National Health Service Reform and Health Care Professions Bill
Lord Hunt of Kings Heath (Parliamentary Under-Secretary, Department of Health; Labour)
My Lords, I must apologise to the noble Baroness, Lady Masham; I thought that I had answered that question on several occasions. The role of the CHC in relation to significant changes of services is being transferred from appointed bodies—the CHCs—to democratic local government. The overview and scrutiny committee of the principal local authority in an area, which is democratically elected, will deal with those issues. It will have the right to call in officers of NHS bodies to examine them. If there is disagreement on a proposal, that can be referred to a national body, the Independent Reconfiguration Panel, which will advise the Secretary of State. Far from dissipating the current mechanism, we have strengthened it by linking it to locally elected councils.
I accept that the amendments are worded differently from those that we debated on Report. However, they cover much the same ground. The noble Earl, Lord Howe, and the noble Lord, Lord Clement-Jones, clearly hark for some national body to focus on representing what might be the views of patients. The noble Earl referred to their attempts to speak out. That misreads the whole purpose of the commission.
Subsection (2)(a) clearly states that it will advise the Secretary of State,
"and such bodies as may be prescribed, about arrangements for public involvement in, and consultation on, matters relating to the health service in England".
The principal aim in that regard is to ensure that we get patient and public involvement right. I do not believe that the public interest would best be served if such a commission allowed itself to go down the track of having a representative role, which we know cannot be carried out by such an appointed body. That is why I resisted the amendments on Report.
The noble Earl, Lord Howe, underestimated the commission's functions. He described that as involving a rather process-oriented set of roles. Paragraphs (a) to (h) in Clause 20(2) contain a very powerful set of responsibilities, which will ensure that we get public and patient involvement right. I draw his attention in particular to paragraph (d), which refers to,
"providing assistance to Patients' Forums and Patients' Councils, and facilitating the co-ordination of their activities".
The commission has the potential to help local patients' forums by pulling together their activities, which will enable patients' forums to work together. When a number of patients' forums wish to come together over various issues, the commission will help and enhance that process. That is a much better approach. It involves using experience at the local level—helping patients' forums to come together to express views on patients' experience and thinking rather than seeking at a national level to carry out a role that I do not believe such bodies can be expected to carry out effectively.
I point out to the noble Earl that Clause 20(3) gives the commission the function of promoting,
"the involvement of members of the public in England in consultations or processes".
The arrangement is not focused solely at prescribed bodies. The commission has a much wider role—to examine the way in which individuals' involvement in the National Health Service can be enhanced and developed. It is much better for the commission to focus on helping to ensure that we get effective public involvement rather than being side-tracked by attempting to have a representational role that I do not believe it could carry out effectively.