Health Bill [HL]

This is an exceptionally difficult and complex issue. It is clear that in relation to any review of the NHS Constitution local authorities must be consulted. All noble Lords who have contributed to the debate on this group of amendments have spoken very persuasively and with expertise based on their personal experience. Plainly, it is important that carers should be consulted as well as trade unions and professional organisations representing staff, as the noble Lord, Lord Campbell-Savours, said. Clearly, all these individuals have an abiding interest in the National Health Service, in the constitution and in any revision that may be developed in future. Incidentally, the noble Earl referred to the BMA. It is not widely known that the BMA is a registered trade union, although it is not affiliated to the Trades Union Congress. The BMA and the Royal College of Nursing might be included but what about physiotherapists, occupational therapists, medical technologists and clinical psychologists? In the light of what we said about the crucial importance of the NHS in relation to educational issues and research, what about the Association of Medical Research Charities, the Medical Research Council, the General Medical Council, the bodies concerned with the education of nurses and the Health Professions Council? One could go on and on. We are in serious danger of going back to the question of developing a list. I sympathise with the Minister about the challenge with which he is faced. These are very important issues and the organisations referred to are vital to the future of the National Health Service, but how can the Government find inclusive terms which embrace the necessity to consult all these bodies? It is a very difficult issue. These are all very worthy amendments but, as they stand, they would exclude the possibility of consulting a large number of other organisations which also need to be consulted. Happily, there is a phrase about other organisations that the Secretary of State may prescribe. That is a very important part of this exercise. But I believe that the Minister has a very difficult task in making these amendments inclusive but not at the same time too prescriptive in excluding many other bodies which are vital to the future of the NHS and require to be consulted.