HC Deb 08 July 2003 vol 408 cc916-25 1.42 pm
Mr. David Hinchliffe (Wakefield)

I beg to move amendment No. 164, in page 1, line 4, leave out clause 1.

Mr. Deputy Speaker (Sir Alan Haselhurst)

With this it will be convenient to discuss the following:

Amendment No. 60, in page 1, line 7, at end insert 'and Wales'.

Amendment No. 166, in page 1, line 10, leave out clause 2.

Amendment No. 96, in clause 2, page 1, line 12, after 'Foundation', insert 'and Community'.

Amendment No. 168, in page 2, line 3, leave out clause 3.

Amendment No. 169, in page 2, line 9, leave out clause 4.

Amendment No. 154, in clause 4, page 2, line 10, after 'trust', insert

'or combination of NHS trusts'. Amendment No. 321, in page 2, line 10, after 'trust', insert

'or a Primary Care Trust'. Amendment No. 65, in page 2, leave out line 12 and insert 'appropriate Minister'.

Amendment No. 322, in clause 4, page 2, line 12, at end insert—

'(1A) The Secretary of State may not support more than six applications make by NHS trusts and more than six applications made by Primary Care Trusts during the pilot test period.'. Amendment No. 155, in page 2, line 14, after 'trust', insert 'or trusts'.

Amendment No. 323, in page 2, line 14, after 'trust', insert 'or Primary Care Trust'.

Amendment No. 156, in page 2, line 18, after 'trust', insert 'or trusts'.

Amendment No. 324, in page 2, line 18, after 'trust', insert 'or Primary Care Trust'.

Amendment No. 157, in page 2, line 19, after 'applicant', insert 'or applicants'.

Amendment No. 158, in page 2, line 21, after 'has', insert 'or NHS trusts have'.

Amendment No. 325, in page 2, line 21, after 'trust', insert

'or a Primary Care Trust'. Amendment No. 159, in page 2, line 26, after 'trust', insert 'or trusts'.

Amendment No. 326, in page 2, line 26, after 'trust', insert 'or Primary Care Trust'.

Amendment No. 160, in page 2, line 28, at end insert 'or them'.

Amendment No. 161, in page 2, line 29, after 'it', insert 'or them'.

Amendment No. 170, in page 2, line 31, leave out clause 5.

Amendment No. 328, in clause 5, page 2, line 32, after 'trust', insert

'or a Primary Care Trust'. Amendment No. 66, in page 2, leave out line 35 and insert 'appropriate Minister'.

Government amendment No. 245.

Amendment No. 171, in page 3, line 20, leave out clause 6.

Amendment No. 329, in clause 6, page 3, line 22, after 'trust', insert

'or a Primary Care Trust'. Amendment No. 233, in page 3, line 27, at end insert—

'() taken as a whole the actual membership of the applicant's public constituency will be representative of those eligible for such membership,'. Amendment No. 402, in page 3, line 37, leave out subsection (4) and insert—

'(4) In deciding whether or not to give an authorisation in response to an application under section 4 or 5, the regulator shall have regard to the outcome of a public consultation under section [public consultation relating to applications for foundation status].'. Amendment No. 403, in page 3, line 39, at end insert—

'(4A) The regulator shall not give an authorisation under section 7(1)(a) or (b) unless and until the Secretary of State confirms support for the application to which such authorisation may relate after responding to—

  1. any recommendations made to him by virtue of section 21(2)(f) of the Local Government Act 2000 (Overview and Scrutiny Committees) in relation to the application, or
  2. any referrals or representations made to him by any Patients Forum by virtue of section 15(6) of the NHS Reform and Healthcare Professions Act 2002 in relation to the application.'.
Amendment No. 172, in page 4, line 1, leave out clause 7.

Amendment No. 330, in clause 7, page 4, line 2, after 'trust', insert

'or a Primary Care Trust'. Amendment No. 331, in page 4, line 3 after 'trust', insert

'or a Primary Care Trust as the case may be'. Amendment No. 100, in page 4, line 4, at end insert—

'(1A) On an authorisation being given to a Primary Care Trust—

  1. it ceases to be a Primary Care Trust and becomes an NHS community trust,
  2. the proposed constitution has effect.'.
Amendment No. 101, in page 4, line 10, at end insert

'or community trust as the case may be'. Amendment No. 102, in page 4, line 13, after 'trust, insert 'or community trust'.

Amendment No. 173, in page 4, line 17, leave out clause 8.

Amendment No. 103, in clause 8, page 4, line 18, after 'trust', insert 'or community trust'.

Amendment No. 104, in page 4, line 20, after 'trust, insert 'or community trust'.

Amendment No. 174, in page 4, line 22, leave out clause 9.

Amendment No. 175, in page 4, line 35, leave out clause 10.

Amendment No. 105, in clause 10, page 4, line 37, at end insert 'and community trusts'.

Amendment No. 106, in page 4, line 38, at end insert 'and community trust'.

Amendment No. 107, in page 5, line 6, after 'trust', insert 'or community trust'.

Government amendment No. 355.

Amendment No. 67, in page 5, line 14, leave out 'Secretary of State' and insert 'appropriate Minister'.

Amendment No. 176, in page 5, line 17, leave out Clause 11.

Amendment No. 68, in clause 11, page 5, line 18, leave out 'Secretary of State' and insert 'appropriate Minister'.

Amendment No. 108, in page 5, line 19, after 'trust', insert 'or community trust'.

Government amendment No. 356.

Amendment No. 177, in page 5, line 22, leave out clause 12.

Amendment No. 109, in clause 12, page 5, line 24, at end insert 'or community trust'.

Government amendment No. 246.

Amendment No. 69, in page 5, line 29, at end insert—

'(aa) the Assembly,'. Amendment No. 332, in page 5, line 30, after 'trust', insert 'and Primary Care Trust'.

Amendment No. 110, in page 5, line 31, at end insert—

'(bb) every Primary Care Trust intending to make an application to become an NHS community trust,'. Amendment No. 70, in page 5, line 33, at end insert

'and send a copy to the Assembly'. Amendment No. 111, in page 5, line 36, at end insert 'and community trust'.

Amendment No. 178, in page 5, line 37, leave out clause 13.

Amendment No. 333, in clause 13, page 5, line 38, after first 'trust', insert

'or a Primary Care Trust'. Amendment No. 112, in page 5, line 38, after second 'trust', insert

'or a Primary Care Trust becomes an NHS community trust'. Amendment No. 113, in page 5, line 40, at end insert 'or community trust'.

Amendment No. 114, in page 6, line 3, after 'trust', insert 'or community trust'.

Amendment No. 71, in page 6, line 6, leave out 'Secretary of State' and insert 'appropriate Minister'.

Amendment No. 72, in page 6, line 10, after 'England', insert

'or (as the case may be) in Wales'. Amendment No. 73, in page 6, line 12, leave out 'Secretary of State' and insert 'appropriate Minister'.

Amendment No. 74, in page 6, line 14, leave out 'Secretary of State' and insert 'appropriate Minister'.

Amendment No. 115, in page 6, line 14, after 'trust', insert 'or community trust'.

Amendment No. 179, in page 6, line 18, leave out clause 14.

Amendment No. 75, in clause 14, page 6, line 23, at end insert 'and Wales'.

Amendment No. 76, in page 6, line 28, after 'England', insert 'and Wales'.

Amendment No. 77, in page 6, line 37, after 'England', insert 'and Wales'.

Amendment No. 180, in page 7, line 13, leave out clause 15.

Amendment No. 397, in clause 15, page 7, line 14, leave out 'may' and insert 'must'.

Amendment No. 78, in page 7, line 15, after 'England', insert 'and Wales'.

Government amendment No. 247.

Amendment No. 398, in page 7, line 17, leave out 'power' and insert 'duty'.

Government amendment No. 248.

Amendment No. 400, in page 7, line 23, at end insert—

'(3A)An authorisation must state that no services be provided to a patient, other than an NHS patient, by an NHS foundation trust, other than in circumstances prescribed by subsection (3B). (3B) These circumstances are that a certificate issued by the lead clinician in that specialty states that the services so provided are not needed by an NHS patient with equal or greater clinical need.'. Amendment No. 181, in page 7, line 28, leave out clause 16.

Amendment No. 116, in clause 16, page 7, line 29, after 'trust', insert 'or community trust'.

Amendment No. 79, in page 7, line 38, at end insert 'and Wales'.

Amendment No. 117, in page 7, line 41, after 'trust', insert 'or community trust'.

Amendment No. 182, in page 8, line 1, leave out clause 17.

Amendment No. 118, in clause 17, page 8, line 2, after 'trust', insert 'or community trust'.

Amendment No. 119, in page 8, line 7, after 'trust', insert 'or community trust'.

Amendment No. 120, in page 8, line 12, after 'trust', insert 'or community trust'.

Amendment No. 183, in page 8, line 15, leave out clause 18.

Amendment No. 121, in clause 18, page 8, line 16, after 'trust', insert 'or community trust'.

Amendment No. 122, in page 8, line 22, after 'trust', insert 'or community trust'.

Amendment No. 184, in page 8, line 29, leave out clause 19.

Amendment No. 123, in clause 19, page 8, line 31, after 'trust', insert 'or community trust'.

Amendment No. 80, in page 8, line 32, leave out 'Secretary of State' and insert 'appropriate Minister'.

Amendment No. 124, in page 8, line 33, after 'trust', insert 'or community trust'.

Amendment No. 185, in page 8, line 37, leave out clause 20.

Amendment No. 125, in clause 20, page 8, line 38, after 'trust', insert 'or community trust'.

Amendment No. 186, in page 9, line 1, leave out clause 21.

Amendment No. 126, in clause 21, page 9, line 2, after 'trust', insert 'or community trust'.

Amendment No. 187, in page 9, line 4, leave out clause 22.

Amendment No. 81, in clause 22, page 9, line 5, leave out 'Secretary of State' and insert 'appropriate Minister'.

Amendment No. 127, in page 9, line 6, after first 'trust', insert 'or community trust'.

Amendment No. 128, in page 9, line 7, after 'trust', insert 'or community trust'.

Amendment No. 82, in page 9, line 13, leave out 'Secretary of State' and insert 'appropriate Minister'.

Amendment No. 83, in page 9, line 17, leave out 'Secretary of State' and insert 'appropriate Minister'.

Amendment No. 129, in page 9, line 21, after 'trust', insert 'or community trust'.

Amendment No. 84, in page 9, line 22, leave out 'Secretary of State' and insert 'appropriate Minister'.

Amendment No. 130, in page 9, line 23, after 'trust', insert 'or community trust'.

Amendment No. 188, in page 9, line 28, leave out clause 23.

Amendment No. 131, in clause 23, page 9, line 30, after 'trust', insert 'or community trust'.

Amendment No. 132, in page 9, line 34, after 'trust', insert 'or community trust'.

Amendment No. 189, in page 10, line 7, leave out clause 24.

Amendment No. 133, in clause 24, page 10, line 9, after 'trust', insert 'or community trust'.

Amendment No. 134, in page 10, line 14, after 'trusts', insert 'or community trusts'.

Amendment No. 190, in page 10, line 17, leave out clause 25.

Amendment No. 135, in clause 25, page 10, line 19, after 'trust', insert 'or community trust'.

Amendment No. 136, in page 10, line 32, at end insert 'or community trust'.

Amendment No. 85, in page 10, line 33, at end insert—

'(bb) a Local Health Board,'. Amendment No. 86, in page 10, line 35, leave out 'Secretary of State' and insert 'appropriate Minister'.

Amendment No. 137, in page 10. line 42, at end insert 'or organisation'.

Amendment No. 138, in page 11, line 1, after 'trust', insert 'or community trust'.

Amendment No. 139, in page 11, line 2, at end insert 'or organisation'.

Amendment No. 192, in page 11, line 3, leave out clause 26.

Amendment No. 87, in clause 26, page 11, line 5, leave out 'Secretary of State' and insert 'appropriate Minister'.

Amendment No. 193, in page 11, line 18, leave out clause 27.

Amendment No. 140, in clause 27, page 11, line 20, leave out 'and NHS foundation trusts' and insert

'NHS foundation trusts and NHS community trusts'. Amendment No. 194, in page 11, line 23, leave out clause 28.

Amendment No. 141, in clause 28, page 11, line 26, at end insert—

'(e) NHS community trusts'. Amendment No. 195, in page 11, line 27, leave out clause 29.

Amendment No. 142, in clause 29, page 11, line 36, at end insert—

'(fb) NHS community trusts;'. Amendment No. 143, in page 12, line 3, after 'trust', insert 'or community trust'.

Amendment No. 196, in page 12, line 5, leave out clause 30.

Amendment No. 145, in clause 30, page 12, line 9, leave out 'and NHS foundation trusts' and insert

', NHS foundation trusts and NHS community trusts'. Amendment No. 197, in page 12, line 11, leave out clause 31.

Amendment No. 146, in clause 31, page 12, line 15, at end insert—

'(bc) an NHS community trust;'. Amendment No. 198, in page 12, line 21, leave out clause 32.

Amendment No. 200, in page 12, line 24, leave out clause 33.

Amendment No. 147, in clause 33, page 12, line 26, after 'trust', insert 'or community trust'.

Government amendments Nos. 249 to 251.

Amendment No. 201, in page 13, line 3, leave out clause 34.

Amendment No. 148, in clause 34, page 13, line 4, after 'trust', insert 'or community trust'.

Amendment No. 202, in page 13, line 7, leave out clause 35.

Amendment No. 91, in clause 35, page 13, line 10, at end insert—

'the appropriate Minister" means—

  1. in relation to England, the Secretary of State; and
  2. in relation to Wales, the Assembly,
the Assembly" means the National Assembly for Wales,'. Government amendment No. 357.

Amendment No. 92, in page 13, line 13, leave out 'or a Primary Care Trust' and insert

', a Primary Care Trust or a Local Health Board'. Amendment No. 320, in page 13, line 14, at end insert—

'"parliamentary constituency" has the meaning given in section 1 of the Parliamentary Constituencies Act 1986 (c.56) (parliamentary constituencies); the pilot test period" means the period that—

  1. begins with the day on which the first order is made under section 184 which brings into force a provision of this Part, and
  2. ends three years after the day referred to in paragraph (a);'.
Government new clause 25—Audit.

Government new clause 36—Mergers.

Government new clause 37—Section (Mergers): supplementary.

New clause 1—Review of democratically accountable governance—

  1. It shall be the duty of the Secretary of State to establish an independent review body to carry out the functions specified in subsections (4) to (6).
  2. The Secretary of State shall appoint at least nine members to the independent review body.
  3. The independent review body shall elect a Chairman from amongst its members.
  4. The independent review body shall prepare reports containing proposals relating to the establishment of a local, democratically accountable system of governance for NHS foundation trusts and Primary Care Trusts.
  5. The independent review body may in particular make proposals in accordance with the provisions of subsection (4) relating to—
    1. methods of securing wider public participation in the governance of NHS foundation trusts and Primary Care Trusts;
    2. methods of increasing public awareness and access to information about the governance of NHS foundation trusts and Primary Care Trusts; and
    3. the membership of public benefit corporations.
  6. The independent review body must—
    1. lay a copy of any report prepared in accordance with the provisions of this section before Parliament, and
    2. once they have done so, send a copy of it to—
      1. the Secretary of State, and
      2. the regulator.'.
New clause 9—Foundation patients' fora—

'(1) The Secretary of State shall establish a body to be known as a Foundation Patients' Forum—

  1. (a) for each NHS Trust which has made an application under section 4(2);
  2. (b) for each person who has been incorporated as a public benefit corporation under section 5(5).
(2) The members of the Foundation Patients' Forum are to be appointed by the Commission for Patient and Public Involvement in Health. Once the Foundation Patients' Forum has been established. it may do anything (including the things mentioned in subsection (4) below) which appears to it to be necessary or desirable for the purpose of preparing for effective patient and public involvement in the NHS Trust or public benefit corporation once it becomes a Foundation Trust. (4) A Foundation Patients' Forum must—
  1. (a) monitor and review the range and operation of services provided by, or under arrangements made by, the trust for which it is established,
  2. (b) obtain the views of patients' and their carers about those matters and report on those views to the trust,
  3. (c) provide advice, and make reports and recommendations, about matters relating to the range and operation of those services to the trust,
  4. (d) make available to patients and their carers advice and information about those services,
  5. (e) in prescribed circumstances, perform any prescribed function of the trust with respect to the provision of a service affording assistance to patients and their families and carers,
  6. (f) carry out such other functions as may be prescribed.
 (5) In providing advice or making recommendations under subsection (4)(c), a Foundation Patients' Forum must have regard to the views of patients and their carers. (6) If, in the course of exercising its functions, a Foundation Patients' Forum becomes aware of any matter which in its view—
  1. (a) should be considered by a relevant overview and scrutiny committee, the Forum may refer that matter to the committee,
  2. (b) should be brought to the attention of the Commission for Patient and Public Involvement in Health, it may refer that matter to the Commission.
 (7) Subsection (6) does not prejudice the power of a Foundation Patients' Forum to make such other representations or referrals as it thinks fit, to such persons or bodies as it thinks fit about matters arising in the course of its exercising its functions. (8) An NHS Trust or public benefit corporation exercising its powers under sections 4(4)(b) or 5(7)(b) as the case may be shall be obliged to have regard to and take account of the reports and recommendations of the Foundation Patients' Forum. (9) The governors and non-executive directors of the Foundation Trust shall be obliged to respond in writing to the reports and recommendations of the Foundation Patients' Forum. (10) All the members, governors and directors of a Foundation Trust shall be obliged to have regard to and take account of the reports and recommendations of the Foundation Patients' Forum in exercising their functions within the Foundation Trust. (11) The terms in this section shall be construed in accordance with the provisions of section 15(8) and (9) of the National Health Service Reform and Health Care Professions Act 2002 (c.17).'. New clause 18—Community Health Councils and NHS foundation trusts in Wales—

'(1) Schedule 7A of the 1977 Act is amended as follows. In paragraph 2 (general provisions)—

  1. in subparagraph (f), for "and NHS trusts" there is substituted ", NHS trusts and NHS foundation trusts";
  2. in subparagraph (g), for "and NHS trusts" there is substituted ", NHS trusts and NHS foundation trusts";
  3. in subparagraph (j), for "and NHS trusts" there is substituted ", NHS trusts and NHS foundation trusts";
  4. in subparagraph (k), for "or NHS trusts" there is substituted ", NHS trusts or NHS foundation trusts".
In paragraph 3 (entry and inspection of premises), in subparagraph (1), after sub-subparagraph (f) there is inserted— (fa) NHS foundation trusts;". New clause 19—NHS community trusts—

'(1) An NHS community trust is a public benefit organisation which is authorised to commission goods and services for the purposes of the health service in England. (2) A public benefit organisation is a body corporate which, in pursuance of an application, is constituted in accordance with Schedule [constitution of public benefit organisations].'. New clause 20—Applications by Primary Care Trusts—

'(1) A Primary Care Trust may make an application to the regulator for authorisation to become an NHS community trust if the application is supported by the Secretary of State. (2) The application must—

  1. describe the goods and services which the applicants propose should be commissioned by the NHS community trust,
  2. describe the goods and services which the applicants propose should be provided by the NHS community trust, and
  3. be accompanied by a copy of the proposed constitution of the trust;
and must give any further information which the regulator requires the Primary Care Trust to give. (3) The applicant may modify the application with the agreement of the regulator at any time before authorisation is given under section [authorisation of NHS community trusts]. (4) Once a Primary Care Trust has made the application—
  1. the provisions of the proposed constitution which give effect to paragraphs 3 to 16 of Schedule [constitution of public benefit organisations] have effect, but only for the purpose of electing a shadow board of governors and appointing a shadow board of directors,
  2. the Primary Care Trust may do anything (including the things mentioned in paragraph 16 of Schedule 2 to the National Health Service and Community Care Act 1990 (c.19) (general powers)) which appears to it to be necessary or desirable for the purpose of preparing it for NHS community trust status.'.
 New clause 21—Authorisation of NHS community trusts—

'(1) The regulator may give an authorisation under this section to a Primary Care Trust which has applied under section [applications by Primary Care Trusts] if he is satisfied as to the matters specified in subsection (2).> (2) The matters are that—

  1. the applicant's constitution will be in accordance with Schedule [constitution of public benefit organisations] and will otherwise be appropriate,
  2. there will be a board of governors, and a board of directors, constituted in accordance with the constitution,
  3. the steps necessary to prepare for NHS community trust status have been taken,
  4. the applicant will be able to commission or the goods and services or to provide the goods and services which the authorisation is to require it to commission or to provide, and
  5. any other requirements which he considers appropriate are met.
(3) Subject to the provisions of subsection (4), the authorisation may be given on any terms the regulator considers appropriate. (4) An authorisation must authorise the NHS community trust to commission goods and services for the purposes of the health service in England. (5) If regulations require the applicant to consult prescribed persons about the application, the regulator may not give an authorisation unless he is satisfied that the applicant has complied with the regulations.'. New clause 24—Representative membership—

'An authorisation may require an NHS foundation trust to take steps to secure that (taken as a whole) the actual membership of its public constituency is representative of those eligible for such membership.'. New clause 34—Extension of provisions of Part 1 following pilot tests—

'(1) Within three months of the conclusion of the pilot test period—

  1. the Secretary of State,
  2. the regulator,
  3. the CHAI, and
  4. the Comptroller and Auditor General
shall lay before each House of Parliament a report on the operation of the provisions of Part 1 of this Act during the pilot test period. (2) After all of the reports under subsection (1) have been laid before Parliament, the Secretary of State may by order—
  1. amend the provisions of Part 1 so as to extend the application to other NHS trusts and Primary Care Trusts, and
  2. make such other amendments of Part 1 as arise from the reports.
 (3) No order may be made under subsection (2) unless a draft of the order has been laid before and approved by a resolution of each House of Parliament.'. New clause 39—Public consultation relating to applications for foundation status—

'(1) The Secretary of State shall—

  1. (a) by regulations require that an NHS Trust proposing to make an application under section 4(1) or any person proposing to apply under section 5(1) shall first consult prescribed persons, and
  2. (b) by regulations prescribe persons to be consulted which shall include the Patients Forums for the NHS Trusts and Primary Care Trusts in the area in which are resident all or any of the persons to whom the applicant NHS Trust has provided goods or services for the purposes of healthcare or to whom the applicant or person (as the case may be) intends to provide such services if its application is successful.
  1. (2) In section 7(3) of the Health and Social Care Act 2001 (functions of Overview and Scrutiny Committees)—
  1. (a) at the beginning of subsection (3) (matters to be covered by regulations) for "may" there is substituted "shall";
  2. (b) at the end of subsection (3)(b) there is inserted "which shall include all matters prescribed under subsection 7(3)(c) below,";
  3. (c) at the end of subsection (3)(c) there is inserted "which shall include any application or proposed application under section 4 of the Health and Social Care (Community Health and Standards) Act 2003".'.
Government new schedule 2—Audit of accounts of NHS foundation trusts.

New schedule 1—Constitution of public benefit organisations—

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