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The Parliamentary Under-Secretary of State, Department of Health (Baroness Thornton): My Lords, the aim and purpose of the preferred provider policy is to set out the ground rules on which the provision of NHS services can be challenged. This approach should not be used either to allow underperformers to continue, or to freeze out partners in the independent and third sector, but where existing providers fail to improve services, or in the procurement of new service models, all providers should have a fair and equal opportunity to bid.
Lord Warner: I thank the Minister for that Answer. Is she aware that in the east of England, 14 primary care trusts have been prevented from offering community services from PCTs, and put them out to tender? Is she further aware that this policy contradicts the 2005 manifesto, which sought to increase diversity of providers? That is on page 63, if she wants the reference. Can she confirm that the Department of Health lawyers have said that this policy is ultra vires under UK procurement law and is therefore illegal?
Baroness Thornton: No, I cannot confirm that last point, and I am very sad and disappointed that my noble friend seems so out of sorts on this issue. I am sure we can agree that, where the NHS is providing excellent, high quality and cost-effective services, we would not wish to see tendering for the sake of tendering. I am aware that tendering for services in the east of England has been halted temporarily to ensure that those bodies that are discussing what to do with their community services have the most up-to-date guidance-that was published on 5 February-and that they are taking note of the fairness that we wish to have in the system. I think that it is as simple and straightforward as that.
Baroness Murphy: Does the Minister agree that reversing a successful policy after approximately 10 years by an announcement at a party conference at the end of September looks very much like a sodden sop, pre-election, to the public sector unions? What impact
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Baroness Thornton: I refute the suggestion of the noble Baroness about this policy. It seems to us that the preferred provider policy sets out the grounds on which NHS services can be challenged, so that staff know where they stand and so that they will have the opportunity to improve services before those services are put out to tender. There is no expectation or intention either to freeze out private or third sector providers, or to diminish their contribution to NHS services. The decisions of the co-operation and competition panel are based on our policy. I will go back and investigate whether there is a problem here, but I think the noble Baroness is mistaken.
Lord Davies of Coity: Does my noble friend agree that the National Health Service is undoubtedly the best service to provide this care and that, if an alternative means was introduced, it would be an extension of private medicine?
Baroness Thornton: I agree with my noble friend. Of course, we are proud of our National Health Service, but it is only fair to say that the NHS has depended on contributions of providers from the independent and third sectors since its inception in 1948. At the moment, we have a thriving third sector in the provision of NHS services. I might mention Macmillan Cancer Support, Marie Curie Cancer Care and Diabetes UK, as well as smaller groups who are providing innovative care, such as Turning Point and Whizz-Kidz. We also have a growing independent sector providing excellent services within our NHS framework.
Baroness Thornton: I thought that I had made it clear to the House-I apologise if I did not-that we expect the best providers to provide the best quality service. We expect there to be diversity in the provision of services. The provider policy will not be used to freeze out partners in the independent and third sector. In fact, national guidance makes it clear that procurement must be transparent and non-discriminatory.
Lord Low of Dalston: My Lords, does the Minister agree that the aborting of the whole commissioning process in the east of England, of which she has told us, is a highly damaging outcome for the provision of services to have resulted from the Secretary of State shooting from the hip at the party conference in giving
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Baroness Thornton: I think I have said that three times now. The answer to the noble Lord's latter point is yes, that is exactly the point. The procurement process in the east of England has been halted only temporarily. We expect it to be back on track soon, and we expect it to be the fair and transparent process that I have outlined.
Baroness Barker: My Lords, services provided by the NHS need be put out to tender only when there has been a failure to meet standards twice, while services provided by the independent and voluntary sectors have to be put out to tender automatically even if they are very good. What is the rationale for that unequal treatment?
Baroness Thornton: In my original Answer, I said that where excellent cost-effective services are being provided by the NHS, we would not seek to go out to tender for the sake of it. It is not only the replacement of services that we are looking at, though, it is the new and innovative services, many of which we have discussed in this House, connected with the amalgamation of social care and health. These new services will be open to the best provider of the best service at the best quality, be they NHS, private or third sector.
Baroness Pitkeathley: My Lords, I am sure that my noble friend will agree that her remarks about third sector providers will be welcome to the voluntary and charitable organisations that provide such services. Will she confirm that they are particularly important in the field of social care as well, especially if we consider what patients want when we talk about innovation and flexibility?
Baroness Thornton: My noble friend is correct. We work with dozens of third sector organisations, particularly in the delivery of social care services. Our expenditure rose from £366 million in 2007 to £513 million in 2009. This is the NHS providing a diversity of services.
Baroness Gardner of Parkes: My Lords, I declare an interest as a member of the All-Party Minerals Group. It is important that the whole House is aware of the concerns for the mineral industry expressed in Grand Committee over these regulations.
In fact, operators of a category A facility will be required to submit applications by April 2011. No guidance has yet been published to indicate what information these operators must provide or how soon they will know the designation of their category. When will they have these answers?
It is still unclear exactly which sites will be category A, where a refusal of a permit would result in operations being forced to cease. Closure is a complex process, and closing such a facility prematurely and suddenly could pose greater risk to life, health and the environment than allowing time for proper engineering and other procedures. This would clearly run counter to the principal aims of the mining waste directive of protecting the environment and human health.
There are already very effective regulations and controls in place in this country. Interestingly, Germany and Sweden have decided that their existing controls are sufficient to comply with the new EU directive. Many believe that the UK could have taken this view. The UK minerals industry has an exemplary safety record and there have been no significant incidents since the 1964 Aberfan disaster.
The industry welcomes efforts to protect environmental and public health. Introducing a formal arbitration or mediation process between operators and the local authority emergency planning services would prevent unnecessary refusals and the resultant impact on the supply of essential minerals. This process could also help to ensure that permits were in place by May 2012, as required by the mining waste directive. I would be grateful if the Minister could explain when people will know which category they are in and what information they need to provide.
Lord Teverson: My Lords, I echo the remarks of the noble Baroness, Lady Gardner. These regulations are on an area where there is a very strong obligation-a must-for the authorities to refuse a permit for ongoing mining where there is even a question that there might not be sufficient information to make a plan, even though that might not be in the control of the company concerned. Given the timescale, it is important that this is looked at again, and I too would very much appreciate the Minister's response.
The Parliamentary Under-Secretary of State, Department for Environment, Food and Rural Affairs (Lord Davies of Oldham): My Lords, I am grateful to both noble Lords, who also spoke with great strength during the deliberations on the regulations in Committee. At that stage I undertook to write further on this issue, and it was quite clear that the response which I gave at the time was not entirely satisfactory to the noble Baroness or the noble Lord, nor indeed to the noble Earl, Lord Selborne, who also raised the issue in Committee. I had in process a draft of a letter to respond to all noble Lords who participated in the Committee; but when it became clear that the noble Baroness was going to raise this issue in the House on the regulations-an unusual initiative, but one which is perfectly proper-I looked again at the letter and felt that we needed more work on it in an area in which all noble Lords recognise is both very important and very difficult.
We have to balance the obvious rights of the industry with regard to how it complies with the regulation and the timetable. At the same time, we may be dealing with an emergency position in which the actual process is a threat to public health in some respects. Because of that difficulty there is a real issue, as far as the Government are concerned, in balancing these two points. I thought I had given, in Committee, the assurance that the Government were engaged upon substantial work in this area. I will write to the noble Baroness-I was going to say "almost immediately", but the delay of
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(1) The Secretary of State must, as soon as reasonably practicable after the end of the 2010 target year and in any event not later than 30 June 2012, lay before Parliament a report on whether the 2010 target has been met.
(2) The 2010 target is that in the financial year beginning with 1 April 2010, 1.7 million children or fewer live in qualifying households in the UK that fell within the relative low income group as defined by section 2(2).
Lord Freud: My Lords, this amendment reframes a proposal that we put forward in Committee. Essentially, I propose that the Government of the day report to Parliament on their success or otherwise in hitting the interim target of halving child poverty in 2010-11. That report should be prepared when figures are available. Before going into the reasons why this would be a valuable exercise, I will deal with the changes to the amendment since the Committee stage.
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