My Lords, it is my pleasure to support all the amendments in this group, so ably introduced by the noble Baroness, Lady Thornton. I thank her for tabling this amendment and Amendment 28, to which I was pleased to attach my name.
I agree with pretty well everything that has been said but want particularly to highlight the contribution of the noble Baroness, Lady Hollins. As she was talking, I was thinking about testimony that I heard
earlier this week at the All-Party Parliamentary Group for Art, Craft and Design in Education. A teacher was saying that if their educational provision caters to the most vulnerable and disadvantaged pupil in their school, that means that it is catering the best for everyone. It might be thought that having a representative for the interests of those with autism and learning difficulties will affect the care that they receive but it would actually greatly improve the care that everyone would receive. That is not often adequately understood.
As the noble Baroness, Lady Thornton, said in her introduction, there are really two sub-groups here. Going from consideration of Amendment 18 to Amendment 30, we are essentially talking about, as the noble Baroness, Lady Bakewell, was saying, the need to avoid corporate capture of our NHS, although the corporate sector has already won many battles and taken over a great deal of the NHS. If the need for profit is the way in which things are being run, care must suffer. Care is the second priority and that is an unavoidable fact. When one considers privatisation—I have later amendments that will address the care sector in particular—we see where this has been allowed to extend to extremes, whereby the private equity sector has taken over our care system at enormous cost to the quality of care for public and private pockets. The system is in a state of near-continual collapse. We have to make sure that ICBs do not go down the route that our care sector has already gone down.
I am thinking about this matter for Report. There is also a further issue whereby although these amendments address people’s current employment and roles, we also need to think about the revolving door situation, about which, I see from social media, the public are increasingly concerned. We see people flipping between the private and public sectors and taking the interests, direction of travel and thinking of one to the other—and not for positive purposes.
I am aware of the hour but I am looking at the second sub-group of amendments, Amendments 37 to 41, and at who should be there. The issue relates to my comments on the previous group. We cannot just say, in terms of managing the NHS, “Just leave it to the doctors and the experts. They know about care.” Of course they do in terms of running services but in making choices and allocations and in ensuring that the ICB meets the needs of its community, it is the community that knows what the needs are and should tell the medical people what needs to be delivered, and the shape of that delivery. The technical details will come down to the medical people.
It is therefore crucial that we do not see the ICBs as technocratic places for people with MBAs and doctors but that we should include trade unionists, patients and carers. Carers are particularly important because our current system does so poorly in meeting their needs and supporting them. We need bodies that truly serve to represent the community.