Clause 3
Health Bill [Lords]
5:15 pm
Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)
I beg to move amendment 12, in clause 3, page 3, line 14, after ‘(5)’, insert—
‘(fa) Local Involvement Networks.’.
This causes some grave concern and it may take us a tiny bit longer than the previous couple of amendments. The amendment seeks to add to the list of bodies that must be consulted about the NHS constitution on a 10-year review. Amendment 167 tabled a few days later by the Liberal Democrats does exactly the same thing in exactly the same way. They have added their names to this and will not be moving their separate amendment. I thank them for their support. I find it sad that the Government have consistently sought to undermine the patient voice. It has been a 10-year journey almost to the day for me as part of my experience of the House.
The Government decided to get rid of community health councils. That was announced just a day before we rose for the summer recess in 2000, when they published the NHS plan. Hidden away in the middle of the document was a phrase stating that after consultation, the Government were going to axe the CHCs for not being effective as advocates of the patient voice and for a number of other reasons. They were pretty strident criticisms of the CHCs. I think I am right in recalling that there were 107 of them, of which 4 had been criticised, and well over 100 were regarded as being extremely important to the local communities.
It was something of an outrage, because during Prime Minister’s Question Time, I challenged the then Prime Minister Tony Blair on the matter. He said that the Government were certainly getting rid of them, but of course, only as a result of a widespread consultation. It was perfectly clear that they needed to be got rid of, and that was what was supported. Within minutes, I received a handwritten, three-page, “Dear Stephen. Love, Tony” letter, which was basically a grovelling apology written quickly by someone called Alastair Campbell, saying that the House had been completely misled House: there had been no consultation whatsoever, and it was a complete misrepresentation in the NHS plan document.
We managed to get a stay of execution for a year. But as a result of that, we discovered that the true motive that lay behind that was a real concern on the part of the Government that if there was any ability to have credible criticism of the NHS, it would be regarded as a personal slight to the Labour party. Therefore, the Government replaced CHCs with patient and public involvement forums. Then they found those to be too outspoken as well, particularly through the Commission for Patient and Public Involvement in Health, or CPPIH, commonly known as “chippy”—that seemed to be the way the Government saw them. So the Government abolished those as well, and replaced them with local involvement networks. We had quite a run-out on that during the course of the Health and Social Care Bill just over a year ago. The contempt in which the Government hold the patient voice was shown in tagging the issue of local involvement networks on to another portmanteau Bill—the one about local government.
The reason it is so important—why I am making something of an issue of it—is because lately, the tragedy of Mid Staffordshire hospital has been in part attributed to the cull of LINks, and the lack of a strong local patient voice in holding trusts, NHS executives and ultimately Ministers to account. It is right that the LINks should be able to comment on the constitution. They provide the most independent and local voice on how Government policy is operating on the ground.
Interestingly, part of the Government’s problem with CHCs was that they were genuinely independent. The trouble with all the successor bodies—we have had many relevant debates in the House on a number of Bills—is that the Government have brought them into the ambit of the NHS, to cease to allow them to be independent. We cannot say that that is an unintended consequence, because the debate has been held over and over again. The trust and confidence of people, particularly those who need their hand held—often at their most vulnerable time—to chart their way through the labyrinthine processes of the NHS, is because they trust something that is independent from it, not something that is from within it. That is the key to this—to try to find the new way forward with something that is independent.