Health and Social Care Bill

Debate between Baroness Williams of Crosby and Lord Kakkar

Monday 14th November 2011 Lords Chamber

[Lord Kakkar]

My Lords, I would like to ask the Minister what the potential relationship is between clinical senates and an expansion of academic health science networks, or academic health partnerships, that may be proposed from the ongoing chief executive of the NHS review of innovation. It is suggested that that review may endorse an expansion of the current academic health sciences network. I must remind noble Lords of my own declaration and involvement in University College London Partners academic health science centre.

As I understand it, the purpose of clinical senates is to provide support in helping clinical commissioning groups to draw on expertise available from a broader group of clinicians and disciplines within their region to help inform ultimate clinical commissioning decisions. However, if the proposal that the current network of five academic health science centres is expanded into a network of broader academic health partnerships, serving a population of about 3 million to 4 million for each partnership, within those partnerships there would be a broad range of academic and other disciplines. They would be represented in a health partnership or network fashioned on the current academic health science centres to be able to deliver expertise and advice on commissioning and provide the opportunity to aid in a transformation of health practice pathways of care, to provide a potential home for the education and training functions that will need to be rolled out at a sub-national level, and also promote interest with regard to research and innovation.

Under the circumstances, if academic health partnerships were to be expanded and promoted as a result of the ongoing innovation review, could not the responsibility suggested for clinical senates be undertaken by the academic health partnerships and current academic health science centres? This would avoid the need for yet another grouping or layer of bureaucracy to be created within the systems responsible for the commissioning and provision of health services.

[Baroness Williams of Crosby]

My Lords, if I may, I will pursue what has been raised by the noble Lord, Lord Kakkar, and also, in some ways, by the point made by the most reverend Primate the Archbishop of York. I could not help thinking that perhaps protesters count among the networks and the people responsible for running St Paul’s count as part of the commissioning group. With that in mind, I will pursue also what was said by the noble Lord, Lord Hunt. If you look at his Amendment 224A(6), he helpfully refers to the clinical senate having,

“the function of establishing and maintaining a system of clinical networks”,

in the area. I think that should be applauded. I am very impressed by the way in which networks at their best not only extend information very widely among patients with a chronic condition but bring the patients into the discussions about what should be done in their situation. It becomes a huge educational and, indeed, morale-boosting process. So on subsection (6) I think that the noble Lord, Lord Hunt, has put his finger on something that could be very important and where the clinical senate would give clinical backbone to the deliberations and thoughts of the clinical network. That is almost, I suppose, what we are all trying to achieve.

I am not so clear about subsection (8) of Amendment 224A, where the noble Lord, Lord Hunt, has effectively given the clinical senate something of a veto over the commissioning group. I am not sure that that is wise, as that plays right into what the noble Lords, Lord Patel and Lord Kakkar, were saying about creating yet another layer of bureaucracy. I think that would be unhelpful and might indeed feed into a certain self-importance on the part of people who call themselves senators, whether clinical or merely political.

I would like to ask the Minister, bouncing off the amendment from the noble Lord, Lord Hunt, whether, looking through that amendment, he does not find parts of it that are helpful, useful and constructive. It would make a clinical senator a significant part of the whole structure of the relationship between patients and clinicians. Whether he needs to press ahead with provisions that would bring in the senate as a requirement of the decision-making process of the commission is much more questionable. I am playing a kind of ping-pong, in which the ping of the noble Lord, Lord Hunt, has to go to the pong of the noble Earl, Lord Howe.