I thank the noble Baroness for her sympathy for my role. Debates like this are important. They give the Government a measure of the strength of feeling on particular issues. It would be blind for me not to acknowledge the strength of feeling and the support for the noble Baroness, Lady Hollins. As I have done with some of the other issues discussed in this debate, I will take this back to the department and call a meeting of those who are interested, as we did for mental health, and hopefully we can have a discussion to find a way forward. I thank noble Lords for expressing the strength of their feeling. It is very helpful to know where we can focus time and resources as we try to get this Bill through and ensure that it is workable and leads to the integration that we all want to see.
I will also add that NHS England intends to assess ICBs, as I does CCGs. This may not be reassuring, given some of the strength of feeling about NHS England’s drive behind the Bill. The CQC will also make assessments of ICSs and systems, and part of that will be to consider how health and social care are working together.
I will now talk about rehabilitation—not of my career but of health. Our intention with this legislation is to establish overarching principles and requirements, while allowing ICBs space and discretion. This means avoiding being prescriptive, wherever possible. I am sure that noble Lords acknowledge that. Looking at the duties on ICBs that are relevant here, the first—in Clause 16—requires an ICB to arrange for the provision of the listed services it considers necessary to meet the needs of those for whom it is responsible. This includes aftercare which, in turn, includes rehabilitation. The ICB is also required to develop a joint forward plan, setting out how it will meet the health needs of its population—which should consider rehabilitation. ICBs are also under a duty to seek continuous improvement in the quality of care. That of course has to include rehabilitation. We hope that, without legislating for the production of a separate annual plan, ICBs will be required to provide, and improve provision of, community rehabilitation services.
I turn to Amendment 101B. I can assure noble Lords that the Government fully support the increased focus on mental health spending. I thank noble Lords who met with me earlier this week to discuss some of the issues around mental health and how we make sure that it gets the profile it deserves. We are trying to move towards parity between mental and physical health, and indeed all other types of health service. If I may, I will leave that there for now. If we have to continue the conversations about mental health, those who were not invited to this week’s meeting might like to drop me an email to let me know if they are interested in joining the meetings, and I will make sure that the Bill team invites them.
I am trying to get through this as quickly as possible. Turning to Amendment 110, I thank my noble friend Lady McIntosh of Pickering for the conversations we have had on inequalities, particularly in rural areas. A number of noble Lords alluded to this. I should also like to record my thanks to noble Lords in the Committee and in the other place who have campaigned so strongly on this issue. We have listened. The amendments already
accepted in Clause 20 have directly addressed the need to consider victims of abuse, including victims of domestic and sexual abuse.
Clause 20 ensures that integrated care boards and their partner NHS trusts and foundation trusts set out a joint forward plan for any steps that the ICB proposes to take forward. As the noble Baroness, Lady Barker, said, we also have to make sure that this is not seen as just an NHS issue. We want to make sure that we work more widely with all agencies in the area to tackle these issues. For these reasons, we do not feel that a separate strategy is necessary in the Bill. Also, the accepted amendment is more comprehensive. It covers all forms of abuse. There are also duties on CCGs to consider the needs of victims of violence, including a joint strategic needs assessment. CCGs must respond to these, and this will be transferred to the ICBs.
Under the Government’s new Domestic Abuse Act, local healthcare systems will be required to contribute to domestic abuse local partnership boards. It is also worth noting that the Government are undertaking wider work to protect and support victims of domestic violence. Clearly, further action is needed beyond the NHS. In particular, the Police, Crime, Sentencing and Courts Bill will require action from across government, and we will ensure that this work is aligned as much as possible.
The proposed amendment would place a requirement on ICBs to have a domestic abuse and sexual violence lead. We agree with the principle, but we think we can do this effectively through existing legislation and guidance, as set out in the Government’s recent violence against women and girls strategy. My department will engage with ICBs and partnerships to make sure that we have appropriate guidance.
Beyond ICBs, there is a huge opportunity for ICPs to support improved services for victims of domestic abuse, sexual violence and other forms of harm through better partnerships. I hope that I have given noble Lords some assurance about this.
2.45 pm
Once again, I am grateful to the noble Baroness, Lady Barker, for tabling Amendment 297J. Good sexual and reproductive health and healthy relationships make a significant contribution to our health and well-being. We believe that access to appropriate and high-quality interventions is much needed. As the noble Baroness once again said, this is not just for the NHS. We are currently developing a new sexual and reproductive health strategy, which will be published this year. In the HIV action plan, published last year, we set out our plans to end new HIV transmissions in England by 2030. This amendment would require us to report to Parliament within six months of the passage of the Bill—also subject to the findings of the report.
We accept that there are concerns about fragmentation in commissioning and delivery of SRH services across England, which were so eloquently laid out in the contribution from the noble Baroness. In her words, we cannot continue in this inefficient way. The Government are determined to address this, given the shared agenda on sexual and reproductive health between local government and the NHS, as well as
having stronger commissioning and leadership responsibilities. We want to see stronger collaboration and co-operation right across government to ensure more efficient and effective services.
Subject to the successful passage of this Bill, we will update the existing duty on ICBs and local authorities to co-operate with each other. Clause 66 will give us the power to issue statutory guidance on the duty of local government and the NHS to co-operate. We will consider using this power in relation to sexual and reproductive health services to support the implementation of our new strategy and our ambitions for both our sexual and reproductive health and HIV programmes.
I regret that the Government cannot accept these amendments. I hope I have given noble Lords some assurance on the issues where I have sensed the strength of the House’s feeling. I hope we can continue these conversations. In that spirit, I hope that noble Lords will not press their amendments.