Health Bill [HL]

Amendment 27, tabled by the noble Baronesses, Lady Barker and Lady Tonge, proposes that the same list of persons and bodies that are required to be consulted on the 10-year review of the constitution, with the addition of carers, should also be consulted on the regular reviews of the handbook. Amendment 29, tabled by the noble Earl, Lord Howe, addresses a similar point, but suggests that the Secretary of State shall consult, "““such persons as he shall consider appropriate””," on any revision of the handbook. I understand that the amendments seek to ensure that any reviews of the handbook to the constitution cannot be made without consulting those persons or bodies that might be affected by them. I have already set out my concerns about Amendments 26 and 28, so I will move on to the other amendments in the group. First, I would like to reassure noble Lords by restating our intentions behind the review of the handbook. As I mentioned previously, the handbook is the explanatory guide to the NHS Constitution, to be used by patients, public and staff. The Secretary of State may make minor technical and legal changes to the handbook at any time, to reflect current departmental policy or changes in the law. We do not think that it would be proportionate to have to consult on such changes, and I think that most noble Lords agree. However, any significant changes to policy or law that affect the handbook are in themselves likely to trigger consultation requirements. We should bear in mind that if there is a policy change, that change itself will be consulted on. This debate is about the idea that there should be consultation on the policy change and then another consultation on the change to the handbook. I hope I have clarified that whatever change is to occur, there will be consultation on it. Requiring a second consultation on putting the change into the handbook would be a further burden and more bureaucracy. I reassure noble Lords that the Secretary of State is obliged to consult on any change in policy. The intention behind the regular reviews of the handbook is to assess whether the handbook continues to be fit for purpose for patients, public and staff. While the constitution is a formal document with formal consultation requirements, the handbook, as I said, acts more as an explanatory guide. I hope that I have reassured noble Lords on these amendments. If there is still fairly strong feeling about it, I would be more than happy to look at the wording. Although I completely agree with the intention here, it is very important that, whatever we do, we do not increase the burden of consultation by requiring two consultations on a policy change that has exactly the same purpose.