introduced by the noble Baroness, Lady Thatcher, in 1960. In it there is a catch-all phrase which allows for the health authority to go into private session on any pretext which it determines.

One hopes therefore that the Government will accept the provisions of the amendment. Dare one hope that they will go even further and, if they are to issue new guidance and codes of practice, incorporate some of the provisions of the local government access to information legislation, under which local authorities act, to give the new health authorities the responsibility to publish reports, produced for the consumption of their members, more widely and allow the background papers to be seen?

As I said, this is an exploratory amendment designed to establish the Government's intentions in terms of their guidance to health authorities under the new regulations. However, I hope that they will at least accept this very minimal amendment, which does no more than ensure that in future matters will not get any worse than they are now. I beg to move.

Baroness Robson of Kiddington: I wish to speak to Amendment No. 26 which is linked to the amendment moved by the noble Baroness, Lady Jay. It is essential that meetings of health authorities should be held in public. That does not apply only to one annual meeting. All meetings of health authorities should be held in public so far as possible. There will be times when that is not appropriate. I remember from my own experience that delicate subjects arise which involve personalities. In such cases meetings would have to be held in private session. However, those should be kept to a minimum.

It is desperately important that members of the community health council should have the right to attend and take part in such meetings. They provide the best communication between health authorities and the general public. They have served us very well over the years. They have progressively been deprived of their rights under the health reforms. I should like those rights to be reinstated so that the voice of the community health councils can again be heard.

7.15 p.m.

Baroness Miller of Hendon: Amendment No. 10 is not necessary. Existing health authorities are covered by the Public Bodies (Admission to Meetings) Act 1960, to which the noble Baroness, Lady Jay, referred, under which, subject to certain conditions, any meeting of an authority must be open to the public. The necessary amendment to that legislation to cover the new health authorities is included at paragraph 91 of Part III of Schedule 1 to the Bill.

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Having established in general terms that all meetings of a health authority will be open to the public, what is not addressed in the Bill is how many such meetings should be held. However, there has never been any provision in legislation to dictate to a health authority how many meetings it must hold. The Committee will know that it is not the policy of this Government to interfere unnecessarily in the administrative arrangements of National Health Service boards. Health authorities hold as many meetings as are needed to transact their business. That arrangement will continue under the new system. It is for the chairman and members of such boards to make the arrangements that meet the needs of that body.

Those Members of the Committee who hold or have held positions on management boards will particularly appreciate the need for flexibility in these matters. There will be times when a board, having a great deal of business to conduct, needs to meet frequently. There will be other times when board meetings can be kept to a minimum. It would be inappropriate to interfere in such a local management matter in the way suggested by the amendment. Health authorities must be free to conduct business in the way that best fits their needs rather than having unnecessary restrictions placed upon them.

On a more general point, the Committee will be aware that we are committed to ensuring that the public have access to as much information as possible, not only through access to meetings of health authorities. Consultation on a draft code of openness for the National Health Service has now been completed. The code will set out the public's right to information, except in clearly defined circumstances, and it will be published soon.

Also, under the codes of conduct and accountability introduced in April 1994, health authorities are for the first time expected to publish an annual report. The steps we have taken and the plans we have for future improvements demonstrate our commitment to openness in the National Health Service. Amendment No. 10 at best achieves nothing and at worst interferes with the smooth management of the National Health Service.

As regards Amendment No. 26, all health authority meetings will be open to the public because the Public Bodies (Admission to Meetings) Act will apply to health authorities, as I stated earlier.

The amendment also raises the issue of the role of community health councils. The councils perform a very important function in representing the interests of the community in the National Health Service. On a personal level, when I was chairman of the Barnet Family Health Services Authority, we regarded highly the way in which the community health council performed its function on behalf of the local community.

Community health councils already have observer status on health authorities and the right to meet them annually. As my honourable friend the Minister for Health made clear in another place, there will be no change in the requirement on health authorities to consult community health councils as a result of the Bill.

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We do not wish to do anything which undermines effective working relationships between community health councils and their local health authorities. However, it would not be right for them to take an active part in health authority meetings.

It is important that CHCs retain their independence. Their members act wholly on behalf of local patients. There must be no risk of a conflict of interest that might cause them to take other obligations into consideration when dealing with local health authorities or trusts on behalf of patients.

Health authorities and community health councils perform two completely different functions. The health authority is responsible for ensuring that the health needs of the local communities are met. The community health council is there to provide a voice for the local community. It is important that those two functions remain distinct if they are to be performed effectively.

Health authority meetings will be open to the public. The right of CHCs to observe at health authority meetings and to meet health authorities annually will be retained. Their role as an independent voice in the National Health Service will not be changed by the Bill. I very much hope that the noble Baroness, Lady Jay, and the noble Baroness, Lady Robson, will not feel it necessary to press their amendments.

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