With this it will be convenient to discuss the following amendments: No. 256, in clause 108, page 53, line 40, at end insert—
‘(c) such other organisations representing patient and public interests as the Secretary of State shall by regulation specify.’.
No. 257, in clause 108, page 53, line 41, after ‘matters’, insert ‘of policy’.
No. 258, in clause 108, page 53, line 41, at end add—
‘(5) The Council must—
(a) consult with public and patient organisations in England, Scotland, Wales and Northern Ireland on its work programme, including—
(i) the standards,
(ii) minimum requirements, and
(iii) supporting evidence, to be used in its regulatory performance review, and
(b) publish at least annually a report on its consultations in England, Scotland, Wales and Northern Ireland held in accordance with this section.’.
The amendments seek to strengthen clause 108 by inserting in subsection (4) the word “consult” instead of “seek the views of”. It seems strange that the word “consult” is included in the clause heading and is then softened further down to “seek the views of”. The process of seeking views is less active, less mutual and weaker than the process of consulting. Consulting is a two-way process; “seeking the views of” is a one-way process. I, therefore, ask my hon. Friend the Minister to consider seriously this amendment.
The other component of my amendments would give more powers to my hon. Friend, or the Secretary of State, to specify other organisations that might be consulted. Proposed subsection (4)(c) would give the Secretary of State—in addition to the council—powers to specify other bodies that might represent patients and the public. It seems to me that giving extra powers to the Secretary of State might appeal to my hon. Friend, and I hope that he accepts the amendments. The firming up of the clause would be welcomed by those who are concerned about public and patient representation in health.
As my hon. Friend has rightly pointed out, the CHRE will have a new duty to inform and consult the public about the exercise of its functions in the clause. That comes on top of the new main objective that we have already discussed about aligning the exercise of its duties with the interests of both patients and the wider public, and the improvement in the new board structure, which will be mainly lay with no regulatory body representatives. His amendment, however, would tie the CHRE’s hands as to how it consults. The view of the council’s current chief executive, which we share, is that such formal consultation as my hon. Friend refers to may not always be the most appropriate way to take soundings from people.
I am sure that my hon. Friend will know from his own experience that formal consultation with particular groups can be dominated by what one might unkindly call groups of self-selecting busybodies, rather than reflect a true sense of public feeling in a particular area. The council’s chief executive thinks that it may need the flexibility to use a quorum, academic studies, focus groups and other means of engaging with patients, the public and stakeholders, depending on the gravity and complexity of the issue at hand, as well as traditional formal consultations. It would not be helpful to tie the council to the latter.
We believe that the CHRE will be capable of making the right decisions about how to consult on particular issues, but as my hon. Friend has probably noticed, it will be possible use the new Secretary of State power to issue directions to the council on the manner in which it must exercise its functions. We have that safeguard if we feel that it is not consulting properly. As we discussed earlier, the council also has the obligation to promote best practice and good regulation, which will include good consultation.
As the Minister has seen, I did not participate in the debate on the amendments, but he has just prayed in aid the fact that he could use the Secretary of State’s reserved power to direct. That is what causes us some concern about independence. There is tension in the Bill between seeking to protect by having a power of direction and convincing many of us that there will be sufficient independence.
We think it a sensible balance, which will meet the concerns expressed by my hon. Friend that the body might not consult adequately. It will provide a way for hon. Members to express their concerns, so we think that it is a sensible power to keep. We do not expect to have to use it.
On my hon. Friend’s amendment No. 258, paragraph 16 of schedule 7 to the 2002 Act already requires the council to
“prepare a report on the exercise of its functions during each financial year”,
so we do not think the amendment on that matter is necessary. The report that the council is required to table under the 2002 Act should include details about how it has undertaken its duty to consult and inform the public.
Although the amendments in the group are well intentioned, they are not strictly necessary. They are more prescriptive than the proposals in the Bill and would not enable anything that is not already possible given the council’s existing powers. In that light, I urge my hon. Friend to withdraw the amendment.
I am rather disappointed that my hon. Friend has not at least accepted the amendment to substitute “consult” for “seek the views of.” There is a difference, and I know from my experience of dealing with health bodies in my constituency and local area that some health officials—I shall not name names—are less than enthusiastic about consulting the public. They will receive a letter and say, “Thank you very much”, but when it comes to consultation they are less enthusiastic. Sometimes we want to get our point across; we have an active patient and public involvement forum, with a redoubtable chairperson who would undoubtedly be considered a busybody by the health authority but is a fine representative of my constituents and a personal friend of mine.
I wish to articulate the thought that went through my mind when the Minister talked about “busybodies”. I can think of several people whom he might describe as busybodies, who are usually fine women of a certain age past whom no detail goes without their ensuring that it gets to the right desk. We need a few more busybodies examining what is going on in the health service. The fact that they do that in their free time is an asset.
I did not want to start that hare running, but I say to the hon. Lady that I will not pass on the word “busybody” to my dear friend locally who is chair of our PPI forum and does a splendid job, especially as she happens to be, privately, a member of our party as well, which would probably automatically come under the general category of busybody. Our job as representatives is sometimes to be busybodies and I am a bit of a busybody myself. I hope that the Minister will think further on these matters and the wording of the provision and perhaps return with an improvement to the clause at a later stage. I beg to ask leave to withdraw the amendment.