Clause 3 — Functions of the Centre

Part of Health (Wales) Bill – in the House of Commons at 3:13 pm on 9th January 2003.

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Photo of Don Touhig Don Touhig Parliamentary Under-Secretary, Welsh Office, The Parliamentary Under-Secretary of State for Wales 3:13 pm, 9th January 2003

I beg to move, That the Bill be now read the Third time.

The Bill has been considered in Standing Committee and on Report. It exemplifies the partnership that exists between the Labour Government and the Labour-led National Assembly for Wales and is a practical example of the benefits of devolution. Although Westminster and Cardiff have already achieved a great deal by working together, the Bill proves that that partnership has the potential to deliver much more for the people of Wales. The Bill helps to fill in the detail of the strategic framework established in the last Session by the NHS Reform and Health Care Professions Act 2002. It will deliver some of the key elements of the Assembly's 10-year plan to improve the health and well-being of the people of Wales. By bringing patients closer to the centre of the stage, the Bill will give them a stronger voice in the improvement, development and running of the health service in Wales. The newly reformed community health councils will be the main vehicle for giving patients a greater say.

The Bill retains and reforms CHCs in Wales and provides an independent NHS complaints and advocacy service, which will strengthen public and patient involvement in health service planning and delivery. It establishes the Wales centre for health to provide independent training, advice and research in health care, which will make an important contribution to arrangements for protecting and improving health. It also establishes Health Professions Wales to provide education and training of health care professionals. That will increase the equality, effectiveness and efficiency of the health care system.

The Bill is important not just for its content, but for the process by which it has come before us. It is the first all-Wales Bill to have been subject to the rigours of pre-legislative scrutiny. It is no exaggeration to say that it is regarded as the model for the way in which that should be carried out. As such, it comes to us not only improved in its contents by pre-legislative scrutiny, but as an ambassador for the process. It underlines how the House can change and reform its processes to improve legislation making. The Government are rightly proud of that innovation and gratified by the reaction to it. We consequently intend to make more use of that form of scrutiny. However, it is right to pay tribute to the four Opposition parties and their leaders in Wales and the House who welcomed and embraced the pre-legislative process. They helped to underpin its legitimacy. Rather than merely having a political party express its will, hopes and aspirations in Parliament, they expressed the will of the House in Parliament.

The Bill was first published in draft as the NHS (Wales) Bill in May last year. Some 87 organisations and individuals representing the profession and other bodies that would be affected by it were sent copies and explanatory notes on which they were invited to comment. Some 27 did so. To facilitate the widest possible public involvement, the draft Bill was also published on the Wales Office website. Some 15 people responded to that including, as I said on Second Reading, a Mr. Lei Leiu in China, who sent an e-mail offering to sell us an excellent forging hammer. It is clear that something was lost in translation. That aspect of scrutiny produced 25 recommendations for changes to the draft Bill.

The Welsh Affairs Committee considered the draft Bill in this House. I want to pay tribute to my hon. Friend Mr. Jones, who chairs that Committee, and Committee members for their work in scrutinising the Bill. The Committee also consulted stakeholders widely. Both the Assembly Health and Social Services Minister, Jane Hutt, and I gave evidence before the Committee, which produced a carefully considered report with 17 recommendations for change. The Welsh Grand Committee had a full day's debate on the report. The National Assembly for Wales also debated it in Cardiff in committee and in its plenary session. The Health and Social Services Minister and I also accepted an invitation to appear before an all-party group in the other place. The Assembly asked for a number of changes to the Bill to which we were able to accede in most cases.

Publication in draft has allowed for a lengthy, thorough and open consideration of the Bill and the policies that it contains. It says much for the effort put into the original draft, including discussion with stakeholders by the Assembly, that the draft Bill received warm and widespread welcome across Wales. Indeed, none of the pre-legislative scrutiny revealed any concerns with the principle of what was proposed. The pre-legislative scrutiny produced 45 recommendations for changes to the draft Bill. Some of those duplicated recommendations and some suggested extending the Bill to include, for example, a ban on smoking in public places, which, as I explained on Second Reading and in Committee would be outside the Bill's scope.

The Bill adopts the principles behind 16 of the recommended amendments. The revised Bill was considered by the Standing Committee and agreed without amendment. It remains unchanged. All amendments to the draft Bill could be categorised as minor or technical—even the change to the long and short title. It is worth reflecting on some of the more significant changes because they provide a context for the issues raised in Standing Committee. The Bill is essentially enabling by nature. It quite properly devolves responsibility for determining the detail of the function of the bodies established by the Bill—the reformed community health councils, the Wales centre for health and Health Professions Wales—to the Assembly. It would fly in the face of devolution to do otherwise.

Questions were raised during consultation about the extent to which this approach might be seen to constrain the freedom or independence of the bodies. The policy intention was that they should enjoy considerable autonomy. On reflection, we concluded that the Bill would be improved if we made that clearer, so we amended the draft Bill to give more powers to CHCs to require information, and to impose on them a clearer duty to report on their activities. We also restricted the Assembly's powers to direct the activities of the Wales centre for health and removed the Assembly's power to issue directions about the functions of Health Professions Wales.

When we came to Second Reading, several hon. Members dwelt on those issues. Mr. Evans asserted that the Assembly's powers over CHCs were too wide. My hon. Friend Mr. Jones called for greater independence for CHCs, and Chris Grayling extended that to call for more independence for CHCs, the Wales centre for health and Health Professions Wales.

In the Standing Committee, we were privileged to work under the guidance of my hon. Friend Mr. Griffiths. I am sure that hon. Members on both sides of the House want me to pay tribute to his wise and skilful chairmanship and to say that we will miss him when he stands down at the next election. We wish him well for the future. He made a major contribution to the Bill's passage through the Committee. Opposition Members tabled several amendments, and some, where the Bill's intentions may not have been clear enough, were of a probing nature. I hope that we satisfied all hon. Members on those matters. Other amendments continued the theme of the Second Reading debate and sought to strengthen the position of the CHCs, the Wales centre for health and Health Professions Wales.

The intention behind those amendments was summarised by the hon. Member for Epsom and Ewell at the Committee's third sitting, when he said:

XBroadly speaking, the Committee is agreed that the Bill is a decent set of steps, sensible, based on consultation and welcomed by health care professionals in Wales."

In fairness to him, I point out that he went on to say:

XIts main weakness is that in several different ways it hands excessive power to the politicians of the Assembly".—[Official Report, Standing Committee B, 12 December 2002; c. 89.]

I wholeheartedly concur with his first point, but I disagree with him totally on the second. Giving power to the Assembly within a carefully constructed legislative framework, and making those powers subject to the Assembly's arrangements for democratic determination, so that there can be detailed, open and transparent consultation, can hardly be deemed excessive when considered in the context of the devolution settlement.

The independence that Opposition Members seek to enshrine in the Bill is already assured. We took careful note of the views expressed by stakeholders during pre-legislative scrutiny. We amended the draft Bill in 16 areas to address the concerns expressed and, as I was able to remind the Standing Committee, amendments were made to provide greater autonomy and to clarify the independence of CHCs, the Wales centre for health and Health Professions Wales.

I was also able to assure the Standing Committee that the Assembly's freedom to impinge on the autonomy of those bodies was itself constrained by its own consultation arrangements, which I further explained in a subsequent letter sent to all members of the Committee.

This is a short Bill—short in content and short on controversy—but it is important. It breaks new ground in pre-legislative scrutiny and it is important for the future of health care in Wales. It is a key part of the reform agenda of the Government and the Assembly. It had a thorough airing before introduction. It reflected the views of stakeholders when introduced, and its intentions have been further clarified in Standing Committee and in the House today. I therefore have no hesitation in commending the Bill to the House and asking hon. Members to give it a Third Reading.