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

I would encourage the hon. Gentleman to read the Opposition Front Bench amendment tabled in the House of Lords which set out how we could have a separate independent body with clear lines of accountability to local healthwatch organisations. That is the policy of the Opposition. Unfortunately, however, that amendment was not accepted. National Voices represents 150 patient groups. I was interested that the Minister said that the Richmond Group of charities somehow supported everything that the Government were doing in this area. However, I should remind the House that National Voices includes groups such as Asthma UK, Arthritis Care, the British Heart Foundation, Breast Cancer Care, Carers UK, Cancer Research UK, Diabetes UK, Dementia UK, Mencap, Mind, Macmillan Cancer Support, Rethink Mental Illness, the Stroke Association and many others. Those groups are saying that the Government are setting HealthWatch up to fail, because it will not provide a strong enough voice for patients and the public. Interestingly, officials within the Government's own Department are saying the same thing. Hon. Members will know that the Government have refused to publish the transition risk register, but today I have been passed the risk register from the Department of Health's programme board for HealthWatch. It is marked ““Restricted””, and it sets out clearly what the Department's officials see as the risks involved in the Government's proposals on HealthWatch. It deals with high risk in terms of impact, as well as with likelihood, so it does involve prediction. The risk register says that there is a high risk that"““existing LINks members and volunteers become disenchanted about the new arrangements for local HealthWatch and leave the system””" because of ““insufficient consultation””. It goes on to say that there is a high risk that local authorities"““will not invest in establishing effective relationships with existing LINks and other community organisations””" because the process has been poorly managed. It states that there is a high risk that there will be a ““narrow engagement group”” and that HealthWatch"““doesn't work effectively with providers and commissioners. HW is not fully representative.””" It identifies the cause for that as the engagement process having been ““insufficiently inclusive””. It sees a further high risk in relation to HealthWatch England:"““The establishment of the HWE committee within CQC is either too isolated or too prescribed by DH/CQC plans.””" The cause is identified:"““Early design processes for establishing HWE do not engage broad range of partners resulting to ineffective regulations being laid.””" Those ineffective regulations are being laid by this Government, according to the risk register of the Department of Health's own HealthWatch programme board. Some of the Lords amendments in this group would make minor improvements to the Bill in relation to the National Institute for Health and Clinical Excellence and to the functioning of the information centre. I want to return to the Minister's earlier claim that huge improvements would be seen in public health. Some amendments relate to the employment of public health professionals by local authorities. The trouble is that the Faculty of Public Health, the body that represents those people, opposes the Bill and wants it to be dropped. It has stated that the Bill will widen inequalities, increase health care costs and reduce the quality of care. It says that there are significant risks—[Interruption.] If hon. Members are making claims that their Bill will improve public health and that the amendments will improve arrangements for public health professionals, perhaps they should listen to the views of those public health professionals. The Faculty of Public Health has identified"““significant risks associated with the NHS structures, the new health system and environment that the Bill will enact.””" The right hon. Member for Bermondsey and Old Southwark (Simon Hughes) was, perhaps courageously, trying to get the Minister to set out what powers local authorities would have under the new system. He will know, however, that health and wellbeing boards will not have the final say over GP commissioning plans. They will not be able to stop them. The only course left to them will be to appeal to the NHS Commissioning Board. I would respectfully point out to the right hon. Gentleman that if he thinks that the NHS Commissioning Board will automatically agree to complaints from local authorities, his experience of the NHS is very different from mine. We need to be clear that there will be no sign-off by health and wellbeing boards.