Health and Social Care Bill

I will speak to Amendment 101A, in my name and that of other noble Lords. Before I do, I will say one word about the amendment spoken to by the noble Lords, Lord Kakkar and Lord Patel. I was pleased to hear what they both said because in a way it reflected the crucial nature of trust in the medical experience, the relationship between the patient and the doctor. That is at the centre of the ability to create a successful health service. They were absolutely right to emphasise that. Without going into detail, it is fair to say that the Nolan principles are becoming a kind of gold standard of the behaviour of people in public life. It is eminently suitable that that gold standard should be openly applied to those who are members of clinical commissioning groups at the local level. That will go some way to retaining the level of trust that exists between the medical profession and citizens. Turning to Amendment 101A, we do not want go over the ground again about membership of the board. This is, in a sense, the board in a miniature—the membership of the clinical commissioning groups. It is crucial that clinical commissioning groups are very close to their communities. The reason that my amendment refers in particular to a representative of the nursing profession is because almost nobody is ever closer to a local community than nurses. The information and knowledge that he or she carries can be vital to the working of the local clinical commissioning board. Also, nurses tend to be the recipients of any complaints there may be, so again it acts as a two-way channel. I also hope that we can bear in mind the importance of somebody with public health experience on a clinical commissioning board. I make one other, final remark. As evinced by amendments later on that we will come to discuss, the major guarantee of the behaviour of a clinical commissioning group will be transparency. I hope that when we come to look at the extent to which members of boards should declare any interests that they may have, and should be recused from any decision which might bear upon that interest, we will recognise that this is one of the most important elements in dealing with the point that the noble Lord, Lord Hunt, legitimately raised. The real concern is about the interests of individual GPs or groups of GPs in their own particular business—so to speak—and the way that that must be made absolutely plain before the clinical commissioning group takes a decision that can have any bearing upon the individual interests of individual members of the board.