Health and Social Care Bill

My Lords, this amendment brings us to NICE. I start by paying tribute to its work, and I should say that I much appreciated the commendation for the institute made by the noble Earl, Lord Howe, in the Oral Question last week. NICE was established because of the slowness of the NHS to take up proven new treatments and drugs, and although there was concern at the time of its establishment, I do not think there is any doubt that it has done a good job and that it has achieved global recognition for aspects of its work. It is important to build on this in the future and not to put any qualifications or impediments in its way or undermine its independence. That is why Amendment 340W would provide that the consent of the Health Select Committee ought to be required for the appointment of the chairman of NICE. This is a very important appointment, and I would have thought that parliamentary scrutiny will enhance confidence in the independence of NICE’s role. Amendment 340X would remove the current provision in Schedule 17 to give the Secretary of State a veto over the appointment of the chief executive of NICE. Given the Secretary of State’s desire to take a hands-off approach and given also the enhancement in the status of NICE, I remain somewhat puzzled as to why the Secretary of State wishes to maintain a veto power over the appointment of the chief executive, and I wonder if the noble Earl would consider removing it. Surely it would be appropriate to leave it to the good sense of the chairman and members of the board to appoint the chief executive. Amendment 344ZA ties in with Amendment 344, to which my noble friend will speak in a moment. It is important that NICE should continue to assess the cost-effectiveness to the health service of new pharmaceutical products, and certainly until this matter is incorporated into a system of quality standards as provided for in Clause 231. I assume that this is also tied to proposals on value-based pricing which we debated a little at Second Reading. Essentially, however, I would like some assurance from the noble Earl that in the current circumstances, appraisals by NICE will be subject to directions so far as implementations are concerned and that clinical commissioning groups will be required to implement such guidance. The point here is this. The other reason NICE was established was to try to remove postcode prescribing as far as possible, so it is important to ensure that this continues under the Government’s new proposals. I beg to move.