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Local Government and Public Involvement in Health Bill

My Lords, I hope I can offer some reassurance. I do not accept the noble Earl’s analysis of the question of consultation around a provider. The whole policy remit of the Bill is about providing for consultation around the provision of services. New duties are introduced, for example, for strategic health authorities to consult on their role and the frameworks for which they are responsible. Some of the concerns that the noble Earl has raised in this amendment might legitimately be answered in those clauses if one is looking at the general thrust of policy towards the delivery of services in an area. I do not accept the noble Earl’s analysis, although I accept the point made by the noble Baroness, Lady Neuberger, about the importance of developments outside the terms of the Bill, such as the National Voices initiative. Additionally, a level of scrutiny exists over and above the Bill through bodies such as the Health Select Committee, which holds the Government to account. That is equally important. We do not accept that the change proposed by the amendment makes good sense. Involvement and consultation should be meaningful and have some relevance to patients and the public. The clause provides specifically for consultation to relate to services received by patients and the public, because that is relevant and meaningful to them. I do not want to repeat our discussions in Committee. The clause relating to services supplied has the effect of requiring involvement and consultation of patients and the public on matters where they would have no ability to judge the effect of any change, except possibly through any preconceptions they might have about a provider. It makes more sense for consultation to be about the services that a patient receives rather than the nature of the provider supplying them. If a change in the nature or name of the provider results in a change to the service, the duty to involve and consult remains. I am happy to put that on the record. We are quite clear that there should be appropriate consultation whenever there is a change to services, and where that change has an impact on the nature of services and the manner in which they are provided. I am comfortable that the existing provisions are right, in that they ensure that consultation requirements kick in when there is a meaningful impact on the people who use or may use them. I understand the concerns that noble Lords have raised, but the additional measures in the Bill will, I hope, encourage them to withdraw the amendment.