LOCAL HEALTH COUNCILS (Hansard, 26 July 1972)

§ Mr. Monro
I beg to move Amendment No. 9, in page 7, line 13, leave out "Subject to subsection (2) below".
This is a paving Amendment for Amendment No. 10 which will be moved by the hon. Member for Glasgow, Wood-side (Mr. Carmichael). In Committee we discussed in detail whether we should make it a definite requirement for area health boards to initiate a health council. After listening to the debate and the fears 1990 expressed by the Opposition that it might be possible for an area board to avoid having a health council I agreed to the hon. Gentleman's proposal to delete subsection (2).

§ Mr. Carmichael
I beg to move Amendment No. 10, in page 7, line 21, leave out subsection (2).

§ Mr. David Steel
On a point of order, Mr. Deputy Speaker. I take it that it will be in order to discuss my Amendment No. 8, in page 7, line 13, leave out Clause 14.

§ Mr. Deputy Speaker (Mr. E. L. Mallalieu)
I understood that the three Amendments to the Clause were being taken together.

§ Mr. Carmichael
As the Minister said, in Committee we took exception to the fact that it might be possible for a health board not to set up health councils. Incidentally, perhaps inadvertently the Minister spoke about a health board setting up its own health council. In fact there will almost certainly be a number of councils for each health board, not just one council.
The Minister gave examples of where the Secretary of State may accept that a health board need not set up health councils because there may be a local authority that is perfect for the area. We felt that there was a certain ambiguity about the provision. We did not feel that the whole Clause should be left out, and we are therefore glad that the Minister has facilitated the making of this Amendment.

§ Mr. David Steel
I remain unhappy with the provisions of the Clause, even after the removal of subsection (2). The matter was discussed on Second Reading and in Committee. Unless it is clear that the local health councils are to have some democratic content, or that the local area health boards will, in some way, be answerable to the House, either through Members or through the new local authority structure within Scotland, I have strong reservations about the setting up in limbo of advisory bodies which have no responsibility to anybody.
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There is a tendency, the more organisations or Government Departments we 1991 hive off to independent organisations, automatically to counter-balance the situation in every piece of legislation. It happens under all Governments. It seems that if we set up some sort of public machinery we must go through the motions of setting up checking mechanisms. We have organisations like the Post Office Users Consultative Council, the electricity consultative committees and the gas consultative committees—there are any number of them.

§ Mr. Robert Hughes
They have no power.

§ Mr. Steel
The public's awareness of their existence is at a low level. They have no powers and are responsible to no one. I am chary of setting up yet another piece of mechanism of that kind. That is why we have tabled what may appear on the surface to be a destructive Amendment to remove Clause 14 from the Bill. It would be far healthier to say, "We will not attempt to set up the machinery. We will not go through the facade of having some sort of consultative machinery. We will retain the right of area health boards to be answerable in some way through the Minister either to the House or, alternatively, to the new regional councils which are being set up in legislation which will be before the House next Session."
I am unhappy about the establishment of bodies which will float around in limbo, thus adding to the number of appointments which may be made by the Secretary of State on goodness knows what sort of basis. It does not strike me as a good provision in an otherwise excellent Bill.

§ Mr. Monro
I shall not detain the House long in responding to the hon. Member for Roxburgh, Selkirk and Peebles (Mr. David Steel) who I know, because of his meticulous care of detail, will have read the fairly long and important discussions which we had in Committee. In the main there was a general welcome from both sides of the Committee for the setting up of the councils. I am a little surprised that the hon. Member should feel that the provision might not be worth while. I know, as he does, of the tremendous spirit of co-operation within the National Health Service in the Borders which applies also 1992 to Common Ridings and rugby football. Matters are dealt with extremely smoothly. I am sure that may be the basis of some of the hon. Gentleman's arguments later this evening.
I apologise for the slip I made earlier. Of course, there can be a number of health councils within each health board area. Bearing in mind that there will be a number of health councils, they will be, despite what some hon. Gentlemen have said, an important check on the boards. The councils will have regular meetings and will be serviced by the boards. Councils will have the right to ask representatives of the board to go to their meetings and explain matters of policy and listen to their constructive views and criticisms. I hope to see the councils being positive and constructive rather than carping.
A number of representatives will be appointed by the local authorities to the health councils. The hon. Gentleman must know from his knowledge of children's hearings that there has been no shortage of able people coming forward to do this sort of work. I think that will happen in respect of the health councils.

§ Mr. David Steel
Surely that is not a correct analogy. The people who have volunteered to come forward for children's hearings are doing an executive, a positive, job. There is no suggestion that the health councils would have any executive functions.

§ Mr. Monro
I take the point that the health councils will have no executive powers but I was pointing out that a large number of people have come forward voluntarily and enthusiastically to do this sort of work—people like those in the "Friends" of various hospitals throughout Scotland. I believe that we must have these health councils set up to keep area boards in close touch with the hospitals at local level. I believe also that given a strong lead by the boards and by the Secretary of State they will do a most worth-while job. I accept and welcome Amendment No. 10.

§ Mr. Monro
I beg to move Amendment No. 11, in page 8, line 17, at end insert: '(c) requiring local health councils to submit annual reports on their activities to 1993 their Health Board and requiring Health Boards to transmit a copy of any such report to the Secretary of State;'. The hon. Member for Lanarkshire, North (Mr. John Smith), in a number of valuable contributions in Committee, suggested that it should be a duty of the health councils to submit annual reports to their activities to the boards, which should then forward them to the Secretary of State. I promised to give the suggestion careful thought. Having done so, I agree that there are a great many advantages in it. It will not only ensure that the area health boards had the views of the councils annually—although I hope there will be monthly or six-weekly reports—but also that the Secretary of State has the opportunity to know what the health councils are thinking at the grass roots of the National Health Service. I had pleasure in putting down Amendment No. 11 in order to meet the hon. Gentleman's wishes.

§ Mr. John Smith (Lanarkshire, North)
I thank the Under-Secretary of State for his kind remarks about me and I express our appreciation for his constructive attitude towards a matter we think of importance.

§ Mr. Robert Hughes
We had a great deal of discussion in Committee about local health councils, their procedure and their right to submit reports—indeed, about the view that they should be required to submit reports. We agreed that Clause 14 should be retained but were worried about the lack of control there is to be—even less control by ordinary people or even by elected representatives in the new set-up because we are losing the democratic element in the National Health Service which lay in the local authority health services. What little democratic control there was is now gone, and therefore we were concerned to see that the local health councils should be placed on an important footing.
We discovered in discussion with those dealing with these questions outside that there is fear among regional board members that the local health councils would simply be rubber stamps. Bodies such as the Post Office users' consultative committees are without teeth. On the other hand, some, other members of regional boards feel that the health councils might have too much power without responsibility. 1994 Their fear is opposite to that which we feel. That was one reason we thought there should be annual reports to the health boards and through the health boards, to the Secretary of State.
Even since the Amendment was put down, a point has arisen which had escaped everyone before—that there is nothing in the Clause which says that this report shall see the light of day. The only people entitled to see them are the area health boards and the Secretary of State.
If these reports are to have full and real value they should be seen by the public. Although the Bill is silent on the requirement to publish, it may be the Secretary of State's intention that the combined reports of the health councils should be made public as parliamentary or non-parliamentary papers, available in the Vote Office and to be bought by the public from the Stationery Office.
I do not know the Secretary of State's intentions because we did not discuss this in Committee, but if he has not thought about this perhaps he will now and, if there is an opportunity, perhaps he will put down an Amendment in another place to give himself permissive powers to public or put a statutory duty on himself to publish these reports. It should be done.
Apart from Parliament having the right to examine these reports to see how legislation which has passed this House is operated, it would give a check on how things are operating and might change our attitude to other Bills to correct or develop the National Health Service. These councils are supposed to represent consumer interest. That is their primary purpose and, if they are to represent the consumer interest properly and fully, the consumers should see the results of what they are doing.
It has escaped attention up to now that there is no provision for the reports to see the light of day. They should, and it would be in the spirit of Clause 14. Therefore I hope that we shall have an assurance from the Secretary of State that it is his intention to publish and that, if he has no powers to do so, those powers will be created in another place.

§ Mr. Monro
I should like to clarify that point right away. It never crossed 1995 my mind that the reports should not be published. I should have thought it absolutely essential that maximum publicity be given to the health council reports in the local Press in the board areas, and the Secretary of State will be looking at them himself.
I would expect, too, that the health councils would always be in touch with their Members of Parliament and would send them copies of the reports. If that did not happen, the Secretary of State would make certain that hon. Members received copies of reports of the health councils in their own areas and, if they wished, in other areas. I am all for maximum publicity.