My Lords, again, I have heard the excellent contributions that have been made, really holding the Government to account on a number of these amendments.
I begin with Amendment 93, tabled by the noble Lord, Lord Hunt. I assure him that social value is a very important matter for the Government. I know that this importance is echoed across the NHS, as the country’s largest employer and public service, and that we see the value of the excellent services and innovation that social enterprises, independent providers and charities bring to health and care—indeed, not just to health and care but to the wider economy. However, we do not think that this is an appropriate duty to put on NHS commissioners, or an appropriate addition to the triple aim.
We have been discussing the triple aim and other issues around how that ends up. We fundamentally believe that the focus of NHS commissioning decisions should be on offering the best possible treatments and services based on quality, rather than any decision being based on the type of provider, but, again, while recognising the diversity of non-clinical providers, especially social enterprises, voluntary organisations and charities. The duty of the triple aim is intended to be shared across the NHS. The aims represent a core shared vision of what the NHS should offer, and are intended to align NHS bodies around a common set of objectives and support a shift towards integrated systems. In this context we would not want to split the duty by adding a section relevant to commissioners, NHS England and ICBs, but not to trusts and foundation trusts.
On Amendment 211, in its long-term plan the NHS committed to reducing health inequalities and supporting wider social goals. Again, this refers back to previous debates on how we make sure that we really capture the essence of tackling inequalities in the Bill. We recognise that NHS organisations can contribute to social and economic development, and aim to reduce the impact of social determinants of health and reduce heath inequalities. It is with this in mind that social value, alongside sustainability, has been proposed as one of the key criteria which will be used for decision-making under the provider selection regime.
We believe that this amendment, at this stage, is not necessary, as alongside the role of social value as a key decision-making criterion, NHS England and NHS Improvement will produce guidance on applying net
zero and social value in healthcare procurement, which includes taking account of social value in the award of central contracts.
The Cabinet Office social value model has been applied to procurement decisions taken by NHS England and NHS Improvement since 1 April 2021 and will be extended to the whole NHS system from 1 April 2022. Adopting the Cabinet Office social value model across the NHS complements strategic initiatives and policy within the NHS.
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Amendment 206 is on the wider provider selection regime reforms. The NHS procures many services, but has specifically asked us to introduce a new tailored provider selection regime with key criteria that would enable decision-makers to arrange healthcare services in a more flexible way and deliver value for patients. With regard to the noble Baroness’s desire to cover non-clinical services—catering, porters, et cetera—while these are valued roles within the NHS, it is right that the procurement of these services should still fall under the Public Contracts Regulations 2015 and, in future, the new Cabinet Office procurement regime so that these services are arranged in a way that continues to add the best value to the healthcare system.
There may also be cases where it is essential that a service is procured as part of a healthcare service contract. It is for this reason that we have included the ability for regulations made under this power to include provision in relation to mixed procurements, where other goods and services are procured together with healthcare services. The regulation of these mixed procurements needs to work both for the effective management of health services and for the arrangement of wider public services. We are working closely with the Cabinet Office and stakeholders across the health service to ensure that this is the case.
If a contract were not awarded to a trust or foundation trust, Amendment 207 would require a commissioning body to conduct a consultation on the process and to specify terms and conditions. As we have set out, we intend that the new provider selection regime will allow the NHS and local government the flexibility to best arrange healthcare services for patients.