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26 Feb 2003 : Column GC1

Official Report of the Grand Committee on the

Health (Wales) Bill

Wednesday, 26th February 2003.

(First Day)

The Committee met at half past three of the clock.

[The Deputy Chairman of Committees (Lord Ampthill) in the Chair.]

The Deputy Chairman of Committees (Lord Ampthill): Before I put the Question that the Title be postponed, it may be helpful to remind your Lordships of the procedure for today's Committee stage. Except in one important respect, our proceedings will be exactly as in a normal Committee of the Whole House. We shall go through the Bill clause by clause; noble Lords will speak standing; all noble Lords are free to attend and participate; and the proceedings will be recorded in Hansard. The one difference is that the House has agreed that there shall be no Divisions in the Grand Committee. Any issue on which agreement cannot be reached should be considered again at the Report stage when, if necessary, a Division may be called. Unless, therefore, an amendment is likely to be agreed to, it should be withdrawn.

I should explain that in the unlikely event of a Division in the Chamber while we are sitting, the Committee will adjourn as soon as the Division Bells are rung and will resume after 10 minutes.

Title postponed.

Clause 1 [Community Health Councils in Wales]:

Lord Roberts of Conwy moved Amendment No. 1:

    Page 1, line 8, at end insert ", following consultation with the Councils affected"

The noble Lord said: For my part, I shall try to deal as briefly as possible with the majority of the amendments tabled in my name and that of my noble friend Lord Luke, with a view to completing the Committee stage today. The Bill has undergone pre-legislative scrutiny in another place and has been discussed extensively not only there but in the National Assembly for Wales. The amendments, or similar ones, have also been discussed in another place. We know the Government's view. Nevertheless, each amendment contains a point worth making.

Amendment No. 1 relates to a council's name change. I assume that it is the name of an individual council or councils, rather than the whole genre of community health councils, that the Government have in mind. If that is the case, we think that it would be courteous, to say the least, for the Assembly to consult councils affected. It would also be helpful to the Assembly to get a local view of the proposed name

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change. As Members of the Committee who know Wales are aware, a name change can be a very sensitive issue.

Amendment No. 2 requires consultation with those affected in the event of the abolition of a council, a change of the district covered or the establishment of a new council. It is a sensible requirement for a variety of reasons. As we know, local loyalties are very strong in Wales. Care must be taken that any changes affecting local institutions are fully justified in local terms. I know that only too well from my experience of past changes in local government boundaries and so on. The Minister may argue that it is inconceivable that changes such as those envisaged would be made without consultation. But it can happen and can cause a rumpus when it does. The amendment does not inhibit changes; it simply helps to ensure that such changes are effected as smoothly as possible. I beg to move.

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): In responding to the noble Lord, Lord Roberts, I hope for the same brevity as he seeks in moving his amendments. He is right to suggest that both the Bill and some of the issues raised in the amendments have been discussed extensively in the National Assembly for Wales and in another place.

I shall deal first with name changes. Apparently, many CHCs have long advocated a name change to one more easily recognised by the public. As I read it, the clause that the noble Lord seeks to amend would provide both for a change of the name of individual CHCs and the genre. The debate that took place in Wales focused more on whether the term "community health council" was appropriate and recognisable. I do not know the statistics for Wales, but in surveys carried out in England in which the public were asked whether they knew what a community health council was, and what its purpose was, few recognised the name. There is a view in Wales in particular that changing the name to one more easily recognised by the public might end current confusion over the role of community health councils. For instance, the word "council" may have confused some.

On consultation, the Assembly has already asked CHCs to start thinking about name changes. Some have made suggestions, including the Patients' Voice and Health Council Wales. Sadly, I do not think that anyone has suggested the Patients' Forum yet, but one never knows. So the position on consultation is already clear. The Assembly already has a statutory obligation to consult before legislating in many cases. Section 65 of the Government of Wales Act 1998 and the Assembly's Standing Orders require that a regulatory appraisal be undertaken before any subordinate legislation is made. They further require that, if the appraisal indicates that the costs of complying with the legislation will be significant, the persons or bodies affected must be consulted. Regardless of whether the costs of a name change will be significant, there is no doubt that the Assembly will consult CHCs and the wider community before making any changes.

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The same response applies to Amendment No. 2, which relates to the creation or abolition of CHCs, or changes to them. My understanding is that there is no intention to change the boundaries of CHCs in Wales in the short term, although it might be required at some future date. If it becomes necessary, the Assembly will consult closely with relevant councils and other key stakeholders to seek changes that are acceptable to them. I referred to Section 65 of the Government of Wales Act and the Assembly's Standing Orders. I also refer the noble Lord to the note produced by the National Assembly for Wales, Procedures for Consultation, which sets out guidance to the Assembly on how local organisations and bodies should be consulted. I have read it and think that it is very comprehensive. I have no doubt that consultation would take place on possible changes to the name of individual or all CHCs and on changes to their boundaries.

I hope that I have reassured the noble Lord that the points he made will be fully reflected in how the National Assembly for Wales will discharge its responsibilities relating to community health councils.

Lord Roberts of Conwy: I am grateful to the Minister for his comments. I am glad to learn that the Assembly must consult and will consult, certainly in relation to the matter covered by Amendment No. 2. I am also grateful to him for the clarification. On reading the Bill it was not clear to me whether an individual council or the genre would have its name changed. The Minister has made it clear that it could be both. I shall not venture to suggest to the Assembly an alternative to the community health council title, but the Minister's suggestion of a patients' forum takes a lot of beating. I beg leave to withdraw the amendment.

Amendment by leave withdrawn.

[Amendment No. 2 not moved.]

Lord Roberts of Conwy moved Amendment No. 3:

    Page 1, line 15, at end insert—

"( ) that due regard is paid to the boundaries of health authorities with a view to such authorities and councils being coterminous"

The noble Lord said: Amendment No. 3 seeks to deal with the coterminosity issue. I refer to it as such because it appears always to have been an issue. There is a general desire that health area boundaries should coincide with local authority boundaries and other boundaries because of the close connection between health, social services, housing, education and other aspects of local government.

As I understand it, at present we have 20 CHCs in Wales and 22 local health boards proposed. Local health boards are coterminous with the 22 local authorities. It seems odd to me that the community health councils are not coterminous either with the local authorities or with the local health boards. If they are not coterminous, clearly some CHCs will deal with more than one board which, I would have thought, would significantly increase their workload. The boards will be coterminous with the local authorities

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and I believe that to operate effectively it is incontrovertible that the CHCs should have similar boundaries.

I understand the Welsh Executive's reluctance to become involved in adjusting CHC boundaries while they are still establishing the main framework for the NHS in Wales. However, they will have to examine the CHC structure sooner or later and in doing that they must bear in mind the desirability of coterminosity. What is proposed currently and what is about to be imposed does not make sense at all if the 20 CHCs are not—as they cannot be—coterminous with the 22 health boards. I beg to move.

3.45 p.m.

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