Health Bill [HL]

I am grateful for that intervention. I am referring to revision of the constitution, which could happen much sooner than in 10 years, rather than the constitution itself. I am talking about minor revisions and changes in policy that may be necessary and about how we consult in relation to them. I will come back to the issue of the 10-year review of the constitution. I agree, though, that local authorities have been, and will remain, a vital group in shaping the constitution or any future changes. Amendments 15 and 17, tabled by the noble Earl, Lord Howe, would add to the subsection that requires patients to be consulted on the 10-year review of the constitution the words, "““including such bodies representing patients as the Secretary of State considers appropriate””," and, to the subsection requiring staff to be consulted, the words, "““including such bodies representing staff as the Secretary of State considers appropriate””." Similarly, Amendment 18, tabled by my noble friend Lord Campbell-Savours, proposes that trade unions and professional organisations representing staff are consulted. This makes a reference to the 10-year review. I reassure the Committee that bodies representing patients and staff, including trade unions and professional bodies, have been throughout the past 18 months, and will remain, a vital group in shaping the constitution and any future changes. Many patient groups, including the Patients Forum, contributed to the production of the final NHS Constitution, as did many bodies representing staff, such as the NHS Confederation and Unison, as my noble friend pointed out. I am pleased that the chair of the Patients Forum, Sally Brearley, believes that, "““The NHS Constitution is a very valuable re-affirmation of the principles and values of the NHS … It demonstrates the commitment of Government to the NHS, and of the NHS to its patients””." Similarly, the Head of Health at UNISON, Karen Jennings, has declared that the constitution, "““is a vision of which Nye Bevan could be proud””." Our intention is to continue to work with as many bodies representing patients and staff as possible in the 10-yearly review of the constitution in any more minor revisions where they are affected and, more broadly, in ensuring that the constitution has a real impact. However, we believe that the legislation already captures these bodies in the 10-year review: Clause 3(5) sets out the duty to consult, among others, patients, staff and, "““such other persons as the Secretary of State considers appropriate””." That could include the bodies representing patients and staff; indeed, I can put on the record our intention that such bodies will be consulted on any 10-year review of the constitution. I turn to carers. Amendments 16 and 20, tabled by the noble Baronesses, Lady Barker and Lady Tonge, the noble Earl, Lord Howe, and the noble Baroness, Lady Cumberlege, propose that carers must be specifically consulted on the 10-year review of the constitution, a point made strongly by the noble Baroness, Lady Pitkeathley. Again, I reassure the Committee that we recognise the importance of the role of carers in the NHS and the importance of carers being an integral part of the constitution. Indeed, noble Lords will be aware that one of the core principles of the constitution states that NHS services must reflect the needs and preferences of patients, their families and their carers. I am pleased that Carers UK, which we have already mentioned, was able to support the introduction of the constitution, saying that the new NHS Constitution gives carers, "““prominence as partners in care. We welcome this as the beginning of a culture change in the NHS towards valuing the extraordinary caring contribution of ordinary people.””" The Government’s intention is that when the constitution is reviewed in 10 years, carers will be included in the consultations. It is also the Government’s intention that carers should be consulted on those affected by more minor revisions of the NHS constitution. As drafted, Clause 3(3) and 3(5) refers to the need to consult members of the public and it was our intention that carers would be part of that. But I have listened; I will take into account what has been said and come back at a later stage having looked at the issue more specifically. Amendment 19 proposes that local involvement networks, or LINks, be consulted on the 10-year review of the constitution. Again, the Government recognise the valuable part that LINks played in shaping the constitution that is now before the Committee. Many LINks across England contributed to the consultation process, including those at Gateshead, Hull, Gloucestershire and Sandwell. Again, it is our intention to continue consulting local involvement networks on relevant matters when reviewing the constitution or when the constitution is reviewed in 10 years’ time. In Amendment 21, the noble Baronesses, Lady Barker and Lady Tonge, propose that local authorities be consulted on the 10-yearly review of the NHS Constitution. Again we understand the importance of joined-up care and we believe that local authorities have already been captured. I am sorry this goes on; this involves each contributor based on the long list eloquently put by the noble Lord, Lord Walton. I can reassure the noble Earl, Lord Howe, that producing a report on the result of the constitution, as proposed in Amendment 14, is a standard government practice. For this reason, the amendment is unnecessary. I return to the Government’s code of practice on consultation which sets out that, following a consultation exercise, a summary of any significant comment should be provided. This feedback should normally set out what decisions have been taken in the light of what was learnt from the consultation exercise. This information should normally be published before or alongside any further action. I can put on record that the Department of Health has every intention of complying with this code of practice when it consults on revisions of the NHS Constitution. Indeed, it has produced a written response to last year’s consultation on the draft constitution. The noble Baroness, Lady Cumberlege, was very kind in relation to the consultation exercise that the next stage review went through. I agree that some have a cynical view about consultations, mostly clinical consultations, which they say bring groups of clinicians together to come up with the answer that we want. Far from it. The next stage review engaged more than 2,000 clinicians, most of whom felt empowered by the consultation, and what is in front of the Committee in High Quality Care for All is, more or less, the policies that we captured through consulting with clinicians. What we have done in the constitution is based very much on similar principles. I hope that I have been able to clarify why it will not be necessary to extend the list of persons or bodies to be consulted every 10 years. However, I have some sympathy with the persuasive arguments that noble Lords have put forward for recognising certain persons or bodies explicitly. I am more than happy to discuss these in greater detail—carers specifically—and some other groups that have been pointed out in this important debate. I shall look again at the drafting of the clause to ensure that the balance is right in relation to the 10-year review and the report, keeping in mind the advice that I have received from the noble Lord, Lord Walton. In giving these commitments to look at the issue again and at the relevant parts of subsections (3) and (5), I hope that the noble Baroness will feel able to withdraw her amendment.