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NHS Reform

Volume 527: debated on Tuesday 26 April 2011

3. What processes he has put in place to allow lay members of the public and elected public representatives to contribute to discussions on the reform of the NHS. (52550)

Following formal consultation last year, and as I told the House on 4 April, we are taking this opportunity to pause, listen, reflect and improve the Health and Social Care Bill. A total of 119 events have already been organised centrally, and the regional and local NHS will organise many more. Those events will allow us to hear a full range of views from professionals, the public and patients.

The Health Secretary knows that colleagues welcome the pause and the opportunity to reflect on what changes might be beneficially made to the legislation. Will he assure us that lay people and elected representatives, such as councillors and others, will be fully engaged in the process? The professionals have had their say, and they have very strong views, but the patients and elected people need to have their say, too.

Yes. I am grateful to my right hon. Friend, and I can give him that assurance. Indeed, one reason why it is important to pause and to listen now is not least that shadow health and wellbeing boards have been put forward by 90% of relevant local authorities in England, and it is an opportunity for them to be very clear about how we can improve patient and public accountability. I hope that they and others will take that opportunity. As my right hon. Friend knows, the Bill already substantially improves both the public and the patient voice in the NHS, and we have to ensure that we take every opportunity now further to improve it.

If the Government do come back with some major changes to the Bill, will those changes go out to public consultation, and will this House have the opportunity to oversee and to look in detail at any further proposals they may make?

I think I made it clear to the right hon. Gentleman in the House on 4 April that we were looking to pause, to listen, to reflect and to improve the Bill, and we are taking the opportunity to do so now, before Report and Third Reading.

Can my right hon. Friend confirm that in the listening exercise it is his intention, in addition to listening to representatives of local authorities and the public, to ensure that we fully take account of the views of representatives of the full range of clinical opinion within the health service—nurses, hospital doctors and community-based clinicians as well as GPs?

Yes. My right hon. Friend will know that we have done that in the past, and we continue to do so. Just as early implementers of health and wellbeing boards have an important voice in how local authorities will strengthen public accountability and democratic accountability, we also now have an opportunity that we did not have in the consultation last year for the new pathfinder consortia, as they come together—88% of the country is already represented by them—to have their voices heard. I hope that the public generally will exercise this opportunity too. I know that groups representative of patients are doing so and very much want to get involved in these discussions.

The Secretary of State will be aware that if Lib Dem MPs were seriously opposed to this reorganisation, they could have voted against it on Second Reading—so how can he expect the public to take these discussions and the listening exercise seriously? Are they not just a device to get the coalition through the May elections, and is he not determined to get away with as little substantive change as he can manage?

On the contrary—the hon. Lady should know, because I made it clear on 4 April, that my objective, and that of the Prime Minister, the Deputy Prime Minister and all of the Government, is further to strengthen the NHS, and we will use this opportunity to ensure that the Bill is right for that purpose. The reason Government Members supported the Bill on Second Reading, and Labour Members should have done so, is that, as the right hon. Member for Wentworth and Dearne (John Healey) said, the general aims of reform are sound.

As part of the listening exercise, will the Secretary of State confirm that the public, patients and medical professionals will be listened to? Many of them want to see root-and-branch reform of the NHS in order to improve its effectiveness and efficiency and improve patient outcomes.

Yes, my hon. Friend is right. We have an opportunity, which we want to realise to its fullest potential, to improve many of the ways in which patients and the public are involved. For example, we want to arrive at a point where patients feel that the invariable response of the NHS to their need is that there is no decision about them without them. We are proposing in the Bill to strengthen the scrutiny powers of local authorities. We are also proposing to bring in a patient voice through HealthWatch and HealthWatch England that has not existed since the Labour Government abolished community health councils, and we are going to strengthen substantially democratic accountability through health and wellbeing boards.