Health and Social Care Bill

AMENDMENTS
TO BE MOVED
ON REPORT

Clause 1

LORD CLEMENT-JONES

LORD MARKS OF HENLEY-ON-THAMES

BARONESS BARKER

BARONESS TYLER OF ENFIELD

 

Page 2, line 12, at end insert—

“(4) The provision of the health service is a service of general economic interest within the meaning of Article 106 of the Treaty of the Functioning of European Union.”

After Clause 9

LORD CLEMENT-JONES

LORD MARKS OF HENLEY-ON-THAMES

BARONESS BARKER

BARONESS TYLER OF ENFIELD

 

Insert the following new Clause—

“Duty of co-operation

For section 72 of the National Health Service Act 2006 (Co-operation between NHS bodies) substitute—

“72 Duty of co-operation

(1) It is the duty of each NHS provider of health care services to co-operate with—

(a) other such providers (whether providing the same or different types of health care services for the same or different areas),

(b) persons providing health-related services, or

(c) persons providing social care services.

(2) In carrying out their duty of co-operation, NHS providers of healthcare must have regard in particular to co-operating in the integration of health care services with health-related services or with social care services, as the case may be, where they consider this would—

(a) improve the quality of health services (including the outcomes that are achieved from the provision of those services) or the efficiency of their provision,

(b) reduce inequalities between persons with respect to their ability to access those services, or

(c) reduce inequalities between persons with respect to the outcomes achieved for them by the provision of those services.

(3) For the purposes of this section—

(a) “NHS provider of health care services” means NHS Foundation Trusts and Care Trusts,

(b) “health-related services” and “social care services” have the same meaning as in section 61 of the Health and Social Care Act 2012.””

Clause 14

LORD RIX

 

Page 8, line 12, at end insert “including those with profound and multiple learning disabilities and people with complex needs whose behaviour challenges services”

Clause 22

LORD WARNER

LORD PATEL

 

Page 16, line 22, leave out “and” and insert—

“( ) the priority and scope for commissioning service redesign and reconfiguration in the light of the best clinical advice available,

( ) the priority and scope for transferring resources to adult social services to improve service integration and achieve best value for health services,”

BARONESS WILLIAMS OF CROSBY

LORD CLEMENT-JONES

LORD MARKS OF HENLEY-ON-THAMES

BARONESS BARKER

 

Page 16, line 25, at end insert—

“( ) The Secretary of State must make a statement as to how the objectives and requirements specified in the mandate under section 13A(2)(a) and (b) will further his discharge of each of his duties under sections 1 to 1F of this Act.”

LORD WARNER

LORD PATEL

 

Page 17, line 38, at end insert—

“( ) In exercising this duty the Board must, after consultation with the Secretary of State, specify for commissioners and providers of health services minimum standards for the production of annual audited management accounts that relate their expenditure to activities and performance so that comparisons of their relative efficiency are available publicly and a digest of these accounts should be published annually by the Board or Secretary of State.”

LORD RIX

 

Page 18, line 30, at end insert—

“(c) collect data on the experience and outcomes experienced by all patients and where the person has a disability, break data down by impairment type.”

BARONESS FINLAY OF LLANDAFF

 

Page 18, line 39, at end insert—

“( ) The National Commissioning Board must have regard to advice from a range of healthcare practitioners from across the patient pathway, including local clinical specialists and allied health professionals.”

LORD WARNER

LORD PATEL

BARONESS PITKEATHLEY

 

Page 20, line 8, at end insert—

“( ) In this section and elsewhere in the Act—

“integration” means the integration of health and social care commissioning, assessment, service provision or payment arrangements with the primary purpose of improving the delivery of integrated care and treatment to individual patients or service users or groups of such individuals.”

 

Page 21, line 42, after “13E” insert “, 13M”

 

Page 22, line 16, after “13E” insert “, 13M”

Clause 24

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

BARONESS BARKER

LORD CLEMENT-JONES

 

Page 29, line 23, at end insert—

“( ) The Board must exercise its functions under this Chapter so as to ensure that every person resident in England is required to be provided with services by a clinical commissioning group.”

Schedule 2

BARONESS BARKER

LORD MARKS OF HENLEY-ON-THAMES

LORD CLEMENT-JONES

BARONESS TYLER OF ENFIELD

 

Page 281, line 34, at end insert “and shall apply the provisions of paragraphs 19A and 19C and the guidelines as established by paragraph 19C of this Schedule”

 

Page 282, line 34, at end insert “and shall apply the provisions of paragraph 19B of this Schedule”

 

Page 282, line 43, at end insert “provided that the public may not be excluded from any governing body meeting during a discussion involving a choice between potential providers”

 

Page 282, line 43, at end insert—

“(5) A record of the decisions made at any meeting or part of a meeting from which members of the public are excluded must be published not later than two weeks from the date when the meeting occurred.”

 

Page 288, line 12, at end insert—

“Register of interests and conflicts of interest

19A (1) Every clinical commissioning group must keep a register of the financial interests of all members of the Group.

(2) Within 28 days of a member joining a clinical commissioning group, the member must inform the group’s accountable officer of any relevant financial interests requiring registration.

(3) Within 28 days of any change to a member’s registered interests, the member must inform the group’s accountable officer of such change.

(4) The accountable officer shall ensure that the register of interests is freely available to inspection by the members of the public.

19B (1) A director of a healthcare provider organisation, or a general practitioner having a significant financial interest in a provider organisation, may not serve on the governing body of a clinical commissioning group if there is a contract between that clinical commissioning group and that organisation.

(2) If a clinical commissioning group enters into negotiations with a healthcare provider organisation and a member of the governing body of that clinical commissioning group is a director or has a significant financial interest in that provider organisation, that member shall take no part in the proceedings of the governing body until such negotiations are concluded and shall then stand down from membership of the governing body if a contract is entered into between the clinical commissioning group and the healthcare provider organisation.

19C The Guidelines on Conflict of Interest for Members of Clinical Commissioning Groups referred to in section 14Z8A (as inserted by section 25 of the Health and Social Care Act 2012) shall be drawn up by the Board.”

Clause 25

BARONESS WILLIAMS OF CROSBY

LORD MARKS OF HENLEY-ON-THAMES

BARONESS BARKER

LORD CLEMENT-JONES

 

Page 36, line 18, at end insert—

“14PA Duty to provide services by the clinical commissioning groups

Each clinical commissioning group must exercise its functions so as to ensure that every person resident in its area is provided with services by the clinical commissioning groups.”

BARONESS FINLAY OF LLANDAFF

 

Page 37, line 18, at end insert—

“( ) A Clinical Commissioning Group must have regard to advice from a wide range of healthcare practitioners from across the patient pathway, including local clinical specialists and allied health professionals.”

BARONESS BARKER

LORD MARKS OF HENLEY-ON-THAMES

LORD CLEMENT-JONES

BARONESS TYLER OF ENFIELD

 

Page 41, line 42, at end insert—

“14Z8A Power of Board to refer to relevant professional body regarding conflicts of interest

The Board must refer to his or her relevant professional body any member of a clinical commissioning group whom it reasonably believes to have been in material breach of any of the provisions concerning conflict of interest set out in paragraphs 19A and 19B or the guidelines in paragraph 19C of Schedule 2 (as inserted by Schedule 2 to the Health and Social Care Act 2012).”

 

Page 48, line 40, at end insert—

“14Z21A Declaration of financial interests

A person who is a provider of primary medical services must declare any financial interest that person may have in a commissioning decision by a clinical commissioning group of which he or she is a member and must absent him or herself from the making of any such decision.”

Clause 52

LORD WARNER

LORD PATEL

BARONESS PITKEATHLEY

 

Page 84, line 6, at end insert “and its integrated working with adult social care services”

Clause 61

LORD WARNER

 

Page 88, line 3, after “to” insert “identifying and”

Clause 78

LORD CLEMENT-JONES

LORD MARKS OF HENLEY-ON-THAMES

BARONESS BARKER

BARONESS TYLER OF ENFIELD

 

Leave out Clause 78

Clause 111

LORD CLEMENT-JONES

LORD MARKS OF HENLEY-ON-THAMES

BARONESS BARKER

BARONESS TYLER OF ENFIELD

 

Page 119, line 24, leave out subsection (2)

Clause 112

LORD CLEMENT-JONES

LORD MARKS OF HENLEY-ON-THAMES

BARONESS BARKER

BARONESS TYLER OF ENFIELD

 

Leave out Clause 112

Clause 113

LORD CLEMENT-JONES

LORD MARKS OF HENLEY-ON-THAMES

BARONESS BARKER

BARONESS TYLER OF ENFIELD

 

Leave out Clause 113

Clause 114

LORD CLEMENT-JONES

LORD MARKS OF HENLEY-ON-THAMES

BARONESS BARKER

BARONESS TYLER OF ENFIELD

 

Leave out Clause 114

After Clause 132

LORD WARNER

LORD PATEL

 

Insert the following new Clause—

“Action prior to health special administration orders

(1) Monitor shall publish annually a report to the National Commissioning Board with evidence on any trusts that it considers are at serious risk of requiring a health special administration order and make this report available to the Secretary of State and the relevant clinical commission groups and health and wellbeing boards.

(2) It shall be for the Board and the relevant local organisations to establish an appropriate mechanism to review the services concerned and to produce within six months a report to Monitor indicating how those services can be made clinically and financially sustainable and the extent to which the proposed changes have been agreed by local interests.

(3) It shall be for Monitor to decide whether such responses are adequate to secure clinical and financial sustainability in the areas concerned and to inform the Secretary of State and interested parties of their decisions.

(4) It shall be for the Secretary of State either to endorse any report that achieves clinical and financial sustainability or to specify to the National Commissioning Board what further action should be taken to deliver such sustainability and the Secretary of State’s decisions and Monitor’s reports shall be made public.

(5) It shall be open to the National Commissioning Board in consultation with the Secretary of State to establish a panel of independent people with appropriate expertise to assist with securing local agreement on the reconfiguration of services required to secure clinical and financial sustainability.”

Clause 184

LORD RIX

 

Page 182, line 5, at end insert “ensuring that there is no upper limit on the length and type of advocacy support that may be provided”

Clause 287

LORD MARKS OF HENLEY-ON-THAMES

BARONESS TYLER OF ENFIELD

BARONESS BARKER

LORD CLEMENT-JONES

 

Page 261, line 16, after “duty” insert “or are otherwise in conflict with each other or at significant risk of being in conflict with each other”

 

Page 261, line 40, at end insert “or may require one or more of the bodies concerned to exercise specified functions in a specified manner”

Prepared 1st February 2012