asked Her Majesty's Government:

My Lords, the functions of community health councils have not altered following the abolition of the regional health authorities. The composition and appointment of community health council members will remain as now, except that regional offices of the National Health Service Executive will act on behalf of the Secretary of State instead of the former regional health authorities.

My Lords, I thank the Minister for that reply. Will she agree with me that with so many changes in the National Health Service, and more emphasis on primary healthcare, commissioning and GP funding, community health councils—and they are called that—should have more involvement in primary healthcare?

My Lords, we issued guidance quite recently in March on the role of community health councils. We have tried to ensure through them that primary healthcare is also part of their remit, but there are no statutory obligations as yet.

My Lords, will consideration be given to those members of staff who might otherwise be dismissed, who have considerable knowledge and experience and who are only too ready to continue to give their excellent service to our National Health Service?

My Lords, I am not aware of any community health council staff being displaced through this move. Indeed, there is a study going on at the moment, through a firm of consultants, to see what their role is and whether the resources are properly or adequately allocated.

My Lords, after the abolition of the regions, can the noble Baroness say whether the number of CHCs will remain the same or will perhaps increase, and that they will be adequately resourced?

My Lords, I believe that I have dealt with the question of resources. There is a firm of consultants looking at that question. We shall be reporting back in June. As regards the numbers of CHCs, the Secretary of State is always very open to any suggestions as to different sizes or the numbers of CHCs. As I understand the situation at the moment, they are satisfied, although there are some marginal changes in boundaries where some of the district health authorities have been amalgamated with family health services authorities.

My Lords, can my noble friend clarify the position as regards government policy on cottage hospitals, in view of the number of reports on the closure of such hospitals which contribute so much to community care?

My Lords, wherever there is a major change in service it has to be referred to the community health council. If the council objects to a closure, then it is referred to the Secretary of State. As regards cottage hospitals, my noble friend will have read over the weekend that there is now greater emphasis on ensuring that hospitals which are useful and serving a purpose remain in being.

My Lords, is it not correct that, as the Minister said, the CHCs are about the only part of the NHS structure which has not changed in the past five years? Is it not true that after five years of perpetual and continuous reorganisation culminating in the abandonment of RHAs this week, all the evidence from this year's contracting round is that the NHS is facing this year exactly the same issues of resourcing and financing as sparked off the whole reorganisation process in 1987?

My Lords, when we were debating the Bill to abolish regional health authorities, I remember that noble Lords opposite tried very hard to stop the abolition and the saving of £300 million, which have gone from administration into patient care. As regards the contracting for this year, I have been in the health service for a good many years and I have to say, "'twas ever thus".

My Lords, as the Minister recalls the debates last year on the health authorities Bill, she will no doubt recall the amendments that we on this side of the House put forward in order to retain the independence and the powers of the community health councils under the new organisation. Is she now confident that there are sufficient safeguards to protect the access of the community health councils to independent trust organisations and district health authorities at local level?

Yes, my Lords.

My Lords, does the Minister have available for the House the figures for the number of referrals by community health councils for proposed closures of local cottage hospitals? How many of those closures have gone ahead after referral?

My Lords, I do not have those figures. I shall certainly write to the noble Baroness.

My Lords, does the Minister agree that members of community health councils who represent patients on tribunals when they have problems and difficulties, as well as looking at the standard of all healthcare facilities, work very hard and do not get paid?

Yes, my Lords, they do a splendid job. They are voluntary workers and they put an enormous amount of time and effort into their work. That is why, when the Government were considering NHS reforms, they decided to keep community health councils as they are now.