Local Government and Public Involvement in Health Bill

moved Amendment No. 238P: 238P: Clause 223, page 155, line 34, at end insert— ““(5A) The Secretary of State shall by regulations specify conditions upon which payments under subsection (5) may be made. (5B) The conditions in subsection (5A) shall, in particular, relate to— (a) governance arrangements, and (b) arrangements for dealing with potential conflicts of interest, within a local involvement network.”” The noble Earl said: One of the least satisfactory aspects of the Government's proposals for LINks, as has been said many times, is their vagueness and lack of tangible substance. In relation to the Bill, local involvement networks are rather like ghosts at the feast; they are invisible and barely defined in any material sense. The Government's argument, which I do not in anyway dismiss because I believe it has something genuine going for it, is that Ministers want to leave it up to LINks to decide how best to set themselves up and they do not want to be prescriptive in legislation about matters of this nature. In another place there was a fair bit of debate about amendments designed to introduce an element of prescriptiveness on what a LINk should be and how it should be constituted. Apart from the fact that such amendments are most unlikely to commend themselves to the Minister, I was personally not convinced that this approach was the right one. I have therefore not tabled an amendment of quite that sort. Nevertheless, I remain troubled that what we are contemplating doing through the Bill is to allow structures and organisations to be set up with absolutely no means of guaranteeing that they are fit and proper bodies to be in receipt of public money. Indeed, we have no idea at all about the kinds of organisation to which the money will be going. If the legislation leaves it totally open as to what a LINk can be and how it can behave in terms of its internal operations, then I suggest we are not being responsible as legislators for the way in which the public purse is to be dispensed. There really must be a minimum set of conditions laid down before that can happen. The Minister may well argue that all this will be dealt with in the arrangements made by host organisations and that clearly no public money will be dispensed by a host until it is satisfied that the body set up to represent patients and the public is fit for purpose. Of course we trust that that will be the case, but is it enough for us to leave it entirely to host organisations to sort all this out? Do we not have a responsibility to say to those host organisations, ““You can work within your own parameters, but there are two or three things on which you must satisfy yourselves absolutely before parting with any public money, and on which you cannot compromise””? A LINk has to have some recognised system of governance to receive public money. I am not saying what that system should be. There are several possible options. But there have to be appointed or elected officers and a constitution that makes it clear what the rules of the LINk are. We cannot do without those things. Somebody or some identifiable group of people has to be accountable for what the LINk does in terms of its public activities, as well as how it operates internally. I suggest that the Secretary of State should make regulations which specify simply that without being any more prescriptive or detailed. I also suggest that although it is not the business of the Secretary of State to dictate who should or should not be a member of a LINk, we have to recognise that for any organisation in receipt of public funds, considerations of propriety do matter in the way it operates internally. In particular, for an area such as this, there have to be clear ways of dealing with conflicts of interests. If literally anyone at all can be a member of a LINk it is obvious that conflicts of this kind are going to arise. They need to be dealt with in some way that is satisfactory. In other words, a LINk should not be allowed to let this issue go by default. If it does, it will fail to do those things for which it was set up, which are to represent the views of patients and the public in a fair and unbiased manner. I need take only one example to illustrate the importance of what I am talking about. Under the Bill it is perfectly possible for a provider of local care services to be a member of a LINk. If an organisation such as BUPA, for example, whose staff are ““people”” under the Bill, were to be a member of a LINk at a time when it was bidding to provide health services or had already secured a contract to do so, there would need to be procedures to recognise and deal with that conflict of interest in order that the LINk’s activities in relation to the bid or the contact were fair and seen to be fair. There is no single way of achieving this, although one excellent way has been suggested to me, about which I can tell the Minister later if she is interested. The point here is that conflicts of interest, whatever form they take, will inhibit arms-length, unbiased input from LINks. That has to be avoided. This amendment is minimalist. It would bind the Secretary of State only in the sense that he would be obliged to make regulations which addressed the issues of governance and conflicts of interest without being prescriptive in either case and which made such minimum stipulations about those matters in relation to LINks as he saw fit. I beg to move.