Clause 106

Health and Social Care Bill – in a Public Bill Committee at 4:45 pm on 22nd January 2008.

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Constitution etc. of Council

Photo of Kelvin Hopkins Kelvin Hopkins Labour, Luton North

I beg to move amendment No. 250, in clause 106, page 52, line 7, leave out ‘one executive member’ and insert ‘two non-executive members’.

Photo of Derek Conway Derek Conway Conservative, Old Bexley and Sidcup

With this it will be convenient to discuss the following amendments: No. 52, in clause 106, page 52, line 13, leave out ‘three non-executive members’ and insert ‘one non-executive member’.

No. 251, in clause 106, page 52, line 13, leave out ‘three’ and insert ‘seven’.

No. 53, in clause 106, page 52, line 14, after ‘State’, insert—

‘( ) two non-executive members appointed by the Appointments Commission.’.

No. 163, in clause 106, page 52, line 14, after ‘State’ insert—

‘( ) one non-executive representative of the regulatory bodies.’.

No. 252, in clause 106, page 52, line 15, leave out ‘two executive members’ and insert ‘one executive member’.

Eagled-eyed Members will have noticed that amendment No. 365 refers to leaving out “one executive member”, when it should say, “one non-executive member”. I mention that to ensure that we are all singing from the same hymn sheet.

Photo of Kelvin Hopkins Kelvin Hopkins Labour, Luton North

The amendments deal with the membership and composition of the CHRE, and would, among other things, increase the number of Scottish members from one to two and the number of English members from three to seven, and cut the number of CHRE executive members from two to one. If the overriding objective is a UK-wide approach to professional health care regulation, we need to acknowledge the need to continue and strengthen the relationship with Scotland, something that I suggest is politically important at the moment—I do not think that any Scottish Members are present today, but I hope that if there were they would support what I am saying—by having a more Scotland-specific view. Other UK-wide bodies, such as the Food Standards Agency, have two non-executives from Scotland, so why not the CHRE?

There is increasing fragmentation of health care across England, and CHRE needs to be able to reflect that in its composition, diversity and size. The extra English members will also provide reassurance that the CHRE council has the capacity to reflect a range of experience and expertise to span existing and additional functions indicated in the Bill. The CHRE’s senior executives already prepare council papers, attend, contribute and sit alongside council members and have considerable opportunity to influence CHRE decision making before, during and after council meetings. It would be more appropriate, and in keeping with the spirit of the White Paper, to focus on strengthening the CHRE’s lay membership. Our amendments are designed to achieve that through increasing English and Scottish membership, and therefore the council’s capacity to be, in the words of the White Paper, a truly

“authoritative independent voice for patients on the regulation of professionals, providing expert advice on policy”.

I think that I have made the case, and hope that my hon. Friend the Minister will be sympathetic to it.

Photo of Stephen O'Brien Stephen O'Brien Shadow Minister (Health) 5:00 pm, 22nd January 2008

I think that what the hon. Member for Luton, North is trying to achieve is not dissimilar to what we want to achieve. The power of appointment is always a difficult area, because at this stage it can look rather benign, but it can in practice prove very influential and representative.

Our amendment. No. 52 would limit the Secretary of State to appointing one non-executive member in line with one from Scotland and one from Wales. Amendment No. 53 is consequent on that, giving the Appointments Commission the power to appoint the other two. The question that the provisions pose to a Government who purport to believe in devolution is why the devolved Administrations are in this context subordinate to the Secretary of State. Our amendments Nos. 52 and 53 are intended to obtain equality, in effect, between the Secretary of State and his counterparts in the devolved Administrations, notwithstanding the fact that, to go by the Secretary of State’s response when challenged on Second Reading, all appointments are likely to be devolved to the Appointments Commission in any event. I seek some guidance about representative capacity.

Amendment No. 163 would leave on the CHRE some representative of the regulators. While in my view, currently, the council of 19 members, with every regulator represented, might be unwieldy, surely it is not right that their voice should be completely silenced, which is why the amendment would preserve it.

Photo of Ben Bradshaw Ben Bradshaw Minister of State (Regional Affairs) (South West), The Minister of State, Department of Health

The reason we are reforming the Council for Healthcare Regulatory Excellence is to ensure that it fits with the new regulatory landscape, including shifting its role from being the sum of the existing regulators to being the independent voice of the patient. Part of the change, we believe, merits reducing the size of the council from the rather large membership of 19 to nine—seven non-executive and two executive. That is consistent with the Government’s general approach in trying to make the professional regulatory bodies more board-like and strategic.

The amendments would significantly increase the size of the council, bringing it back up from nine to 16, and would alter its make-up by adding a non-executive member representing the regulatory bodies. Amendment No. 53 specifically would add two further non-executives appointed by the Appointments Commission alone. As I have said, it is already our intention for the Secretary of State to arrange for his appointments functions to be exercised by the Appointments Commission anyway, which I hope renders the amendment unnecessary.

I am particularly concerned about amendment No. 163, because of the point that I have just made. I am not clear whether the regulatory bodies would collectively nominate the member. The important point to note, however, is that the function of the council is changing, so that the CHRE can promote the interests of patients and members of the public in relation to the performance of regulatory bodies and be an authoritative independent voice on the regulation of professionals. It is not appropriate for regulatory bodies themselves to delegate or to send a representative to the body that regulates the professions.

On the point about Scotland, I hope that I can reassure my hon. Friend the Member for Luton, North. The change has already been agreed, and the Scottish Parliament has agreed to legislate a consent  motion for the Bill. It is therefore content with the level of Scottish representation. I was trying to find out about the size of the FSA board and whether there are similar plans to downsize it, but I have not managed to do so in the time available. If I can find that out offline, I will let my hon. Friend know.

Amendment No. 252 would decrease the number of executive members to just one. That would not be consistent with usual practice among other arm’s length bodies sponsored by my Department and others. For example, it is common practice for regulatory bodies to include their finance director on the board or council, and it obviously makes sense to allow the CHRE to follow that example if it so wishes.

In the light of those reassurances, I hope that my hon. Friend and the hon. Member for Eddisbury will not press their amendments.

Photo of Kelvin Hopkins Kelvin Hopkins Labour, Luton North

I thank my hon. Friend for his response, particularly on the Scottish point, and I entirely accept what he says. As he may recall, emphasis was placed during the hearings on the importance of having diverse representation on all health bodies, particularly in constituencies such as mine, and it is important for people from minorities to be genuinely represented. I will not press my amendments to a vote, but I hope that my hon. Friend will seek to ensure that diversity in gender and everything else is properly reflected in public appointments to all these bodies.

Photo of Stephen O'Brien Stephen O'Brien Shadow Minister (Health)

I shall not press my amendments to a vote because we have had our debate, and it has been helpful to have a bit more clarity from the Minister on the issue, although we may return to it. Clearly, this is an important issue, and I dare say that we shall all do some more thinking about it.

Photo of Kelvin Hopkins Kelvin Hopkins Labour, Luton North

I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Photo of Stephen O'Brien Stephen O'Brien Shadow Minister (Health)

I beg to move amendment No. 164, in clause 106, page 52, leave out line 27.

The amendment can be dispatched very quickly, and I almost feel inclined to say, “Give us a break.” The clause seeks to replace the word “chairman” in the 2002 Act with the word “chair”. I could do a complete rant about political correctness. We have all moved on and we do not need to go back and completely redraft everything. I really think that the provision smacks of “Animal Farm”, and we could do without it. I therefore hope that the Minister will accept my amendment so that we can move on quickly.

Photo of Stephen O'Brien Stephen O'Brien Shadow Minister (Health)

I was not talking about the commission.

Photo of Ben Bradshaw Ben Bradshaw Minister of State (Regional Affairs) (South West), The Minister of State, Department of Health

Yes, but it is the commission’s recommendation that we are carrying out by replacing the term “chairman” with the term “chair”. If the hon.  Gentleman really wants to take up the Committee’s time by debating the issue at length or putting it to a vote, that is his call.

Photo of Stephen O'Brien Stephen O'Brien Shadow Minister (Health)

It is not worth the time. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 106 ordered to stand part of the Bill.