Health and Social Care Bill (Programme) (No. 4)

This group encompasses a number of Lords amendments relating to public health, public involvement, local government, the Health and Care Professions Council, the National Institute for Health and Clinical Excellence and the NHS Information Centre. We believe that the Bill has been improved as a result of the amendments made in the House of Lords. For example, the Government have directly addressed the concerns raised in this House and elsewhere about the status and security of directors of public health within local authorities. We have also introduced safeguards to ensure that local healthwatch organisations and HealthWatch England can operate effectively within the Care Quality Commission, and that the CQC can have better links with, and transparency to, local healthwatch organisations. Throughout the Bill, we have emphasised the importance of public health. In particular, local directors of public health will have a leading role within their local authorities in ensuring that public health is a consideration across the full range of local government activity, not just its health responsibilities. For example, they will use their participation in health and wellbeing boards, alongside directors of adult social services, directors of children's services and clinical commissioning groups, to find innovative solutions to local health needs. To further strengthen the status of public health in local authorities, amendments tabled by my noble friend Earl Howe establish directors of public health as statutory chief officers of their local authorities. They also give the Secretary of State the power to issue guidance on the role of directors and other public health staff, to which local authorities must have regard. Along with the guarantee of chief officer status and statutory guidance, that is equivalent to the situation that currently applies to directors of children's services and of adult social services. Other Lords amendments will enable us to give directors of public health a key new role in considering applications for the licensing of premises for the sale of alcohol, and enable the national child measurement programme to continue once it is transferred to local authorities. Beyond the provisions of the Bill, we have stated clearly that Public Health England will have a board with an independent, non-executive majority and an independent chair, to provide the chief executive and the Secretary of State with frank and expert challenge. Public Health England's ability to undertake research and bid for external funding for health protection research in the same way as the Health Protection Agency is also provided for in the Bill as it is now drafted. Finally on public health, we have announced our intention, subject to consultation, to require the registration of non-medical public health specialists with the Health Professions Council. We introduced safeguards in the other place to ensure that HealthWatch England could operate effectively within the CQC and have better links with, and transparency to, local healthwatch organisations. That will help to ensure that issues arising between them can be addressed, and local authorities and local healthwatch organisations will have to have regard to similar guidance. HealthWatch England will also exercise additional functions to assist local authorities with the arrangements that they make for local healthwatch. HealthWatch England may make recommendations of a general nature to local authorities about the making of those arrangements. When it is of the opinion that local healthwatch activities are not being properly carried out, it can draw that to the attention of the local authority. The Lords amendments will ensure that regulations are able to, and in some cases must, make adequate and appropriate provision about HealthWatch England's membership. That will include specifying that the majority of members must not be members of the CQC board, and setting out the procedures for selecting members or proposing persons for appointment as members. We listened to the concerns on that issue and have now undertaken a public consultation on the proposed regulations. The results are currently being carefully analysed. A number of the amendments in this group apply to local healthwatch organisations. They will strengthen the statutory powers of those organisations, enabling them to become a powerful champion of patients' interests locally. As a result of the Bill, they will have stronger and more wide-ranging powers than local involvement networks do under the current arrangements. The Government are ardent proponents of localism and of local authorities being able to take account of local needs and be accountable to their local population for the decisions that they make.