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Local Government and Public Involvement in Health Bill

moved Amendment No. 210ZB: 210ZB: After Clause 229, insert the following new Clause— ““Local involvement networks: accompanying visits (1) Any person proposing to act pursuant to a relevant authorisation has a duty to invite any relevant local involvement network to provide one or more authorised representatives to accompany that person. (2) In this section a ““relevant authorisation”” means any authorisation by— (a) the Commission for Healthcare Audit and Inspection under section 66 of the Health and Social Care (Community Health and Standards) Act 2003 (c. 43), (b) the Commission for Social Care Inspection under section 88 of the Health and Social Care (Community Health and Standards) Act 2003, (c) the Mental Health Act Commission under section 121(5)(a) of the Mental Health Act 1983 (c. 20). (3) The Secretary of State may by directions in writing extend the duty in subsection (1) to such persons as the Secretary of State considers appropriate. (4) No duty shall arise under subsection (1) when, in exceptional circumstances, the person considers that issuing an invitation will compromise the effective provision of health services or patients’ safety, privacy or dignity. (5) For the avoidance of doubt, the provisions of section 229 and regulations under section 229 apply to the activities of authorised representatives of local involvement networks entering premises in connection with an invitation under subsection (1). (6) In this section ““authorised representative,”” ““local involvement network”” and ““services-provider”” have the same meanings as in section 229.”” The noble Baroness said: My Lords, this amendment takes us back to long discussions which the noble Earl, Lord Howe, and I have had at various times with present patients’ forum members and voluntary organisations. I have since held some of those discussions—partly wearing my new hat in looking at the issue of volunteering for the Prime Minister. At Second Reading, I raised the possibility that the default position should be that LINks members—appropriately trained, of course—should be part of the team carrying out Commission for Social Care Inspection and Healthcare Commission inspections. As the noble Earl has just said, that should apply across any kind of provision of service, whether in the statutory, private or voluntary sector. The noble Lord, Lord Hunt of Kings Heath, at that time said that he would take the suggestion back; I raised it again and we had widespread support for it in Committee, and the Minister agreed to look at it again. In her letter to me, which other noble Lords will have seen, she stated that this was not exactly the position that the regulators wanted and that they would be happier not, "““routinely involving lay representatives in every visit they undertake””." She continued, "““it is not always appropriate to do so, rather than seek lay involvement as and when it is appropriate””." I think that there is a bit of a misunderstanding here. I do not think that any of us is suggesting that any member of a LINk should be able to join any CSCI or Healthcare Commission visit of inspection; rather we are suggesting that this should be the default position, with the assumption being that if there are suitable people involved in LINks—as there must be if the system is to work at all—they would be included. That would be the way forward. After all, this is what happens with the experts by experience system in CSCI. Indeed, Denise Platt has made it clear to me that the voluntary organisations—many of which will be involved in LINks at a local level—do the actual recruiting and then experts are trained and involved. I have met some of these experts by experience and I am enormously impressed by their knowledge and skill. Similarly, there is some lay involvement in Healthcare Commission inspections and a serious growth more widely in expert patient groups. Both Denise Platt of CSCI and Anne Walker of the Healthcare Commission are broadly supportive of this. Neither wants any Tom, Dick or Harry, or Joan, Jane or Harriet for that matter, joining inspections. However, trained expert patients and service users going on inspections as the default position would give LINks a hugely greater sense of their own worth and influence—and, above and beyond that, be the right thing to do. We all accept that there will be times when the inspection is too rapidly arranged or there is a crisis, but if the default position is to be positive vis-à-vis this role of accompanying inspections, it would do a great deal to make the many hundreds of people who have written to me in disquiet at the lack of powers and the lack of clarity of role for LINks feel better. A lot of us were distressed by the letter in today’s Guardian signed by Sharon Grant and various others on behalf of some of the major voluntary organisations. It concerned what is happening with patient watchdogs. If we could make it the default position that members of LINks would accompany regulators’ inspections, it will reassure the people who are so disquieted. It would also show that we greatly value those who volunteer in health and social care in this watchdog role. It would be possible to train and support them as part of the role of supporting LINks networks generally. I ask the Minister to look again at whether this would be possible. It would make things a great deal better and ease much of the disquiet. I beg to move.