Clause 3 - Functions of the Centre

Health (Wales) Bill – in a Public Bill Committee at 5:45 pm on 10th December 2002.

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Photo of Chris Grayling Chris Grayling Opposition Whip (Commons), Shadow Minister (Health) 5:45 pm, 10th December 2002

I beg to move amendment No. 3, in

clause 3, page 2, line 24, at end insert—

'Provided that it shall be obliged to coordinate those activities with those carried out by similar bodies elsewhere in the United Kingdom.'.

I view the amendment and the principles in it as perhaps the most important for the Bill. It seeks to enshrine in the Bill a duty of co-operation across borders in the United Kingdom. It is designed to be commonsensical and constructive, and in no way to remove rights and powers from the Wales Centre for Health, but to ensure that it works in partnership, for the good of the United Kingdom, rather than in isolation from the United Kingdom. I say that with genuine passion because, despite all the processes of devolution that have taken place, we are one nation. In all parts of our country, we share issues, in particular health issues. I simply do not believe that there is one single health issue that applies to Wales alone; certainly not the issues that, one could argue, have a significant impact in the Welsh community.

The hon. Member for Vale of Glamorgan (Mr. Smith) intervened on me on Second Reading to refer to his proper concerns about deep vein thrombosis and about the experience of that unfortunate condition in Wales. As I pointed out to him, however, it is not an exclusively Welsh issue. Wales is undoubtedly affected by other issues. Former coalminers face problems after many years in the pits, but so do former coalminers in other parts of the country. The young generation faces health and well-being issues, but those, too, are shared by other parts of the country.

We do not have a Welsh health service or an English health service; we have a national health service, as is right and proper. It is right that we make the best use of the resources available to us as a nation and that we do not commit resources unnecessarily to duplicating effort. At the same time, we must recognise that the localisation of health education and of some aspects of research may meet some local community needs.

It is fundamentally important that the Bill enshrines a spirit of co-operation, without detracting from the Welshness of certain services. As I told the hon. Member for Monmouth in the previous debate, health issues cross boundaries.

Photo of Hywel Williams Hywel Williams Shadow PC Spokesperson (Work and Pensions), Shadow PC Spokesperson (Health)

Is the hon. Gentleman aware of the condition that affects slate workers and ex-slate workers in my constituency? It is probably unique to north Wales, as is the fact that the employers went bankrupt. In 1979, that led to the passing of legislation that applied only to those slate workers and nowhere else in the UK, as far as I know. I do not see how there could be co-operation, as the hon. Gentleman called it, with parts of the UK where a condition does not exist and where employers have not gone out of business.

Photo of Chris Grayling Chris Grayling Opposition Whip (Commons), Shadow Minister (Health)

If there is an individual case, I stand to be corrected. I should remind the hon. Gentleman, however, that there has been an established slate mining industry in other parts of the country; most notably in the peak district. It would surprise me, therefore, if his constituents' experience was limited wholly and exclusively to his part of Wales. It may have suffered more than any other part of the UK, and different areas will always be affected differently. However, I should be astonished if any complaint was wholly and exclusively limited to Wales, even though some complaints are more significant there. I fully accept the hon. Gentleman's point about his constituency experience, but when he hears the full details of my argument, he will see that that one case does not prove that I am wrong.

Health services cross borders. I mentioned that the Association of Welsh Community Health Councils had embarked on a project to assess the level of service provided by English health organisations to Welsh patients in the cross-border region. In the areas around Chester and, indeed, right the way up the border, there will inevitably be crossovers involving people who live in Wales and the English health service, as well as people who live in England and the Welsh health service. Several years ago, a significant issue arose right on the border, in the constituency of my hon. Friend the Member for Leominster, where a

hospital closure had undoubted implications for both communities.

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

I have just thought of a crossover problem, and the hon. Gentleman might like to think about whether the amendment would deal it. If, as reported, the Welsh Assembly does not enact the Bill's provisions on bed blocking, but they are enacted in England, English hospitals will presumably be entitled to charge Welsh local authorities for bed blocking, while Welsh hospitals will not be able to charge English local authorities. Would the amendment sort that interesting problem out?

Photo of Chris Grayling Chris Grayling Opposition Whip (Commons), Shadow Minister (Health)

The hon. Gentleman makes an interesting point, although I do not think that my amendment would solve the specific issue. None the less, it is a good point. As funding regimes differ between local authorities, and, potentially, between England and Wales, the whole issue of placements for the elderly in care homes will open up a Pandora's box of problems for the care home sector and for local authorities, such as placing people across the border for financial reasons.

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

Perhaps the Wales Centre for Health will look into that, to work out what will happen to elderly people in certain areas who are bed blocking. The hon. Member for Cardiff, Central (Mr. Jones) raises an interesting point. If fines are introduced in England but not in Wales, bed blocking may be eradicated in England but not in Wales. That should interest both the Wales Centre for Health and community health councils.

Photo of Chris Grayling Chris Grayling Opposition Whip (Commons), Shadow Minister (Health)

I thank my hon. Friend for that salient point. My amendment is designed to focus primarily on two areas; medical and health research, and the provision of public information and education on health. I strongly believe that we need to ensure that there is proper collaboration and co-ordination in those two areas. Medical research already crosses boundaries. I have looked to see what research is currently being conducted, and it is obvious that the medical research that is taking place in Wales—either research generated from within Wales or research programmes to which people in Wales are contributing—is international. For example Cancer Research UK has been funding a project involving girls in Wales, England and three other European countries, to investigate links between health issues for girls before puberty and cancer. That is an example of a health problem that crosses many boundaries and a research project that is being carried out in several countries; people are pooling information and working collaboratively for the benefit of everyone in those countries.

Some excellent medical research is taking place in Wales, for example on cancer. The cancer charity Tenovus, based in Wales, is doing excellent work, both in the Principality and internationally, looking for new treatments to combat cancer. Its research is based on work carried out in Wales but it is used in an international arena. The charity is working across the United Kingdom, and has people working in Cardiff, as well as at its research centres in Southampton, Liverpool and Bournemouth. That UK team is doing a first-rate job, developing new

projects to tackle different sorts of cancer. Their work should be applauded.

Among the international community, the UK remains at the leading edge of medical research. We need to use our strengths to benefit everyone, because the health solutions that we discover will provide better outcomes for patients around the world. That is why we must not be provincial in our approach to health research.

Under the legislation, the Wales Centre for Health has a particular remit, to

''undertake and commission research into such matters''.

I appreciate that much of that research may be at a low level or local, but equally it could be at a high level or relate to public health or specific issues of concern. It would, therefore, be a dereliction of duty on the part of that organisation and the health service in Wales if research were simply undertaken in a Welsh context, without examining whether there were similar issues elsewhere in the United Kingdom, without exploring whether similar projects were being considered by bodies elsewhere in the UK and without a degree of partnership between the Wales Centre for Health and its counterparts elsewhere in the UK. That is plain common sense, making the best use of resources in the NHS.

The amendment is designed only to write a duty of care into the Bill and to send a message from the UK Parliament—ultimately responsible for our national health service—that the different component parts of our nation should work together. Where they face common issues, they should make the best use of available resources, pool their expertise and share their best practice. I hope that the Minister will accept that the amendment would enhance the role of the Wales Centre for Health, without detracting from its powers. It would underline the fact that the centre operates within a United Kingdom health framework, of which it should be mindful in undertaking its work.

On public information and education, consistency of message is important. We face several significant health issues. My hon. Friend the Member for Ribble Valley referred to the alarming growth over the past 12 months in the number of people found to be HIV positive. I fear that, as a nation, we have become too complacent about the threat of AIDS.

Fifteen years ago, public information campaigns warned people of all ages, but particularly the young, about the risk of AIDS and the different ways of contracting it. Advice was given about the steps necessary to remain infection-free. The campaign was largely successful. The doom-mongers in this country, who said that AIDS would swamp us within a few years were proved wrong. We have not been swamped; we have remained relatively immune, though it remains tragic for the small minority who are infected.

As we look abroad, we recognise that the threat is far from gone. In parts of the world, AIDS remains a scourge on humanity, perhaps the greatest threat that

humanity faces. Africa has infection rates of 30 to 40 per cent., and both India and China face mounting infection rates. We must recognise how vulnerable we are as a nation to HIV/AIDS, in a world where people travel and cross borders legally and illegally. It is crucial to pick up on the work of 15 years ago and make a new generation of young people aware of the threat of HIV/AIDS. It is just one example of many where our society has a duty to educate people about the health threats that they face, the lifestyle choices that they make and their implications for their future health.

Let us examine the practicalities. When AIDS campaigns were waged in the 1980s, extensive use was made—quite rightly, as it is the most effective means of reaching our population—of television. However, let us reflect on the implications of ITV companies, for example. HTV, viewed in many parts of the west of England, is not an exclusively Welsh organisation; Granada, covering areas beyond Chester and extending into north Wales, is not an exclusively English organisation. BBC programmes have the same problem, as do local radio stations and newspapers. The media does not stop at the boundaries of England and Wales. People in England will hear messages sent out by the Wales Centre for Health and the population of Wales will hear messages sent out by public health bodies in England. Without co-operation and partnership between the bodies, we will be sending conflicting messages to the younger generation over matters such as HIV/AIDS at a time when we simply cannot afford to do so.

Photo of Mr Jon Owen Jones Mr Jon Owen Jones Labour/Co-operative, Cardiff Central 6:00 pm, 10th December 2002

Conflicting messages can be a benefit because no one has a monopoly on truth and wisdom. For example, when the BSE crisis arose, there was a monopolistic view that eating beef was perfectly safe. However, the then medical adviser in the Wales Office, under a Tory Government, took the opposite view. It turned out that she was correct. Had there been a separate body, both views would have been put into the arena, to the public benefit.

Photo of Chris Grayling Chris Grayling Opposition Whip (Commons), Shadow Minister (Health)

There will always be multiple opinions in the medical and scientific communities. New research comes out one week and we are told that we can eat something. The following week there is another piece of research and we are told not to eat it, only to be advised the week after that that the food is very healthy. One loses touch with what is good for you and what is bad.

Should a young person watching a public information campaign about HIV/AIDS, produced by the Wales Centre for Health and shown on HTV, receive a dramatically different message from that shown a moment or two later on Channel 4 from the public health bodies in London? Would that be prudent? That is why I believe in a partnership campaign and the co-ordination of messages.

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

The proposal would not work in that way; various pressures would be put on agencies. If I may to return to my earlier example, in the case of BSE, the pressures came from the industry not to frighten the consumers. No matter what side of the River Severn we are talking about, if it was believed that someone would publish and be damned in any

case, people would consider the research more carefully and probably come up with a united, and therefore better, view.

Photo of Chris Grayling Chris Grayling Opposition Whip (Commons), Shadow Minister (Health)

The hon. Gentleman is making my case for me. It would be a nonsense if the Wales Centre for Health said that beef was safe, the Food Standards Authority in London said the opposite and public information campaigns in London and Cardiff reflected those diametrically opposite opinions. When messages are crossing borders, it should be beholden on the bodies involved to get together and work out the best message.

Photo of Hywel Williams Hywel Williams Shadow PC Spokesperson (Work and Pensions), Shadow PC Spokesperson (Health)

Will the hon. Gentleman explain what ''co-ordinate'' means? I accept that he uses the word for the purpose of argument but he suggests a situation in which the Welsh body might go in one direction and bodies elsewhere in the United Kingdom in another. On the whole, people tend to go in the same direction, with variations. Does ''co-ordinate'' mean that everyone has to be absolutely the same and hold a monolithic view of the issue or is the hon. Gentleman allowing a variation for the Celtic fringe?

Photo of Chris Grayling Chris Grayling Opposition Whip (Commons), Shadow Minister (Health)

The word ''co-ordinate'' means just that. Those running public health information services in the Wales Centre for Health should be in touch with their counterparts in London and know what they are doing, and vice versa. Ideally, the same should be done in Scotland although I appreciate that that is not within the remit of the Bill. We should ensure that the bodies focusing on health issues in different parts of the United Kingdom are in contact with each other and work together. Even if the nature of their campaigns is different, they should at least ensure that there are no absurd conflicts of the kind that could arise if a dialogue does not take place. That is the sole purpose of the amendment.

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

I agree with the hon. Gentleman's argument. However, if science on a particular issue is well established and agreed, there is hardly likely to be a different approach to communicating it to the public.

Photo of Chris Grayling Chris Grayling Opposition Whip (Commons), Shadow Minister (Health)

One would hope that the approach would not be different. Anyone who has been involved in communication—my professional background before I came to this place—knows that organisations are wonderfully good at saying things that contradict one another. A marketing campaign from one department will say one thing, and another campaign from another department will say something diametrically opposite. The company concerned is then in a mess as a result.

That lesson should be taken on board by the public sector, especially the national health service in this arena. It should simply be a duty of care for those responsible for research and for public information and education to ensure that they talk to each other, work together and co-ordinate their work, so that each strengthens what the other does, rather than weakens it by putting out contradictory messages.

The amendment would not remove any powers from the Wales Centre for Health, but would put a duty of care on it, simply to remind the centre that it is part of a health service that is spread across the United

Kingdom and that it will indulge in activities that cross borders. The need for co-ordination and to work together with other parts of the UK is sacrosanct and should be included in the Bill.

Photo of Hywel Williams Hywel Williams Shadow PC Spokesperson (Work and Pensions), Shadow PC Spokesperson (Health)

I asked the hon. Gentleman what ''co-ordinate'' means, as the amendment states that the centre is obliged to co-ordinate

''with . . . similar bodies elsewhere in the United Kingdom''.

That is in terms of

''the provision and development of training''

as well as information on

''protection and improvement of health''

and the commissioning of research. My fear is that the amendment would prevent a specific Welsh view being taken of specific Welsh problems.

If I were in the hon. Gentleman's shoes, I would take care when using the word provincial. Some people get rather prissy about its use in terms of Wales, because we see some issues as national.

Perhaps ''co-ordinate'' means allowing certain variation, but would it prevent the Wales Centre for Health from taking a particular course? I recently visited the Fresno centre for ageing in California, where there is an innovative and promising project on the health of older people. It combines several features, such as a public health campaign against abuse of the elderly in co-operation with the sheriff's departments and prosecution departments. I am not aware of a similar venture in the UK. If the Wales Centre for Health wanted to do such work, would it need to co-ordinate that with something that did not exist elsewhere in the UK?

Photo of Chris Grayling Chris Grayling Opposition Whip (Commons), Shadow Minister (Health)

If the Wales Centre for Health were to invest in excellent research such as that, would the hon. Gentleman think it prudent of the centre to tell organisations elsewhere in the UK that it was going to do so, and to offer to share the findings with them?

Photo of Hywel Williams Hywel Williams Shadow PC Spokesperson (Work and Pensions), Shadow PC Spokesperson (Health)

The hon. Gentleman makes a good point. The centre could commission research. I do not underestimate the propensity of academics to fight and disagree, but it is a matter of good practice and pride for people who have done such research to publish their views and engender a discussion among their peers. It is entirely reasonable to expect the Wales Centre for Health to do that as part of its day-to-day business.

The hon. Gentleman argued that there was nothing unique in terms of health in Wales, and I referred to silicosis. The relevant employers in Wales have gone out of business and, therefore, there was legislation to provide compensation, funded by the Government. I hope that he accepts that explanation.

Photo of Chris Grayling Chris Grayling Opposition Whip (Commons), Shadow Minister (Health)

I accept that there may be an exception to every rule, but those exceptions are not the norm; that was my point.

Photo of Hywel Williams Hywel Williams Shadow PC Spokesperson (Work and Pensions), Shadow PC Spokesperson (Health)

My concern is that ''co-ordinate'' might prevent development rather than encourage co-operation. I have in mind the patterns of Welsh health and ill health; in particular the chronic health problems arising from our industrial past, and the provision of public health information in rural areas,

particularly in terms of the bilingual situation. I would suggest that the sort of bilingualism that we have in Wales is not replicated elsewhere.

The hon. Gentleman referred to broadcasting organisations. I can imagine a public health campaign that was conducted in Welsh on S4CSianel Pedwar Cymru—having limited application over the border, but I would not like it to be prevented for that reason. The Wales Centre for Health should not be prevented from providing and developing training either. I was once involved in developing Welsh-medium training in social work. That was probably unique and of limited application; we certainly had limited success in interesting people over the border in the research. I would encourage hon. Members to resist the amendment for those reasons. The Wales Centre for Health should have the widest possible freedom of operation.

Photo of Don Touhig Don Touhig Parliamentary Under-Secretary, Welsh Office, The Parliamentary Under-Secretary of State for Wales 6:15 pm, 10th December 2002

The hon. Member for Epsom and Ewell has made an important contribution to the debate; he has taken it to a higher level. It is refreshing to know that he has a wide and deep interest in the health service, which is not always characteristic of members of his party.

I hope that my remarks will reassure him that his amendment is not needed. It would place a statutory duty on the centre to co-ordinate its functions with other unspecified bodies in other parts of the United Kingdom. Organisations such as Cancer Research are not statutory bodies; they cannot be required to co-operate or co-ordinate, nor would it be possible to ensure reciprocity so far as they were concerned. The amendment would also impose a considerable unnecessary burden on the centre. It would mean an unjustified restriction on its freedom of action and its scope to address the problems of Wales.

The hon. Member for Caernarfon referred to the hopes and aspirations of the centre working within Wales. The Assembly sees it as its key task to help to prevent ill health in Wales, promoting health and well-being and tackling inequalities in the health service in Wales. The issues referred to by other colleagues, such as bed blocking, are matters for CHCs to scrutinise. Research and surveillance of health trends is a public health issue that would be in the orbit of the Wales Centre for Health. It is important to point out that the amendment says:

''Provided that it shall be obliged to coordinate those activities with those carried out by similar bodies elsewhere in the United Kingdom.'.

There are no other similar bodies; there are no bodies equivalent to the Wales Centre for Health in the rest of the United Kingdom, so it would be difficult to comply with that part of the proposal. There are many bodies in the UK that might carry out some of the functions of the centre, but there is not one equivalent that would have a duty to work in the way in which the Wales Centre for Health will do.

Paragraph 20 of schedule 2, which covers general powers, states:

''The Centre may do anything which it considers necessary or expedient for the purpose of, or in connection with, the exercise of its functions.''


''That includes, in particular—co-operating with other public authorities''.

It is built in to the legislation that the Wales Centre for Health will have the opportunity to co-operate with other public bodies. The Assembly intends that the Wales Centre will co-operate with other public bodies. It is the intention of the Assembly that the centre should co-operate with other public bodies in Wales and in other parts of the United Kingdom. Indeed, as hon. Members will know, a shadow Welsh centre for health already exists in the Velindre NHS Trust in Cardiff. That shadow body has already collaborated with the Agency for Toxic Substances and Disease Registry in the United States of America on matters relating to the landfill tip in Rhondda Cynnon Taff. Even in its embryo state, the centre has been collaborating with organisations outside Wales.

The centre will work in collaboration with several bodies, but it should be free to determine how best to do that without the imposition of an unnecessarily burdensome statutory requirement. I hope that the hon. Member for Epsom and Ewell is reassured that the centre will have the opportunity to collaborate and co-operate with a range of bodies throughout the country, and that he will feel able to withdraw the amendment.

Photo of Chris Grayling Chris Grayling Opposition Whip (Commons), Shadow Minister (Health)

I take that at face value, but I differ from what the Minister says in this respect. I accept that provision is in place to enable the centre to work with others, but my point of principle is that its work—not all, but some of its work—will have an impact beyond the Welsh borders. I fully accept the point made by the hon. Member for Caernarfon that there are some specifically Welsh issues, such as public health provision in the Welsh language and Welsh language services. I might tell him that when I lived in Cheshire, I used to watch some of the programmes on S4C in English because of the mix of languages.

The impact of some of the work carried out by the Wales Centre for Health will be exclusively Welsh, and I do not want to prevent it from doing things in Wales for Wales. Indeed, I accept the Minister's assurances that the shadow body has already started to do that. However, it should work with organisations elsewhere, where there is a benefit in doing so. My concern is that its work will have an impact on other parts of the United Kingdom. It could generate work that is duplicated elsewhere or it may be able to contribute to work taking place in other parts of the UK.

The hon. Member for Caernarfon mentioned rural areas and the industrial past of Wales. I fully accept that those issues exist, but I would argue that they exist in other parts of the country, such as Cornwall, the north-west, the north-east, Yorkshire, and the black country. In some of the more rural parts of the UK, such as the lake district and the west country, there are common issues reflecting rural issues and industrial heritage. The border issue causes me most concern, however. If the Wales Centre for Health adopts a role in public information provision and education, the

messages it sends out will inevitably cross borders and be heard in England, as well as in Wales. There is no wall between the two countries; we mix and match across borders.

The word ''co-ordinate'' was chosen carefully because it does not imply that something must be done or not done. It simply requires discussion to take place to ensure that work is co-ordinated, is not duplicated and does not unnecessarily contradict work carried out by similar bodies. I do not accept that those similar bodies include cancer research charities, but rather public bodies with a remit in the same field of public health information, medical and health research and training. I am happy to listen to suggestions from the Minister about how to draft the amendment differently. I would be happy if the Minister took away the principle and offered to return, on Report or in another place, with an alternative suggestion for including in the Bill a strong signpost to the Wales Centre for Health to that effect.

The principle, which is in the interests of the United Kingdom health service, is that the Wales Centre for Health should be free to do what it needs for Wales, while being mindful that what it does may have an impact in other parts of the country. There may be issues on which it should work with its counterparts, or with organisations that have some of its functions, in other areas of the country.

No one would lose by the Government accepting the amendment. Indeed, the UK—and health provision throughout the UK—stands to gain by it. I wish to press the amendment. I hope that I have persuaded the Minister to accept the principle of the amendment in its own right. If not, I hope that he will go away and consider the issue and return with a proposition that would encompass my general point in the Bill in a way that he can live with.

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

I accept that ill health knows no boundaries. Miners in my local valleys are suffering just as badly as the boys in Durham and Scotland as a result of the problems in the pits. However, good health practice knows no boundaries either. In Wales, we have set the pace on some good health practice, but we can also learn many things from other parts of the UK.

I accept the hon. Gentleman's argument; we should not have artificial, albeit historical, boundaries between us on health care. However, the reports of the Wales Centre for Health will be posted on its website; its work will become known. Under schedule 2(20), there is an opportunity for collaboration with other bodies throughout the UK.

I strongly resist placing in the Bill a requirement that says ''You must'' to the Wales centre for health. The amendment states that the centre

''shall be obliged to coordinate those activities with those carried out by similar bodies elsewhere in the United Kingdom.''

It does not say that the centre may or can do that. I am resisting a heavy-handed approach, because I do not wish to place unnecessary burdens on the new centre when all the opportunities are there for collaboration and sharing best practice.

I urge the hon. Gentleman to reconsider and to accept that the opportunity to do as he wishes exists under the Bill. We are not prepared to place the obligation that he proposes on the centre, because that would be unnecessary. As I said, all the opportunities are there for the centre to collaborate with bodies throughout the whole of the UK.

Photo of Chris Grayling Chris Grayling Opposition Whip (Commons), Shadow Minister (Health)

I have listened carefully to the Minister's arguments and I do not wish to detain the Committee by pressing the amendment to a vote now. However, I will consider what might be done on this front at a later stage, because I feel strongly that the amendment would do nothing but strengthen the provision of health care throughout the country, and would in no way detract from what the Minister rightly wants the centre to be able to do. For now, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Photo of Chris Grayling Chris Grayling Opposition Whip (Commons), Shadow Minister (Health)

I beg to move amendment No. 9, in

clause 3, page 2, line 35, leave out subsection (4).

Photo of Mr Win Griffiths Mr Win Griffiths Labour, Bridgend

With this we may discuss the following amendments: No. 10, in

clause 3, page 2, line 37, leave out subsection (5).

No. 11, in

clause 3, page 3, line 1, leave out subsection (6).

Photo of Chris Grayling Chris Grayling Opposition Whip (Commons), Shadow Minister (Health)

These are more probing amendments. They are designed to elicit from the Minister what he anticipates being able to do under the powers, because in theory they are quite draconian and quite disruptive. We are establishing the Wales Centre for Health through primary legislation, but we are devolving to the Assembly the power to get rid of it, which seems contradictory. I should welcome clarification from the Minister, because I understand that primary legislative responsibility for the health service in Wales remains with this House. It seems odd to say the least that we are debating this issue here, but are willing to give the Assembly carte blanche to abolish the entity that we are legislating into place.

It is important to understand the potential use of the powers. These not only allow the Assembly to take the decision to abolish the body, but give the Assembly the power to emasculate it. We need to understand precisely why that is necessary and what safeguards exist to protect the centre against, for example, a new empire-building Minister who wanted to create a more substantial Department with greater control over what happened to health care in Wales.

We were particularly concerned about subsection (4), which states:

''The Assembly may by order make provision for the transfer to it of any or all of the Centre's functions.''

In what circumstances does the Minister expect that power to be used? What would be the implications for the Wales Centre for Health? What financial compensation would be made to the centre? Making a transfer of that kind would reduce the scale of the centre without necessarily reducing its core overheads. It is theoretically possible that removing a key department could undermine the centre's viability and cause financial problems. What safeguards does the Minister envisage being put in place to prevent the

centre being undermined, perhaps by an Assembly keen, in particular circumstances, to put a department under the control of the Welsh Department responsible.

What are the implications for staffing? We are talking about the wholesale transfer not only of property but of employees. Are we saying that the Assembly has the power to transfer people on a whim? Would that have implications for the independence of the body? A variety of matters could arise as a result of the use of such powers. Indeed, in considering the purpose of the provisions, my hon. Friends and I have considered various scenarios in which we could imagine that happening. For instance, if a foot and mouth outbreak were to occur—God forbid—the Assembly might choose to bring together a team of people from a number of organisations to combat it. That might be a proper and sensible thing to do, but it could undermine the viability of the centre. It would make it much more difficult for the rest of the centre to do its job by pulling out people and core resources; perhaps even putting a building under the separate control of a different body or department.

In what circumstances does the Minister envisage those powers being used? What would the issues be? How would those powers apply to staff? Will staff be employed by the centre, or will they remain effectively as Welsh civil servants? What powers would the board of the Wales Centre for Health have to challenge decisions with which it disagreed? Can he reassure us that those measures would not allow short-term political expediency to take over from good practice? The loss of functions would frankly make it much more difficult for the centre to continue functioning.

The amendments are probing, but we need to know precisely how the Minister sees those powers being used and what their purpose is.

Photo of Don Touhig Don Touhig Parliamentary Under-Secretary, Welsh Office, The Parliamentary Under-Secretary of State for Wales 6:30 pm, 10th December 2002

I will try to help the hon. Gentleman, and clarify the circumstances that might require the Wales Centre for Health to be wound up. The provision recognises that in future the Assembly may want to make changes to the functions of the centre, or even abolish it in favour of other arrangements. I stress—I even underline it—that there are no plans to abolish the centre; the provision is included merely so that proper arrangements can be made should the centre be wound up.

It is important that we should give the Assembly the ability to meet future contingencies. For instance, it might consider that some or all of the functions of the centre would be more appropriately undertaken by another organisation; its training functions might be undertaken by a training organisation, for example. It might be necessary to wind up the centre and arrange for certain functions to be carried out by the Assembly itself, as the body responsible for delivering the health service in Wales, or by bodies within its control.

The provision is designed to enable the Assembly to respond to future developments in public health in Wales. Many changes have occurred over the years and we will need to respond to further changes, as required.

The proposal for the Wales Centre for Health was part of a package of changes set out in ''Better Health, Better Wales''. Next year, other public health functions in Wales will be reorganised, with health authorities abolished and a new public health service created. We have seen evolving management structures within the health service over recent years and it is appropriate to make provision in the Bill ''in case''. It is right for the Assembly to review working arrangements and make necessary adjustments; it will need the powers to do so.

Amendment No. 10 is linked with amendment No. 9. The Assembly should have discretion over how it organises the public health function in Wales. In future, as I said, the Assembly might want to abolish the Wales Centre for Health, in favour of other arrangements in support of that function. I cannot speculate about what the exact arrangements might be; that is for the Assembly to decide, but I repeat that we have no plans to abolish the Wales Centre for Health. The possibility is there, should circumstances change. It is part of the Assembly's devolved function to be able to determine organisational arrangements for itself in accordance with its own priorities.

As for amendment No. 11, the Assembly must be able to make provision for dealing with the centre's staff, assets and liabilities in the event of an order transferring its functions under clause 4. The Assembly might in future want to change the centre's functions in order to achieve greater effectiveness or efficiency. We must recognise that, although we have no plans whatever to abolish the Wales Centre for Health, it is appropriate to make provision in case the Assembly wants to revisit its functions and re-examine its work. Under the Bill, the Assembly will be able to take appropriate action without the need for further primary legislation.

Photo of Chris Grayling Chris Grayling Opposition Whip (Commons), Shadow Minister (Health)

It is strange that we are establishing a body through primary legislation, while passing to the Assembly the power to abolish it. I am doubtful whether that is consistent with a national health service. We properly devolve powers within the NHS to Wales, but we should retain national health service frameworks, so I am unconvinced of the need for abolition powers. However, I am happy with the Minister's explanations and reassurances on other matters, so I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 3 ordered to stand part of the Bill.

Further consideration adjourned.—[Mr. Ainger.]

Adjourned accordingly at twenty-two minutes to Seven o'clock till Thursday 12 December at five minutes to Nine o'clock.