Schedule 1 - Constitution of public benefit corporations
Health and Social Care (Community Health and Standards) Bill
Mr Stephen McCabe (Birmingham, Hall Green, Labour)
I, too, take the opportunity to welcome you to the Chair, Mr. Atkinson.
I have talked to a lot of people about how we should define ''public constituency'', and I have a great deal of sympathy with the amendment tabled by the right hon. Member for North-West Hampshire. The Government's intentions may be good. I have no problem with the idea of decentralising hospitals and with giving them greater scope to innovate, to expand their capacity and to improve the care and treatment of patients; I am all for that. However, I wonder exactly how we can ensure that such public constituencies are genuinely representative.
The right hon. Gentleman alluded to the problems that might arise if particular groups were to attempt to pack the membership. He cited the example of people with radical health perspectives, but that could apply also to religious sects. Indeed, in one of the weekend newspapers, I read how the Socialist Workers party has been able to block reforms in some secondary schools by manipulating the views of certain teachers. I dare say that if Lady Olga Maitland, the erstwhile colleague of Opposition Members, were still alive and kicking, she would be happy to resurrect a militant Mothers Union in pursuit of something similar. [Interruption.] I always remember her being fairly robust.
We need to be clear that the public constituency will be fair in representing people, and that it will not be possible for groups to combine with the deliberate aim of subverting the health service's values and intentions. I hope that the Minister will be able to offer some reassurance, but nothing in the Bill suggests that it will.
The hon. Member for Westbury (Dr. Murrison) was right about the centre for defence medicine. The university trust's initial submission points out that the RCDM air commodore is currently part of the management executive of the trust. It would be a peculiar state of affairs if a military man were to be part of the existing management executive, but that the military had no significant status in the sort of public constituency defined in the Bill. We should be given an answer to that question.
Two other amendments struck me as interesting. Amendment No. 118 seeks to extend the provision to family members. That, too, seems appropriate, but we could end up with the bizarre situation in which the family member who regularly travelled from another part of the country to provide care and attention would be part of the public constituency but, were the amendment to be accepted, someone living a few miles down the road could be excluded. It is important that we cater for family members and those who provide direct care, but the amendment throws up the fact that we need greater clarity on how to define the public constituency and how to ensure that those involved have a say.
I am intrigued by amendment No. 119, which suggests that staff members would need to live in the area. I can see that that might be suggested if we were using a definition used elsewhere—the requirement to reside in a specified area—but it seems absurd to say that the staff should have a stake and an interest in the hospital, and therefore a right to participate, but only those who live within a defined area. That suggests that we do not have clarity on what constitutes a public constituency.