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Health and Social Care Bill

I am grateful to you, Mr. Deputy Speaker, and I apologise for the fact that I had to absent myself briefly from the Chamber towards the end of the debate on the previous group of amendments. We come now to Local Involvement Networks, and it will not have escaped your notice, Mr. Deputy Speaker, that we had a partial discussion about them in relation to Government amendment No. 62, which sought to make clause 2 read:"““In performing its functions the Commission must have regard to—""views expressed by or on behalf of members of the public about activities to which the functions relate””." I pay tribute to the co-sponsoring of our amendments by the hon. Members for North (Kelvin Hopkins), for North-West Leicestershire (David Taylor) and for Romsey (Sandra Gidley). Amendment No. 131 would make it explicit that LINks were one of the groups that the commission must have regard to. Amendment No. 132 would include LINks as a group that the Office of the Health Professions Adjudicator must seek the views of, and amendment No. 133 is consequent to that. Amendment No. 134 would include LINks as a group that the Commission for Healthcare Regulatory Excellence must seek the views of from time to time, and amendment No. 135 is a consequential amendment. Amendment No. 136 defines LINks for the purpose of part 1, and amendment No. 137 defines them for the purpose of part 2. I welcome the concession that the Government have made to the arguments advanced by me and Committee members of all parties that LINks should be consulted by the Care Quality Commission. Unfortunately, having promised a number of times in Committee to revisit the issue on Report, the Minister has been disappointingly unambitious in his amendments, which were accepted without opposition. I will not suggest, therefore, that those amendments show more of the contempt that many, including myself, have accused the Labour Government of showing in their treatment of the patient voice in England. They scrapped community health councils, which I was very involved with. I exposed an answer given at Prime Minister's questions: the Prime Minister said that there had been consultation when it was announced that they would be axed in the July 2000 NHS plan, but there had not. The patient and public involvement forums are now also to be replaced, and if LINks are not mentioned in the Bill, the Government's latest solution could appear as a vote of no confidence in them. That perception is held by the hon. Member for Tamworth (Mr. Jenkins), who noted in Committee that the reason for not prescribing LINks in the Bill was"““in case it ceases to exist during the lifetime of the Bill””.––[Official Report, Health and Social Care Public Bill Committee, 17 January 2008; c. 284.]" The hon. Member for Luton, North, who is co-sponsoring the amendments, told the Committee that"““ever since the community health councils were abolished Labour Members have been concerned about the strength of protection for patients and of patient representation””.––[Official Report, Health and Social Care Public Bill Committee, 22 January 2008; c. 412.]" I admire him for saying that. He is right and it needed to be said. I will not rehearse the arguments made in Committee, but simply note a few essential points in support of the amendments, the most vital of which is amendment No. 131. In December 2005, an independent review of the regulatory framework of the NHS, ordered by the Department of Health, concluded:"““Establishing representative national and regional fora to contribute a reasoned collective consumer perspective to the process of reform could well improve both the efficacy and legitimacy of that reform.””" In their response to the consultation preceding the Bill, the Government stated:"““The Care Quality Commission's…priority will be to safeguard service users and help improve their experience of health and adult social care services—recognising that it can only do this effectively by involving them.””" I note that Ofcom has a consumer panel that plays a similar role, which convenes a regular consumer forum of interested parties, such as consumer and disability organisations. In its written evidence to the Committee on this Bill, the Healthcare Commission stated it considered the first ““clear principle””"““underpinning the design of a regulatory framework””" to be that the"““regulatory system should focus on the needs of the patients and the public””." The Commission for Social Care Inspection put it even more strongly:"““It would be useful if there were an explicit expectation that the new care Commission had a relationship with Local Involvement Networks””." That is precisely what our amendments seek to achieve. It is clear that there is a genuine and grand opportunity for the Minister to accept that the amendments are workable and desirable. The Government are giving a vote of no confidence to their own system by leaving LINks out of the Bill, which is another nail in the coffin of genuine patient and public involvement. As I said, that process began with the abolition of CHCs. We are disappointed that the Government have not used the opportunity offered by this Bill to steal our policy of creating HealthWatch, a national consumer voice for patients. HealthWatch would provide support to patients at a national level and leadership to LINks at a local level. It would incorporate the functions of the independent complaints advisory body; make representations to the NHS board on such things as the closure of NHS services; and, subject to consultation, it would have a statutory right over guidelines issued nationally concerning the care NHS patients should receive and over decisions that affect how NHS care is provided in an area. Hopefully, the Government will support us when we introduce our NHS autonomy and accountability Bill. That would be welcome, and consistent with what the Government are purportedly seeking to achieve. Now that the Government amendments have been accepted, I am concerned that the door is open for any group that claims to speak on behalf of members of the public to harangue the new commission, or engage it in some difficult dialogue. We also note that there is no duty to consult, only the weak phrase ““have regard to””. That weakness is repeated in relation to other organisations mentioned in the Bill. The hon. Member for Luton, North, who has studied the matter carefully, pointed out in Committee that clause 103, which deals with the OHPA, is entitled ““Duty to consult”” and contains the phrase ““seek the views of””—two very different things. A similar wording is used with regard to the CHRE. The title of clause 112 talks of a duty to consult, but again we find the phrase ““seek the views of”” in the text of the clause. Our amendments would beef up the consultation carried out by such bodies by including LINks. I commend the amendments standing in my name and those of my hon. and right hon. Friends, and Members from the Labour and Liberal Democrat Benches. This is a genuine cross-party approach to the matter, so I hope that the Government will feel persuaded.