My Lords, I am very grateful to the Minister, the noble Baroness, Lady Barker, and my noble and learned friend Lord Mackay for taking part in this debate. My noble and learned friend indicated that it would be very difficult to formulate guidance. I do not doubt that he is right. However, at one and the same time, he had a pretty good shot at framing some of the main points which such guidance might contain. I do not think that it is a totally impossible business. Nevertheless, I recognise its complexity. My noble and learned friend drew out the point that the degree of regard which should be taken of different elements within the constitution changes in accordance with the matter in question. For example, a right is a right, as the Minister pointed out, and it is not enough simply to have regard to it; you have to implement it and honour it. Part of what would be teased out by guidance in the broadest sense is the scope for confusion and settling that.
The same applies to values. If one takes two of the values contained in the constitution, respect and dignity, one sees that they are meant to guide the NHS in all that it does. That is what we are told and what we would expect but what does it mean to say that the NHS merely has to have regard to them? Either it has those values or it does not. Equally, if we take the principle that the NHS aspires to the highest standards of excellence and professionalism, what does it mean to say that an NHS body merely has to have regard to that aspiration? Either it aspires to the highest standards of professionalism or it does not. If it does not, in what kinds of circumstances may it not do so? But for my noble and learned friend, those questions would have been left somewhat open by this debate; I think they are less open now than they were. For that, I thank him.
The Minister did not cover the issue of staff. Will individual members of staff within NHS bodies be bound by the duty to have regard to the constitution? I am not sure I understood whether I had got it right or not. As the Minister will remember from my opening remarks, I suggested that the Bill should be interpreted as imposing a duty on NHS bodies and organisations; in other words, the boards of those bodies, rather than each and every member of staff. If I am wrong in that I should be very grateful if the Minister would write to me. For now, with thanks to all noble Lords who have taken part in the debate, I beg leave to withdraw the amendment.
Amendment 9 withdrawn.
Health Bill [HL]
Proceeding contribution from
Earl Howe
(Conservative)
in the House of Lords on Tuesday, 28 April 2009.
It occurred during Debate on bills on Health Bill [HL].
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2008-09Chamber / Committee
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