NHS: Future Forum

Lord Walton of Detchant Excerpts

Tuesday 14th June 2011 Lords Chamber

[Earl Howe]

I am most grateful to my noble friend. He is right that the concerns that arose in relation to the Bill stemmed from many quarters—certainly from my own Benches and his but also from the wider public. I think we took on board those concerns almost as soon as the Bill was published. They were reflected in a large volume of correspondence, a high proportion of which I dealt with. I was keenly aware of the issues occupying people’s minds. I believe and hope that in the Future Forum’s report, and in our acceptance of that report, we have the basis for allaying most of those concerns.

My noble friend asked three questions. The first was around the duties of the Secretary of State. The Statement made clear that, as now, the Secretary of State will remain responsible for promoting a comprehensive health service. It has never been our intention to do anything else. Indeed, the Bill did not specify anything else. That will be underpinned by the new duties that the Bill already places on the Secretary of State around promoting quality improvement and reducing inequalities. We shall be setting out other duties on the Secretary of State to strengthen his accountability.

On private providers, the noble Lord is right. We are clear that private providers should not be advantaged over the NHS. Indeed, the amendments that we will make to the Bill will put that concern to rest, I hope, once and for all.

Monitor will have its duties rephrased. As the Statement also made clear, the duty to promote competition, which is now in the Bill, will be replaced by a different set of duties around patients, integration and the promotion of quality. There will be quite a different flavour to Monitor's duties.

[Lord Walton of Detchant]

My Lords, I, too, congratulate the noble Earl, who is so widely respected on all sides the House, on the statesmanlike way in which he and the noble Baroness, Lady Northover, have led discussions on the Bill in the past few weeks. I pay tribute also to the contribution of the Opposition. In all, we have had something like 25 seminars looking at the detail of the Bill. The developments that have been discussed and which Steve Field and his colleagues have put forward look as though they will produce major amendments to the Bill, which will be welcome on all sides of the House.

I have three specific questions. The one of greatest importance relates not only to the local clinical commissioning groups, but the clinical senates. We need to know a good deal more about them. Will they take on board some of the people who were previously employed by regional strategic authorities who are involved in the specialist commissioning of highly specialised services? That needs to be looked at carefully because of the unevenness in standards of specialised care throughout the country.

In relation to those clinical senates, will the role of universities be taken on board; not only those with medical schools but the ones that have responsibility for training other healthcare professionals? They should be thought of as having some kind of formal role in relation to those senates. I also suggest to the noble Earl in relation to clinical networks that, with the development of genomic medicine, rare diseases are becoming so important that we may need to have a clinical network for them because of the very expensive and rare orphan drugs that are being rapidly introduced for the treatment of these conditions.

Finally, the Bill as originally constructed did not deal in any depth with research or clinical education and training. The developments in this particular report on those two fields are very welcome. We look forward to having further details.

[Earl Howe]

I am most grateful to the noble Lord, Lord Walton, as I always am, particularly for his welcome for the idea of clinical senates. They will provide the kind of multiprofessional advice on local commissioning plans that everybody has been calling for. The senates will be hosted by the NHS Commissioning Board. The detail is still to be worked out, but it is likely that they will be located regionally. They will be in prime position to do the very thing that the noble Lord seeks: to provide expert advice on good commissioning, not just for the treatment of everyday conditions, but for specialised services, which I know is of particular concern to noble Lords.

The noble Lord suggested that there should be a role for the universities, and that is a constructive idea that I will take away. As regards clinical networks, we are certainly of the view that they have proved their worth over the past few years and we are keen to see more of them created. I hope that that will be facilitated by the structures we are putting in place.