New Clause 8

Health and Social Care Bill – in a Public Bill Committee at 3:30 pm on 24th January 2008.

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‘(1) The Commission shall establish and maintain a committee to be known as “HealthWatch”.

(2) HealthWatch shall consist of—

(a) a chairman appointed by the Commission; and

(b) such other members appointed by the Commission as the Commission think fit.

(3) The chairman appointed under subsection 2(a)—

(a) shall be a non-executive member of the Commission

(b) but is not to be chairman of the Commission.’.—[Mr. Stephen O'Brien.]

Brought up, and read the First time.

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

I beg to move, That the clause be read a Second time.

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

With this it will be convenient to discuss the following: New clause 9—General duty of HealthWatch

‘It shall be the duty of HealthWatch to further the interests of patients and the public in relation to the provision of health services in England.’.

New clause 10—Functions of HealthWatch

‘(1) HealthWatch shall make arrangements for ascertaining—

(a) the state of public opinion about the manner in which health services in England are provided,

(b) the views and experiences of patients in relation to the provision of health services in England; and

(c) the views and experiences of patients in relation to the handling, by commissioners and providers of healthcare services, of complaints made to them by such patients.’.

New clause 11—Local Involvement Networks.

‘(1) HealthWatch shall be regarded as an “English network” for the purposes of section 222 of the Local Government and Public Involvement in Health Act 2007 (c. 28).

(2) HealthWatch may make such arrangements as it thinks fit for consultation with Local Involvement Networks.’.

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

It does not matter how many times one does it; returning to a discussion of many days or weeks ago is the most challenging part of the procedure. At least we have reporters if I have got any of that wrong.

We have had an important discussion on public and patient involvement. That is something that is of great concern across the House and I do not intend to seek to embarrass or press in a partisan way. As hon. Members are aware, there is a proposal, which happens to come from the Opposition, to establish an organisation called HealthWatch. I have urged the Minister to look seriously and carefully at what my party proposes. We have worked very hard on this matter: we have discussed it with a lot of people and we have made a commitment to establish HealthWatch, a national consumer voice for patients and service users. Having had many discussions about local involvement networks with patients and public involvement throughout the Committee stage, we are very grateful, and I genuinely mean that, that the Minister has undertaken to look at the matter again. His commitment is welcome.

I will not unduly delay the Committee although we are not particularly rushed. New clause 8 seeks to establish HealthWatch as a committee of the CQC and makes provision as to its constitution. New clause 9 is established to

“further the interests of patients and the public in relation to the provision of health services in England.”

New clause 10 would require HealthWatch to ascertain:

“the state of public opinion about the manner in which health services in England are provided...views and experiences of patients in relation to the provision of health services in England; and...the views and experiences of patients in relation to the handling, by commissioners and providers of healthcare services, of complaints made to them by such patients.’.”

New clause 11 would establish HealthWatch as an “English network” for the purposes of the Local Government and Public Involvement in Health Act 2007. I do not know whether any members of this Committee served on the Public Bill Committee for that legislation, but I should have checked, given that there has been genuine interest from many hon. Members present. HealthWatch would use existing legislation to achieve the aim of having a national representative body for local involvement networks.

Contrary to the Minister’s assertion that our proposal is opposed to the bottom-up, organic approach—he will recall that discussion—LINKs would be the drivers. HealthWatch would give them the power to engage with policy at national level, which they are denied by the Government. That is the essential part. I am sure that Committee members will recall the importance of the old community health councils and the bed watch publication. That had a major impact on the way in which Governments thought about the patient experience, what needed to happen and priorities. Indeed, in their early years in office, one of the Labour Government’s priorities was capacity issues.

With the new clauses, we aim to deliver on our commitment to establish a national consumer voice for patients—HealthWatch—to provide them with support at a national level, to provide leadership to LINKs at a local level and to incorporate the functions of the independent complaints advisory services. That is very important. We have had many discussions on concerns about the capacity to process complaints, assuming the Bill becomes an Act, and the capacity of the complaints handling system. Today’s memorandum helped to put a little more flesh on the bones regarding complaints issues. That welcome and important document has been placed on the record as a memorandum.

HealthWatch would also make representations on the closure of NHS services, for example. We would have it make representations to the NHS board, and we have published a draft Bill on that, which we hope to have the opportunity to introduce. Subject to consultation, HealthWatch would have statutory rights over nationally issued guidelines on the care that NHS patients should receive and on decisions that affect how NHS care is provided in an area. I urge the Minister to take our new clauses into account as he seeks a way forward for patient involvement in the CQC and our NHS.

My hon. Friend the Member for South Cambridgeshire (Mr. Lansley) has promised to bring our proposals forward as part of our announced NHS Autonomy and Accountability Bill. I hope that this debate has sufficiently whetted the Minister’s appetite for that discussion and that he has no concerns about pride of authorship or the fact that the measures happen to have been proposed by us rather than his Government. It is undoubtedly the right way forward for our NHS. On that basis, I commend the new clauses to the Committee and very much hope that the Minister will regard them as a useful addition that will improve the Bill as we speed its passage through Parliament.

Photo of Kelvin Hopkins Kelvin Hopkins Labour, Luton North

I reiterate my concern that the representation of patients should be sufficiently strong and robust both in representing patients as a group and providing access for individual patients with particular problems. I am also concerned about access to advocacy. Some Labour Members will be watching carefully to see how the new arrangements work in practice and to ensure that patients have proper representation in every way necessary and appropriate. I hope that my hon. Friend the Minister will take note of our concerns that the new machinery should work properly. If it does not work so well, we will look forward to more reforms in the future.

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

I am sorry to tell the hon. Member for Eddisbury that we think the HealthWatch idea is as flawed as other ideas in the Conservatives’ draft Bill, such as giving over the running of the health service to an independent, unaccountable national quango. The reasoning behind the new clauses appears to be that the committee will represent patient and public views to the commission more effectively than the local involvement networks—or the regional or national networks that they might choose to establish with the Care Quality Commission—might otherwise be able to achieve.

The re-establishment of a centralised body, especially one that sits within the Care Quality Commission would undermine our move towards more local determination, flexibility and responsiveness. It would also go against the conclusion of the arm’s length body review in 2004, which recommended the abolition of the Commission for Patient and Public Involvement in Health—a not dissimilar body to the one being proposed as part of the wider Government agenda to move resources from centralised bodies to the front line.

LINKs should be given time to determine their own way of being represented regionally and nationally if they wish. Together with other changes we are making such as the complaints reform to which the hon. Gentleman referred, that will more than cover the function set out in the Bill for HealthWatch and ensure the representation of the public and patient voice to the new regulator, as my hon. Friend the Member for Luton, North so eloquently advocated.

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

I put it on the record that we do not accept the Minister’s analysis of the approach advocated by our NHS Autonomy and Accountability Bill but there may be a future opportunity to consider it in detail. I recognise that the soundbite used in relation to it has been repeated.

I pay tribute to the hon. Member for Luton, North, who did not necessarily support the new clause, for his consistent approach to patient involvement and the level of advocacy that needs to be established. He and I have shared a view on that issue over at least eight years since we looked very closely at what was happening when the community health councils were abolished, as it was one of their key roles. The independence and trust that they enjoyed led to advocacy that worked, which was especially helpful to those in a very vulnerable situation. Our HealthWatch proposal, which is contained in the new clauses, is intended to try to replicate that aspect of the CHCs.

I do not want to press the hon. Gentleman to make a decision and I recognise that the Government are taking a view on these matters. The point is well heard as well as well made and the best I can do is hope that if we continue to take opportunities to press these ideas, the Government will one day realise that they are not intended to be something that they should resist, but something that they should embrace. That would be one of the best ways of demonstrating that there is a unity in many of our objectives for making sure that the NHS is not only robust and well designed but that its priority is to serve patients from the very first to the very last and to improve their lives through better health.

I beg to ask leave to withdraw the motion.

Motion and clause, by leave, withdrawn.