Health Bill [HL]

On behalf of all noble Lords, I thank the Minister for the very detailed and considered response that he gave to the debate. It was characteristically generous and assiduous of him. I sincerely thank him for that. I thank noble Lords for their contributions. This group of amendments has answered for me what I might call Lord Walton’s question: if there is to be a list, who should be on it? I come back to what I think is the answer to that. It was enormously helpful to have explained the distinction between small revisions to be carried out periodically and the process of the 10-year review. The Minister’s general commitment to the inclusion of a wide range of stakeholders, to use the jargon, was welcome. The success of this document, once it is launched, does not rest solely with the NHS. It cannot; the NHS cannot implement it all—it has to be done in conjunction with others. There was recognition of that in what the Minister said. To the noble Lord, Lord Campbell-Savours, I say, ““Hold on””. At the rate they are nationalising banks, the noble Lord may yet see a piece of legislation containing the words ““trade unions””, so he should not give up. Just persist. It was important to have the discussion about specialised services. There is always a legitimate concern that those who have specialised conditions tend to be pushed out of the picture by those who have conditions that are more prevalent and therefore tend to be far higher up the political list. We may have teased out one thing in the discussion. There is a case for putting carers into this. That point was made principally by the noble Baroness, Lady Wilkins, who talked about the fact that her partner became her carer at a particular point. The question of who is a carer and who is not changes over time. That is one thing. The second thing is that in the NHS, and increasingly in social care, there is a more coherent and consistent view of users and the rights of users. The distinction is that in the NHS it is more likely that practitioners will see users without their carers being present and will therefore be less likely to feel comfortable with breaking clinical confidentiality. Therefore, with all the best will in the world, carers in the NHS are in a slightly different position from those in social care. That is not to say that there is bad practice in social care—there is not—but there is a recognition in social care that the majority of the work is done by informal carers and that they have to be involved in their own right much more so than in the NHS. For those two reasons, it was very good that we drew out why carers have to be mentioned distinctly. Nobody wants the review of the constitution to become a cumbersome exercise, but we want it to be valid and to throw out valid results and challenges to the NHS every 10 years. That would be a very useful thing to do. With those caveats, I welcome the Minister’s agreement that he will take away part of our discussion and perhaps refer to it at a later stage. I beg leave to withdraw the amendment. Amendment 13 withdrawn. Amendments 14 to 21 not moved.