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Local Government and Public Involvement in Health Bill

My Lords, it is with some hesitation that I intervene in this debate, because I have the highest regard for the noble Baronesses, Lady Murphy and Lady Meacher, and their views. However, I have to say I disagree with the approach they have taken in these amendments. I shall quote from the report on the Bristol inquiry to explain why I do so. Paragraph 14 of the report says that, "““if the quality of the care given to patients is to be taken seriously, there are some matters on which only patients are qualified to speak, for example, the extent to which any particular service accords with the needs of the patient … The views of patients and the public are relevant not only to the standards to be observed by healthcare professionals; but also to the standards and performance of hospitals””." To argue that patients in a given locality are adequately represented by boards of governors misses the key point that boards of governors are concerned only with what is done or not done in their particular organisation. The patient perspective on local services encompasses more than just a single trust; it also encompasses groups of people who may be completely unrepresented on trust boards. Foundation trust members are a self-selected group of people who officially have no duty towards the wider community served by the trust. The Department of Health website says: "““The main function of the Board of Governors will be to work with the Board of Directors to ensure that the NHS Foundation Trust acts in a way that is consistent with its terms of authorisation and to help set the strategic direction””." None of that has anything to do with the activities of a LINk. Indeed, I venture to say that a board of governors cannot fulfil its duties towards the trust while also attempting to fulfil the role of a LINk. Amendment No. 210ZA would confer on boards of governors a role that, I humbly suggest to the noble Baroness, they have neither the vires nor the funding to undertake. If there is still doubt about this, we have only to consider a situation in which major changes to local health services are being proposed to appreciate how the perspective of a trust board could not possibly be an adequate substitute for that of local patients and their representatives. If a LINk were to be denied access to information from a particular foundation trust or denied entry into that trust, it would be impossible for it to take a measured and informed view of locally provided services across the whole area. I hope the noble Baroness will, on reflection, reconsider her amendment.