Health Bill [HL]

My Lords, Amendments 1 and 16 tabled by the noble Earl, Lord Howe, would place a duty on the Secretary of State to publish a statement of accountability, to review it every three years and to ensure that it continues to be available to patients, staff and members of the public. I agree with the sentiment behind these amendments. The system of responsibility in the NHS should always be made clear and accessible to the public, the patients and the staff. As I explained in Grand Committee, it is critical that the public know how the NHS is accountable at a local level and how they can get involved. During the formal consultation on the draft constitution, patients, the public and NHS staff told us that it would be helpful to produce a document that explains accountability and the roles and responsibilities in the NHS. The Statement of NHS Accountability, which was published alongside the constitution on 21 January, was a response to what we heard. It is a public-facing document that explains the roles, responsibilities and accountability in the NHS. However, I do not believe it is necessary to place in the Bill the requirement to review and update the statement of accountability. This is because the Government have already committed to doing this through the NHS Constitution. Principle 7 in the constitution explains that, ""the NHS is accountable to the public, communities and patients that it serves"." It says: ""The system of responsibility and accountability for taking decisions in the NHS should be transparent and clear to the public, patients and staff"." It goes on to commit that, ""the Government will ensure that there is always a clear and up-to-date statement of NHS accountability for this purpose"." Therefore, we have already committed to ensuring that the statement of accountability is always clear and up to date. Imposing a timeline on how often the statement must be updated risks being too prescriptive—at least once every three years may be too long to wait, or, conversely, the roles, responsibilities and accountability in the NHS may not change in one three-year period. By keeping the time flexible, we will ensure that it is constantly up to date and continues to be useful to the public, the patients and the staff. I turn to the point that the noble Earl raised in relation to the interactive form of the Statement of NHS Accountability and the supporting document. I will certainly look at the interactive version that the noble Earl referred to, but I think that the intention was to say that the interactive guide, and not the constitution, contains a statement of accountability. I hope that I have demonstrated that there is no need for extra legislation on the face of the Bill. The Government have already committed to publishing a clear statement on NHS accountability that is always up to date. I turn to the point raised by the noble Lord, Lord Walton, in relation to the transparency of it. I made it quite clear, through the process of the NHS next-stage review in May last year, that any service redesign or reconfiguration has to be evidence-based, clinically led and needs to involve the local population and the public through the whole period of the consultation. Change has to be locally owned. I hope that the service redesign concept that the noble Lord referred to is already covered within the statement of accountability. I hope, therefore, that the noble Earl is able to withdraw his amendments.