Health and Social Care Bill

My Lords, the amendments in my name are about patient and public involvement, and accountability to patients and the public. They would amend new Sections 13H, ““Duty to promote involvement of each patient””; 13I, ““Duty as to patient choice””; and 13J, ““Duty to obtain appropriate advice”” by the Commissioning Board, in the 2006 Act. I shall also speak to Amendments 141A and 206A. The latter is in the name of the noble Baroness, Lady Hollins, who unfortunately had to leave for another engagement but will return later. All these amendments are about the requirement for the NHS Commissioning Board and all clinical commissioning groups to engage in meaningful and substantial consultation with users of services, particularly with regard to ensuring that commissioners commission services and pathways that are navigable and coherent. The current requirement to be placed on the board and the clinical commissioning groups is that they must make arrangements to secure that individuals to whom the services are being provided are involved. It is not enough for the suggested means of doing this to be quite as open-ended as the Bill suggests. The Bill implies that this consultation is really aimed at representatives of patient groups, and I would like clarification from the Minister that both individuals and groups of patients should be able to make representation. It is quite easy to conceive of a situation in which a patient is consulted or provided with information and yet is none the wiser and no more involved in the services that they receive. Within this amendment is the implicit recognition that different patient groups may need to be treated differently when it comes to getting advice or consultational services. Providing a consultational service that adopts a ““one size fits all”” approach would be cheaper than one which took the needs of individual groups into account. I use the example of my noble friend Lady Hollins and the Royal College of Psychiatrists about adequate consultations with users of mental health and learning disability services, where individual patient consultation would not be appropriate. The crux of this group of amendments is therefore a proper definition of what it means to involve service users in the design and commissioning of the services they receive. An understanding of involvement which limits the patient’s role merely to being the recipient of a service, would be one that renders the current wording of ““requirement”” useless. The inclusion of the word ““involve”” necessitates an active role for the patient in the commissioning processes. Different patient groups will require different levels of consultation involving different clinical and social networks in order for them to be considered to be actively participating. The board and clinical commissioning groups will be responsible for ensuring that the procedures are in place to make this happen. By explicitly stating in the Bill the requirement to arrange for patients to be involved, the necessary assurance will be provided. My Amendment 128 therefore requires the board to publish in its annual report a paragraph on what advice it received and what it did with it. I beg to move.