Committee (7th Day)

Part of Health and Social Care Bill – in the House of Lords at 4:31 pm on 22 November 2011.

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Photo of Baroness Wheeler Baroness Wheeler Opposition Whip (Lords) 4:31, 22 November 2011

My Lords, I start by saying that I was not one of the ones who beat up the noble Lord, Lord Patel, over grouping issues, although it was extremely frustrating to have them appear and disappear all the time. Anyway, we now have our list and I am speaking to that.

I am pleased to support the amendments in the group, which have two important aims. First, to ensure that HealthWatch England and local healthwatch organisations are truly involved and consulted where decisions are made about the development and planning of commissioning services and on reconfiguration or changes to services. Secondly, to ensure that it is an independent statutory body and not a subcommittee of the Care Quality Commission.

The Government's far-reaching proposed changes to the NHS, with the emphasis on competition and regulation, make the need for HealthWatch England to be given robust and independent scrutiny powers even more important. Amendment 305 from my noble friend Lord Harris and myself is a probing amendment with the intention of ensuring that HealthWatch England and local healthwatch organisations have the strengthened power and functions they need. It establishes HealthWatch England as an independent body responsible for providing the Secretary of State, the NHS Commissioning Board, the Care Quality Commission, Monitor and local authorities with information and advice on the views, needs and experiences of users of health and social services, and the views of local healthwatch organisations on care standards and how they can be improved.

Under Amendment 305, HealthWatch England is responsible for providing local healthwatch organisations with resources, advice and assistance. The amendments of my noble friend Lord Whitty, Amendments 318C and 318D, set out similar and additional powers and functions for HealthWatch England to those proposed in Amendment 305. We fully support these, which include powers of investigation into complaints and powers to seek disclosure of information from health and social care providers, the NHS Commissioning Board, CQC and others. Important functions also include information, research and representation functions.

The independence of HealthWatch England from the Care Quality Commission is vital if it is to be the national service users' watchdog and champion. It must be able to hold regulators in the whole of the health and social care system to account and be the independent guarantor of the rights, duties and independence of local healthwatch organisations. Given the uncertainties still surrounding how Monitor and the CQC will work together, and the current trials and tribulations facing the CQC, how realistic is it to expect the CQC to undertake this role or for HealthWatch England to function properly as a CQC committee?

Does the Minister acknowledge these problems? Will he-or she-consider working with NLAM and other interested stakeholders to produce an alternative model for HealthWatch England that will secure the Government's stated policy for a powerful and independent system of public involvement in health and social care? To be effective, local healthwatch must be able to scrutinise how consortia and health and well-being boards undertake public engagement and transparency and are ensuing that the public voice is embedded in the care pathway design. They should also be given the right to comment on tenders and commissioning contracts before release.

LINks organisations currently have significant powers to enter and view the premises of all health and social care providers regulated by the CQC-another potential conflict of interest if the CQC relationship is not changed. These powers are often little used by local LINks organisations and we hope that their retention in the Bill and robust guidance to local healthwatch organisations on how they can be applied to the benefit of improved patient care and treatment will lead to these important powers being more frequently used. I would welcome the Minister's endorsement of that.

On the question of the transition from LINks to HealthWatch, we would underline that the involvement of LINks organisations is essential to ensure that the skills, knowledge and dedication of the existing volunteers are not lost. I also emphasise the importance of ensuring that healthwatch local organisations are properly funded. This is an uncertain time for the development of local healthwatch, with local authorities beginning to tender for hosting healthwatch organisations. Moreover, in Surrey, Sutton LINk, for example, has been selected as a pathfinder HealthWatch but is rightly concerned at how realistic it is to take on a new role and the increased costs of undertaking new duties such as the complaints advocacy without any form of transition or improved funding. Will the Government reconsider their decision not to fund pathfinder LINks healthwatch organisations to enable an effective transition to HealthWatch?

We should recognise the widespread concern raised by current LINks organisations that the healthwatch arrangements make them dependent on the local authority for funding. With local authorities' greater involvement in healthcare, particularly for public health, how will healthwatch organisations be able to exercise independence and have public confidence and trust in their role? I look forward to the Minister's response on these key transition issues.