Local Government and Public Involvement in Health Bill

I am not sure I can give the noble Earl the comfort that he seeks. I shall do my best, but I fear that we may need another round of letters. Amendment No. 242ZA seeks to ensure that the duty on NHS bodies to consult, which is set out in Clause 232, is a duty to consult not only users of services but the public in general, as he explained. That is, however, unnecessary, as this is already captured by new subsection (1F) in Clause 232, which defines a ““user”” of health services as, "““someone to whom those services are being or may be provided””. " I entirely understand his point about relatives or carers. I might have to read Hansard and think carefully about the point he is making to see whether the definition encompasses the additional groups he is talking about. On Amendment No. 242A, I am not sure I can help the noble Earl. I am not at all surprised that he raises this point and I am very interested in the points he makes. This amendment seeks to retain the original wording of Section 11 of the Health and Social Care Act 2001, which has since become Section 242 of the consolidated NHS Act 2006, which gives NHS bodies a duty to involve and consult patients and the public. On the noble Earl’s analysis, I can confirm that during a judicial review into Section 11 in north-east Derbyshire, the judge found it difficult to perceive any real difference between ““involve”” and ““consult””. We have taken this on board and have revised the section, not to reduce the requirement but rather to clarify our expectations of the NHS. We have retained ““consult”” because it fully reflects what we want the NHS to do, which is to seek the views of patients and the public in the planning of the provision of services and in developments of proposals, and to ensure that people are consulted on decisions affecting the operation of services. I am happy to write to noble Lords explaining the legal basis for the use of ““consult””, and demonstrate that this fully covers all the activities that are described in the old Section 242 under ““involve and consult””. I think this is a good time to mention one of the ways we are strengthening the duty of consultation. We are placing a requirement on NHS bodies to have regard to statutory guidance issued by the Secretary of State. Currently this is not the position and we think explicit expectations set out in guidance will provide considerable help to the NHS in fulfilling the duty. The guidance will set out clearly examples of when it is appropriate to consult under Section 242 and what form that consultation should take. This will clarify what the expectations are for NHS organisations to comply with their duties and perform better user engagement. The work to deliver the guidance to Section 242 will cover a range of stakeholder consultations and will include regional road shows and reference group workshops. That engagement activity will include input into the early drafts of the guidance and the testing of the text as it develops. The Department of Health is very confident that the statutory guidance will go a long way to support more effective involvement and consultation. With an undertaking to write further, I hope that at this stage the noble Earl will consider withdrawing his amendment.