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Mental Health (Registered Practitioners and Approved Clinicians)

Volume 558: debated on Tuesday 5 February 2013

In my oral statement on 29 October 2012, Official Report, column 32, I said that I had asked Dr Geoffrey Harris to conduct an independent review into the technical irregularities that had occurred within four strategic health authorities (SHAs)—North East, Yorkshire and the Humber, West Midlands and East Midlands—with regard to the functions of approving registered medical practitioners and approved clinicians under the Mental Health Act 1983. In addition, I asked Dr Harris to consider this matter in the context of the new NHS structures that come in to force from April this year in order to identify whether any lessons need to be learned.

Dr Harris has now submitted his report to me. “Independent review of the arrangements made by SHAs for the approval of registered medical practitioners and approved clinicians under the mental Health Act 1983” has been placed in the Library. Copies are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office.

In summary, Dr Harris found that the SHAs involved did not overtly or wittingly delegate the functions concerned. However, he identified two key principles as to how the technically irregular delegation happened. First, the SHAs concerned should have been aware that, where a function has been conferred by statute on a public authority, the public authority may not further delegate the performance of the function to another body unless expressly permitted to do so.

Secondly, the SHAs considered that, because they remained accountable for the functions, the delegation of the operation of the approval arrangements to mental health trusts through contracts was not something that risked legal irregularity. The report sets out the factors that led to this situation in more detail.

In the second part of his review report, Dr Harris recommends that every organisation in the post-April 2013 NHS, including the Department of Health, should undertake a process of due diligence. To guide this process he sets out four key principles:

that there is a clear and secure location of responsibilities across the system and that all organisations taking on transferred functions, and receiving new ones, should have a full understanding of them;

that each organisation is assured that it has the authority to exercise its powers and duties. All of the bodies must be cognisant of the duties and powers conferred upon them by Parliament, or delegated to them by the Secretary of State, and recognise that this provides the essential authorisation for all decision making and action;

that each organisation ensures it has the appropriate capability and capacity to carry out its functions; and

that there should be a process of continuing audit, that is once the functions of the organisations are settled, understood and resourced, that there is periodic audit of their discharge;

Finally, Dr Harris recommends that all bodies should include material in their governance statements for 2012-13 and for all subsequent years, which confirms that any arrangements in place for the discharge of their current statutory functions have been checked for any irregularities, and that they are legally compliant.

I have accepted all of Dr Harris’ recommendations, and will ensure that the Department and the NHS now take these forward.