Clause 7 - Functions of Overview and Scrutiny Committees
Health and Social Care Bill
4:30 pm
Mr John Denham (Minister of State, Department of Health; Southampton, Itchen, Labour)
I, too, welcome you to the Committee, Sir David. We have had some productive sittings, and I am sure that that will continue under your chairmanship.
It is an interesting group of amendments; they would be contradictory if we were to accept them all, but they allow us to explore the issues involved. The hon. Member for Sutton and Cheam (Mr. Burstow) asked whether PALS should be a statutory body. We envisage the service being one of the functions of trusts, and such functions—the specific services provided by trusts, such as running out-patients clinics or doing operations—are not provided for in primary legislation. It would therefore be rather odd to include PALS in the Bill. The hon. Gentleman will have noticed, however, that under later amendments we shall provide the means by which a failing PALS or one that had been neutered by management could be taken out of the trust. If those later amendments are accepted, we shall, in a roundabout way, have provided some protection of the advocacy and liaison service.
We disagree with the hon. Gentleman on independent advocacy to support patients through the formal complaints procedure. We have been persuaded by CHCs and others that that formal role needs to be separate from the advocacy and liaison service role. New clause 5 would seem to put PALS in charge, but we would not want that. Nor do I agree that the independent advocacy service should be provided by the local authority scrutiny committee, but where it should go is something for further discussion. There are two possible models of providing the independent advocacy service. It could either be commissioned by the health authority—the obvious choice—or by the local authority. In turn, the local authority could be either the commissioner of the service or a provider of the service, commissioning the service from itself.
At this stage, it is better to allow further discussion and even some local flexibility. Funds will clearly be needed. We may take a similar route to that taken for CHCs, which is to use the regional health authorities for that purpose. There are clear attractions in locating the advocacy service in a local authority, particularly if, as we suggest in the explanatory document, the authority were to provide the secretariat for the patients forum in the area. That would mean a concentration of staff; they would be working for the same service in the same location. It is better that the Bill is not too prescriptive. Discussions are continuing with the health service, the Local Government Association, CHCs and other patient groups. A clear line suggests itself, and we want to discuss it in more detail.
It has been a brief debate, but I hope that I have responded to the major points raised by the hon. Member for Sutton and Cheam.