Clause 19 - Information

Health and Social Care (Community Health and Standards) Bill – in a Public Bill Committee at 6:00 pm on 3rd June 2003.

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Photo of Chris Grayling Chris Grayling Shadow Minister (Education) 6:00 pm, 3rd June 2003

I beg to move amendment No. 23, in

clause 19, page 8, leave out line 24 and insert 'the regulator requires'.

Photo of Peter Atkinson Peter Atkinson Conservative, Hexham

With this it will be convenient to discuss the following:

Amendment No. 193, in

clause 19, page 8, line 24, at end insert

'such information to be less in aggregate than that required of the trust before it became a foundation trust'.

Amendment No. 457, in

clause 19, page 8, leave out lines 25 and 26.

Amendment No. 458, in

clause 19, page 8, line 28, at end add

'subject to such request not being supplementary to information currently provided under the existing powers of the Secretary of State.'.

Photo of Chris Grayling Chris Grayling Shadow Minister (Education)

The amendment would remove a power that we believe is unneeded. Why does the Secretary of State need to specify to the regulator what should be the information disclosure requirements of the foundation trust? Why should it not be a matter for the regulator and the trust to work out together? The Secretary of State does not have a great track record when it comes to setting appropriate and sensible levels of bureaucracy and paperwork. We see no benefit in inserting the Secretary of State into that relationship.

The amendment would remove the phrase

''the Secretary of State specifies to the regulator''

and insert the words ''the regulator requires''. That would be a prudent amendment: the regulator would still be able to extract from foundation trusts information that was appropriate for the regulator to use when making his report to Parliament and when ensuring that NHS foundation trusts make public enough information about their financial and constitutional affairs, and about their performance in

the services that they deliver. There is no possible reason to allow the Secretary of State to decide what the regulator needs; surely that can be done by the regulator himself.

Amendments Nos. 457 and 458 offer two options to the Government. They are designed to make a similar contribution and are to some extent mutually exclusive, but I hope that the Minister will accept the principle in one of them.

Our problem is with subsection (1)(b), which says that an authorisation

''may require an NHS foundation trust to disclose other information to the regulator.''

That is surely taken into account in paragraph (a), so there is unnecessary duplication. The provision does not add anything to the Bill.

The Bill also provides:

''The regulator may require any other health service body to disclose any information to him which he requires for the purposes of his functions.''

Why should we give the regulator the power to ask any other health service body to deliver any information that the regulator decides that he requires? We should not give the regulator the power to seek information from NHS bodies other than foundation trusts over and above the information that the Secretary of State already requires to be provided to Government.

We are simply considering the status quo, and it is perfectly reasonable for the regulator to ask the same question of other organisations in pursuit of his judgment about, for example, the nature of an authorisation that should be given. It is also reasonable for the regulator not to have powers to request information over and above the existing powers of the Secretary of State.

These are tidying-up amendments, designed to reduce bureaucracy in a system in which there is too much. I hope that they are not controversial and that, if the Minister does not accept the substance, he can accept the direction and will acquiesce with steps to ensure that the provision of information is carried out with as little impact as possible on the operational side of the trust's activities.

Photo of Andrew Lansley Andrew Lansley Conservative, South Cambridgeshire 6:15 pm, 3rd June 2003

I should like to express the apologies of my right hon. Friend the Member for North-West Hampshire for not being able to be present to speak to amendment No. 193.

The amendment is fairly straightforward and self-explanatory. If the intention of the legislation is to lift regulatory burdens and compliance requirements on foundation trusts to help them to do their job, that should be carried forward into clause 19(1)(a). Although the NHS foundation trusts should comply with the general requirements on the NHS to provide information for audit and other purposes, the aggregate of that information should be less than was required of them before they became foundation trusts. That is the burden of the amendment.

Mr. Hutton: I cannot accept any of the amendments, and I shall set out the reasons why. Clause 19 serves two distinct purposes, the first of which is to ensure that the Secretary of State has the information that he needs to set standards, allocate resources and plan provision of health care across the NHS in line with his responsibilities under the National Health Service Act 1977. That means collecting information from all parts of the NHS, including NHS foundation trusts, for national policy development, funding decisions, manpower planning and tracking performance throughout the NHS. Those matters go further than the regulator's specific functions, and it would be inappropriate for the independent regulator to decide what the Secretary of State should have. That is why I am unable to accept amendment No. 23 and the consequential amendment No. 457.

However, it is true that we do not want to replicate existing data collection, and to the extent that amendment No. 193, tabled by the right hon. Member for North-West Hampshire, is designed to minimise data collection, I have a great deal of sympathy with it. However, we want to consider information requirements from NHS foundation trusts as a subset of that required from other NHS bodies. We want to continue the work that is under way to streamline further the information that is required to be sent in to the centre.

Photo of Gary Streeter Gary Streeter Shadow Minister (Foreign and Commonwealth Affairs)

We are all concerned about the quantity of reporting requirements imposed on hospitals at present, and we hoped that those requirements would be lighter under the foundation trusts regime. Will the Minister assure me that the amount of information required by the Secretary of State under the provision and the format in which it is required will be the same as that required by the regulator, so that the hospital trusts will not have to produce the information in two different ways, thereby increasing cost, time spent and bureaucracy?

Photo of John Hutton John Hutton Minister of State, Department of Health, Minister of State (Department of Health) (Health)

Obviously, that would be an ambition to which we would sign up. In practice, there is no doubt that the range of information required from foundation trusts will be narrower in scope than that required from NHS trusts, which will reflect the difference in performance management responsibilities over the actions of NHS foundation trusts. As the hon. Gentleman knows, that will no longer be the direct responsibility of the Department.

The second purpose of clause 19 is to ensure that the regulator is able to obtain the information that he needs to set the terms of the authorisation, to monitor NHS foundation trusts' compliance with the terms of authorisation and statutory obligations, as well as to investigate breaches. In so doing, the independent regulator may need access to information from sources other than NHS foundation trusts. For example, he may need information from primary care trusts on their commissioning needs, or on the services that they have received from NHS foundation trusts.

We do not expect the independent regulator routinely to collect data from bodies other than NHS foundation trusts, nor that the provision of that

information will place a significant burden on them. He is most likely to require specific information in cases in which he needs to take specific action, such as varying the terms of authorisation or investigating breaches. It is true that the information that he requires may differ from that submitted to the Secretary of State, and that is why amendment No. 458 is also not acceptable. I cannot accept amendments that would restrict my right hon. Friend the Secretary of State's ability to carry out his duties with respect to the NHS, or would restrict the regulator's ability to monitor compliance with the terms of authorisation. I am afraid that this group of amendments would do both.

Taking a more bipartisan approach, I share some of the wider concerns that were expressed. The Secretary of State and I do not intend to duplicate or set up parallel systems of bureaucracy related to NHS foundation trusts. That would run counter to our ambitions for foundation trusts, and to the way in which we would like to see the NHS of the future develop.

Photo of Chris Grayling Chris Grayling Shadow Minister (Education)

I thank the Minister for those points of clarification. May I raise one further area of concern? The regulator sits fairly and squarely in the foundation hospitals camp, but he is being given the right to seek information from primary care trusts, who are the buyers of the service. The Minister will be aware that acute hospital trusts and primary care trusts sometimes end up in significant disputes over financial matters. It therefore seems curious that the regulator may be given powers of access to information from the primary care trust that go beyond those held by the Secretary of State today. Will the Minister assure me that such a situation could not arise, and that there is nothing that the Secretary of State would be precluded from seeing relating to the way in which the primary care trusts have been set up to which the regulator, as someone who works with the supplier of services to the primary care trusts, would have access?

Photo of John Hutton John Hutton Minister of State, Department of Health, Minister of State (Department of Health) (Health)

I would not rule out the possibility that that could be the case. However, the hon. Gentleman is wrong in his characterisation of the regulator as being in the NHS foundation trusts camp. I am sure that hon. Members on both sides of the Committee would accept that it is appropriate and necessary for the regulator, if he is to do his job properly, to have the right to seek information from primary care trusts, because they are significant partners in the whole exercise of improving NHS services through NHS foundation trusts. It would be bizarre if the regulator were not able to approach primary care trusts to request information, because that would impede his ability to monitor compliance with the terms of authorisation and the general progress made by the foundation trust.

We are not creating a Gestapo: the provision is not an inappropriate manifestation of unnecessary powers. We are trying to find the right balance between giving the regulator the tools that he needs to do the job properly and ensuring that my right hon. Friend

the Secretary of State is still able to take an overview of performance right across the NHS, including the performance of NHS foundation trusts. I am sure that the Bill, as currently drafted, strikes that balance, and it is for that reason that I am not able to accept the amendments that the hon. Gentleman has tabled.

Photo of Chris Grayling Chris Grayling Shadow Minister (Education)

I am grateful to the Minister for that clarification. It is conceivable that a dispute could arise between a foundation trust and a primary care trust over a significant amount of money and, because of the consequential impact on the finances of the foundation trust, the regulator would feel the need to intervene and take a close interest? Under these powers the regulator would also have the right to examine the other side of the argument and inspect the books. I am slightly anxious about the implications of that when there are genuine disputes between two NHS bodies. That said, I am happy not to pursue the issue. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 19 ordered to stand part of the Bill.