Health Bill [Lords]

We are the party that introduced the NHS constitution. We certainly want to ensure that it sets out the guiding principles to the NHS, but not to turn it, as the hon. Member for Eddisbury (Mr. O'Brien) appears to want to, into exactly what he referred to—a "lawyer’s charter". I use exactly the same phrase as he did because that is precisely what we need to avoid. It is supposed to be a declaratory document, not a legal one. We need to ensure that the NHS is the area where this decision-making takes place, not the courts. Equally, if the NHS’s principles were enshrined in primary legislation, that would rigidify and fix them in a way that meant that they could not be adapted as medicine and the NHS change. The result would be inflexibility in how the constitution develops. We need to ensure that the NHS can move with the times and adapt when it needs to, and that it has the flexibility to develop its constitution in a way that responds to patients. The hon. Gentleman’s proposal would prevent all that and ensure that the courts constantly intervened with detailed legal decisions. Difficult decisions that are currently made within the NHS would instead have to be referred to the courts by way of judicial review again and again. He knows, and I know, that issues related to the NHS can require difficult decisions. If we abrogate those decisions to the courts across the board, we will create substantial difficulties and delays. Amendment 15, tabled by the hon. Members for Romsey (Sandra Gidley) and for Southport (Dr. Pugh), would require the Secretary of State to conduct a review of the NHS constitution within two years of its coming into effect. The constitution will be able to be examined constantly to ensure that it adapts. We will avoid the rigidity that the Conservative Front Benchers want, and we will be able to undertake the type of review that the hon. Member for Romsey wants, but we do not want to fix a review in time. We need to ensure that the NHS constitution can be kept under regular review—whether in two, three or four years. I therefore hope that she will not press her proposal. Amendment 20, tabled by the hon. Member for Wyre Forest (Dr. Taylor), would require the NHS constitution to be revised in the light of the findings of the Care Quality Commission and the National Patient Safety Agency. Although I commend the hon. Gentleman’s intention and sentiment, the provision of high-quality care in a safe environment is at the heart of NHS values, and I am sure that we can agree that we want the NHS to deliver high-quality care across the board. The good work of the CQC and the NPSA helps to support that, and both will continue to play an important role as we move forward.