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Health and Social Care Bill

My Lords, my intervention will be extremely brief and I cannot but say somewhat wryly that in 19 years in this House I have learnt conclusively that one can never predict with any degree of confidence that entries in one’s diary will be fulfilled when interesting developments, such as the intervention of Statements of various kinds, almost inevitably disrupt the timetable on which one would hope that the issues that one wished to speak about could be resolved. However, I have great sympathy with Amendment No. 2, ably moved by the noble Earl, Lord Howe, and supported by others. I confess that when the Bill was first drafted, I, like many others, including the noble Lord, Lord Lipsey, and my noble friend Lord Ramsbotham, felt grave concerns about the merger of these very important bodies, each of which seemed to have clear-cut and distinct functions. The more I have listened—from time to time I have been concerned with the discussions in Grand Committee—the more I have recognised that there is a very substantial virtue in the merger of these bodies. In any event, this is now water under the bridge. Initially, I felt strongly in favour of Amendment No. 8, put forward by the noble Lord, Lord Lipsey. If this merged body is to function effectively, it might be necessary to have three separate commissions. But that is contrary to the whole ethos of the Bill. Integration is crucial for this whole issue; that is, a closer degree of understanding and mutual interest between those concerned with the regulation of health, those concerned with the regulation of social affairs and those concerned with mental health. Many years ago, I chaired the Nuffield Provincial Hospitals Trust meetings on communication between doctors in various branches of medicine, and also on communication between doctors and members of other professions, and one comment has stuck in my memory. It was of a social worker speaking to a doctor, who said, ““I can’t hear what you are saying when what you are rings so loudly in my ears””. Such a lack of mutual understanding quite often prejudiced the collaboration between doctors and social workers. The situation has vastly improved. The crucial aspect of this Bill, which is enshrined in Amendment No. 2, is that within this commission there should be individuals who are experienced in and knowledgeable about health, social care and social matters and, also, those who have got experience in mental health. The membership must reflect that kind of interest. If that is achieved, it is likely that the integration will result in a much closer degree of collaboration and mutual understanding between the various branches of work to which I have referred. For that reason, I strongly support the principle outlined in the amendment tabled by the noble Earl, Lord Howe, and others. The crucial thing is that that kind of membership will be achieved within this commission in order to develop the integration which everyone wishes to see.