Health Bill [HL]

The effects of Amendments 74, 77, 78 and 80, tabled by the noble Earl, Lord Howe, and the noble Baroness, Lady Cumberlege, would be twofold: Amendments 74, 77 and 78 would add requirements to consult staff, governors and trustees prior to the trust special administrator being appointed, while Amendment 80 would require the trust special administrator to consult staff when preparing the draft report. I understand why the noble Earl and the noble Baroness have tabled the amendments and I could not agree more with the sentiments behind them. Having worked in the NHS for many years, I passionately believe that achieving high staff morale through effective engagement is central to obtaining high-quality care in the NHS. I also believe that many of the staff have the solutions. That is why staff engagement is one of the essential principles of this regime. My understanding is that when a trust becomes unsustainable it will, understandably, be an extremely unsettling time for the staff. To help address that point we have designed the regime to produce a swift resolution while ensuring that staff are engaged throughout that process. I want to place on record that the staff should be engaged through the process, and that essential principle will be further strengthened in the statutory guidance that we will produce. Amendments 74 and 77 would require staff to be consulted prior to the appointment of the trust special administrator. It is important to consider who would be the most appropriate person or body to engage with staff at that stage. The Bill includes a requirement for the Secretary of State for the NHS trust, or Monitor for a foundation trust, to consult the trust prior to the trust special administrator’s appointment. In turn, we would expect the organisation in question to engage its staff prior to that appointment. It would be most appropriate for the individual trust or foundation trust to do so. The Secretary of State, or Monitor, should not bypass the existing leadership of the trust or foundation trust at that stage, which is probably quite a sensitive stage. We have built in a delay of up to five working days between the announcement of the trust special administrator and them taking up their post to allow time for staff in the organisation to be briefed on the issue, to understand how the process will work and to understand how they will be able to engage with and influence it. Once the trust special administrator is appointed, they will communicate to the staff about their role and, again, will set out how individuals can input into that process. Amendment 78 seeks clarity on how foundation trusts and their governance arrangements fit into this regime. Boards of governors play an integral role in foundation trusts and, because of this core role, foundation trust governors should be aware of performance issues within their foundation trusts. They should also be aware of any previous performance interventions that Monitor has taken. Because of this role and the established relationship they will have with the board of directors, we would expect governors to feed directly into the response that Monitor requests from the trust in new Section 65D(4). Foundation trust members have an important role in influencing the strategic direction of a foundation trust. They will also be able to input into the formal consultation process at new Section 65H. In our response to the consultation on the policy we recognised that both the governors and the members would be able to provide a valuable contribution to the process and agreed that we should provide details on how a trust special administrator should engage with them in the statutory guidance. The trustees of a foundation trust are appointed to hold its charitable funds. As such, trustees will have an interest in the trust special administrator’s recommendations, particularly with regard to the future of the organisation, but I do not think it is appropriate for them to have a specific role in deciding whether Monitor should take action which results in the de-authorisation of a foundation trust. Trustees, along with any interested party, will, however, be able to input into the consultation on the trust special administrator’s draft report outlined in new Section 65(H). Finally, Amendment 80 seeks to insert a requirement for staff to be involved in the production of the draft report. I have already set out the importance that is given to engaging staff in this regime. There is already a requirement for the trust special administrator to hold at least one meeting with staff and their representatives to seek their responses on the draft report. Of course, individual staff and staff representatives will also be able to respond formally, in writing, to the consultation on that draft report. This valuable input will help inform the trust special administrator in compiling their final report. There is also a requirement for the trust special administrator to produce a summary of all responses to the consultation with the final report itself, which will include responses from meetings with staff. This means that the views of staff will be represented in a clear and transparent manner when the final report is submitted to the Secretary of State. Given these steps it will not be necessary to specifically require staff involvement in the draft report. As I said earlier, tremendous engagement will have happened and the opportunity to contribute is there. I hope these explanations reassure the noble Earl, Lord Howe, and the noble Baroness, Lady Cumberlege, and that they will feel able to withdraw the amendment.