Health and Social Care Bill

My Lords, this group consists of amendments to the Secretary of State and the Commissioning Board's powers of intervention over health bodies and to the Secretary of State's powers in the case of breaches of duty to co-operate. First, I should like to discuss the amendments relating to the powers of intervention. In doing so, I thank my noble friend Lord Marks for tabling the amendments and presenting them to the House so ably. He committed a great deal of time and effort to developing these amendments and I believe that they will make this a better Bill. As noble Lords will be aware, the amendments sit within the package of amendments relating to ministerial accountability that was agreed through a process of cross-party negotiation and consensus-building. They address concerns from several Peers that, in the words of my noble friend Lord Marks, "““the bar may be set too high against the Secretary of State's intervention””.—[Official Report, 11/10/11; col. 1572.]" I hope they provide reassurance to the House that this will not be the case. I support the amendments and hope that other noble Lords will follow me in doing so. In answer to the noble Lord, Lord Hunt, my noble friend's amendments clarify that the Secretary of State can intervene where he considers that a national body is failing to discharge its functions consistently with what he considers to be the interests of the health service, provided that he considers that the failure is significant. They also clarify the same point for the Commissioning Board's intervention powers over CCGs and, in addition, where a national body may have functions beyond the remit of the health service, these amendments clarify that the Secretary of State can intervene where the body significantly fails to exercise the function consistently with the purpose for which it was conferred. I hope that that explains fully the point of the amendments and answers the noble Lord's question. I turn to Amendments 294 and 295, tabled by my noble friends Lord Marks, Lord Clement-Jones, Lady Tyler and Lady Barker. They relate to the Secretary of State's powers to take action where national bodies are breaching their duties to co-operate. Amendment 294 would allow Ministers to issue a formal notice if two bodies were, "““in conflict with each other””," in the words of the amendment, not just if they were in breach of their duties to co-operate. In cases where the conflict between two bodies arises from a failure to co-operate with each other, this extension of the power is unnecessary. However, there may well be legitimate occasions when different bodies have different views, and we would not want to make that situation an automatic cause for ministerial intervention. The onus should be on the bodies themselves to work through any differences in a co-operative way. Ultimately, Ministers would be able to intervene when, and if, intervention is appropriate, as my noble friend's amendments will clarify. Ministers would be able to intervene when a body's significant failure was contrary to the interests of the health service, and if a body's conflict with another body constituted such a failure the intervention route would be open. I hope that that is helpful. Amendment 295 would give the Secretary of State the ability to instruct bodies on how to carry out their functions in cases where they breach their duties to co-operate. That is also unnecessary. The clause allows the Secretary of State to place bodies under an agreement lock whereby they can carry out specified functions only with the agreement of the other body. The point of that is to ensure that bodies in dispute are strongly reminded of their interdependence as part of a national system and are pressed to resolve their differences without the need for ministerial direction. However, the agreement lock is only one of a number of levers open to the Secretary of State to promote co-operation and prevent conflict, as I have already said. My noble friend's earlier amendments will clarify that the Secretary of State could invoke his intervention powers to direct the bodies in the exercise of their functions if he believes that the bodies are not acting in the interests of the health service. For those reasons, which I hope my noble friend will accept are robust, I cannot support Amendments 294 and 295. I hope that I have persuaded him not to press them.