I have concerns about how the powers provided under the clause enabling the Assembly to make regulations will work in practice. How does the clause address the issue of duplications that may occur in the system? That concern applies equally to the practice of dealing with complaints in NHS bodies in England and in Wales. In debating some of the recent clauses, we did not consider in any way, shape or form the provisions dealing with complaints in respect of English NHS bodies, but in respect of Wales I want to tease out from the Minister how the powers might be used and whether they would be allowed to be used in a certain way.
I will use the example of a Welsh NHS acute trust that carries out a poor assessment, resulting in the early discharge of a patient to intermediate care provided by a primary care trust in Wales. That primary care trust then fails to pick up the fact that the patient has been prematurely discharged, and as a result it fails to take the necessary steps for a readmission to the acute trust. In those circumstances, is it reasonable to expect the patient, when complaining about the nature of the treatment that they have experienced, to navigate their way round the system and to decide whether it is the acute trust or the primary care trust—or indeed both bodies—to which they should make a complaint? They might find themselves having to deal with several different complaint processes about different aspects of one ongoing patient journey.
Do the powers in clause 110 provide for regulations to be made by the Welsh Assembly that would require NHS bodies to co-operate in dealing with patient complaints? That applies particularly in terms of sharing information between NHS bodies, or nominating one or other of the NHS bodies dealing with the complaint to act as the lead body for giving a comprehensive response to the complainant. Where issues of negligence come into play, NHS bodies, whether primary care trusts, acute trusts or other bodies, are suddenly more reluctant to share information. They may have an interest in ensuring that they do not end up with the responsibility of dealing with the consequences of a successful negligence claim.
I was anxious to take the opportunity to take up those issues with the Minister under clause 110. It seems to me that they are not entirely addressed within the regulation-making powers. It would be most helpful if the Minister could give me some reassurance on the matter.
Section 20 of the National Health Service Reform and Health Care Professions Act 2002 places a statutory duty on health care providers and on
local authorities to develop well-being strategies. That partly covers the point that the hon. Gentleman made about discharge—the problems of discharge have already been covered in previous legislation. The Health (Wales) Act also gave strengthened powers to community health councils. In England those powers were given to patient forums so that they could act as advocates for a person who had a complaint about his treatment.
The provisions in the Bill will allow us to implement a robust complaints process that reflects the needs and concerns of Welsh patients, and we must ensure that they have confidence in the procedure. The clause gives the Assembly regulation-making powers covering the NHS complaints procedure, but replaces the present direction-making powers. That would ensure that we have a health care complaints system in Wales that could be tailored to the needs and concerns of Welsh patients. The handling of the second stage of the complaints procedure will be different in Wales. In England, it will be carried out by CHAI; in Wales, trained lay people appointed by the Assembly will carry it out. The provisions in the Bill allow for cross-border situations and links in social services to be dealt with. I hope that that helps the hon. Gentleman.
That is helpful. I appreciate that there are some differences between arrangements in England and Wales. I take from that that it would be possible for regulations to be made by the Assembly to allow for greater co-operation and to place a requirement on NHS bodies in Wales to co-operate when dealing with complaints, so that the patient does not have to go through numerous NHS bodies.
Much of that is covered in the Health (Wales) Act, in which we strengthen the advocacy role of community health councils to ensure that a patient's voice can be heard and complaints in Wales are properly investigated.
Question put and agreed to.
Clause 110 ordered to stand part of the Bill.
Clauses 112, 129, 130 and 131 ordered to stand part of the Bill.