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NHS Governance

Volume 501: debated on Tuesday 24 November 2009

8. If he will bring forward proposals to involve more elected representatives in NHS governance structures at local and regional level. (300146)

There are many ways in which elected representatives can be involved in the NHS locally. These include opportunities for elected representatives to seek membership of primary care trusts and strategic health authority boards as non-voting members or non-executive directors. There is joint working by elected representatives, local authorities and primary care trusts in local strategic partnerships and, of course, there is the use of overview and scrutiny powers by local government.

When I want to discuss health matters with a directly elected person in this country, I cannot do it at either the local or regional level. The first person I come across who is directly elected is my hon. Friend, along with his capable colleagues on the Front Bench. Does he not think that that is going a bit too high up the pay grade? Can we not have people who are directly elected and capable at the local council and regional levels?

I know that my hon. Friend plays a huge role in chairing his local strategic partnership, where he has locally elected representatives and members of the primary care trust sitting round the table talking about local needs and issues. However, I might also draw his attention to the new Regional Select Committees, which can hold regional health authorities to account for specific aspects of their performance. [Interruption.] And as you can hear from the noise, Mr. Speaker, the Opposition voted against those regional forms of accountability.

The hon. Member for Shrewsbury and Atcham (Daniel Kawczynski) and I have worked as locally elected representatives on his energetic campaign to prevent the movement of the accident and emergency unit from Shrewsbury hospital. We have now received assurances from the authorities at the hospital that the service will not be moved, but I do not understand what formal mechanism we would have under the current arrangements to object, especially bearing in mind that this is a cross-party issue. How would the Minister advise us to ensure that our constituents’ concerns about any such move are formally registered, given the system that he has been outlining?

I am not familiar with the hon. Gentleman’s specific concern, but in general terms, decisions about reconfiguration, which is what I suspect he is talking about, are clinically led decisions, made by leading local clinicians determining what is in the best interests of patients and services in his constituency and those of his neighbours. I would hope that he, his constituents and other local bodies would make their representations in the normal way, but be guided by the clinicians, who I think probably know what is best for patients in their area.

But are patients’ voices being heard in the NHS, and what about these local involvement networks? What assessment has the Minister made of their effectiveness?

The creation of LINks is an important additional form of accountability in the NHS locally, not only to local Members of Parliament and locally elected councillors but directly to service users and patients, who will have an opportunity through LINks to influence the pattern of service, including procurement, provision and quality.