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Baroness Barker: My Lords, I would never accuse the Minister of being perverse or obstructive. I accept her argument. I believe that the discussion has been helpful and that, in fact, it has been helpful to have it repeatedly and in detail, because there is a great deal of concern out there about the scope and extent of the procedures. At this stage, I shall not treat the House to a summary of the upheaval going on around the ICAS project or the Commission for Patient and Public Involvement in Health. There is a great deal of uncertainty out there about how complaints systems will work in practice. It has been good to hear the Minister's statements about the extent of the consultation and of the involvement that different people will have in the process.

Fair game to the Minister—she has parliamentary counsel on her side and I do not. Several noble Lords in the past few weeks have talked about the rugby, but those of us who are Scots or Welsh are far more interested in the football this week. Therefore, on that note, I shall say that it is a score draw to the Minister. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 145 [Co-operation between Assembly and CHAI]:

The Deputy Speaker (Baroness Lockwood): My Lords, I should point out that, if Amendment No. 24 is carried, I cannot call Amendment No. 25, under the pre-emption rule.

Baroness Andrews moved Amendment No. 24:


The noble Baroness said: My Lords, I am pleased to speak to government Amendment No. 24 and to respond, at the same time, to Amendment No. 25, standing in the name of the noble Earl, Lord Howe.

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When I spoke on Report to an earlier amendment of similar intent tabled by the noble Earl, I undertook to return with a government amendment to meet concerns expressed by him, by the noble Baroness, Lady Finlay, and by other Members of your Lordships' House. Concerns were expressed that English NHS bodies that provided services to Welsh patients under commissioning arrangements made by Welsh NHS bodies—or, indeed, Welsh bodies providing services to English patients—might be the subject of conflicting or duplicated reviews or inspections by both CHAI and the Assembly and that none of that would be in the interests either of those running the health service or the patients themselves.

Government Amendment No. 24 meets the obligation I gave. It strengthens the duty of co-operation between the Assembly and CHAI in Clause 145 by removing all the qualifications. In that way, we are making it absolutely clear that CHAI and the Assembly must co-operate with regard to their relevant functions at all times and in all circumstances in order to avoid unnecessary overlaps or duplication. That will ensure that joint working and mutual support are in place, ensuring that patients' interests are served as well as they can be.

In effect, the government amendment goes rather further than the amendment tabled by the noble Earl, Lord Howe. Clause 145, as it would be amended by the government amendment, requires, as I said, the Assembly and CHAI, without qualification,


    "to co-operate with each other for the efficient and effective discharge of any relevant function".

They will be under an unequivocal duty to co-operate with respect to all their functions.

The amendment tabled by the noble Earl would seem to oblige the bodies to consult the other body on each occasion that it exercises a function that affects an English or Welsh body, as the case may be. Our amendment goes further. I would expect CHAI and the Assembly to co-operate with each other on the inspection planning process and as regards their general work plans for their proposed activities over a particular period, in order to anticipate and prevent things going wrong. So it is very much a positive and proactive power rather than a reactive power. We believe that it is preferable to give CHAI and the Assembly the widest scope to determine the precise method of co-operation. The Bill will be extremely clear on those points. I think that that is important as they are new bodies. HIW, in particular, is very much in its formative stage. The government amendment sends a crystal clear signal that that is what we expect to happen. As I believe that our amendment is preferable, I invite the noble Earl not to press his amendment. I beg to move.

Earl Howe: My Lords, very briefly, this seems to me a neat amendment, and I welcome it. I agree that it is superior to the amendment that I tabled, for the reasons that the Minister gave. I certainly will not move my amendment.

We had a useful debate on Report in which the noble Baroness, Lady Finlay, and I raised separate but related concerns on cross-border issues. I know that

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the House was grateful to the Minister for saying that she would look at ways of strengthening the duty of co-operation contained in Clause 145. It has always seemed to me that, with the duty qualified as it is, the success of cross-border collaboration and the avoidance of duplication would depend on the extent to which CHAI and the Welsh inspectorate applied themselves to those issues. With the qualification removed, we can all have a lot more confidence that the potential problem areas will be eliminated or at least minimised.

I thank the noble Baroness for recognising the worries that I and a number of others have raised and for addressing them in the amendment.

Baroness Finlay of Llandaff: My Lords, I feel that the noble Baroness, Lady Andrews, deserves congratulations on the way in which she has listened carefully to all the points and negotiated with both CHAI and the Assembly inspectorates. She has given a crystal clear signal that there must be collaboration and co-operation. All we can do now, other than support her amendment, is to wish those inspectorates well in the task that lies ahead of them. There has been a huge amount of work behind the scenes. I think that the amendment neatly addresses the concerns about the future direction which needed to be addressed.

Baroness Carnegy of Lour: My Lords, if I may, I should like to use this debate on cross-border co-operation to thank the noble Lord, Lord Warner, for a helpful letter he wrote in response to a question that I asked about whether Scottish-based patients would be able to use foundation hospitals in England. It was explained to me that, provided the Scottish health body commissioned work from a foundation hospital, that could take place, and that any Scottish-based patient who required accident and emergency help could receive it from an English hospital. I was grateful for that. Although it does not impinge upon CHAI, I hope that I will be forgiven for saying that.

On Question, amendment agreed to.

[Amendment No. 25 not moved.]

5.45 p.m.

Clause 185 [Replacement of the Welfare Food Schemes: Great Britain]:

Baroness Andrews moved Amendment No. 26:


    Page 104, line 39, at end insert—


"( ) The Secretary of State may not make a statutory instrument containing the first set of regulations made under subsection (1) unless a draft of the instrument has been laid before, and approved by resolution of, each House of Parliament."

The noble Baroness said: My Lords, I am pleased to move this amendment, which was anticipated on Report. We appreciate that noble Lords felt that there was insufficient detail about our proposals for reform of the Welfare Food Scheme to enable them to be confident that it was appropriate for regulations made under subsection (1) to be subject to negative, rather than affirmative, resolution. We had good debates in Committee and on Report about the emerging scheme.

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As I promised on Report, we have considered again the level of parliamentary scrutiny that should be applied to the regulations.

Our amendment will require the first set of regulations made under subsection (1) to be laid before, and approved by resolution of, each House of Parliament. That will ensure that each House has full opportunity to consider carefully the regulations and to debate them. Of course—it goes without saying, but I shall say it—it is still our intention to consult fully all those with an interest in the content of the regulations before they are laid. I hope that noble Lords will find that acceptable. I look forward to our first debate on the affirmative regulations. I beg to move.

Earl Howe: My Lords, it is with much pleasure that I thank the noble Baroness for listening to the concerns raised at earlier stages of the Bill and for fulfilling her undertaking to table the amendment, which I warmly welcome.

On Question, amendment agreed to.

Clause 187 [Appointments to certain health and social care bodies]:

Lord Warner moved Amendment No. 27:


    Page 106, line 25, at end insert—


"( ) Nothing in this section applies in relation to the Commission for Healthcare Audit and Inspection or the Commission for Social Care Inspection."

The noble Lord said: My Lords, I wish to speak to all the government amendments in the group. Amendments Nos. 44 to 46, 48 to 50, 53 to 59, 61 and 64 in this group were tabled following your Lordships' decision on Report. They ensure that a special health authority rather than the Secretary of State will be responsible for appointing the chair and members of CHAI and CSCI. In practice, we intend to give that task to the NHS Appointments Commission, which, at present, is the special health authority charged with the making of appointments to NHS bodies. I will return presently to the issue of why we have not named the NHS Appointments Commission in the Bill.

Given the amendments we are proposing in relation to the role of the Secretary of State, Assembly officials have agreed that it would be inappropriate for the Assembly to continue to maintain the power to appoint a member to the board of CHAI. Consequently, the amendments make similar provision in relation to the Assembly's powers to appoint a member of CHAI. We have also provided that other functions of the Secretary of State relating to appointment or removal may be delegated to the special health authority. That was previously dealt with in Clause 187, but it seemed more logical to deal with the entire position concerning those functions in Schedules 5 and 6, rather than partly in Clause 187 and partly in the schedules.

Amendment No. 27 is a technical amendment that clarifies that Clause 187, which gives the Secretary of State a general power to delegate appointment functions in relation to health and social care bodies to a special health authority, does not apply to CHAI and

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CSCI, as the exercise of such functions in relation to CHAI and CSCI is now dealt with in Schedules 5 and 6.

We are also proposing Amendments Nos. 51, 52, 62 and 63, which are technical in nature. The amendments clarify that the Secretary of State or the Assembly, in the case of CHAI, may remove a member from office where it comes to light after he has been appointed that he was disqualified from appointment at the time he was appointed.

It may be for the convenience of the House if I give a clarificatory explanation in relation to why the NHS Appointments Commission is not named specifically, which I think is probably the intention behind Amendments Nos. 43 and 60 in the name of the noble Earl, Lord Howe, and the noble Baroness, Lady Noakes. However, the noble Baroness shakes her head so I shall not delay the House further. I beg to move.


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