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After Clause 2, insert the following new clause:

Special Authority for Wales

(" . After section 8 of the National Health Service Act 1977 there shall be inserted—
"Special Authority for Wales.

. The Secretary of State shall, by order, establish a Special Authority for Wales which shall have such clinical and non-clinical duties of a specialized and all-Wales character as the Secretary of State shall in such an order determine and shall include (but not be limited to)—
(a) a blood transfusion service,
(b) an artificial eye and limb appliances service,
(c) a breast cancer screening service,
(d) a service relating to the examination, checking and pricing of prescriptions for drugs, medicines and appliances supplied by the National Health Service,
(e) a health complaints administrative service,

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(f) a research, intelligence and health service management information system,
(g) such functions relating to capital works, the procurement of supplies, income generation and the provision of computer services on his behalf or on behalf of the Health Authorities as the Secretary of State may direct it to perform in the interests of the Welsh National Health Service,
(h) such other functions as the Secretary of State may direct it to perform on his behalf of a Health Authority."").

The noble Lord said: My Lords, as I mentioned in our exchange on Amendment No. 1, I learnt during the recent Recess that there is considerable anxiety that in many ways Wales is being overlooked and neglected in the Bill. The amendment is intended to correct that neglect and to provide Wales with a number of services which I am sure the House will agree are essential. They were mentioned by my noble friend Lord Prys-Davies when he spoke in Committee on 28th March. My noble friend made a comprehensive case and went in detail into the various services affected by the Bill. He dealt with the work and contribution of the Welsh Health Common Services Authority, which provides special services and has an excellent workforce of 1,750 experienced people.

I must pay tribute to the noble Lord, Lord Thomas of Gwydir, who set up that authority in 1974 when he was Secretary of State for Wales. Since then, every Secretary of State for Wales has built on that authority and extended it. Its contribution to Welsh health has progressively been considerable.

I regret to have to say that the present Secretary of State, Mr. John Redwood, has taken an attitude quite different from his predecessors. He proposes to detach three of the clinical services because, he said, he wanted to bring them closer to the mainstream of the National Health Service. That is totally unnecessary. The three services were already an essential and integral part of the Welsh National Health Service.

The Secretary of State has also instructed the staff to find work in the private sector. I find that extremely difficult to understand. They appear to be the actions of a ruthless operator who places his dogma before the interests of the Welsh people. The special health authority was deliberately disbanded, without adequate consultation or concern for those whom it served so well.

I would like the Minister to explain why consultation did not take place; that is, consultation with Welsh general practitioners, the Welsh committee authorities and the county councils in Wales. They all work together effectively in the Principality, as those who know Wales are aware. Perhaps I may ask the noble Baroness to tell the House what will happen to the 1,750 people whom I have mentioned because—and I must press this home—they have a very good reputation throughout Wales for the work which they are doing in their various areas. Will the Minister give an assurance that their jobs are safe?

I understand that the Secretary of State has said that they must find work in the private sector. May we be told where in the private sector in Wales those splendid people are to find work? We are entitled to an

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explanation about that matter. Work is not easy to find in Wales and unemployment is high. In some parts unemployment is higher than others. In Gwynedd, where I live, I know from experience how difficult it is to find work. I must ask the noble Baroness to tell the House how work will be found in the private sector for 1,750 people. I do not wish to see those people having to leave Wales and cross the Severn to find work as they did in the 1920s and 1930s.

I know that both noble Baronesses are ladies of compassion. I am quite sure that they feel as strongly as I do and they certainly would feel strongly, as I do, if they went to Wales to find out the feelings of the people there. This amendment is reasonable. The Welsh people support it. It is necessary. I hope that the noble Baroness will agree with me. I beg to move.

5.15 p.m.

Lord Prys-Davies: My Lords, I wish to support as sincerely as I can the amendment moved by my noble friend Lord Cledwyn. This is a positive amendment; it is not a destructive amendment. It is positive because it seeks to ensure the continued existence of the Welsh Health Common Services Authority—WHCSA, as we know it in Wales. This amendment is identical to that which was moved in Committee except that it does not include a new health promotion function. The simple reason for that is that we have no wish to complicate the debate by mixing up two arguments.

As my noble friend Lord Cledwyn demonstrated, the case for WHCSA stands on its own merits. It has given excellent service to the NHS in Wales since it was set up some 22 years ago. I should like to stress that the noble Baroness acknowledged in Committee the high quality and achievements of WHCSA and the dedication of its staff. Therefore, its contribution is not an issue. That was a helpful contribution by the Minister but the rest of her speech, which I have no doubt was written by someone else, was disappointing. That is why we are not content to let the matter rest.

As my noble friend Lord Cledwyn pointed out, notwithstanding its achievements in April last year the present Secretary of State decided that the authority should be disbanded, dismantled. We heard the Secretary of State's reason; namely, that that organisation should move nearer to the mainstream NHS, as though it were standing in splendid isolation from it. In Committee, the Minister sought to defend that curious position on an additional but ambiguous ground. The Minister said:


    "Trusts need freedom now to introduce different mechanisms and services to support them".

Two sentences later she added the extraordinary statement—particularly in view of the enormous growth of the Welsh Office—


    "It is no longer tenable to have a large central organisation".—[Official Report, 28/3/95; col. 1595.]

Those statements by the Minister do not absolve the Welsh Office from giving evidence in support of their decision. But I am sure that there in the Minister's own

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sentences we have the explanation. The reason is essentially ideological. That is the problem and that is the anxiety.

As I said, in Committee the Minister spoke of the need to give freedom to the NHS trusts. If that concept rightly claims a top priority—it has not been argued or demonstrated—why is it proposed to transfer the breast-screening service to a single authority; to transfer the artificial limb service to three authorities; and why is it that the blood transfusion service, thankfully, is to remain where it is? How can those arrangements for the breast-screening service and the artificial limb service give freedom to all the other trusts in Wales?

Have the risks, the damage and the injury which may flow from that decision been weighed properly in the Welsh Office? Has it occurred to the Welsh Office that the dismantling of WHCSA may do great damage to the health service of the future? As my noble friend Lord Cledwyn pointed out, the Welsh people speak highly of that organisation and they wish the high WHCSA standards to continue. But such standards, expertise and commitment require an abundance of WHCSA skills, dedication, efficiency and experience. If the WHCSA structure is removed, there will be a risk—I put it no higher—that the support will not exist. Therefore, we ask the Minister whether that down-side has been considered properly.

It is our understanding, which I believe was confirmed by the Minister in Committee, that some rapid studies were undertaken by officials to see how the post-WHCSA services could best be organised, subject to the proviso that, in any calculation, WHCSA was to be eliminated from the computation. In Committee I asked that a copy of those studies be placed in the Library before Report stage. I thought that that was a helpful suggestion on my part. That would at least help us to get at the facts. That information had not been provided to the Library by five o'clock today. Why is it being withheld? But, as it is being withheld, how can we have any confidence that the right decision is being made?

If a businessman wishes to change the administration or management of a business, he works out the costs of doing so stage by stage. He identifies the risks and the new problems which may arise and compares the proposed arrangements with the present arrangements and assesses the effects. But, in relation to WHCSA, we have no means of knowing whether that essential exercise has been undertaken properly by the Welsh Office. We have no means of ensuring that the Welsh Civil Service has done its homework properly.

The Minister claimed on two occasions during her short speech in Committee that the promoters of the amendment were seeking to set,


    "one particular set of administrative arrangements ... in legislative concrete". [Official Report, 28/3/95; col. 1596.]

With respect to the Minister, whom the House holds in high regard, that does a disservice to the arguments that we have deployed.

My noble friend Lord Cledwyn and myself are not interested in an academic argument about the merits or demerits of primary and delegated legislation. However, I would add that neither of them is set in concrete; they

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can be changed. But if it pleases the Minister and her advisers, I am sure—although I have not discussed this with my noble friend—that we would be content to rely on the statutory instrument if she gave an undertaking to the House that there will be no substantial change in the role of WHCSA during the foreseeable future. Does that help the Minister?

I turn now to my final point. Sadly, the present Secretary of State declined—indeed, refused—to meet staff-side representatives to discuss such a curious decision which will affect their daily lives. Surely that is not the way to treat people. The Minister, who has to defend the decision taken by her colleague, tried to persuade us in Committee (at col. 1595 of Hansard) that, "Handling the process"— people are experiencing some difficulty in understanding that phrase—


    "is a matter for WHCSA's own management".

The fallacy of the argument is clear. It ignores the fact that WHCSA's management is not empowered to decide whether the organisation does or does not have a future. Its future is in the hands of the Secretary of State for Wales in the Welsh Office. We say, without underlining it, that in his decision not to meet the staff representatives—indeed, representatives of 1,750 people—the Secretary of State went wrong. We hope that the Secretary of State's mind is not closed, at least on this issue, and that he will listen to argument.


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