Clause 2 - Wales Centre for Health

Health (Wales) Bill – in a Public Bill Committee at 5:15 pm on 10th December 2002.

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Photo of Nigel Evans Nigel Evans Shadow Secretary of State for Wales 5:15 pm, 10th December 2002

I beg to move amendment No. 8, in

clause 2, page 2, line 12, at end insert '; but at least one-third of the members shall be appointed only on the nomination of community health councils.'.

I welcome the hon. Member for Caernarfon back to the Committee after the strains and tortures of finding a dentist who was prepared to deal with him. I hope that he is in much better shape now than he was a few hours ago.

The clause and the amendment deal with the Wales Centre for Health, a body that we all welcome. It could be vital in promoting activities to protect and improve health in Wales, and will also be known as Canolfan Iechyd Cymru. I see it as an important body, which is why we seek to amend the Bill in such a way. I should be interested to hear what the Minister has to say on our suggestion, which tries to ensure some independence for the body, and with good reason.

Subsection (2) states:

''The Centre is to consist of such number of members appointed by the National Assembly for Wales as the Assembly may determine''.

That is an extremely wide power, and lets the Assembly appoint exactly whom it likes. The nomination powers may be the same as those that we spoke about on the previous amendment. The Assembly will be able to appoint the chairman or propose further regulations as to how he may be appointed.

One reason why we seek more certainty of independence for a body that champions patients' rights is that it will deal with some important aspects

of health promotion and protection. Prevention of smoking in public places was mentioned on Second Reading. Perhaps the centre will recommend policy guidance on that on behalf of the Welsh Assembly, or on behalf of us in Westminster if we want to take primary powers to try to improve health. Smoking raises the emotions of many people in one way or another, but the subject is controversial.

The body may deal with substance abuse as well, a vital subject that is sometimes overlooked. Ten years ago, I was extremely concerned about glue sniffing, as it was then known. Substance abuse still goes on, involving glue and other substances, and some direction is needed on it. Alcohol abuse is widely recognised in the House; the all-party group on alcohol misuse has an important role in bringing those problems to the fore. CHCs may want to carry out a study so as to start a campaign to promote sensible policy guidance on the subject.

I am a former chairman of the all-party group on drugs misuse, and there may be a campaign on drugs. I would welcome that in the whole community in Wales, especially schools and youth centres. I was saddened to read today that nine pupils had been suspended from a north Wales secondary school after they were allegedly caught with cannabis. The school is in Denbighshire, and the pupils have been suspended for up to 10 days. Disturbingly, the report on the matter stated that it would be the fifth time in 2002 that pupils at schools in north and mid-Wales had been disciplined over drugs.

That must concern all members of the Committee. We must put the message across, whether in relation to cannabis or other drugs, and we must deal with the problems that young people face. We would all welcome a campaign in schools led by the Wales Centre for Health. Again, there are resource implications, but the money would be saved in spades.

Photo of Mr Jon Owen Jones Mr Jon Owen Jones Labour/Co-operative, Cardiff Central

On a point of order, Mr. Griffiths. Is it in order for the hon. Gentleman to make a speech on a wide variety of drugs without declaring an interest as owner of a tobacconist shop?

Photo of Mr Win Griffiths Mr Win Griffiths Labour, Bridgend

I call the hon. Member for Ribble Valley to declare his interest.

Photo of Nigel Evans Nigel Evans Shadow Secretary of State for Wales

The interest is in the Register of Members' Interests for everyone to see.

Photo of Mr Win Griffiths Mr Win Griffiths Labour, Bridgend

The hon. Gentleman does not sell cannabis.

Photo of Nigel Evans Nigel Evans Shadow Secretary of State for Wales

Not to my knowledge, Mr. Griffiths. I suspect that the profits would not be as dire if we did, but I would not recommend that policy for our humble newsagent's shop. We do, however, sell cigarettes, which I sometimes find awkward, as, I suspect, do the tobacco companies because I recommend that people give up smoking. Any campaign that we can encourage in that regard must be welcomed.

The Wales Centre for Health will have much work on its hands. There will be many campaigns. The Assembly will have powers to recommend that the centre examines certain key areas. No doubt, some hon. Members will write to the centre to highlight their areas of concern. As we know, there is the problem of

crime and drugs, not just youth and drugs. Three quarters of crime is drug-related, and if we can tackle the one, surely we can tackle the other. On a more positive note, the centre may want to campaign on healthy lifestyles and on gaining fitness through taking more exercise, such as walking instead of taking the bus or driving the car. We tabled the amendment with the aim of ensuring an independent element within that body.

My hon. Friend the Member for Epsom and Ewell referred to active voluntary groups. They should be allowed to be independent so that they can act on behalf of patients and see at first hand some of the problems with which the health service is faced. I am not sure how active those active groups are, or whether they have one person who is a champion for a particular cause. All hon. Members know people who fall into that category and who write to us regularly. Where would we be without them? Where would we be without the organisations that draw from a much wider pool of people; people who meet regularly to discuss issues such as the Red Cross, death, multiple sclerosis, strokes, or ME, which was commonly referred to as ''yuppie flu''? I suspect that all hon. Members have received letters from people who want the Government to do more about ME, and who doubtless want the Welsh Assembly to recognise it as a real illness, which I do, as well as to place greater emphasis on securing more consultants and specialists to deal with it.

The Assembly may not be so keen to concentrate on one area because of the resource implications. A group of people with their own nominees on CHCs may push the centre to consider key conditions that may not be as high profile as others. People with such conditions should not be denied access to the research that the centre will promote. I hope that when the centre is created, several of its reports will be made as widely available as possible on the internet and elsewhere.

We tabled the amendment because, under the schedule, the Assembly has the powers to appoint anyone to this particular body, to determine how the chairman may be appointed or even to appoint the chairman itself. That gives me cause for concern. The centre could be extremely effective in helping to promote good health in Wales and to prevent illness if it can do its job in the most effective way. I hope that the Committee will accept that there should be an element of independence within that body. I hope that we can gain some support for our amendment.

Photo of Don Touhig Don Touhig Parliamentary Under-Secretary, Welsh Office, The Parliamentary Under-Secretary of State for Wales

We have decided that Wales needs an independent body that can provide information and impartial advice on public health issues. There is currently no equivalent body that can provide such independent advice. The status of the Wales Centre for Health will enable it to draw on academic and public sector expertise and different public and professional interests to work together. It will also support professional training in public health, including joint training between different sectors and professional disciplines.

The Assembly has identified the need for a body with suitable standing and expertise, which can act as an advocate for public health at the national level. That has been the aim of health policy in Wales since the issue of ''Better Health, Better Wales'' in 1998. The centre will play an important role in advising the Assembly, as well as public agencies and voluntary organisations. The statutory basis for the Wales Centre for Health will ensure its legal independence and establish its role as an impartial advocate for public health in partnership with all sectors. The restructuring of the NHS underlines the relevance and importance of the part that the centre will play in addressing the long-standing legacy of ill health in Wales. The centre will be a health service body. It will not be a servant or agent of the Crown or the National Assembly for Wales. It will function at local, regional, all-Wales, United Kingdom and international levels. That is the ambition and status we have in mind for it.

The amendment would provide that a number of places would be reserved on this body for nominees of community health councils. Like the previous amendment, it reserves a block of places for a group, which is contrary to the way in which we are trying to develop the openness of the health service in Wales. The amendment would reduce the ability of the Assembly to determine the overall composition and balance of membership of the centre. It is the Assembly's intention that members of the centre should be appointed for their expertise and experience. Surely that ought to be the only criterion. They should be drawn from the statutory, voluntary and academic centres.

Photo of Chris Grayling Chris Grayling Opposition Whip (Commons), Shadow Minister (Health) 5:30 pm, 10th December 2002

One of the great tensions within the NHS at the moment is between the academic view at the centre and the practical needs of communities. An awful lot of major health care issues are being significantly shaped by the royal colleges' textbooks—by the leading members of the profession—without reference to the implications of those decisions for the delivery of local services. Does the Minister not think that having a balance between that top level, with its undoubted expertise, and representatives of the services on the ground would provide an effective means of reconciling those different demands?

Photo of Don Touhig Don Touhig Parliamentary Under-Secretary, Welsh Office, The Parliamentary Under-Secretary of State for Wales

The hon. Gentleman makes a fair point. We want the Wales Centre for Health to be as broadly based as possible, but to draw on all possible expertise. I am reluctant to start reserving blocks of places for groups, whether they are broadly described as having some sort of vested interest, albeit an admirable interest so far as CHCs are concerned.

Photo of Roger Williams Roger Williams Liberal Democrat, Brecon and Radnorshire

Will the Minister explain the role of the centre on a UK and international basis? I understand that it may provide information and knowledge that would helpful to Wales, but does he expect that it will disseminate knowledge on a greater basis than just throughout Wales?

Photo of Don Touhig Don Touhig Parliamentary Under-Secretary, Welsh Office, The Parliamentary Under-Secretary of State for Wales

The work of the centre will be posted on its website, so there will be access across the planet to the work and research that it is doing. We need

hope, aspiration and vision that the centre will make a wide contribution across a whole range of issues. The hon. Member for Ribble Valley (Mr. Evans) and my hon. Friend the Member for Cardiff, North spoke of AIDS and so on, and the centre may well do some work on that problem. I do have that hope and ambition for it.

I remind Opposition Members that we undertook extensive public scrutiny on the Bill before we bringing it forward. That does not take away from hon. Members the right to seek to amend it in Committee, but no one who was consulted asked that a block of places should be reserved for a particular group.

Wales Centre for Health members will be recruited by the same process—and under the Nolan principles—that apply to the community health councils, and the process will be open, transparent and accountable. Nothing will be hidden. As part of the recruitment drive, people will be able to look on the Assembly website for guidance on how to become members of the Wales Centre for Health. It is important that we should make the process open, transparent and accessible, so that everyone who feels that they can make a contribution can apply. However, we want to take the proposal forward without setting a number of places aside for a particular group or any vested interest group. We think that that is the best way to push it forward. I hope that the hon. Gentleman will consider withdrawing the amendment.

Photo of Nigel Evans Nigel Evans Shadow Secretary of State for Wales

I share with the Minister the same hopes and aspirations for the Wales Centre for Health. The hon. Member for Brecon and Radnorshire asked whether it was intended that the centre should consult with other UK bodies, or even more widely. I am reassured to hear that part of its research, perhaps into AIDS, will not be a Wales-only thing, or even a UK-only thing; it should be much wider than that. The implications of AIDS for Africa are huge and immense. We look on aghast at the problems being faced on that continent, which is being ravaged by AIDS. Anything that the Wales Centre for Health can do to help produce programmes that may spread even into Africa would be welcomed by every member of the Committee; indeed, we would be proud of its work.

I asked about the internet and I am reassured by the Minister's answer. He said that the centre would have a website that could be accessed by all interested groups, wherever they happened to be, so long as they had access to the internet. I am grateful for that confirmation.

Like the Minister, we want the centre to be independent. However, we want at least some part of it to be more independent of the Assembly than it would be under the Bill, which is the reason for the amendment. It is a probing amendment to allow us to press the Government on whether there are any means of ensuring that the centre is independent of the Assembly. Although the Minister assured us that the Nolan committee appointments procedure would be followed, that may change. It is not included in the Bill; I cannot see the word ''Nolan'' there. What

assurances do we have that that procedure will always be followed? We in Parliament are placing a huge amount of trust in the Welsh Assembly and its Executive.

Photo of Don Touhig Don Touhig Parliamentary Under-Secretary, Welsh Office, The Parliamentary Under-Secretary of State for Wales

I accept and value the hon. Gentleman's comments. I should have stressed earlier that the Assembly has agreed a code of practice for recruitment to all such organisations. That can be changed only by a majority vote in the Assembly. I hope that he will accept that reassurance, because it would require all-party support to make such a change.

Photo of Nigel Evans Nigel Evans Shadow Secretary of State for Wales

I am grateful to the Minister. I know how much more difficult it is for any one party to have overall control of the Welsh Assembly. Even if a party wished to go down that route, I hope that there would always be an element of independence that would resist such a move. We want the Wales Centre for Health to be manned by people who are appointed for their expertise and experience, as it will be dealing with many wide-ranging areas of health promotion in Wales. However, I am sure that he will not blame us if we look for worst-case scenarios and ways of ensuring that the Bill is as watertight as we can make it. The Minister has given us certain assurances. The suggestions that we have made may be reconsidered in the other place, but I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 2 ordered to stand part of the Bill.