Local Government and Public Involvement in Health Bill

I support amendment No. 249 to clause 182, in my name and those of my hon. Friends the Members for Blaydon (Mr. Anderson), for Pudsey (Mr. Truswell) and for North-West Leicestershire (David Taylor). This simple amendment is about fairness, accountability and ensuring a level playing field in consultation. In Committee there was a welcome acknowledgement by Ministers that the Government would ensure that health commissioners included clauses in contracts with independent health care providers, obliging them to allow LINKs access to premises. That is important, and we look forward to seeing the guidance that will accompany the legislation. As we know, however, there is a difference between providing guidance and having something in black and white in the Bill. Unfortunately, the Bill does not achieve a level playing field regarding the scrutiny to which health providers will be subjected, whether by LINKs or by local authority overview and scrutiny committees. The Government’s choice agenda will mean that health services are increasingly likely to be run by providers from the private and voluntary sectors. I have strenuously opposed the privatisation of our health services, and will continue to do so; nevertheless, it is happening. I want to ensure that local people can hold service providers to account, because that has never been more important. We need to strengthen health scrutiny arrangements, not weaken them. In contrast to what my hon. Friend the Minister for Local Government said earlier, last month the Health Committee’s report on patient and public involvement highlighted a number of the problems in the Bill. Arguably the most important point made by the Committee was that the Bill weakens consultation by restricting to ““significant”” decisions the obligation to consult local communities under section 11 of the Health and Social Care Act 2001, now section 242 of the National Health Service Act 2006. Clause 182 concerns the definition of ““significant””. Two areas are already included: the manner in which services are delivered and the range of health services available. That is helpful, but it is not enough. The amendment would add a third tier to the definition: whether the ability to scrutinise services is affected. In effect, that would mean that if provision of a given health service was to be transferred to an organisation or company that was not subject to the same levels of scrutiny as the NHS, the public would have the right to be consulted on whether they wanted the change. The Select Committee also criticised the fact that too many sham consultation exercises are carried out in the health service. Patients and the public want and need to be actively involved in the delivery of their health care, and engaged by meaningful consultation. The more that we as Members of Parliament can do to facilitate that, the better. I, too, have been concerned about the changes in patient representation. I was more than uncomfortable about the abolition of community health councils. In Luton, we had a shop front in the town centre where patients could go in and talk to people; they did not have to write a letter or engage in any difficult communication. What they wanted to talk about was dealt with face to face over a counter in the town centre. That has now gone, replaced to some extent by the patient advice and liaison service in the hospital and by PPI forums. Luton has a strong PPI forum, led robustly by my very good friend and constituent, Mrs. Josephine MacLean, who keeps the local health service on its toes; that is her job. However, her position is to disappear and I am concerned about that. I want to make sure that the replacement is at least as robust, and that people like Mrs. MacLean, who have the interests of patients and my constituents at heart and fight for them, will have a role in the new arrangements and will be able to take a strong position on both the remaining public sector part of the national health service and on any services that move to the private sector. I suspect that the private sector is not keen on having strong patient representation. It does not want to be so accountable. Perhaps it prefers to rely on market forces—after all, under the choice agenda, if something does not work with one provider, one goes to another—but that is not good enough. Private providers will get away with murder unless they are held to account through some sort of local patient representation. We must have robust representation. I hope that the Government will take note of that point and accept my amendment.