Clause 14 - Abolition of community health councils in england
Health and Social Care Bill
10:30 am
Dr Liam Fox (Woodspring, Conservative)
I shall speak briefly to the amendment, but I intend to speak mainly on clause 14 stand part.
The hon. Member for Sutton and Cheam (Mr. Burstow) has a touching naivety if he does not believe that Parliament is the last place where we are likely to find out the details of any part of Government policy; and the abolition of the community health councils could not be a better example. It is one of the most controversial parts of the Bill—if not the most controversial—and it will cause the most difficulty in the other place. If the Government do not change their view on this part of the Bill, they will have a great deal of trouble getting it through the other place, as a substantial number of Cross-Benchers oppose the measure.
We accept that the Government's proposals are likely to remain in place, and we are in no doubt that amendment No. 241 would simply buy time to ensure that any new mechanisms are up and running and properly in place before CHCs are abolished and before those whom they help are abandoned to the new system. Nothing could be worse than to abolish something that works before putting safeguards in place to ensure that people will not suffer as a result of the changes.
In this debate, we shall examine exactly what CHCs do, how they work, what they have done, what functions they fulfil and whether those functions will be fulfilled by the new bodies that the Government propose. CHCs have 700 permanent staff and 5,000 volunteer members. They were created by a Conservative Government under the National Health Act 1973. It must not be forgotten that they effectively offer free labour to the national health service worth about £8 million a year. Each year, CHCs assist about 30,000 people with complaints.
In his briefing notes, the Minister accepts how well CHCs work. They say:
``While some CHCs have done a very good job, their effectiveness and breadth of service across the country is patchy and too highly dependent on individual officers and members. Only in some parts of the country do patients receive a high level of support from their CHC when making a complaint about NHS services.''
That surely is the best possible argument for reform and standardisation. We should raise the standard of all CHCs to that of the best, which the Minister accepts are already doing a good job in representing community interests and patients. If that is possible under the current model, it requires us only to ensure that the best practices apply equally across the whole system, not to pull the entire system apart. Such vandalism, undertaken for reasons that we can only guess at, is completely unacceptable.
We move from an easy and coherent system to one where the functions will be divided up between the patient advocacy and liaison services, patients forums and local authority scrutiny committees. The ensuing fragmentation will mean that no individual body will oversee the whole of the patient's experience. That may well result in increased litigation costs due to patients failing to receive appropriate advice. Elderly patients, for example, have complex problems, which can span acute and community care services. With the separation of scrutiny and complaints work the broader patterns of local health service problems are less likely to emerge and the exchange of information will be enabled only through the creation of yet another new quango. Under the current system, patients know exactly where to go for advice and their complaints are dealt with in a single, transparent manner. Under the new system, they will—for the first time—have to shop around for their rights, and that can only lead to increased patient confusion.
I am sure that the point of order raised earlier by the hon. Member for Sutton and Cheam about the information supplied to the Committee reminded the CHCs of the manner in which they were treated as they were kept in the dark until the Prime Minister announced the plan to abolish them. To add insult to injury, there is the Government's—and the Prime Minister's—concept of consultation. Given that the Government refer to such Orwellian concepts as ``earned autonomy''—whereby bodies are free to do things, but only with the Government's approval—I suppose that consultation might mean something different to them than it does to the rest of us.
The Prime Minister said in the House that the CHCs had been consulted about their abolition, but clearly nothing could have been further from the truth. The CHCs were not consulted. We are all aware of the subsequent exchange of letters between the Prime Minister and my hon. Friend the Member for Eddisbury (Mr. O'Brien). The Prime Minister said:
``I am aware that there is bitter opposition—
that is to the abolition of the CHCs—
which is why the proposals are being consulted on.''—[Official Report, 15 November 2000; Vol. 356, c. 937.]
Even after the Prime Minister said that there was consultation, there was still no consultation on whether or not the CHCs should be abolished. During the debate on Second Reading, many Government Back Benchers were clear that there had been no consultation.