Health Bill [HL]

It is unfortunate that this is the next amendment. Members of the Committee might think that I have a fixation with five-year plans, but I do not. There is a reason for this amendment. The length of time in which the handbook and the constitution should be reviewed has turned out to be interesting. Before I put down this amendment, I discussed it with a number of people. As I thought about it, I tried to note off the top of my head all the documents that have an impact on the NHS in a year. They include: NICE recommendations; new legislation; Healthcare Commission reports; CSCI reports and, in future, CQC reports; investigations into serious matters that have gone wrong; medical or surgical innovations; and documents outlining budgetary pressures. Every year, each of those will routinely have a clear impact on how the NHS responds to the needs of patients. It is within that context that the constitution and the handbook lie. I therefore searched for an answer to the question: what would be a reasonable length of time within which to measure the impact of the constitution and the handbook and expect to see a change that would inform a new version? I felt that three years was not long enough. Three years does not seem the right length of time in an organisation the size of the NHS in which to implement something, review it and make a report of this kind. I then thought about other policy-led initiatives or documents around the NHS which are similarly reviewed, and I turned to the national service frameworks, which were developed as 10-year programmes with a built-in review after five years. It has certainly been possible with the older people’s NSF, which I know best, and with some of the others, to look at the detailed and strategic impact on the NHS of these strategic documents over five years. In some ways, these are similar documents. The National Service Framework for Older People had within it eight or nine factors, one of which was about dignity and the way in which people were treated. Over five years, Professor Ian Philp and his team were able, working with clinicians on the ground, to note change and to come up with a realistic programme for the implementation of the latter part of the national service framework. I make it clear that my intention in moving this amendment is not to undermine the constitution in the national service frameworks or to push the frameworks off into the long grass. I am trying to find a timescale in which they can be reviewed in ways which are meaningful to the staff, who have to work with them, and to the patients who see the outcome. With that in mind, can the Minister say whether the department considered a timescale such as mine and whether it decided on this timescale for a particular reason. I beg to move.