|Health and Social Care Bill
Mr. Burstow: I want to ask a couple of questions arising out of page 15 of the explanatory notes, to which my hon. Friend the Member for Isle of Wight referred this morning. It would be helpful if the Minister could provide some further clarification. Paragraph 69 talks specifically about access and states:
I want to talk about the amendments standing in my name and that of my hon. Friend the Member for Isle of Wight. What we are seeking to do here, in the same way as the hon. Member for Runnymede and Weybridge (Mr. Hammond), is to turn this permissive power to make regulations into a duty on the Secretary of State to make regulations. We then want to go further and stipulate specifically in the Bill that the regulations should allow for unannounced visits. Unannounced visits are invaluable for getting a picture of how the NHS is performing, and when CHCs undertake such visits, they often uncover things that may not revealed if the trust is aware of the visit. It is important that the Government are clear and upfront that they intend and envisage that, in all but the most extraordinary of circumstances, it would it be possible, to undertake unannounced visits in the same way as CHCs do now.
Amendment No. 86 deals with the issue of reporting. It seeks to establish that, having undertaken such visits, patients forums should be reporting to the relevant trust after a period of 60 days. Alsothis is important to establish the interconnections between the various bodies that are to replace CHCsit deals with the fact that the forums should report to the overview and scrutiny committees, the ILAF and the health authority. All those organisations that have an interest in how the trust is performing should be in the picture in respect of what the patients forum has found.
Mr. Hammond: I understand what the hon. Gentleman is seeking to do. However, as he goes wider, is it not better simply to require publication of those reports, as our amendment proposes?
Mr. Burstow: Our amendment seeks to identify the specific bodies and to ensure that the channels of communication exist. As both our amendment and that of the hon. Gentleman are intended to establish the Governments' intentions, I should be happy to support his amendment if there were to be a Division. The key point is that we have greater clarity about reporting lines and that the material is put into the public domain so that scrutiny can be carried through. With that point, I hope that the Minister will be able to give some reassurances, especially about unannounced visits, because of the benefit that they can have for the oversight process.
Mr. Denham: We have made it clear that patients forums should be able to visit and to inspect any aspect of the care provided to patients. The clause provides the framework that enables us to meet that commitment. As the hon. Member for Runnymede and Weybridge acknowledged, we do not want the process to be adversarial or combativeit should be done responsibly and productively. The capacity to make unannounced and short-term visits must be an option available to the patients forum but, in the normal course of inspections, one would want a more structured approach.
There are key areas vital to patient safety and services that the patients forums should be able to inspect. Equally, there are areas of trust responsibility, such as accommodation provided to nursing staff, for which it is unnecessary to create a right of unannounced inspection by patients forums. However, by agreement with trust staff, patients forums might want to take an interest in that. We must draw a sensible line, but we have no intention of denying patients forums access to places under the right circumstances, when it is relevant to their work.
Mr. Hammond: Will the Minister give way?
Mr. Denham: I should like to make progress.
So that there is no misunderstanding, I want to be clear about the way in which access will need to be secured. We are dealing with different types of premises. It is relatively straightforward, legally, to make it clear through directions that access to NHS premises will be provided. However, it is not appropriate to legislate in the Bill about private premises such as GP premises, because it would raise European Court of Human Rights issues, among others. We intend to seek access to those places through terms-of-service changes for GPs and have notified the profession of that. We intend that access to private sector providers should be provided for within the contract that the commissioning NHS body enters into, as with access by the Commission for Health Improvement.
Mr. Hammond: The Minister will forgive me if I draw a stark contrast between what he said about access to private premises and the premises of private providers and the approach taken by the Minister of State, Department of Health, the hon. Member for Barrow and Furness (Mr. Hutton), in the consideration of the Care Standards Bill. Draconian powers in that legislation allow unannounced access by inspectors to private premises providing care to elderly residents, at any time of the day or night. Why is the Minister proposing a less onerous inspection system for the NHS than is imposed on private sector providers of care?
Mr. Denham: The system for NHS patients should not be any less effective than that for patients in the private sector, but the contractual relationships differ from those dealt with by the Care Standards Commission. I thought it important to set out the ways in which we intended to achieve the aims that we all share.
Two issues have arisen as matters for discussion. First, it is clear from the Bill that patients forums have a duty to make reports and recommendations to the trust to which they relate. That would include reporting on the findings of inspections and visits. I am not convinced that we need a requirement in the Bill to report formally and publicly every single visit, as that would be a bureaucratic imposition. However, we would expect the patients forums to be able to report in that way.
The hon. Member for Sutton and Cheam raised another question, which now escapes me. He may want to raise the matter again.
Mr. Hammond: I confess that the Minister's answer has not entirely satisfied me. Opposition Members seek to establish the extent and nature of the access that is granted and an assurance that, in practice, the reporting and publication of visit information will not be less satisfactory than is the case with community health councils. If the Minister can say that it is the Government's intention that any changes will mean greater access to premises and fewer restrictions, that will be of great reassurance to members of the Committee.
Mr. Denham: I am delighted to be of assistance. I can give that assurance.
Mr. Hammond: I am grateful to the Minister. We are concerned that that assurance is not reflected in the Bill. We shall think more about the matter and hopefully we can find a way in which to make sure that the hon. Gentleman's intention will be translated into the provisions. However, given what he has said, I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Clause 11 ordered to stand part of the Bill
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