Clause 180 - Activities relating to local care services

Health and Social Care (Re-Committed) Bill – in a Public Bill Committee at 3:51 pm on 14 July 2011.

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Photo of Paul Burstow Paul Burstow The Minister of State, Department of Health 3:51, 14 July 2011

I beg to move amendment 230, in clause 180, page 160, line 26, at end insert—

‘( ) After that subsection insert—

(3A) A person to whom views are made known or reports or recommendations are made under subsection (2)(d) must, in exercising any function relating to care services, have regard to the views, reports or recommendations.”’.

The amendment will create a duty on those responsible for commissioning, providing, managing or scrutinising local care services and on HealthWatch England to have regard to the views, reports and recommendations from local healthwatch organisations when exercising functions relating to care services. The NHS Future Forum’s patient involvement and public accountability report was generally supportive of the Government's proposals for HealthWatch, describing it as a

“new powerful consumer advocate at local and national level”.

However, the forum also reported concerns about the extent to which local health and social care bodies would voluntarily pay heed to the outputs from local healthwatch organisations, an issue we have recently discussed. The forum said,

“It cannot be assumed that just because local healthwatch exists in its role as a consumer champion and to provide scrutiny and challenge, that commissioners and providers will be receptive to it looking into areas of concern and take notice of any findings.”

The NHS Future Forum took the view that the way to deal with those concerns was to place a duty on commissioners and providers to have regard to the findings of local healthwatch organisations, and recommended accordingly. That is what the amendments do.

I can assure hon. Members that the duty applies in relation to both health and social care service functions for the people receiving those services. The amendment refers to “care services”, and adds a new subsection to section 221 of the Local Government and Public Involvement in Health Act 2007. Section 221 defines “care services” as services provided as part of the health service in England, or services provided as part of the  social services functions of a local authority. On that basis, I hope that hon. Members will accept the amendment as a way to ensure greater patient involvement.

Photo of Emily Thornberry Emily Thornberry Shadow Minister (Health)

To a certain extent, the amendment illustrates the Government’s lack of understanding of how HealthWatch ought to be and function. If HealthWatch is truly representative of a local area and patients, then any local authority would be foolhardy not to listen to it. That is why an important part of HealthWatch is how to ensure that it is properly representative. We believe that the Government have missed a golden opportunity to firm up legislation in relation to HealthWatch, such as the amendments and arguments we put forward earlier. Structure by itself is simply not enough. Proper public engagement is the key. We do not believe that the legislation as it is currently formulated does that sufficiently.

The Government feel that they can answer the legitimate concerns of the community about HealthWatch by simply saying that health and well-being boards must pay attention to what it says. The fact that we need that in legislation shows that the Government appreciate that people are not confident that HealthWatch will be sufficiently robust, independent or strong to fulfil the very important role that we all want it to have.

Photo of Roger Gale Roger Gale Parliamentary Assembly of the Council of Europe (Substitute Member)

I hate to say this, but the speech from the Front Bench did not relate to the amendment under discussion. We must try to concentrate on the amendments.

Photo of Tom Blenkinsop Tom Blenkinsop Labour, Middlesbrough South and East Cleveland

I have a small question relating to the Government’s description of amendment 230, which says,

“The amendment does not create a duty on any of these persons directly to act on any views, recommendations or reports from local healthwatch, but does mean that they will need to be able to demonstrate that proper consideration has been given to them in exercising functions relating to care services.”

What would demonstrate proper consideration? Having knowledge of negotiations and consultation with other bodies from an employment aspect, I might assume from reading this that writing, “We have paid proper consideration to your recommendations,” would suffice as proper consideration in a written format. Is there any explanation of what proper consideration would constitute? Would there be a system of demonstrating proper consideration? Apart from that, it is welcome, but I would like to check that one small aspect.

With reference to previous clauses, I can see where the Government are coming from in attempting to give HealthWatch more recognition, but clauses 71 and 72, by their very nature, limit HealthWatch’s ability to have any input in the process. From an employment background, this is just like any other works committee, which is a patsy, rather than a genuine, recognised body that can have genuine input and table genuine recommendations.

Photo of Paul Burstow Paul Burstow The Minister of State, Department of Health 4:00, 14 July 2011

The hon. Gentleman gets the prize for being able to bring mergers and acquisitions back into the discussion by referencing clauses 71 and 72. I congratulate him on his perspicacity. Let us return to the clause in front of us and what the amendment is  about, which is how we ensure in one way—it is not exclusive—that the work of local healthwatches is seen as important in the local system. That goes back to the point that was made by Jeremy Taylor when we received evidence at the start of the Committee stage, which is that the legislation and the amendments are certainly essential, but they are not sufficient. That is why we have a pathfinder programme, and that is why we have a collaborative process to roll out both HealthWatch England and local healthwatch. We are working with existing stakeholders from LINks, with local authority colleagues and with all those who have an interest in getting right the design of this important vehicle for delivering patient voices into the system. It cannot, as the hon. Member for Islington South and Finsbury quite rightly said, simply be a matter for legislation. It must be about attitudes and culture. We have quite a lot of work to do to undo the damage that has been done by the constant changes that occurred over the past 13 years.

I therefore hope that, with the changes and amendments, we can secure a patient involvement mechanism, through HealthWatch and local healthwatch, that is effective at delivering what patients and carers need.

Amendment 230 agreed to.

Clause 180, as amended, ordered to stand part of the Bill.