Local Government and Public Involvement in Health Bill

These amendments raise some important issues and I am pleased to have the chance to discuss them. We have talked about the importance of the role of the host. It establishes the independence of a LINk and is vital in providing support, advice and experience according to local circumstances. I can see that there is a tension, but we think that it can be resolved and I hope to explain how. We certainly want organisations that are critically well versed in matters relating to health and social care to have the opportunity to bid for the job as a host. That is only common sense. I understand noble Lords’ anxieties about conflicts of interest. However, it will be commonplace for the organisations that are most likely to want to pitch for this work to be in the field. For example, Age Concern may provide bathing services under a contract with a local authority and, at the same time, it may have a contract to provide host support to a LINk. Age Concern currently provides support to PPI forums without its interests causing difficulties. We know that the current providers of support to PPI forums—the not-for-profit support organisations which have tremendous knowledge and experience—would be interested in acting as hosts. They have certainly been very interested in the story so far. However, so important do we consider this issue to be that the model contract deals with it explicitly. Indeed, the model tender requirements set out that the host will need to demonstrate that it can identify and manage any conflict of interest in delivering the contract, stating any interest that it has, and a protocol is in place to address those interests. Amendment No. 238M seeks to include providers of local care services under the list of organisations that should not be eligible. I hope that I have explained not only why we think that they should be eligible but why they would be well placed to provide the service. Crucially, the local authority will have to take an objective and robust view as to which organisation is best able to deliver the support. We know that some organisations will wish to provide support to LINks and they may also be involved in the delivery of health and care services. We believe not that they are unsuitable but that they may be very suitable indeed. However, local authorities will have to be transparent and clear. When they discuss the relative merits of these bodies, they will have to show that they best fit the criteria. They will performance-manage the delivery. As we discussed earlier, if they fail to satisfy the contract requirements, ultimately the contract can be terminated. There are safeguards in the process, not least because the overview and scrutiny committee is well placed to review the hosting arrangements, and the LINk will form part of the performance-management of the host. I believe that the safeguards that are built in are pretty robust. We have advice available to ensure that all organisations have a structure in place to guarantee openness and transparency. Agencies such as the NHS Centre for Involvement, the Centre for Public Scrutiny and the National Council for Voluntary Organisations can all be involved in helping to determine what will go into making an independent organisation with knowledge, sensitivity and understanding of the issues. Amendment No. 238V and the amendments in the name of the noble Baroness, Lady Howe, Amendments Nos. 238Y and 238Z, all address the need to expand the scope and reach of LINks to ensure that all who should be monitored by a LINk can be. They seek to change the definition of ““services-provider”” to include any provider of a publicly funded service. Noble Lords asked where an organisation such as a private care home fits in? These amendments would mean that independent third sector providers would be named in the Bill as bodies that have to both respond to LINks reports and recommendations and allow LINks representatives to enter and view. That is important, because LINks powers ought to be able to cut across the whole field, but while we agree with the principle we feel that is important to provide for it in ways that are sensitive to differences in the nature of organisations. We are clear that independent providers should provide access and information just as public sector bodies do, but it is not our intention to place such legislative duties on the independent sector. That is not appropriate. However, we will ensure that independent providers in either health or social care comply with LINks powers by ensuring that the commissioners of services include that requirement in their contracts through directions made by the Secretary of State for Health. So, there will be accountability and responsibility in line with wider government policy not to place further statutory burdens on the independent sector—as was also the case with the current patients’ forums. I turn to Amendments Nos. 238VA and 238ZZAA, which also seek to change the definition of ““services-provider”” to include the independent sector and all services commissioned within the local authority’s area, even if they are provided outside the area. I can reassure the Committee that the amendments are not necessary as the activities of a LINk relate to local care services in a local authority’s area. Clause 222(5) covers care services provided in the authority’s area and those provided, in any place, for people from the area. So, services commissioned within the local authority’s area will include those that people received outside the area where they live. Finally, I turn to Amendments Nos. 238SB and 238VCA, on which the noble Baroness, Lady Neuberger, particularly spoke. The definition of ““services-provider”” is given in Clause 224(2), and it includes both commissioners and providers of health and social care, which should take care of the noble Baroness’s anxiety on that point.