Health and Social Care Bill

This is an extraordinarily wide group of amendments—I think there are 27 in this group. I sympathise—well, almost sympathise—with the Minister in terms of how he will respond to them. I wish to comment on just three of the amendments. The first is Amendment 144, which the noble Lord, Lord Patel, has just spoken to, about the importance of sharing information collected on the safety of services provided by the health service. Particularly in the context of what I think we will see as a fragmentation of the service, where a pattern becomes apparent that suggests that particular practices or processes challenge patient safety, it is important that that information is disseminated. To save the noble Earl time, no doubt his brief—should he be able to find it in the mass of papers that he has in front of him—will suggest that Amendment 144 is unnecessary because the present form of words in the Bill talks about sharing information with persons with whom it is appropriate to do so. The advantage of the wording of the noble Lord, Lord Patel, is that it spells out some of those with whom this information should be shared—the CQC, Monitor, all commissioning groups, Healthwatch England and health and well-being boards. That is important because these bodies may well be aware of practices that are taking place in local facilities or they may need to be aware of what is considered to be less than safe practice. That is why it is important that the information is disseminated widely and that the organisations listed are included. Otherwise, there will be a danger that, for example, the matter might be seen as entirely technical and not worthy of distribution or as something that is circulated only to those who have an immediate requirement to know, rather than to a wider group of organisations, some of which will be locally based and may be monitoring the situation. For example, providing the information to Healthwatch England may well mean that local healthwatch organisations will be able to pick up a particular issue and advise the board on its importance. The second issue on which I want to speak is Amendment 153ZZA. I am pleased that I gave way to the noble Lord, Lord Marks of Henley-on-Thames, because I thought that this amendment was not going to be spoken to by any of those who had put their names to it. It concerns the disclosure of information for the purposes of protecting the welfare of any individual and says that this disclosure should take place only with the agreement of that individual. I think that the amendment might be misguided because the health service has a particular duty regarding the welfare of individuals and there may well be circumstances in which the disclosure of information is necessary as a matter of urgency to safeguard the right to life of that individual. For example—this is informed by the work that I do as chair of the Independent Advisory Panel on Deaths in Custody—the board will, I think, have responsibility for commissioning medical services for prisons and custody services. Where an individual may be transferred from one entity to another, repeatedly and at short notice, it will be potentially unwise to expect that individual to have given prior approval of the disclosure of information which may be important for their safety, either because of their medical condition or because they are at risk of suicide.