Schedule 1 - Constitution of public benefit corporations
Health and Social Care (Community Health and Standards) Bill
2:45 pm
Mr Simon Burns (West Chelmsford, Conservative)
I am grateful to my hon. Friend for raising that matter, but I take on board your valid point, Mr. Atkinson.
The proposals are both vague and confusing. The explanatory notes deal with that at paragraph 48 on page 8. On paragraph 3 of schedule 1, which amendment No. 125 would change, the notes state that
''each public benefit corporation is given the power to specify membership criteria in its constitution. The members must include individuals drawn from the public—the public constituency''.
However, it is up to the benefit corporation to specify the membership criteria in its constitution. I find that slightly worrying because one will probably end up with different corporations specifying different criteria. I hope that Ministers agree that that would
not be satisfactory, because it will cause confusion and anger among those who might be excluded in one area but who would be included in another. We must have consistency throughout the country in order to avoid that sort of problem.
Members do not have different specifications as to who may or may not vote for us in our constituencies. It is an across-the-board national specification that an individual has the right to vote in an election provided he or she meets specific criteria laid down by law. We cannot pick and choose the groups or types of people who can vote. It would be unhealthy and unfortunate if that were to be the case under this arrangement.
Amendment No. 125 proposes a way of tightening up the system in order to give it greater clarity. That would deal not with the employees in the corporation but with the users and the population in the corporation area. I suspect that the Under-Secretary may come up with reasons as to why that would be too restrictive or why it would bring disadvantages that are not obvious to me at the moment. She will undoubtedly enlighten me in due course.
Even if that were to be the Under-Secretary's response, I hope that she would concede the reasoning and the motives behind the amendment, which are to try to achieve greater clarity and consistency. If she feels that that should not be achieved based on the geographical areas of a primary care trust, perhaps it should be achieved using other criteria that are an improvement on the vague position currently on offer.
As my right hon. Friend the Member for North-West Hampshire said, the Health Committee, which produced its report on foundation hospitals last Wednesday before Second Reading, had many reservations about the vagueness of the proposals. I hope that the Minister would consider it an advantage—she may not—that she has no less than three members of the Health Committee serving on this Committee to help her with her deliberations; the hon. Members for Leigh (Andy Burnham), for Lewisham, West (Jim Dowd) and myself.
I urge her to re-read the record of the Health Committee meetings because the Committee made some valid points on this problem. I will not repeat what my right hon. Friend said. However, the Committee is a Select Committee with a Labour majority and is not there to play games and cause trouble. [Interruption.] I note the Under-Secretary's facial expression and the one or two guffaws from Members.
The Health Committee is there to help the Government to improve on these proposals. The Under-Secretary will see in paragraphs 31 to 42 not only the criticisms and the points highlighted by my right hon. Friend, but points made by other people who agree with the concept of democratic accountability and the need to include as many relevant people as possible, but feel that by being so unspecific and giving too many powers to the corporations, the proposals will fall between two stools. In certain areas they will fail to achieve what the Government want and, thus, an inconsistent
system could be allowed to develop. That will cause grievances and create confusion and anger for individuals who may not be included in a constituency in a certain part of the country but who would be included otherwise.
Amendment No. 144 seeks to deal with line 17 of schedule 1, because the Government's proposals are vague. I see what they mean, but in order that legislation is good, it is not enough to simply see what the Government mean. Legislation must be absolutely spot-on, with watertight drafting; or, once it is too late and it becomes law, there is the propensity for problems, confusion and misinterpretation.
Paragraph 3(2) to the schedule states:
''The constitution may also provide for the public constituency to comprise individuals who have attended any of the corporation's hospitals as patients''.
However, as we know from the explanatory notes and the guide published in December, that provision is restricted to patients in the past three years. Can the Minister clarify whether ''the past three years'' start when the patient first goes to see a consultant to be considered for treatment or when the patient has completed his or her full course of treatment?
Paragraph 3(2) continues:
''(including individuals attending as the carer of a patient).''
That is an eminently reasonable inclusion in the Bill. I am relieved that the Government have decided not only to do that, but to include it in the Bill, so that everyone knows that that is their intention. However, the drafting is not precise enough for us to know exactly what the Minister means by the word ''carer''. Is it a good neighbour who pops in to see someone who is ill, makes him or her a cup of tea and does some shopping or cleans the house on a purely voluntary, good-neighbourly basis? Is it someone who is a fully paid, full-time carer for an individual? Is it a family member who cares for his or her partner, mother, father or child? Does it apply to people who look after children? Does it mean that those who classify themselves as carers—even if others consider them to be merely good neighbours—would qualify? If there is a dispute over whether a corporation believes that someone is a carer, as specified in paragraph 3(2), is there some form of appeal to resolve who is right and who is wrong?
To minimise the potential for disputes and disagreements, we are seeking, through amendment No. 144, to include a definition of ''carers'' in the Bill. It is a difficult and, some people might argue, unwise thing to do, because different people have different views of the role of a carer.
We have tried to get a definition that is acceptable to as many people as possible and we have that definition from Carers UK. That, I believe, is one of the best ways of trying to find a legal definition of a carer, if one is needed, to incorporate into legislation. Is it really our intention that those people should have the opportunity to become part of the public constituency? Would not that be the effect of the amendment?