Local Government and Public Involvement in Health Bill

I shall touch on three issues that hon. Members have already raised. The first is the abolition of patient forums. I am glad that we all resisted the temptation to rehearse the history of community health councils, but I share the view expressed by hon. Members on both sides of the House about the questionable wisdom of abolishing forums. To repeat a point that the Select Committee on Health spelled out clearly, now that we have abolished CHCs and are moving towards abolishing forums, I am left confused about what local involvement in health networks will be like and how they will operate in practice. I am particularly concerned about that. It was certainly true of CHCs and patient forums that people could see what they were getting. I echo the comments of my hon. Friend the Member for Luton, North (Kelvin Hopkins) about the expertise that was developed by CHCs and passed on to forums. That may be lost if we are not careful to give LINKs the sort of focus that hon. Members have talked about. My second point is about the significance of the word ““significant””, a subject that was discussed by the hon. Member for Billericay (Mr. Baron). As I tried to point out in my brief intervention earlier, there are outstanding concerns about whether there will be a great shift in emphasis, as regards both the right to be consulted and the impulsion on health bodies to carry out consultation. Like the hon. Gentleman, I fear that under this part of the Bill some issues for consultation might fall under the radar, either inadvertently or deliberately. I crave hon. Members’ indulgence while I give a recent example. Wharfedale hospital is not in my constituency, but it serves a great number of my constituents. It has existed for many years, but under the Conservative Government it deteriorated, decayed and lost services. From time to time it was earmarked for closure and we had to fight campaigns against that. Under this Government, it has been rebuilt and it is one of the great achievements that we can point to locally. The new building opened two years ago, but unfortunately instead of it being used to maximum capacity, its progress has been characterised by the gradual withdrawal of services. In autumn last year, a 16-bed ward for older people was closed without any consultation. The explanation given by the trust was that it could provide the same level of service to older patients with fewer beds. That may or may not be true, but in the context of the gradual removal of services, and given what local people saw as the diminution of the hospital’s functions, that ward closure was an extremely significant issue for them. Back in the autumn, under existing legislation, it was questioned whether there should have been consultation on what local people regarded as a major issue, so I wonder whether use of the word ““significant”” in the Bill would allow such issues to drop even further below the radar. Finally, I echo the comments of my hon. Friend the Member for Luton, North about amendment No. 249, to which my name is attached. There is a real fear that—and it will be so argued— under the Bill as it stands, the simple transfer of services to the private sector will not necessarily trigger a consultation. Let me give a hypothetical example that might become a practical one in due course. I am certainly of the view that independent sector treatment centres, given their very nature, should not be introduced without major public consultation. It might be argued that that is not so, because there is a level transfer of service and no reduction in capacity. However, on looking at the proposals for an ISTC in west Yorkshire—thankfully, they were ultimately withdrawn—I was very concerned about the implications of their implementation. The issue was not the level of patient care and capacity—that would certainly have been there—but the proposed transfer of services from the NHS acute trust in Leeds, which would almost certainly have had a wider impact. Resources would have been transferred out of the trust and there would have been implications for its ability to meet its fixed costs, so that would have been an extremely significant move. Perhaps Members can call to mind other such examples of transferring NHS services to the private sector. I therefore seek an assurance that my amendment is not necessary and that this issue, about which I am very concerned, is dealt with in the Bill.