Health and Social Care Bill

Lord Whitty Excerpts

Tuesday 22nd November 2011 Lords Chamber

I would not be surprised if the second Francis inquiry states something similar. Of course, I do not know what it will say—this is just a supposition on my part. It would be good for the Government to show that they are ahead on this and that they understand the importance of these issues and are taking action through mending the Bill. If my noble friend Lady Northover is not totally convinced by my amendments—I hope that she will be, but probably she will not—perhaps she will take them away and at least give them serious thought, because I think they have merit. They will give HealthWatch England a sound basis on which to maintain some independence while still being in the tent and therefore in a strong position to influence the CQC and secure continuous improvement in the provision of healthcare.

[Lord Whitty]

My Lords, I, too, tabled amendments in this group. They are aimed at providing HealthWatch with the independence and resources that it requires to genuinely represent the patients and users of health and social care services. Many noble Lords will understand that I am not a health service expert. However, when the White Paper proposing these changes came out, I still had some responsibility for consumer affairs generally as chair of Consumer Focus. Health service professionals do not like to regard their patients as consumers—I am quite happy to call them patients, users or clients—but we are moving the users of health services to a situation closer to that of consumers in other markets.

If we do not have separate consumer representation that reflects at both local and national level the concerns and interests of those consumers, we will not improve the service in the interests of users and patients. The noble Baroness, Lady Cumberlege, tabled amendments to strengthen the position of the regulator that go a considerable way towards making sure that there is some recognition of independence. However, the role of patient representation is entirely different from that of the regulator. Inevitably there will be conflict.

I turn to other sectors. When I was the Minister responsible, we took the Consumer Council for Water out of Ofwat because there was a conflict. We took out Passenger Focus from what became the Office of Rail Regulation because there was a conflict. We always kept Energywatch and then Consumer Focus separate from Ofgem. There was tension in all those areas, but that tension is more easily resolved if there is independence, ring-fenced funding and an ability to relate directly to the consumers of those sectors independently of the regulator. There is not a huge amount of difference in the health service, although obviously there are some esoteric aspects to it. The question of price and the exchange of money at the point of service does not arise in the same way, but questions about much of the rest of customer service absolutely do arise. Indeed, the main complaints about the health service are related to customer service and are almost equivalent to those made in many private and public sector markets.

I do not accept that a role within a regulator is sufficient to represent the interests of patients and users. Many of the propositions that are before noble Lords are worthy of the Government’s consideration. My own proposals are based very much on the construction of Consumer Focus, and in that sense they are not my own work but the work of the parliamentary counsel at the time. They are in no way superior to my noble friend Lord Harris’s jottings. If we were to look at them all together I am sure that those of us who are arguing for independence could come up with a clear alternative, but it would be much better if the Government themselves recognised the strength of argument in this area and came up with their own proposition between now and Report. They need to make it fit with the total pattern. The Government are the only people who can make a commitment to resources and to genuine independence. After the strength of argument that has come up in this debate, and with the views from LINks and from some of the patient organisations for particular conditions and diseases that the present proposals inadequately reflect, I hope that the Government will think again.

My last point is that, in addition to independence and to separate and clear resources free from the provider and the regulator, the Government need to look at powers, because a genuinely effective consumer, user and patient organisation that does not have the power to request from the providers, and in this case the commissioners, information on how they are conducting their affairs is always at a disadvantage. In other sectors there are clear powers for the consumer organisation. In this sector I am sure that those powers are also necessary for the whole range of bodies which the new configuration of the health service will have as a result of this Bill.

I hope that the Government think about this debate and come up with their own proposals. In the mean time I support the noble Lord, Lord Patel, and others who have spoken in the debate.