Clause 19
Health Bill [Lords]
12:30 pm

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

I beg to move amendment 21, in clause 19, page 23, line 15, at end insert—

‘(1) The Secretary of State may issue guidance on the suspension of NHS and other health appointments. These may include—

(a) details of appeals processes for suspended appointees; and

(b) details of parliamentary accountability.’.

Let me rein in the horse a little. We turn to suspension, but not the suspension of one’s breath. The clause gives effect to schedule 3, which amends various enactments to provide for the suspension of non-executive board members. To make it absolutely clear what we are discussing, the Government already have the power to suspend NHS trust and PCT non-executives. The clause will extend the power to strategic health authority non-executives and those of other NHS bodies. Paragraph 1 of the evidence base mentions social care, and I hope that the Minister can tell me to which non-executive position that applies.

It seems right that the power to suspend should be available as a halfway house between keeping someone in post and firing them too hastily. Equally, it must not be abused as a way of threatening a good person whom the Department does not like or preserving unduly someone who ought to be sacked. Given the almost pre-Runnymede powers the Bill looks to bestow on the Secretary of State, amendment 19 would hold the right hon. Gentleman more accountable for such decisions than the current legislation allows.

The first safeguard is that the suspended person be given details of appeal, while the second safeguard would be that the Government bring some parliamentary scrutiny into the process. Obviously, I worry about their motives in that particular regard. As the explanatory notes make clear, such action arises from events at the Maidstone and Tunbridge Wells NHS Trust. In its summary, the regulatory impact assessment said that the first key non-monetised benefit is maintaining public confidence. The table at paragraph 12 states that the public perception that nothing was being done could be damaging to the organisation and that the first considered monetised cost is public perception—somewhat tellingly, media handling. I put it to the Committee that the Government are not legislating to save the blushes of hospitals, but to help manage the process of public perception and image for themselves.

As the explanatory notes state at paragraph 35, the power to suspend will rightly be devolved to the Appointments Commission. Will the Minister clarify how the suspension process will, as a matter of practice, work? Will suspension be on full pay? We must remember that the Appointments Commission does not yet seem to have succeeded in getting appointments without political bias. Last year, 8 per cent. of applicants were affiliated to the Labour party, as were 10 per cent. of appointees, whereas 4 per cent. of applicants affiliated to the Conservative party resulted in only 2 per cent. of appointments. We had the whole rather damning issue about the resignation of the former Minister of Health from her post at the Department of Health over the appointment of Sir David Henshaw. It would be somewhat  pejorative of me to read into the record the full quote of what she said, as I dare say all members of the Committee remember it well.

According to the submission to the Delegated Powers and Regulatory Reform Committee, the powers fulfil—although that might be too strong a word—a commitment in developing the NHS performance regime. The document was a result of something of a struggle between David Nicholson and Anna Walker. Baroness Young has now taken on the responsibility as chairman of the Care Quality Commission, whether it is the Department or, as it should be, the independent regulator who has the responsibility for performance management. I hope that the Minister will explain what role the CQC will have in the suspension process.

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

As for suspension, we would have to be in a position when there was an issue of considerable importance. The Secretary of State would then delegate his powers of public appointment to the Appointments Commission, an independent organisation accountable to the Secretary of State. To ensure that the relevant bodies are ready for implementation of the powers, the Appointments Commission’s draft guidance was included in the consultation exercise when introducing new powers of suspension, which ran from July to October last year. An updated version was published with the Government’s response in January this year.

The guidance set out how the Appointments Commission will manage resignations, termination of appointments and suspensions of non-executives lawfully and in the best interests of the public, and respecting the rights of the office holders. I was asked whether suspension would be on full remuneration, and the answer is yes. I was also asked about the process for suspending senior appointments. The Secretary of State will delegate his power to the Appointments Commission. Cases would usually be referred to the commission by the person to whom the appointee is accountable for their duty in bringing evidence to its attention. In the referrer’s opinion when it does not lead to the suspension of the appointee from office, the commission’s role will be to work with the referrer as necessary to establish whether there is a case for suspension. In the case of a vice-chair or other member, the referrer would usually be the chair of the organisation. In the case of the chairperson, the commission would have to take a view. We would expect any body with which the commission is not involved to follow good practice.

Essentially, the process of dealing with such suspensions has been published. We want to ensure that the Appointments Commission is operating within the procedures it has set down publicly. When difficulty arises, a key requirement is that public confidence in the NHS must be maintained. That confidence must always remain one of the key priorities for those who run the NHS in ensuring that such issues are dealt with. In the end, it is the taxpayer who funds the NHS and to whom the NHS is ultimately responsible as taxpayers and patients.

The CQC’s role will depend on whether there is a need for a quality examination of the way in which the organisation involved operates. If the issue is financial, the CQC’s involvement will be limited. If it relates to patient care, as in a recent case, the role of the CQC or its equivalent will be important.

I will write to the hon. Gentleman about which organisations relate to social care.

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

I am grateful for those reassurances and I beg to ask leave to withdraw the amendment.