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Local Involvement Networks

Volume 450: debated on Tuesday 24 October 2006

8. How patient and public involvement will be improved by replacing PPI forums with local involvement networks. (95967)

Local involvement networks will provide flexible ways for a much larger number of people to engage with their local health, as well as social care, organisations to help to shape services and priorities in ways that best suit communities and the people in them.

Would the Minister be interested to hear about the good work that is taking place between Croydon’s PPI and the Mayday trust? For example, there was an unannounced visit last week to eight wards and recommendations were made on both the quality of fare and patient care. Such lay-visiting puts as its first question, “Would I like my relative or myself to be in these conditions in the hospital?”, but surely that will not be available under the new and more formalised local involvement networks.

I am certainly aware of the good PPI work that goes on in the hon. Gentleman’s area. However, when we consulted on the future of patient forums and PPI, many of the forums told us that some of their inspection work was duplicated by the Healthcare Commission. We will want LINks to examine the services provided in a specific area by following the patient pathway, in a sense, rather than by being attached to individual buildings and simply inspecting those. I assure the hon. Gentleman that we will expect the Healthcare Commission to involve LINks when it carries out inspections, but we do not want the duplication of inspection activities that exists at the moment.

Given the many changes facing the national health service, does my right hon. Friend agree that we need a stronger and more effective system of patient and public involvement than that which we have had thus far? She will have the opportunity to meet forum members from all over the country at a meeting next Monday in the House, which I am sure will be most productive. Does she acknowledge that the transition from the existing system to LINks must be sensitively handled so that we can maintain the involvement of volunteers and continuity, and deal with all the changes and the comments about them that will be required? Does she accept as well—

I certainly agree, and I congratulate my hon. Friend on all the work that he does on the all-party group to promote patient and public involvement. Patient forums have done an excellent job and we do not want to lose the expertise that has been built up. I will examine the ways in which we can work with local authorities, which will handle the contracts for the local involvement networks, to ensure that they are able to bring existing members into the new system. However, one advantage of the new system is that LINks will examine not only health services, but social services, so they will be able to consider some of the joint commissioning between the two and work closely with some of the overview and scrutiny committees. Such a system will provide a better overview of access to local services. It will ensure that local services are of a high quality and give people the right to challenge them if they are not.

Will the Minister explain how the Department of Health can issue a paper entitled “Patient and Public Involvement in Commissioning”, suggesting that patient petitions be used in primary care trusts, in which there is not a single mention of the local involvement networks that the Government established to provide precisely that sort of communication?

We have made connections between local involvement networks and the possibility of petitions. We have said that local involvement networks can, through the overview and scrutiny committees, approach PCTs and ask for a response within 20 days if there are complaints about a service. LINks will be able to work with PCTs, and can ask them why they have made particular priorities in an area, whether they are adequately assessing local health need, and whether they are prioritising spending to effect any changes needed. They will be able to challenge service delivery and involve a much wider group of people than are currently involved in patient forums. As I have said, we are building on the good work that has already been done by patient forums, but are involving more people and giving them greater powers.

My right hon. Friend will recall her visit to Leicester, during which she paid tribute to the work of a Leicester PPI forum. She will know that it was through the work of that PPI forum, in partnership with the local health authority, that the incidence of MRSA was discovered. How can we be reassured that the issue raised by the hon. Member for Croydon, Central (Mr. Pelling) will be addressed? I take the Minister’s point about duplication, but we need to be reassured that the same rights that were available to the previous forums will be available to her new commission.

I certainly pay tribute to the members of the patient forums in the constituency of my right hon. Friend the Member for Leicester, East (Keith Vaz); their enthusiasm was boundless and their dedication and commitment to ensuring good services was plain for all to see. However, I stress again that it is important that there should be no duplication of the work of the Healthcare Commission and the Commission for Social Care Inspection. We want to give LINks the opportunity to consult local people if there have been a lot of complaints to the patient advice and liaison services, or the independent complaints and advocacy service, about local services. If it is believed that there is a particular problem, LINks can refer it to the PCT and, if necessary, onward through the overview and scrutiny committees to the appropriate regulators. We would expect the regulators to involve LINks in their inspection processes but, as I say, we do not want duplication of a process, which is what happens at the moment.

I put it to the Minister that she totally misunderstands the central point made by my hon. Friend the Member for Croydon, Central (Mr. Pelling) and others. We all agree that, at a time of massive change in the NHS, a strong patient voice is required. However, given that LINks will not have the powers that patient forums had to monitor and inspect the NHS and access information, and given that PCTs will be obliged to listen to the recommendations of LINks, but will not necessarily be obliged act on them, is the Minister not at least a little concerned that LINks will turn out to be nothing more than toothless talking shops?

LINks certainly will not be toothless talking shops. When we carried out our consultation, it was clear that some people felt that there was duplication, and that their inspections were not taken that seriously. We want to empower LINks to gather people’s views about local services and to hold to account primary care trusts and local authorities for the way in which they assess local need and commission services. I know that the Opposition would reinstate a top-down approach—