Health Bill [HL]

My Lords, I want to point out a small error in the printing. The amendment should read: ""Before any revision of the Handbook, the Secretary of State shall consult such persons (if any) as in all the circumstances he may consider appropriate"." With this amendment I bring us back to the issue of who, if anyone, should be consulted when the handbook is revised. As the Bill stands, the Secretary of State may go ahead and revise the handbook without being under a duty to consult anyone at all. In Grand Committee a number of us questioned that. What it means, effectively, is that the Secretary of State has sole power to interpret the constitution as he sees fit. I realise that he would not do that in any way irresponsibly, but it was something that left some of us uncomfortable in the sense that it should be a collaborative process. It also means that those with the closest knowledge of how the constitution works, or should work, in practice have no say at all in the way that the manual to the constitution is drafted. They have no right to make a contribution to that process. That seems, at the very least, short-sighted, but it is also wrong in principle. In reply in Grand Committee, the Minister made two associated points. The first one was that it would not be proportionate for the Secretary of State to have to consult on every minor change which might only be technical. The second one was that if the change was a more significant one relating to a policy issue, the Government would already have consulted on it, so there would be a lot of unnecessary extra bureaucracy if the Secretary of State also had to consult on the change to the handbook which brought the change of policy into play. I understand both those arguments, but I accept the second one only up to a certain point. The purpose of consulting on changes to the handbook is not just to obtain people’s views on changes in government policy. It is just as much to ensure that the information in the handbook is accessible, intelligible and workable. The Minister said in our earlier debate: ""The intention behind the regular reviews of the handbook is to assess whether the handbook continues to be fit for purpose for patients, public and staff".—[Official Report, 26/2/09; col. GC 155.]" If that is so, there is, at the very least, a prima facie case for involving staff, as well as patients and the public, in the review process. After all, there was consultation when the handbook was initially drawn up. I am the first to want to avoid burdening everybody with unnecessary and pointless consultation. No one wants that. But I do suggest to the Minister that, from time to time, there could be a good case for consulting key stakeholders about changes being made to the wording of the handbook. This would not necessarily be when major changes of policy were in prospect, but rather when the practical implications of new or existing policy required explaining in clear and appropriate terms. This is one area of life where I do not believe that the Secretary of State or the Department of Health has a monopoly of wisdom. As it stands, the Bill gives the Secretary of State that monopoly. I, for one, am not comfortable about that, which is why I beg to move.