Lord Clement-Jones: My Lords, I add my thanks to the Minister and my support for this important set of amendments, again particularly Amendments Nos. 42 and 48, bringing the duties of the medical profession in line with the GMC's code of practice. They are very welcome. Amendment No. 29 was unexpected. It does a good job of clarifying the relationship between the
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Audit Commission and CHI. It is always nice to be reminded of what one said in Committee even though it was some time ago--or feels as though it was.
There is the loose end on information relating to deceased patients. I understand that further consultation with the medical profession has been promised by the department and it will be useful if the Minister can describe the current state of play.
Baroness Hayman: My Lords, I am grateful to both noble Lords for their welcome for what we have been able to achieve. They are right to pinpoint the issue in relation to safeguards on information relating to deceased persons. We gave that matter specific attention and discussed it with the professions. It is a complicated area and we came to the conclusion that it would be inappropriate to use this Bill to make provision in that regard.
This is a complex area that goes far wider than the Bill. It needs to be tackled in the round, if that is seen to be necessary, rather than piecemeal in provisions that relate to the commission for health improvement. We hope to be able to develop guidance on the handling of confidential information in consultation with the professions. We will be keeping this under review to keep it in line with current law and practice, and the guidance issued by the professions. It is possible, as noble Lords will be aware, that directions can be issued to the commission on specific issues if that should become necessary.
There are real reasons--for example, the fundamental lack of legal clarity on how far the duty of confidentiality extends after death, if at all--that make this a complex area to tackle in the context of this Bill. But I accept that the wider issue needs to be considered and we hope to continue to do that with the professions.
On Question, Motion agreed to.
ARRANGEMENTS WITH THE AUDIT COMMISSION
Clause 17, page 20, line 35, leave out ("section 18") and insert ("sections 18, (Arrangements with the Audit Commission) and (Arrangements with Ministers)")
Clause 18, page 21, line 35, leave out subsection (5)
After Clause 18, insert the following new clause--
(".--(1) If requested to do so by the Commission in any particular case, the Audit Commission may join with the Commission in exercising--
(a) the Commission's functions under section 18(1)(b) or (d), or
(b) any functions of the Commission--
(i) which are conferred under section 18(1)(e),
(ii) which correspond to its functions under section 18(1)(b), and
(iii) which relate to Health Authorities or Special Health Authorities.
(2) If requested to do so by the Audit Commission in any particular case, the Commission may assist the Audit Commission in the exercise of its functions under section 33(1) of the Audit Commission Act 1998 so far as they relate to any body specified in section 98(1) of the 1977 Act.
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(3) For the purposes of subsection (1), the Commission's functions under paragraph (b) or (d) of section 18(1) are to be treated as including the function of conducting and making reports on studies designed to improve--
(a) economy, efficiency and effectiveness in the performance of any functions of the persons mentioned in that paragraph, and
(b) the management of those persons.
(4) For the purposes of subsection (1), the Commission's functions mentioned in subsection (1)(b) are to be treated as including the function of conducting and making reports on studies designed to improve--
(a) economy, efficiency and effectiveness in the performance of any functions of the bodies mentioned in subsection (1)(b)(iii) to which those functions of the Commission relate, and
(b) the management of those bodies.
(5) Any report prepared by virtue of subsection (1) is to be prepared by the Commission acting in conjunction with the Audit Commission.
(6) The Audit Commission may not act as mentioned in subsection (1) unless, before it does so, the Commission has agreed to pay the Audit Commission an amount equal to the full costs incurred by the Audit Commission in so acting.
(7) The Commission may not act as mentioned in subsection (2) unless, before it does so, the Audit Commission has agreed to pay the Commission an amount equal to the full costs incurred by the Commission in so acting.
(8) Any reference in subsection (5) or (6) to subsection (1) is a reference to that subsection as read with subsections (3) and (4).
(9) In this section "the Audit Commission" means the Audit Commission for Local Authorities and the National Health Service in England and Wales."
ARRANGEMENTS WITH MINISTERS
After Clause 18, insert the following new clause--
(".--(1) Arrangements may be made between the Commission and a Minister of the Crown--
(a) for the Commission to perform any of its functions in relation to any prescribed health scheme for which the Minister has responsibility, or
(b) for the Commission to provide services or facilities in so far as they are required by the Minister in connection with any such health scheme.
(2) Arrangements may be made between the Commission and a Northern Ireland Minister--
(a) for the Commission to perform on behalf of the Minister any functions of the Minister which--
(i) correspond to any functions of the Commission, and
(ii) relate to the Northern Irish health service, or
(b) for the Commission to provide services or facilities in so far as they are required by the Minister in connection with the exercise by him of any such functions.
(3) Arrangements under this section may be made on such terms and conditions as may be agreed between the parties to the arrangements.
(4) Those terms and conditions may include provision with respect to the making of payments to the Commission in respect of the cost to the Commission of performing or providing any functions, services or facilities under the arrangements.
(5) Any arrangements under subsection (2)(a) are not to affect the responsibility of the Northern Ireland Minister on whose behalf any functions are exercised.
(6) In this section--
"health scheme" means any scheme which appears to the Secretary of State to be a health or medical scheme paid for out of public funds,
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"Minister of the Crown" has the same meaning as in the Ministers of the Crown Act 1975,
"Northern Ireland Minister" includes the First Minister, the deputy First Minister and a Northern Ireland department,
"Northern Irish health service" means any of the health services under any enactment which extends to Northern Ireland and which corresponds to section 1(1) of the 1977 Act,
"prescribed" means prescribed by regulations made by the Secretary of State."
Clause 19, page 22, line 28, leave out ("relating to") and insert ("which are the subject of")
Page 22, line 32, leave out from ("provision") to ("identifies") in line 34 and insert ("with respect to the disclosure of confidential information which relates to and")
Page 22, line 36, leave out ("document or information is made available or produced") and insert ("information is disclosed")
Page 22, line 38, leave out from second ("the") to end of line 39 and insert ("information being disclosed")
Page 22, line 44, leave out ("make available or produce the document or") and insert ("disclose the")
Page 23, line 5, leave out from second ("the") to ("without") in line 6 and insert ("information should be disclosed")
Page 23, line 8, leave out from ("provision") to ("prohibited") in line 10 and insert ("with respect to the disclosure of information if that disclosure would be")
Page 23, line 10, leave out ("a document or")
Page 23, line 12, leave out ("document or")
Page 23, line 14, leave out ("as to the inspection, copying or production of the document or") and insert ("with respect to the disclosure of the")
Page 23, leave out lines 29 and 30
Clause 20, page 23, line 41, leave out subsection (1) and insert--