Local Government and Public Involvement in Health Bill

These are indeed important amendments and I want to reassure noble Lords in different ways. I am grateful to them for raising the issue, because it merits clarity and debate. Obviously, the issues that Amendment No. 238VD raises came up quite a lot at Second Reading. It is important to state here, as was stated then, that in practical terms ““view”” and ““inspect”” mean much the same thing and that the use of ““view”” does not in any way diminish the power that LINks have to enter services. I hear what the noble Lord says about ““view”” sounding rather passive, but the term was chosen specifically to recognise that LINk participants are not inspectors or regulators. The term ““inspect”” relates to professional regulatory bodies such as the Healthcare Commission. Those involved in LINks are lay people and, as such, are able to take the patient and user perspective. There is not any diminishment of power from the patient forums and I suggest that noble Lords reconsider their arguments because of that. However, I am keen to be helpful and, because noble Lords are clearly of a mind that this is an important matter, I will take it away and think it through. Amendments Nos. 238VE and 238XA both seek to ensure that LINks can monitor services when they visit them. Again, I understand the purpose of these amendments; we have already considered it. That is why Clause 225(4)(a) states that any visit by a LINk must be, "““carried out for the purposes of carrying-on””," LINks activities. Clause 222(2) lists one of the LINks’ activities as, "““enabling people to monitor, and review, the commissioning and provision of local care services””." I hope that that meets the point raised by the noble Lord and that he will not press his amendment, because it is captured in the Bill. I turn to Amendments Nos. 238W and 238X. We think that the power to interview and observe is very important for LINks to be effective. The power of LINks extends beyond that of patient forums to cover social care as well as health. We also believe that it is important to take account of some key issues when providing for LINk members to enter and view services to protect service users’ safety and dignity, as well as to safeguard the smooth operation of services. Clause 285 therefore sets out some areas where detail is required when the Secretary of State makes regulations in respect of those powers. Amendments Nos. 238W and 238X seek to remove the power to make these conditions and safeguards. I accept that it appears that we are giving LINks power with one hand and taking it away with the other, so it is very important to be clear. The power to enter premises is a formidable one and rarely given; giving it to members of the public is extremely significant. I am sure that noble Lords agree that we cannot be lax enough simply to allow the power to be used without safeguards. We have to bear in mind the fact that it is not just the power to enter premises; it is the power to enter premises where ill, vulnerable and distraught people are receiving treatment. Subsection (2)(a) allows for conditions to be satisfied before the duty arises. This will enable the Secretary of State to make regulations that state, for example, that a LINk must inform the regulator before undertaking a visit to a services provider. I understand what noble Lords have said and I take the point made by the noble Baroness, Lady Masham. This is part of a cross-government gatekeeper initiative that, with the best of intentions, aims to reduce the burden on front-line service providers and to prevent duplication, endless visits and people having to stop looking after people, which is much more important, in order to take someone around, facilitate discussions and so on. We think that it is particularly appropriate in the case of LINks that their visits should be co-ordinated with the work of the regulator to ensure that there is no duplication of effort. These details would be set out in regulations and specify areas where we do not expect people to enter and view, such as in children’s premises, and so on. We intend to publish draft regulations and conduct a full consultation on them before we lay them in Parliament. Amendment No. 238X seeks to remove subsection (3), which would allow for limitations on the right to enter and view premises. For example, we would intend that a LINk should visit only when appropriate—that is, when services are being provided. Equally, it is important to retain the ability to provide some detail on the number of LINk members visiting premises—for example, it could become clear that it would be appropriate to have a minimum of two LINk members on each visit. I take the point made by the noble Baroness, Lady Neuberger, at Second Reading. I will follow that up, because it has interesting potential. I believe that the powers set out in Clause 225 represent important parameters on the duty, but I am conscious that noble Lords have spoken with one voice on the importance of unannounced visits. I am not making any promises, because this is part of a cross-government attempt to rationalise the way in which inspections are made, but I will take this matter away and talk to officials and Ministers about this and come back on Report to make our recommendations. I should say that all those involved in this part of the LINks role will have to have the right skills, receive the right training, be cleared by the CRB and be able to demonstrate understanding of patient confidentiality. It is a serious undertaking and we are putting serious measures in place to ensure that it is done properly.