Sandra Gidley (Romsey, Liberal Democrat)

I beg to move, that the clause be read a Second time.

The Committee will be relieved to know that this will be a somewhat shorter explanation. Earlier in Committee, I raised concerns about the accessibility of the NHS constitution in formats for people with different disabilities, and was not entirely reassured that this was covered under the Disabilities Discrimination Act 2005. We have had that Act for some time, and the figures I produced previously showed that a lot of people—particularly partially sighted people—are not receiving information in a useable and useful form.

The Government have talked a great deal about the importance of information: we have the NHS Choices website and NHS Direct. They have been very committed to providing the public at large with information, and I welcome that. However, people working in government and in trusts have a duty to ensure that as many people as possible can access that. Therefore, this clause asks that trusts should publish, as part of their reporting on their disability equality duty obligations, details of the number of documents they have provided to disabled people in formats other than standard print. Again, it is all very well having the legislation, but if it does not require people actively to do something which can be monitored, it is very often forgotten or, worse still, ignored. With that, I withdraw my remarks to a close—sorry, draw my remarks to a close.

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

I was just trying to work out what withdrawing the remarks meant, and whether I was going to have an opportunity to stand up and support the spirit of the new clause. I would, however, have preferred subsection (2) to say “patients or members of the public with disabilities”.

Subsection (2) seems valid; subsection (3) is more bureaucratic, which I think the hon. Lady accepts, and I am not sure whether accountability could not be exercised in other, somewhat less bureaucratic, ways. Without costs being properly identified and attached to this, it would be difficult to gain the Opposition’s support, but at the same time I welcome the spirit in which it has been presented and moved.

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

The hon. Member for Romsey shares common ground with us in wanting to ensure that people who need access to this sort of information get access to it. The only difference between her view and mine is that I think that the legislation is covered, in the sense that provisions are in place to enable access to such facilities. We would do no good in putting on the statute book something that is already there, merely because the provisions have not yet had the impact that she and I want.

Repetition does nothing. We need to ensure that existing legislation is used effectively. Governments and the House can put on the statute book provisions enabling those with disabilities to get the access and information that they need, but those powers need to be used and enforced. Sometimes that requires individuals taking cases; more often, it requires authorities and organisations to comply better.

I have no problem sharing the hon. Lady’s ideas, but we already have the Disability Discrimination Act 2005, which came into force in December 2006 and is working its way into place. It placed a new statutory duty, the disability equality duty, on public bodies to promote  greater equality of opportunity for disabled people and required public bodies to make reasonable adjustments to meet the needs of people with disabilities. At the time, the Department of Health published “Creating a disability equality scheme: a practical guide for the NHS”, which included sections on monitoring within such a scheme. Further to that, in June 2009, the Government published the revised single equality scheme setting out how we intend to meet our duties under equality legislation, including the DDA. I will be happy to circulate those documents to the Committee so that members can be satisfied about the policy.

As for implementation, the Government are aware that the NHS can demonstrate examples of good practice, but we certainly acknowledge, as the hon. Lady observed, that there is still some way to go in order for equality to be mainstreamed and sustained. In other words, there is still a lot of work to be done. To address those practical issues, the Government put in place a number of initiatives, often working in partnership with the NHS and other key stakeholders. Of central importance will be the new equality and diversity council, which aims to improve the NHS’s equality performance for both patients and staff. Furthermore, as part of the pacesetters initiative, the Department of Health is working with six strategic health authorities and 34 trusts to trial different approaches to deep-seated inequalities, including those arising from disability. Evidenced good practice will then be disseminated widely in the NHS.

Last year, the Department, with support from the Equality and Human Rights Commission, trialled legal compliance workshops. A model workshop is now available for strategic health authorities to use, and NHS South West has already used the model to run its own regional event. As subsection (3) of the proposed new clause highlights, good equality data are needed so that the NHS can better draft and understand its equality schemes, plan, commission and monitor service delivery and plan and monitor work force developments. In November, a new equality monitoring guide covering all equality strands, including disability, will be issued. The guide will confirm the codes that the NHS should use when monitoring for equality and give good practice examples of equality data collection and use.

In other words, we have the law, and I do not think that we need to repeat it. What we need to do now is to find better ways of ensuring that it happens in practice for those affected and those with disabilities. That needs to be the objective.

Sandra Gidley (Romsey, Liberal Democrat)

The Minister is well intentioned, but alarm bells start ringing when I hear the words “we have good practice”. I contend that there is a best practice for almost everything in the NHS—world leading in many cases. Since joining the Select Committee on Health, I have travelled to various places only to find that there is something just as good or better on our doorstep. In the past the NHS has been spectacularly bad at spreading that best practice; I wish the Minister success in improving that. Were all trusts to adopt best practice in everything, we would have a health service that was second to none.

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

One of the key tools we have to spread best practice in the NHS are the quality accounts in this Bill. Ensuring that we spread information and  emphasise the quality of the different components of the NHS does not only mean raising everything to a minimum standard, which we still have to do, but also making sure that best practice is more effectively spread across the NHS.

Sandra Gidley (Romsey, Liberal Democrat)

My concern is that many of the bodies he has announced are fairly new. I welcome the fact that the Department is working with the SHAs and the trusts, but—again there is a health warning—they need to ensure that best practice is more widely implemented. It would only be fair to allow some of that a chance to bed in, to actually have an effect. I hope that, with the coming financial pressures, this is not one of those things that is quietly shunted to the sidelines. For many people, this is fundamental to the optimal use of the health service. I shall be watching closely, so I beg to ask leave to withdraw the clause.