Clause 1 - English health authorities: change of name
NHS Reform and Health Care Professions Bill
12:15 pm
Mr Oliver Heald (North East Hertfordshire, Conservative)
All the amendments are to the same effect. They would change the name of strategic health authorities to area health authorities. Their purpose is not simply to concentrate on the name, but to ascertain whether such authorities are properly designated as strategic. We want to examine the functions that the Government intend for them, and whether it is right to describe those functions as strategic. We might go further and ask whether those bodies have a role to play.
As I understand it, the Government propose to reallocate responsibilities in the NHS so that PCTs will become the bodies that assess need, plan for it and commission services, and as such will be the main budget-holders; I do not use the word ``purchaser'', of course. There are to be about 30 new health authorities, covering about 1.5 million residents each, although I have heard that, in certain areas, the Government are prepared to accept far larger numbers of residents.
Will the Minister explain why it is necessary to have strategic health authorities and what is strategic about them? The research paper says that they will provide
``support to PCTs and NHS trusts to help them . . . improve the quality of the services they provide through their `clinical governance' arrangements''.
What does that actually mean? The paper goes on to refer to developing
``appropriate links with patients and the public as a whole, to ensure that services become genuinely patient-centred''.
We seem to be developing a massive structure of overarching and underlapping bodies to do what the community health councils used to do. Is it really necessary to have another set of bodies developing links and ensuring that patients have a role? Can the Minister justify the claim that those bodies are genuinely strategic?
The research paper says that SHAs will
``play a part in the wider public health agenda so that they contribute to general strategies to promote good health''.
What does that involve? Does the Minister really believe that a strategic role is called for? If so, how will the system operate in terms of the relationship between SHAs and PCTs?
The BMA asserts that the new structures should include a role for public health doctors. Does the Minister intend the high-level appointment of a public health doctor in each area? Would that be part of improving the quality of services within a clinical governance arrangement? I do not think so. Would it assist in developing a link with patients? Probably not. However, it might play a part in the wider public health agenda. Is part of the strategic purpose of SHAs the appointment of public health doctors? The BMA thinks that that is important. It says:
``The BMA is concerned that with such flexibility of appointment to these key public health posts at PCT and SHA level, potentially some areas of the country may be without the expertise of a public health doctor.''
The Royal National Institute for the Blind has commented on the role of sight loss and eye health promotion. Will the Minister explain whether that is a strategic issue that plays a part in the wider public health agenda, or is it the kind of thing that PCTs will deal with? Will he also respond to the RNIB's observation that the NHS and local authorities should work more closely to ensure effective service delivery in terms of sight loss and eye health promotion?
In other words, what does it all mean? [Interruption.] I ask that not in an entirely philosophical sense; I was hoping instead that the Minister might give a little detail and explain what the strategy is, why we need strategic health authorities, and why they should be called that rather than area health authorities.