Health and Social Care Bill

Part of the debate – in the House of Lords at 6:45 pm on 19 March 2001.

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Photo of Lord Hunt of Kings Heath Lord Hunt of Kings Heath Parliamentary Under-Secretary, Department of Health, Parliamentary Under-Secretary (Department of Health) 6:45, 19 March 2001

I am grateful to both my noble friends and the noble Lord, Lord Clement-Jones, for raising an interesting question. I recognise the role of the GLA and the regional assemblies and chambers and I am encouraged by their interest in healthcare issues in the wider sense. I am responsible for the eastern and north-western regions of the health service and I encourage both chairs to become involved in the regional chambers. It is very important that regional chambers understand, for example, the effect of the NHS on the regional economy which can be quite profound. I begin by being positive about constructive relationships at that level.

There are two issues in the context of the Bill. Clearly, we are endeavouring to promote scrutiny at local level, because in the end it is the connection between the health service and local services which has more impact on the quality of the services to the patient and the public. That is why in terms of scrutiny of the NHS we have made local social services the lead authority. I believe that the case for that is as strong in relation to whatever be the regional structure as in relation to the issue raised earlier by the noble Lord, Lord Clement-Jones, who referred to district councils. We need clarity.

I am convinced that the principal local authority which accepts the role of scrutiny should be the local social services authority, but I accept that there are circumstances in which scrutiny on a regional basis is appropriate. The powers in Clause 8 of the Bill enable that to happen through a joint committee of the OSC with NHS scrutiny right across the region. I believe that that approach provides a practical basis for working with the GLA without taking any further powers. I am wary of further powers which in the end make unclear who is responsible for scrutiny of the NHS. I believe that to provide powers to the GLA or regional assemblies on the face of the Bill could lead to confusion of scrutiny responsibilities unless there is clarity as to which authority is absolutely responsible. The Bill already provides for joint committees and will enable a pan-London committee to be established with co-opted GLA members.

I accept the point made by my noble friend Lord Harris that we want to avoid the need for the chief executive of the London Ambulance Service Trust to make 66 visits. We want a sensible arrangement and we believe that the Bill allows for that. I point out to my noble friend that officials of the department are working with the GLA to develop a protocol about the involvement of the GLA in the development of London-wide health strategies. I should be very happy to meet my noble friend to discuss that further.

It is very difficult to accept Amendments Nos. 141 to 143 because it is our policy that CHCs should be abolished. On that basis, those amendments fall.