Clause 10 - Establishment of Patients' Forums
Health and Social Care Bill
6:00 pm
Mr John Denham (Minister of State, Department of Health; Southampton, Itchen, Labour)
The hon. Member for Isle of Wight raises a number of issues. First, should the forum relate to the trust or cover a wider area? Secondly, will the forums become of the trust rather than relating to the trust—in other words, will they loose their independence? Thirdly, the relationship with the local authority was raised. The fourth issue, raised by the hon. Member for New Forest, West, is whether the broad proposal that we have set out for membership is right for the function of the patients forums.
The patients forums will be independent of the trusts to which they relate because the provisions of the Bill establish them as independent and statutory bodies, because they will be funded separately to the trusts and because they will have clear powers in relation to the trust. Their membership will be appointed by the independent appointments commission, rather than by the trust. They will be able to select a non-executive director of the trust and will have the powers to carry out visits and inspections, which we discussed earlier. They will have specific functions.
Under clause 9, we discussed the patients prospectus, but I omitted to say that we intend the patients forum to have the right to sign off the patients prospectus. The fears that were expressed about a glossy document saying how wonderfully the trust was doing will not be realised. The patients forum will need to agree that what the prospectus says about patients' views is correct. For all those reasons, the patients forum will be an independent structure.
The big question is whether the patients forum should relate directly to an individual trust or primary care trust or whether it should cover a wider area. There may be a simple philosophical difference between hon. Members on both sides of the Committee. The Government believe that the forum needs to relate to the particular organisation, its management structure, culture and ethos if it is to bring about change.
A patients forum that covered a wider area would have huge attractions in some ways, because not as many patients would be needed, it would not cost as much to run and so on. However, such a forum would be too remote from any individual organisation and its management structure to effect change on the patients' behalf. We may have to accept that there is a difference in view between hon. Members on different sides of the Committee.
None the less, it will be interesting to explore the potential relationship with the local authority, which is where the hon. Member for Isle of Wight sought to locate the larger patients forum. There are attractions in the idea that a local authority could offer a base or secretariat that supported a number of patients forums in the area. That would enable each forum to be individually independent and established in law. They would relate to an individual primary care trust or NHS trust, but share a common base or secretariat in the local authority. However, there are practical models of administration and co-ordination that would provide what we want to achieve, while delivering co-ordination across the patients forums in an area.
I said that the NHS appointments commission would appoint the membership. We envisage that part of the membership will comprise people who are or have recently been patients of the trust, perhaps drawing on people who have taken part in the annual patients survey. Others will come from local voluntary and patients' organisations. We are clear—probably clearer than the explanatory notes as I recollect—that carers must also be represented in the membership. They will form an important part of the membership of patients forums.