Health and Social Care Bill

My Lords, I am grateful to my noble friend for the opportunity to return to this issue and for the extremely constructive and sincere manner in which she and other noble Lords have pursued it during and between previous debates in this House. My noble friend is anxious for Public Health England to be and to be seen to be a trusted and impartial champion for the protection of the health of the people and free to provide advice based firmly on the science and the evidence. So are we. The Health Protection Agency has built an enviable international reputation that Public Health England must first live up to and then surpass. I take on board the question posed by the noble Baroness, Lady Masham, about downgrading. No, of course we want to build on the HPA's undoubted achievements and have Public Health England seen as a world leader. All the current activity undertaken by the Health Protection Agency will transfer to the Secretary of State. With that in mind, we have listened very carefully to what my noble friend and others have had to say and thought long and hard. I am happy to set out to her fresh proposals to meet her concerns and to build on the undoubted successes of the Health Protection Agency and the other organisations that will evolve into the new organisation. The Bill gives a new and vital duty to the Secretary of State, and only to the Secretary of State, to protect the health of the people of England. To a very large extent, Public Health England will exist in order to help him to discharge that duty. It is for that reason that we feel we must preserve a very direct and clear line of accountability between the chief executive and the Secretary of State. While Public Health England undoubtedly needs operational independence to be most effective—a point raised by a number of noble Lords—it will be essential for it and the Government to work together seamlessly and to share the same objectives. Anything less could severely limit the Secretary of State's capacity to undertake his statutory duty. This is not, however, to say that the Secretary of State and the chief executive can operate in isolation, or behind closed doors. On the contrary, if PHE is to become a respected world leader—as is our ambition for it—we accept entirely that it must be subject to frank, forthright and expert challenge. My noble friend and other noble Lords have made their case cogently and persuasively, and we agree that this level of challenge can best be delivered by a board with both an independent chair and a non-executive majority. I can assure noble Lords now that that is precisely what we intend to establish within Public Health England. We intend the board and chair to provide invaluable advice on the running and future development of PHE, but, if my noble friend will permit, we would like to take a little more time to define the role of the chair in more detail. Interviews for the post of chief executive are about to begin, and we want to ensure that the skills and experience of the successful candidate will be complemented by those of the chair. I would be happy to continue discussing this with my noble friend as we take things forward. She asked whether the non-executives on the board will be members or directors. The crucial issue here is what the board will actually do. PHE will not have a board of directors in the way that a private company might. As we have discussed, we are clear that PHE's objectives must match those of the Government, which precludes a board which can make decisions that are binding. We are, however, just as clear that the board must be seen to be providing robust, impartial and evidence-based advice that the chief executive and Secretary of State will find impossible to ignore. I hope that gives my noble friend the flavour of what this board will be tasked with. We are now in the process of establishing a detailed framework for the way PHE will operate which will address its relationship with local and central government, as well as with the general public. That framework will, of course, be published. However, I can say now that as well as appointing the board and chair we will take a number of other steps to highlight and support the operational independence and transparency of PHE.