Clause 1 - NHS foundation trusts
Health and Social Care (Community Health and Standards) Bill
9:15 am
Mr Andrew Lansley (South Cambridgeshire, Conservative)
I am privileged to have my first opportunity to participate in our Committee proceedings. I have not had the pleasure of serving under your chairmanship, Mr. Griffiths, although Mr. Atkinson is probably bored with the sound of my voice in this parliamentary year. I hope that his patience will not be strained in this first debate.
As my hon. Friend the Member for West Chelmsford made clear, the question of what kind of organisation we are discussing is important. Although we will examine how a ''public benefit corporation'' will subsequently be constituted and defined, the question of why there has been a move away from a ''public interest company'' as such is interesting. The use of public interest company status would bring with it all the tried and tested mechanisms of company organisation.
The hon. Member for Leigh (Andy Burnham) is present. In previous debates he has extolled the benefit of mutual status. He mentioned mutual organisations such as football clubs in which the supporters are the members; the Co-operative Society, which is well known to hon. Members opposite and even to Conservative Members, in a retail capacity; and the John Lewis Partnership. Such mutual organisations utilise company status and the normal arrangements of company law. That begs the question; why is it necessary to escape from the normal constraints and safeguards that have been established under company law in order to establish a different kind of corporate body?
Part of the answer to that question may have to do with the fact that the Bill deals with a body that does not bear direct comparison with those mutual organisations that have been prayed in aid by the Government as exemplars for NHS foundation trusts. The Bill deals with a body that is, at the same time, a mutual organisation for the consumers of a service and a mutual organisation for the producers of a service. That mixing of the two is unique.
The Government will wish to say that this is a unique organisation, but that uniqueness gives rise to many questions. Those who live in a locality that is close to a hospital, those who are patients and their families and those who work in hospitals will have differences of interest. Those differences cannot be waved away by the definition that ''public benefit'' somehow constitutes an overriding consideration to which everything else will be subordinated. That is not what happens. The purpose of making a constitution is not to deal with the happy circumstances in which
everybody agrees; its purpose is to deal with circumstances in which people do not agree and in which conflicting interests have to be reconciled. The establishment of a mutual organisation that consists of producers and consumers internalises the conflict. The constitution needs to be robust in order to deal with that. The constitution of companies is designed to be robust. Although it is not perfect and has its difficulties, it has been tested over time and is subject to constant amendment. The Trade and Industry Committee will shortly set out its ideas on the current review of company law.
In moving from the terminology of a public interest company, the Government have signalled their intention to establish a unique organisation. Before the Committee begins examining the detail of that, it might be helpful to understand why the Government have moved away from the idea of the public interest company. That move is not because a ''public interest company'' has a defined commercial meaning or because there is a requirement that a body be of a profit-distributing character. Companies limited by guarantee are perfectly capable of serving a public benefit. I worked for such a company in the voluntary sector. That company was similar to the organisation that we are to examine, in that it was a public benefit organisation, constituted from members who were drawn from across the country, each of whom subscribed £1. I find it difficult to understand why the Government have moved away from public interest companies. The purpose of the amendment is to try to find out the reasons why the Government have done that.