Clause 178 - Healthwatch England

Part of Health and Social Care (Re-Committed) Bill – in a Public Bill Committee at 2:15 pm on 14 July 2011.

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Photo of Tom Blenkinsop Tom Blenkinsop Labour, Middlesbrough South and East Cleveland 2:15, 14 July 2011

Fundamentally, HealthWatch England is a good idea and welcome, because it will provide patients with a greater opportunity for engagement. The real issue is that to be truly effective HealthWatch England must be an entirely independent advisory body, but in its current conceptual form, it is not quite there yet. The Government have missed an opportunity to act upon their own listening exercise and the Future Forum recommendations.

Nothing is more evident of that than the fact that HealthWatch England will still sit entirely within the CQC. In the Government’s new architecture for the NHS, there will be three big players: the NHS commissioning board, run by Sir David Nicholson; the CQC, which will ensure that basic standards of care are met, run by Cynthia Bower; and Monitor, which will promote competition as a means of improving quality, as the Government claim, run by David Bennett—for now, apparently. However, there will be a fourth crucial  arm, which is a much stronger voice for patients and the public. I do not agree with the Government’s approach. I firmly believe that, if patients and the public are to have a far greater say, the body to achieve that should be more important than the other three bodies. HealthWatch England should be independent.

HealthWatch England will lack independence because it will sit within the CQC, which creates two problems. It will have to work closely with the CQC, as it will with the other bodies, including the NHS commissioning board, so that it can ensure that information is passed up through the CQC to allow it to conduct inspections and investigations. However, what if HealthWatch England thought that the CQC had failed to do its job or work as effectively as it should?

The other problem is resources. By the end of 2012, the CQC has to register 30,000 new providers, including 9,000 providers of primary medical services, which have never before been registered, and 12,500 new providers of social care. In addition to those providers, the CQC also has to inspect and register individual sites, which, as the hon. Member for Stourbridge mentioned, is a huge task. The Ministers know about those concerns, which are being looked into, but the CQC’s resources are, like those of other arm’s-length bodies, being reduced, despite its huge tasks, and there is a real concern that HealthWatch England might not receive sufficient resources. My colleagues and I will be grateful if the Minister guarantees a ring-fenced budget.

How can HealthWatch act as the Minister envisages when it is situated within the CQC? How can it function independently when it will effectively be line managed by the CQC and, simultaneously, its chair will be line managed by the Secretary of State? The chair of HealthWatch England might have been appointed by the Appointments Commission, as mentioned in the original Committee by my hon. Friend the Member for Leicester West, but that is no longer possible because the Government have abolished the Appointments Commission, too. I cannot see how HealthWatch can behave freely, independently or robustly enough to hold its line manger, the CQC, to account. Is not the real danger that HealthWatch will be created with all the negative aspects of a quango, but without any of the benefits of being an independent body?

The Government had not acted to fulfil their promises to the Future Forum until Monday, when, fortunately, a few new amendments were tabled. Having looked at the their promises to the Future Forum, we expected the Government to introduce an explicit requirement that local healthwatch memberships be representative of different users, including carers. Fortunately that has now been done. The Government also agreed to introduce a new duty on health and well-being boards to involve users and the public, but, until Monday, that had not been done. My colleagues and I are predisposed, both politically and on an everyday level, to optimism, so I endeavour to be as positive as humanly possible about the Government’s amendments. Amendment 200—