RECIPROCITY FOR PATIENTS' FORUMS (Hansard, 9 January 2003)

§ Mr. Nigel Evans (Ribble Valley)
I beg to move, That the clause be read a Second time.

§ Mr. Speaker
With this we may discuss amendment No. 4, Title, line 1, after "Wales;" insert to make provision for reciprocity for Patients' Forums in England;".

§ Mr. Evans
The new clause is straightforward, and I am sure that the Minister appreciates that there is a problem that needs to be tackled. If it is not done through the new clause, I hope that it will be properly addressed in another place so that patients forums can cover anyone living in England who wants to receive treatment in Wales. The new clause stems from the purpose of community health councils, the patients' champion. If CHCs in Wales cannot investigate any complaints on behalf of patients who come from England or elsewhere, a problem will arise. Perhaps the issue also relates to people from England or Wales who receive treatment in France or Spain because of the spare capacity there and the extended waiting lists in Wales and England. There is therefore a wider problem. However, I assume that CHCs in Wales could champion Welsh patients in, for example, French hospitals, and deal with any problems that arose.
Patients are increasingly aware of their rights and know that any complaints should be heard. For example, complaints against doctors have increased by 1,450 per cent. in the past 11 years. That is staggering, and reflects the fact that people know that a procedure exists if problems arise and they are unhappy with their treatment.
We are not simply considering people who live in border areas and decide to be treated in the NHS in Wales. International and domestic tourism has expanded greatly. Wales, especially north, west and mid-Wales, receives many tourists from England who make regular weekend, mid-week and lengthier summer visits to some of its most beautiful parts. Sadly, some of them will become ill or suffer accidents, especially on beaches. For example, people who visit the Gower peninsula could cut their feet on glass that has been left on the beaches. I know of cases of people being taken to Singleton hospital or Morriston hospital. The increase in tourism means that people from England will be treated in Welsh hospitals.
The growth of business travel means that people on business who become ill or have accidents will use the NHS in Wales, as will people who drive through Wales 335 and have car accidents. It is therefore right to establish a structure to ensure that people are properly looked after and complaints investigated. That has not been thought through in the Bill. I believe that it is an oversight and I hope that the Minister will be able to reassure me about that.
People whose families live in Wales may wish to be near them if they need an operation or treatment. People are increasingly mobile and we want reciprocity whereby patients forums in England or CHCs in Wales can champion the rights of patients from England or elsewhere who are treated by the NHS in Wales. That matter needs consideration.
It is depressing that waiting lists in Wales have increased. Community health councils will be interested in that and may want to investigate instances of patients from elsewhere who are treated in Welsh hospitals. We know that there are huge cost implications.
Let us consider the position of someone who has diabetes and travels to Wales. Today, the Government produced a new strategy for diabetes in England, but it will take a further 12 months to introduce it in Wales. I am unhappy about that, and I hope that the Welsh Assembly can introduce a strategy for Wales more quickly. I do not understand why people in Wales are treated as second-class citizens and I hope that the Minister can reassure me.
In the context of increasing waiting lists, I hope that the Minister can comment on the story in The Western Mail about calling up reservists for Iraq. Some of the 1,500 will be Welsh doctors and nurses. If that leads to increasing waiting lists, the CHCs will want to investigate the matter. I hope that the Minister will reassure us that there are contingency plans to ensure that patients in Wales are properly treated.
The new clause is straightforward and covers a matter that the Bill does not tackle. The mobility of people throughout the United Kingdom and the world means that we need to ensure that the rights of those who receive medical treatment in the NHS in Wales are properly championed, whether by CHCs or the patients forums in England.

§ The Parliamentary Under-Secretary of State for Wales (Mr. Don Touhig)
I am happy to assure the hon. Gentleman that the Government share his wish that patients forums in England should have the same rights that the Bill will allow the Assembly to confer on community health councils in Wales. I am also happy to be able to tell him that it is unnecessary to amend the Bill to achieve that. The functions of a patients forum are set out in section 15 of the National Health Service and Health Care Professions Act 2002. The main functions are monitoring and reporting, and include the duty to monitor and review the range and operation of services provided by…the trust for which it is established;…obtain the views of patients and carers…and report to the trust;…provide advice, and make reports and recommendations on service-related matters and make information available to patients and carers.
Patients forums have no powers to investigate health issues in England. Those powers are exercised in England and Wales by the Commission for Health 336 Improvement, which was set up in April 2000. New clause 1 and amendment No. 4 would duplicate the commission's powers in Wales by conferring them additionally on patients forums, which operate only in England. The Assembly would not be in a position to make regulations affecting the operation of the patients forums in England because it has no responsibility for them.
The inspection of premises providing NHS-funded services, including the inspection of premises across borders, is a different matter. Section 17 of the 2002 Act, and paragraph 3 of schedule 7A of this Bill give the Secretary of State and the National Assembly respectively identical powers to make regulations conferring on patients forums and community health councils the right of entry and inspection to back up their functions. That is not intended to make them investigatory bodies because that is a role for the Commission for Health Improvement. CHCs will have the same right of entry as patients forums in England.

§ Mr. Evans
If someone from Bristol were holidaying in Swansea and became ill there, who would they complain to in the first instance, and how would that complaint be followed through?

§ Mr. Touhig
In the first instance, if the person lived in England and had a problem with the way in which they had been treated by the health service in Wales, they would complain to their patients forum, which would then have the opportunity under the provisions of the NHS Reform and Health Care Professions Act to investigate the complaint, even though the treatment had taken place in Wales. That is what we are putting right in this Bill: we are providing a reciprocal arrangement for community health councils in Wales to have the opportunity to do the same thing for England.

§ Mr. John Bercow (Buckingham)
The hon. Gentleman refers to the power to make regulations contained in paragraph 3 of schedule 7A. I shall pose to him the question that is invariably of interest to me in such contexts. Are the regulations that are to be made under that schedule to be subject to the negative procedure of the House or to its affirmative counterpart?

§ Mr. Touhig
Where there are regulations relating to aspects of this Bill, they will be made by the Assembly under its proper procedures as a result of the Government of Wales Act 1998. They will not be made by this House. I hope that that helps the hon. Gentleman.
As I was saying, it is not intended that patients forums or CHCs should be investigatory bodies. CHCs will have the same right of entry as patients forums in England, and if a situation arises in which a Welsh CHC wished to inspect facilities in England used by Welsh patients, it will be able to do so—and vice versa. Patients forums will have identical powers to do the same in respect of premises in Wales used by residents of England.
In practice, we would expect that a CHC or a patients forum that wished to conduct an inspection across the border would liaise with its English or Welsh counterpart for it to conduct the inspection on its behalf. 337 That seems practical. The situation is not, however, prescribed in any more detail, as it will be for local CHCs and patients forums to work up the arrangement that is best suited to them. I hope that that explanation will help the hon. Member for Ribble Valley (Mr. Evans) to understand why we would resist the new clause.
The hon. Gentleman made a number of other important points in his speech. He asked about someone from this country being treated abroad and perhaps being dissatisfied with that treatment. The first line of defence for that patient's interests would be his or her CHC in Wales, or patients forum in England. The hon. Gentleman also mentioned the diabetes strategy, and asked about related proposals for Wales. My colleagues in the Assembly are considering such proposals in Wales, and I am sure that they will take note of his point about the need to do it as speedily as possible.
The hon. Gentleman also referred to waiting times. The Assembly has made substantial progress in reducing waiting times in the priority areas of cardiac surgery and orthopaedics over the last year. There has also been an indisputable increase in the number of people being treated. A lot of work is under way to address the continuing problem of long waiting lists, which we are all concerned about, and the piloting of a new booking system for out-patients has shown reductions in cancellations and non-attendance from more than 15 per cent. to less than 5 per cent. The improved system will be rolled out right across Wales from March this year. I hope that that helps the hon. Gentleman so far as the action on waiting lists is concerned and that he will feel able to withdraw the new clause.

§ Mr. Evans
I am reassured by the explanation given by the Minister. I also welcome his comments about diabetes. I hope that—perhaps with some pushing from him—the Assembly will concentrate on introducing a strategy for those who suffer from diabetes in Wales. He made no reference to the issue of reservists, or to whether contingency plans would be put in place to ensure that patients in Wales would be properly looked after should there be a war with Iraq. Even with the reservists being called up, there could well be a problem.

§ Mr. Touhig
I take note of what the hon. Gentleman is saying. I am sure that his view is shared on both sides of the House, and I shall make sure that it is brought to the attention of my colleague, the Assembly Minister for Health and Social Services, Jane Hutt.

§ Mr. Evans
I beg to ask leave to withdraw the motion.