Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)

I beg to move amendment 116, in clause 6, page 4, line 26, at end insert—

‘(1A) The Secretary of State must report every year on the delivery of the pledges in the NHS constitution.’.

Edward O'Hara (Knowsley South, Labour)

With this it will be convenient to discuss the following: amendment 117, in clause 6, page 4, line 27, after ‘report’, insert ‘(a) under subsection (1)’.

Amendment 14 , in clause 6, page 4, line 27, leave out ‘5 July 2012’ and insert ‘31 March 2010’.

Amendment 118, in clause 6, page 4, line 27, at end insert—

‘(b) under subsection (1A) must be published not later than 31 January 2010.’.

Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)

The clause states:

“The Secretary of State must publish a report every 3 years on how the NHS Constitution has affected patients, staff, carers and members of the public, since the last report was produced under this subsection.”

Were the amendments to be made, the clause would require the Secretary of State to report every year on the delivery of the pledges in the NHS constitution, and that the first report must be published not later than 31 March 2010, or, under proposed subsection (1A), not later than 31 January 2010. The amendments are designed to strengthen the review of the NHS constitution.

Amendment 116 takes issue with the concept of a pledge in the constitution, which is rather weakly indicated by the word “pledge” in brackets. How effective would the US constitution be if it stated, “We the people establish this constitution for the United States of America (pledge)?” Surely a constitution is something one either does or does not do. What place do pledges have? I hope that the Minister will be able to give us the benefit of the thinking that lies behind that, because “pledge” in this context is a relatively weak word, although in other contexts it is not.

It seems fitting that the Secretary of State should have to report every year on the delivery of the pledges, which would be achieved by amendments 117 and 118, which propose that the date for the first report should by 31 January, one year after the constitution was signed with great flourish in Downing street by the Prime Minister before it appeared in the Bill, and indeed before consideration by either House of Parliament.

Amendment 14 seeks to have the first review undertaken and published on or before 31 March 2010 rather than 5 July 2012. Clearly, that is designed to make real what is contained in the Bill and to ensure that there is public accountability in advance of the general election. That date has been chosen to ensure that the matter is not shuffled off until after a general election and that the accountability that is envisaged under the Bill is produced in time for the public to have their say in the general election, which we all know must be no later than June 2010.

Sandra Gidley (Romsey, Liberal Democrat)

I have no problem in principle with amendments 116 and 117, but I was curious about amendments 14 and 118. I am glad that the hon. Member for Eddisbury has explained that the intention is for this to take place ahead of a general election. I think that is the wrong approach to take because, yet  again, it makes the NHS a political football at a time when Conservative Members keep telling us the NHS is too politicised. There seems to be some contrary thinking on those Benches.

My major objection to the proposed date is that it is far too early to have a realistic review. I would support a little bit of electioneering if I felt that it was fair to the NHS staff, but it takes a little while for something to bed in, so any date that is within a year of the enactment of the Bill is too early and any information gleaned would be of limited value. There will be far more important debates to be had at the general election than the NHS constitution.

Mike O'Brien (Minister of State (Health Services), Department of Health; North Warwickshire, Labour)

To some extent the point has already been made by the hon. Member for Romsey, but the situation is even worse than she has suggested. The duty in the Bill with regard to the constitution is not expected to come into force until January 2010, subject to its progress through the House, so the Conservatives appear to be proposing that the NHS should undertake a new layer of bureaucracy so that, a mere two months after the duty on the organisation comes into force, it has to review and publish an examination of its effect. They are not even allowing time for the constitution to be read and digested by those who work for the NHS, never mind having to perform the significant administrative task of reporting back.

We do not want to place an excessive administrative and regulatory burden on the NHS, as the Conservative proposal would do. Reporting once every three years will maintain momentum while still allowing time for the constitution to embed and to gather some meaningful evidence. The amendment is mere political opportunism by the Conservatives, who think they will perhaps get something out of it when, in fact, they would be imposing an administrative burden on the NHS.

As for amendments 116 and 118, there is no need to create a separate reporting process for the pledges. That would again create an unnecessary bureaucratic burden on the NHS. Three-yearly reports will cover the pledges as well as every other part of the constitution. We must not forget that the pledges represent existing departmental policy. Many of them therefore have their own reporting requirements, such as waiting times and cleanliness pledges. We know what they are. Why impose an extra bureaucratic burden? If the Conservative Front Benchers want to talk about regulation, let them look at the mote in their own eye; they are creating more administrative regulation than the NHS can stand. Let us deal with these issues in a much more sensible way and not try to use them for mere political opportunism.

Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)

If the Minister is asking me to remove the mote from my eye, I hope that he will remove the three oak facsimile beams from his own eye. I dare say he knows precisely where that comment comes from—it is from the great big book.

I listened with care to what the Minister said, which was an interesting exposition of what I wanted to establish, which was the nature and quality of the pledge that lies behind the measure. Although it is important to recognise that, to a degree, we need to be conscious that, whatever we do and however much we may wish to remove so much of the discussion about  the NHS from the political fray, as the hon. Member for Romsey said, there is of course the reality of electoral time scales, over which most of us have very little control. I simply wanted to establish the quality of the pledge that is in place, to ensure that the measure is outward-facing rather than self-serving, either within Government or within the Department, and to ensure that there is a degree of accountability that would refract back on to the people who sent us here.

Sandra Gidley (Romsey, Liberal Democrat)

I would have some sympathy with the hon. Gentleman’s arguments if an election was a year hence and an amendment was tabled to bring a report after a year, which is not an unreasonable length of time to have an early review. However, I am sure that he must accept that a period of two months—I had not realised that it was quite so short a time—is unhelpful and would provide little meaningful information.

Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)

The point that I was about to conclude on is this. Having had this discussion, it is clear that there are some grave difficulties about the timetable, simply because we are bumping up against the final moment at which the Prime Minister has to make up his mind about when he is prepared to call upon the country to endorse his position or not endorse it. It strikes me that it would be inappropriate to press the matter to a Division, because I think that it has been a useful discussion, so I beg to ask leave to withdraw the amendment.