Clause 15
Health Bill [Lords]
12:15 pm
Mike O'Brien (Minister of State (Health Services), Department of Health; North Warwickshire, Labour)
By using the word “necessary” as well as “appropriate”, as the amendment proposes, a higher standard would be imposed on the Secretary of State when appointing a trust special administrator. I agree with the hon. Lady that that would restrict the ability of the Secretary of State to deal with problems that could arise. These problems could relate to finances, but they could be much broader than that, as we have seen in recent cases. Perhaps this is not the place to discuss those, but I think that we are all aware that there needs to be an appropriate ability to deal with problems that arise in not only finance, but the provision of health care.
If we inserted the word “necessary” and it were argued that other options should be canvassed, the Secretary of State would not be able to take the appropriate action that was needed. The appointment of a special administrator could not be said to be necessary if there was any other option. This would apply even if appointing a trust special administrator might be the best outcome. We do not want to be prevented from using a regime when it is most needed and could be the best possible outcome. For that reason, I cannot accept the amendment.
We envisage that the Secretary of State would use the power rarely. Interventions will be made through the new NHS performance framework or Monitor’s compliance framework. In the very rare cases when these interventions are unsuccessful, or the strategic health authority is not able to get plans agreed on how to address the situation, it would be appropriate to appoint a trust special administrator. The trust special administrator would need to be an individual or a body with the skills and knowledge to work collaboratively with staff, patients and local and national bodies. They would require significant experience of the NHS and would not be in any way described as not appropriate to carry out the role assigned to them.
A degree of flexibility would be necessary when establishing exactly who a special administrator would be. It would depend on whether the key issue was primarily finance, in which case a special administrator would need to have considerable experience in that area, or the management of health care, in which case the expertise would need to be in management. Those are primarily the key issues. However, the requirement that the special administrator should have a clear understanding of the way that the NHS works is enormously important.