Health and Social Care (Community Health and Standards) Bill

Part of the debate – in the House of Lords at 6:15 pm on 13 October 2003.

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Photo of Lord Clement-Jones Lord Clement-Jones Liberal Democrat 6:15, 13 October 2003

In moving Amendment No. 129 I shall also speak to Amendments Nos. 139 to 142 and 200. Clearly, as Committee Members will see from the Marshalled List, we on these Benches feel so strongly about consultation that we have tabled one amendment twice, just to confuse the department in replying.

The new clause set out in Amendments Nos. 129 and 200 would require the Secretary of State to regulate for public consultation on applications for foundation trust status. Many of us have now seen quite a bit of material emanating from foundation trusts. I have personally seen material from two of my local hospitals and other material from Moorfields Eye Hospital, all of which differs considerably between hospitals and is probably constructed in different ways. I have also read the guidance on foundation trusts that is available, which is, in a sense, a precursor of the regulations due to be made under the Bill.

A quiet aside to this debate is that the Government seem to jump the gun on these matters. We are debating a very important aspect of the Bill, yet all the time the steamroller moves forward. Only recently, the noble Lord, Lord Warner, announced a large number of additional trusts to the ones already earmarked that had made their applications. The juggernaut rolls on despite the fact that the Government do not know at this point whether the legislation will actually pass.

Be that as it may, the intention of the amendments is to set out the process of consultation in a much clearer fashion than would otherwise be available by regulation. I recognise the intention is to have provisions by regulation, but as the Bill goes through the House, there is no guarantee that the draft regulations will be available to us. All that we have is the guidance made available to those current applicants for foundation trust status.

The new clause would require the Secretary of State to require public consultation on applications for foundation trust status. Both the NHS trusts and non-NHS bodies applying—this is one of the most important points in this set of amendments—must consult relevant patients forums. In the case of NHS trusts, any relevant local authority overview and scrutiny committee must also be consulted. That is because existing legislation only requires consultation with such committees by local NHS bodies. The amendment would also ensure that the overview and scrutiny committee's right of referral to the Secretary of State will apply if it is unhappy with the merits of the NHS trust proposal. That would ensure that local people would have a say through the local democratic process in whether or not an NHS trust in their area applies for foundation trust status.

In the case of non-NHS applicants, overview and scrutiny committees do not have rights of referral as these apply only in respect of local NHS consultations. As under Clause 5, as we discussed earlier, any body can apply to be a foundation trust, even if not an NHS organisation. The amendment would also require the Secretary of State to require consultation by such organisations with all local patients forums. As patients forums—and indeed CHCs, if the Bill goes through and they still exist—have broader referral powers than overview and scrutiny committees, which may not exist in every area, that would ensure that there is a local mechanism to refer to the Secretary of State an unwelcome application for foundation trust status from a non-NHS organisation.

The amendments integrate, therefore, the foundation trust application process with the new system of patient and public involvement that this Government have been at such pains to introduce—the word pain is what springs most to my mind when I think about the long and convoluted way in which the patient and public involvement system that we now have was introduced.

On Amendments Nos. 139 to 142, the first amendments of the group require the regulator to take account of the outcome of any public consultation in giving an authorisation to foundation trust status. The second amendment suspends the application process if an overview and scrutiny committee for a patient's forum exercises referral rights under new Clause 5. Until the Secretary of State has responded to any referral under the new clause and confirmed his continued support for the application, the regulator may not proceed.

We believe passionately that devolved structures such as the foundation trusts must have the wholehearted support of the local community. That is exactly what the amendments are designed to achieve. I beg to move.