Local Government and Public Involvement in Health Bill

moved Amendment No. 238VD: 238VD: Clause 225, page 156, line 22, leave out ““view”” and insert ““inspect”” The noble Earl said: I shall speak also to Amendments Nos. 238VE and 238W. Clause 225 deals with the duties placed on services providers to allow authorised representatives of local involvement networks to enter and view their premises and to observe the activities taking place within those premises. I think that we need to understand a little more closely from the Minister what this duty will amount to in practice. First, on the word ““view””, those who used to be members of community health councils and those who are currently members of patient forums will tell you that one of the essential features of their functions and powers was the right not only to enter premises but to carry out detailed inspections, part of which could well involve talking to service users and staff. The ability to talk to users and staff is absolutely vital, because without that it is well nigh impossible to gauge the quality of the service being provided. When negligent care is discovered by PPI forums, it is usually as a consequence of disclosure by a patient or a member of staff to a forum member. If I have a concern about the word ““view””, it is that it suggests something rather more remote and passive than the word ““inspect””. If an estate agent takes me to view a house, I expect to be able to look round it without necessarily being allowed to spend time there investigating the state of the plumbing. A viewing, in ordinary language, is not the same thing as an inspection. Patient forums have the right to enter and inspect, as did CHCs before them. Why is not the word ““inspect”” used here as well, and what significance should we attach to that? Secondly, I return to what LINks will be there to do. When they decide to enter and view premises, they will not be there simply to observe the activities going on within them. The point of entering is to monitor the quality and effectiveness of the services being provided. I believe that there is a strong case for having that explicitly stated in the Bill. As the Bill stands, the duty on services providers will extend only to allowing authorised representatives to enter, view and observe. Without a purposive context to this, I would worry that certain services providers might take it upon themselves to deny LINks members a full opportunity to gather the kind of information that they need from the visit. The amendment would strengthen the duty by making it clear that it is not sufficient to allow a nominal sort of viewing or observation by LINks members; it is necessary also to facilitate them in carrying out their task. I turn finally to Amendment No. 238W, to which the noble Baroness, Lady Howe, will speak more fully. I simply want to say this. I understand that the Government propose to make provision in regulations that visits to premises by authorised representatives may not take place unless the LINk has previously notified the appropriate regulatory body of its intention and the regulator has not objected. I can quite see why we should want to avoid inundating services providers with inspections and visits from myriad inspecting bodies. However, I seriously question whether a blanket limitation of the kind proposed is the right way to go. If LINks are to have any credibility at all with the local community, they need to have their own visiting regime, including the ability to make spot visits where there is an urgent concern. The scope for such visits to make a difference to the quality of care is considerable, but if you hedge those visits about with bureaucratic processes and permissions from a remote national body, that potential will be greatly diluted. Indeed, the extent of the restrictions that the Secretary of State can impose through the regulation-making power is so great that I wonder what, if any, freedom of movement will be left to LINks at the end of it all. Patient forum members will tell you that visits to premises are important both to raise public confidence in the NHS and for public safety. The regulations are likely to create a wall between local people and the services that they pay for. I believe that that wall would undermine public confidence in patient and public involvement and in the independence of LINks. I beg to move.