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Local Government and Public Involvement in Health Bill

I accept that, as one might expect, the performance of CHCs was patchy, but the vast majority performed very well with well-qualified, well-trained and experienced people. Of course, there were exceptions to that rule. I will address a little later the national link—and, therefore, the national voice—that can be effective in helping to improve health care. It remains unfortunate that the Government decided to introduce these provisions in a portmanteau Bill, rather than in a Bill specifically sponsored by Health Ministers. Conservative shadow Health Ministers here and in the other place have achieved much in making this Bill workable, but we might have had a more effective discussion of the arguments at stake if the Bill had had a pure health and patient focus. I must put on the record that our support for these amendments is also without prejudice to our NHS autonomy and accountability Bill. In keeping with our commitment to avoiding organisational upheaval, we would not abolish LINks, but we would seek to give them enhanced inspection powers and independence from local authorities. The Bill as amended gives them their own budgets, which is a step in the right direction, but not enough. The amendment to clause 223 on co-operation between LINks is a welcome concession from the Government. Although it does not establish a national voice—to return to the point made by the hon. Member for High Peak (Tom Levitt)—as robust as the Commission for Patient and Public Involvement in Health, or the health watch body that we will seek to establish through our NHS autonomy and accountability Bill, the Government's recognition that an exclusively local voice is simply not effective is welcome. We wait, however, to see whether this amounts to anything in reality. We lost something of a national voice when we lost CHCs, and I share the hon. Gentleman's hope that that absence will be addressed. We have searched in vain in any of the Government's more recent pronouncements—not least the new health and social care regulations, announced by the Secretary of State today—for comfort that such a move will happen. We had hoped that he would remind us how wonderful it would be to have some scrutiny that was independent from the national health service. All of us remember the wonderful work done by CHCs when they produced important and influential national reports, such the one on bedwatch. I would also like to draw the House's attention to the new clauses inserted after clauses 223 and 227. The former makes provisions for governance of LINks and the latter for transitional arrangements to cover the period between the abolition of PPI forums and the establishment of LINks. I am grateful to the Under-Secretary of State for Health, the hon. Member for Brentford and Isleworth (Ann Keen), who met my noble Friend the Earl Howe and acceded to the force of his arguments on those points. It was important to avoid the danger that LINks would simply be a collection of more random people who would volunteer, thus the amendment wrested from the Government was to ensure that the Bill defines a system of governance: decision making; representation; authority; bodies having their own budgets; and a commitment for regulations to be amended accordingly. Again, that does not go as far as we would have liked to establish true independence. Those who are feeling most vulnerable, who need support and scrutiny of how the health service works in their case, need to be able to trust the bodies. Independence invokes trust more readily than something that is not seen to be independent. On the latter new clause on transitional arrangements, our concern remains that there are no provisions for ensuring that local authorities discharge their duty to put in place transitional arrangements. I would be grateful if the Minister could assure us that he will take personal responsibility for the provision of adequate scrutiny in the transitional period. We have continuing reservations about the extent of the power and independence of LINks. We welcome part 14, as amended, and we of course congratulate my noble and hon. Friends on the important concessions that they have obtained from the Government. They were outlined in the Minister's statement, and it cannot be often that he has to list at least 10 amendments that have been the subject of considerable debate. It is important to recognise that we will continue in the next Session the debate about the accountability that will be the subject of the scrutiny apparatus for the NHS, and about how local government and people, particularly patients, are involved. That will be done through what we anticipate will be the health and social care Bill and our own NHS autonomy and accountability Bill. I confirm that, in the light of that, Conservative Members do not intend to divide the House, and we trust that this part of the Bill will speed on its journey.