My Lords, I am very glad I delayed my speech so that I could hear the noble Lord, Lord Stevens of Birmingham, because I agree with everything he said.
My name is on Amendments 179 to 183 in this group. I shall try not to repeat the comprehensive explanation by the noble Baroness, Lady Cumberlege, of the problems these amendments would address, which are similar to those that we debated in the previous group. I hope that the Minister will accept that the proposals in the Bill as they stand are overcentralising, and that this issue will have to be addressed by the Government on Report.
I agree very strongly with the noble Lords, Lord Howarth of Newport and Lord Stevens of Birmingham, who made unanswerable contributions. In the words of the noble Lord, Lord Stevens, these provisions are unnecessary, undesirable and unworkable, and they confuse and obscure accountability. I hope the Minister will take very seriously what is being said because the Bill’s ambition is to increase transparency and accountability. That is right, but it surely should be prioritised at a local level since that is where services are delivered. The Bill undermines that principle. It thinks accountability should lie in Whitehall, yet there has been no strong call to enable the Secretary of State to intervene earlier in the reconfiguration process and, anyway, there is already an established role for the Secretary of State in cases that are referred. Those processes should not be undermined.
Amendment 179 would change the definition of a reconfiguration of NHS services to ensure that only complex and significant changes to NHS services should be considered. Surely that is right. Amendment 180 would require the Secretary of State to consult all relevant health overview and scrutiny committees plus those organisations delivering relevant services locally along with the integrated care board. That must be right. Amendment 181 would require speedy decisions, and that must be right. Amendment 182 would require the Secretary of State to publish a statement demonstrating that any decision made by the Secretary of State on a reconfiguration proposal is in the public interest and has been taken with patient safety as a priority. That must be right. Crucially, Amendment 183 would prevent Secretary of State acting as the catalyst for a reconfiguration. That, too, must be right.
I hope the Minister will understand that there is much concern about the proposed new powers for a Secretary of State to intervene at any stage in a local service reconfiguration without any need to demonstrate the basis of the information on which their decisions might be reached. There is already a clear process for reviewing proposals for NHS reconfigurations, which are health overview and scrutiny processes charged with establishing whether proposals are in the best interests of their local communities.
What the Government are proposing is not in the spirit of the Bill, and I hope they will take note of the concerns expressed by the NHS Confederation and many others and bring back further amendments on Report to address them.