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Health and Social Care Bill

It would be churlish not to welcome the amendments, particularly those that reinforce the importance of social care. Given that most parties have tried to work together on some of these issues, it is a little churlish of the hon. Member for Eddisbury (Mr. O'Brien) to claim that every amendment in the other place resulted from the efforts of the Conservatives alone. I have read the Lords Hansard, and that is not quite my perspective—but I will move on. The inclusion of objectives is helpful in reinforcing the social care aspects of the commission. I was also delighted to see that the commission must now have regard to"““the efficient and effective use of resources in the provision of health and social care services.””" We tried to raise the issue of commissioning quite a bit in Committee, but the Minister resisted our various attempts to include a provision in the Bill, despite the fact that Anna Walker made a powerful case for one during the Committee's evidence sessions. It is probably fair to say, however, that those changes were not resisted as strongly as were the attempts to include LINks, and I am delighted that LINks are now included. Interestingly, I have picked out the same quote as the hon. Member for Eddisbury did from the Committee proceedings, when the Minister clearly said that he did not think including LINks was the right way to go, although he added that he would come back with clearer thinking on the issue. On Report, however, he repeated his earlier sentiment; indeed, we divided the House, and Government Back Benchers, almost to a man and woman, although not quite—there were a few honourable exceptions—agreed with him. I am almost tempted to find a way to divide the House now, to see whether Labour Members, as one body, have changed their minds, but that would be churlish, and we have to welcome what we have. It is all very well including LINks, but some of us have grave concerns about how they will work in practice. They will be very different. They are supposed to respond to local needs. There is no formally prescribed set-up. LINks will have a different make-up in different parts of the country. I welcome the Minister's mention of the fact that there will be a broader basis and a broader consultation, and it would be helpful if he could outline how that will be achieved. I have a couple of specific questions for the Minister. Lords amendment No. 3 deals with"““Matters to which the Commission must have regard””." It is right that it must now have regard to"““the rights of people who use health and social care services””," which means the rights of everybody, not just specific groups. However, the use of the word ““rights”” got me thinking. At various stages in our consideration of the Bill, we have attempted to introduce a human rights-based approach. It is relatively easy to define human rights, and although it is not always easy to enshrine them in new legislation, such legislation does help us to define them. It would be helpful if the Minister could clarify whether the word ““rights”” is intended to include human rights, whether it is intended to be broader, and what is meant by rights. I do not think that the term has particular legal meaning, so a broader outline of the Minister's thinking would be helpful. I also have a question about Lords amendment No. 4. Although I am delighted to see a focus on user involvement, the proposed new clause strikes me as potentially tokenistic. Although the commission has to publish a statement describing how it proposes to involve users and carers, it is not clear when that is supposed to happen. The proposed new clause mentions periodic reviews that must be consulted on, but it does not say by when we should have the statement. Again, it would be helpful to have some clarification from the Minister when he sums up. Finally, I welcome Lords amendment No. 66, which would make it clear in the Bill that a full range of knowledge must be represented on the commission, and that is clearly important. The chair of the commission has now been appointed, and in her evidence to the Select Committee she was very open about the fact that she knew little about social care. Knowledge has to be taken into account, so it would be useful to have further clarification of the depth of knowledge expected, of whether one board member will be enough, and of whether there will be attempts to create a balance. Although there has to be a full range of knowledge, the balance could still be tilted if the composition of the board changed over time and this principle were not kept at the forefront of thinking.