Schedule 1
Health Bill [Lords]
11:15 am

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

I beg to move amendment 140, in schedule 1, page 38, line 32, at end insert—

‘(za) regulations under section 12B’.

Amendment 140 would bring all regulations in new section 12B under the affirmative resolution process. These are the regulations we discussed at length concerning the nature of the direct payment pilots. Unless this amendment is made, neither this House nor the upper House will have the chance to debate the substance of the pilots. It is unlikely that we would want to vote down the regulations supporting the pilots by praying against them. It is likely that we would want to see them amended, depending on how the Government act in the debates we are about to have.

On Tuesday the Minister suggested I was presumptuous in moving an amendment directly referring to the NHS board, something the country is crying out for. Here I offer him the chance to make the life of Health Ministers in the next administration, whoever they may be, more difficult in the interests of Parliamentary scrutiny. I will not repeat the debate we had about new section 12B, but I think there are significant concerns about these issues and we should consider asserting an affirmative power regarding them.

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

We do need to develop regulations to set up the pilots. It is likely that these would have to be amended in light of the review of the pilots if a decision is made to roll out direct payments nationally. We would expect to hold a public consultation on draft regulations for the normal 12-week period. It is our intention to control direct payments with the regulation-making power and that these should be subject to the negative resolution process. I reassure the Committee that it is our intention to use the affirmative resolution procedure for any order either extending direct payments nationally or abolishing the power to grant them. The big issue would come back to the House through the affirmative resolution procedure. If any decision is made to abolish direct payments or to extend them nationally, that would be via the affirmative resolution. As that would be a significant decision for the NHS, we think it is vital that before an order is made it should be approved after a proper discussion in both Houses. We think that many of the rules would be very detailed and although we want to give discretion in the way direct payments  are piloted, we do not want to have a level of unnecessary pedantry involved in looking at the detail of what could be mundane rules. Applying the affirmative resolution procedure to all of that would be quite likely to clog up this place for a significant period of time.

With the assurance that any large-scale decision about national roll-out or not proceeding with direct payments would come back under the affirmative resolution procedure, but the detailed regulations would be subjected to a negative resolution procedure after a 12-week consultation with the relevant stakeholders, I hope the hon. Gentleman feels that amendment 140 can be withdrawn.

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

I have listened to the Minister and it was semi-reassuring. However, there is an issue of principle here about making sure that Parliament has the opportunity to look at these regulations, particularly as we will want the opportunity, not just in terms of regulations, but to hold the Government’s feet to the fire in converting pilots into action. This is an opportunity to state our earnest on this and therefore I would like to press the matter to a vote.

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

After the excitement of that vote, I would like to make the point that, in looking at the 20 May memorandum from the Department of Health on health budget pilot programmes and provisional pilot sites, I am pleased to see that the first one on the alphabetical list is the Secretary of State’s constituency. That will be piloting NHS continuing health care on life care, learning disabilities, mental health and physical disabilities. That will be helpful to give him an insight. I am also pleased to see that Western Cheshire, which covers part of my Eddisbury constituency, is also looking at continuing health care on motor neurone disease, multiple sclerosis, neuro-degenerative conditions and Parkinson’s disease as well as end-of-life care. I shall do my best to follow that closely.

I urge the Minister to see whether he can get something in North Warwickshire included, because the more of an insight we have from our own constituents’ point of view on the way this is working, the more helpful it will be as we try to move pilots into a roll-out.

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

I am not sure whether I should deliberately seek to land these in my constituency, but I will certainly bear in mind the urgings of the hon. Gentleman. It is important that we look at the way in which these pilots proceed and that we make sure that if we are to have a national roll-out it is in the interests of patients everywhere.