Health Bill [HL]

My Lords, it falls to me to open today’s proceedings. With this amendment I shall couple Amendment 16 in this group. I take us to an issue which we did not debate in Grand Committee; the role and standing of the Statement of NHS Accountability for England in relation to the NHS Constitution. This statement was published alongside the NHS Constitution and the Handbook to the NHS Constitution on 21 January this year. In these amendments I am asking: is the statement an integral part of the NHS Constitution? If it is, why is there no mention of it in the Bill? If you access the very helpful section on the Department of Health website which contains the NHS Constitution and you turn to the interactive version, you read the following words: ""This interactive version of the NHS Constitution is designed to help you navigate through all of the supporting information that you may need when reading the NHS Constitution. It consists of the following documents"." Below that there is listed the NHS Constitution, the Handbook to the NHS Constitution, and the Statement of NHS Accountability. It is important to note that the constitution is described as "consisting of" these documents. In other words, the constitution consists of more than the 12-page document carrying that title, and you do not have the constitution in your hand unless you are holding the three documents—four, if you include the Glossary of Terms. This is right and proper. At the beginning of the 12-page document is the section headed: ""Principles that guide the NHS"." The seventh of these principles is concerned with accountability and commits the Government to making sure, ""that there is always a clear and up-to-date statement of NHS accountability"," to enable people to be clear about the system of responsibility and accountability for taking decisions in the NHS. This system is as important for NHS staff to understand as for anyone else. For one thing, if staff are legally obliged to have regard to the constitution, they surely cannot do that in the fullest sense without understanding and having regard to the statement of accountability. That is the function of the statement of accountability, which also provides a very useful summary of the current structure of the NHS and what the bodies within it are tasked with doing. Just as there are cross-references between the 12-page constitution and the handbook, and just as it is not possible to understand one document without the other, there are also cross-references between the constitution and the statement of accountability. How might the statement be useful to a patient? If you were someone who was unhappy about some aspect of NHS services and were seeking to understand how best to impress upon the service that it needed to focus more attention on a particular matter, the statement of accountability would enable you to navigate your way around the NHS and its institutions. It is more than arguable that you would not be able to do that properly by reading only the handbook. Why is it then that the Statement of NHS Accountability receives no mention in the Bill? If it is to be regarded as part of the NHS Constitution, as the department’s website strongly implies that it is, we should be able to see mention made of it here, on a par with the handbook. Indeed, what is the difference between the status of the handbook and that of the statement of accountability? I beg to move.