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The Deputy Speaker: My Lords, if Amendment No. 313 is agreed to, I cannot call Amendment No. 314 by reason of pre-emption.

Lord Warner moved Amendment No. 313:

The noble Lord said: My Lords, Amendments Nos. 313, 347 and 352 have been tabled following our discussion in Committee about the feasibility of placing CHAI under an explicit duty to promote the effective co-ordination of reviews or assessments carried out by public bodies or other persons under Clause 56. We continue to believe that it would be inappropriate to amend the Bill in the manner proposed by Amendment No. 314 tabled by the noble Lords opposite. We have, however, consulted parliamentary counsel on this matter. He advises that the most appropriate way of giving the clause a more mandatory flavour is to amend it—and by extension, and to ensure consistency, Clauses 80 and 81—to give CSCI and the Assembly a function of promoting the co-ordination of reviews.

As with all other functions in the Bill, it will be for each commission to determine the precise manner in which the function will be discharged and which particular bodies and reviews it will seek to co-ordinate. I trust that noble Lords opposite will find that acceptable. I beg to move.

Baroness Noakes: My Lords, I have tabled Amendment No. 314, which I am pleased to regard as trumped by the Minister's Amendment No. 313. I am grateful to him for taking the matter away and finding a solution which satisfies that most difficult of individuals, parliamentary counsel, in achieving what we agreed in Committee.

On Question, amendment agreed to.

Clause 57 [Studies as to economy, efficiency etc]:

Lord Warner moved Amendment No. 315:

    Page 22, line 5, at end insert—

"( ) The Secretary of State may, after consulting the CHAI, by regulations make provision as to the procedure to be followed in respect of the making of representations to the CHAI before the publication of any recommendations or the result of any studies under this section."

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On Question, amendment agreed to.

Clause 58 [Additional functions]:

[Amendment No. 316 not moved.]

Clause 59 [Criteria]:

[Amendment No. 317 not moved.]

Lord Warner moved Amendment No. 318:

    After Clause 60, insert the following new clause—

(1) The CHAI and the regulator must co-operate with each other in the exercise of their respective functions under Part 1 and this Chapter.
(2) In particular, for the purposes of subsection (1)—
(a) the CHAI must keep the regulator informed about the provision of health care by and for NHS foundation trusts;
(b) the regulator must give to the CHAI any information it has about the provision of health care by or for an NHS foundation trust which it considers would assist the CHAI in the discharge of its functions."

On Question, amendment agreed to.

Lord Warner moved Amendment No. 319:

    After Clause 63, insert the following new clause—

The CHAI and the Audit Commission must co-operate with each other in relation to matters in respect of which both have functions."

The noble Lord said: My Lords, throughout the passage of this Bill we have discussed the role that CHAI and the Audit Commission will have in relation to NHS bodies. We are clear that CHAI will be responsible for value-for-money studies in individual English NHS bodies or across a range of such NHS bodies.

The Audit Commission will, however, retain the function of undertaking studies for improving financial management in English NHS bodies. It will also appoint and guide the work of auditors of many NHS bodies and those auditors will cover at a local level many of the areas and issues within CHAI's remit. Amendment No. 319 seeks to strengthen the relationship between the two bodies by placing a duty on the bodies to co-operate in relation to those matters in respect of which they both have functions. In doing so, it also seeks to ensure that the bodies work together in reducing the burdens of inspection on the NHS.

Given the recent utterances on reducing inspection burdens by the Audit Commission and its chairman, I am confident that this amendment has their support. I beg to move.

Lord Clement-Jones: My Lords, I support the Minister's comments. It is eminently sensible and in line with the observation contained in the Better Regulation Task Force report. One of the issues we

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have debated throughout the passage of the Bill is the split of functions not only between CHAI and CSCI but also between CHAI and the Audit Commission. I believe that this duty of co-operation is sensible. They may have been the two Titans about which we spoke earlier, but perhaps this is a different set of Titans—my memory fails me. However, I am sure that both bodies will find it a welcome duty.

On Question, amendment agreed to.

Clause 65 [Right of entry: supplementary]:

Baroness Finlay of Llandaff moved Amendment No. 320:

    Page 25, line 39, leave out "a" and insert "an anonymised"

The noble Baroness said: My Lords, Amendment No. 320 relates to the way in which electronically held records are handled. The Minister's amendment deals with many of the concerns that have arisen during previous stages as regards the way in which CHAI and CSCI can access confidential information. I am grateful to the Minister for having corresponded with several of us about these issues and outlining the meeting he had with Sir Ian Kennedy to discuss them further. The amendment in his name appears to link with the code of practice that has been drawn up with Sir Ian Kennedy, the General Medical Council, the Nursing and Midwifery Council and the National Consumer Council, about which there will be wide consultation.

The Minister's amendment does not deal specifically with electronic records and I have tabled Amendment No. 320 in order to ensure that anonymisation occurs. Anonymising electronic records is quite easy—simply with a substitution for different terms and fields which can render them anonymous quickly. However, hand-held records are extremely difficult and cumbersome to anonymise effectively. Given the legislation around electronically held records, it struck me as being important that there is a specific assurance that there will be anonymisation. It may be that the Minister in speaking to his own amendment will be able to give me the reassurances I seek. I beg to move.

Lord Clement-Jones: My Lords, I want to speak to Amendment No. 320A. We had an interesting debate in Committee which was informed by the Minister's notes to us. Again, the Minister has helpfully written about the code of practice. That is a significant step, but I should like to hear further from him on the role of the Secretary of State. There is the possibility of a considerable disagreement on the thrust of the code of practice. CHAI, the GMC and other bodies concerned with the protection of confidential information will have different interests. Who will resolve them? Who will be the referee? That is the key issue.

Amendment No. 320A is designed to answer those questions. I am not sure that the Minister's amendment yet does so, but I shall be interested to hear from him who will resolve the difficulties. It appears to us on these Benches that CHAI is solely in the saddle on this matter and other parties, perhaps

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not with equal powers but with override powers, can be brought into the equation if major problems arise in reaching agreement on the code of practice.

This is an important area of the Bill. The use of personal information is becoming increasingly important and we must be sure that this part of the Bill works.

Baroness Cumberlege: My Lords, I, too, have an amendment in this group; it is Amendment No. 323A. I am grateful to the Minister for introducing the code and putting it on the face of the Bill. He will remember that my solution was somewhat different from that suggested by the noble Lord, Lord Clement-Jones. He suggested the Secretary of State and I suggest the Patient Information Advisory Group, which was set up two years ago to look at patient information that was not anonymised and on which patients could not give their consent. The body was set up to scrutinise those applications.

I agree with the noble Lord, Lord Clement-Jones, that the Minister's amendment, although helpful, still puts CHAI in the saddle. One of my concerns is that CHAI will acquire the information; it will publish the code; it will consult persons it considers appropriate; and it will keep the code under review. I do not consider that to be a very good practice. I believe that we need an independent body. It seems to me strange that, where we have such a body which we know to work well, we do not use it.

I turn to the progress made by the Patient Information Advisory Group. It is interesting that, when that body was first set up, it was considered bureaucratic. Research applicants did not like it. The PIAG refused many applications because, I understand, the applications were so poor. The reasons given as to why patient consent could not be obtained were that it would be too difficult to do so or that patients would not want to be bothered. However, there was a strong suspicion that it was the applicants who could not be bothered.

I still appear to be the sole standard-bearer for the Patient Information Advisory Group, and am perhaps somewhat isolated in that context. However, I believe that in the PIAG we have an established organisation which is practical and which has a membership respected throughout the National Health Service with people of extremely high quality. We have a mechanism that works, and I am very disappointed that the Minister does not feel that we should use it, thereby avoiding a situation where CHAI would become judge and jury in its own case. That is not a good principle and certainly not a tradition in this country.

7.30 p.m.

Earl Howe: My Lords, very briefly I want to say to my noble friend that she need not feel isolated. I hope that the Minister will consider constructively her amendment in relation to the Patient Information Advisory Group. Surely the code of practice and the regulations need to be looked at independently. I have

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not been specific in my own amendments and I am not particularly speaking to them. However, I sympathise very much with what my noble friend said. I also thank the Minister for taking away this issue and dealing with it so constructively.

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