Health and Social Care Bill

Debate between Lord Clement-Jones and Baroness Northover

Tuesday 13th December 2011 Lords Chamber

[Baroness Northover]

I seem to have been inspired. We do not need primary legislation, it seems, we need regulations subject to the affirmative procedure. However, we are consulting on the best approach to using these. I am sure that that informs the noble Lord far better than my earlier answer, but I return to the point that it is extremely important that we get this right, because we certainly do not want to find ourselves in a situation where things are not as well protected as they were in this last instance.

I will now briefly address government Amendment 270A, which is a minor and technical amendment that makes clear that Monitor is concerned with services provided for the purposes of the NHS. On that basis, I hope that noble Lords will be happy to support it and content to withdraw their own amendments.

[Lord Clement-Jones]

My Lords, this is a slightly disparate group of amendments so I will certainly not try to respond on any other amendments apart from my own.

I am grateful to my noble friend the Minister for signposting where patient and public involvement come in, in Clause 59(7) and Clause 178, and her explanation that my amendment would “constrain Monitor’s flexibility”. I am always interested in the kinds of response that the department is able to come up with in these circumstances. After all, HealthWatch and the local healthwatch organisations are the creatures of this Bill and of the department, so it seems somewhat extraordinary that these are not specifically mentioned in Clause 59(7). I understand that in broad terms Monitor has the duty to,

“secure that people who use healthcare services, and other members of the public, are involved to an appropriate degree”—

that is a useful word as well—

“in decisions that Monitor makes about the exercise of its functions”.

However, of course, “appropriate” is determined by Monitor. It is not an objective test in those circumstances.

[Baroness Northover]

I am sorry to interrupt my noble friend, but perhaps I did not make it clear enough that Clause 178 of the Bill allows HealthWatch England to give Monitor advice and provides that Monitor must respond to that.

Health and Social Care Bill

Debate between Lord Clement-Jones and Baroness Northover

Tuesday 13th December 2011 Lords Chamber

[Lord Clement-Jones]

My Lords, I thank the Minister for a totally convincing response. The trouble is that it was a response to an amendment that I did not put, although I could have. The amendment which was responded to would have eliminated the OFT from consideration of FT mergers. My amendment was about inserting an additional ground for consideration by the OFT or the Competition Commission, if it went as far as that, so that the public interest was taken into account, as it is in bank mergers nowadays.

I thought that the Minister’s arguments about why the OFT should be involved were wholly convincing—eliminating double jeopardy with the Co-operation and Competition Panel, providing confidence to providers and so on. Mergers are a specialist area. I am sure that the OFT is great at merger consideration. I deliberately did not put down an amendment about the OFT being eliminated from FT mergers—that was the House of Commons amendment to which I referred in the course of my speech.

The noble Baroness’s assertion that the OFT could ensure that patients’ best interests are looked after is precisely my concern. If ordinary merger principles are followed in terms of the OFT looking at the merging of two foundation trusts, I do not believe that it is in law able to take a very close view of what genuinely is in the public interest in terms of provision of a comprehensive National Health Service. I am delighted that the noble Lord, Lord Owen, thought that that was ingenious. Certainly, it seemed to be the logical way to try to get some sense into these foundation trust mergers. Therefore, I very much hope that—

[Baroness Northover]

I do not wish to interrupt my noble friend’s flow. If I have not covered all the areas that he wished to flag up, I will indeed write. However, I made the point that the OFT needed to consider the benefits and the negative sides of mergers in terms of how they would impact on patients. I hope that my noble friend was satisfied at least on that point, even if the leapfrogging and slipping of various amendments from the agenda this evening has tripped me up at this late hour.

[Lord Clement-Jones]

My Lords, we could all be tripped up at this late hour, as, indeed, I was earlier. However, it is a question of what it is possible for the body that is judging the merits of a merger in competition terms to take into account. The reason for including the public interest considerations in the amendment was that the OFT would be extremely limited in the patient considerations that it would be able to take into account. The noble Baroness was pretty sanguine about that. There is still further work to be done in that respect and further consideration needs to be given to the matter. It seems to me that, if nothing else, the question of whether one’s local trust and local foundation hospital will survive as entities is of huge importance to local people and is something that needs to be judged properly with their benefit in mind when the time comes.

Unless I divine that my noble friend is going to give me further guidance or inspiration, I beg leave to withdraw the amendment.

NHS: Hospital Patient Maltreatment

Debate between Lord Clement-Jones and Baroness Northover

Wednesday 16th March 2011 Lords Chamber

[Baroness Northover]

I thank the noble Baroness for her question. It is clearly in everyone’s interests, especially in this House, to make sure that older people are treated with care and consideration. One thing that comes through from the ombudsman’s report is that this does not apply simply to people who are stuck in hospital, although that is greatly to be regretted and we want to ensure that that does not happen. People in the hospital setting for routine care also are not treated very well. We have to ensure that for whatever reason a person is in hospital they are treated with care and compassion.

[Lord Clement-Jones]

My Lords, the Minister will have been shocked, as were many of us, by the report from Ann Abraham, the health ombudsman, which reported on some very severe cases of maltreatment in the NHS. However, as the noble Baroness, Lady Knight, said, this sort of maltreatment has been going on for many years in the NHS. Is not fundamental change needed in terms of quality, standards, culture, complaints, inspection and reporting? Can the Minister explain how the new NHS reforms will address these?

[Baroness Northover]

I thank the noble Lord for that question. I would point out that the cases highlighted in that report occurred under the previous Administration. But I would not make a party political point here. It is something which we all have to address and we have to ensure that, as we change the NHS, we build in far better ways to ensure that the voices of patients and their families are heard.

There will be the new healthwatch organisations at the local level and the national level. Those organisations will report their concerns to the national board, which will talk to the CQC and advise the Secretary of State. We are hoping to put in place far greater accountability and there will be more local accountability. This is something which we all have to tackle. I note that the Royal College of Nursing has responded positively to this. But the Royal College of Physicians and the Royal College of Surgeons have not yet responded.