Health Bill [HL]

Amendments 73 and 75 deal with two separate but important issues. New Section 65B(2) of the National Health Service Act 2006, to be introduced under Clause 13, covers the trigger for the appointment of a trust special administrator. It states: ""An order may be made under subsection (1) only if the Secretary of State considers it appropriate in the interests of the health service"." What does "appropriate" mean in this context? Does it mean that the Secretary of State does not have to consider and reject alternatives before deciding to make an order? One could imagine circumstances in which several options were open to the Secretary of State, administration being one. Most of us, I think, would agree that administration should be a last resort after eliminating other possibilities. Unless the pros and cons of all available options are examined thoroughly and unless administration is seen as not only appropriate but also necessary, I do not think that we will have a recipe for achieving the best outcome either for the NHS or for patients. Putting an NHS trust into administration, were it ever to happen, would be a highly charged decision in terms of its local politics. I would like to see the Secretary of State legally bound to consider all options before going down that road. I do not say that I know of any case where local party politics have influenced a Secretary of State in a decision surrounding service reconfiguration. But once in a while suspicions of this sort arise and I believe that it is important to take steps to avoid them arising. It is worth noting that new Clause 65B(5) obliges the Secretary of State to lay a report before Parliament stating the reasons for making the order to appoint a trust special administrator. I welcome this but it is important to ensure that the mechanism, which is designed to promote transparency, is used to demonstrate that the logic of the Secretary of State’s decision was inescapable rather than merely persuasive. Sentiment in a not dissimilar vein underlies Amendment 75: trust special administrators must be independent of Ministers. They must be allowed to act professionally and not be subject to direction, or even the threat of direction, from those who may have a political agenda to fulfil in relation to the failing trust. The trust special administrator must act in the best interests of the NHS, patients and the taxpayer, and he must take his decisions objectively, so far as possible, while taking into account the views of all those whom he has consulted. I repeat that the closure of any NHS hospital is going to be highly politically charged, if it ever happens, and we must protect the process from the possibility of gerrymandering and party-political bias. I hope that the Minister will look carefully at the amendments. I beg to move.