COMMONS AMENDMEN (Hansard, 20 March 1997)

§ Baroness Cumberlege
My Lords, I beg to move that the House do agree with the Commons in their Amendment No. 9. This delivers on the commitment made originally in this House to impose a three-year time limit on the period of time from the coming into operation of a pilot scheme to its evaluation. I should like to take this opportunity to thank the noble Baroness, Lady Robson, who raised this important point and argued for this change with great conviction and persuasiveness in our earlier deliberations on the Bill.
Moved, That the House do agree with the Commons in their Amendment No. 9.—(Baroness Cumberlege.)

§ Baroness Robson of Kiddington
My Lords, the Minister will know that I am delighted that this amendment has appeared. I am particularly delighted that it stands alone; it is as if it is my amendment still. I am grateful to the Minister. At Third Reading she promised that she would raise this matter in the other place. She has fulfilled her promise, as she always does. We receive the amendment with great pleasure.

§ Baroness Jay of Paddington
My Lords, I, too, welcome this amendment and congratulate the noble Baroness, Lady Robson, on succeeding in having it accepted. I believe it was the only amendment from this side of the House during the passage of the Bill which has succeeded in reaching this stage of the proceedings. Without wishing in any way to diminish that success as regards the timing of evaluation, I should add that we remain concerned that the nature of the evaluation is not made more specific on the face of the Bill. As noble Lords will remember, at many stages during the passage of the Bill we asked how the pilot schemes were to be evaluated. This amendment has made specific the time period over which they will be evaluated. However, we remain concerned that simply to rely on the evaluation—however, the word "evaluation" is not used—or the review of the Secretary of State of what may be disparate types of schemes undertaken in different parts of the country without any central criteria for judging them against one another may cause great problems in deciding whether one has been more effective in improving services.
I remember from the context of the discussions which we had at earlier stages of the Bill that noble Lords on all sides of the House agreed that there would be considerable difficulty in establishing any formal matrix, as it were, of national criteria by which these pilot schemes could be judged by the Secretary of State, or whoever undertook that task. Nevertheless, there is an issue to which we shall certainly wish to return at a later stage if we have the opportunity to put this Bill into force; namely, considering the ways of integrating 1073 the processes of objective evaluation into the review of pilot schemes. These ways are well developed in other parts of the National Health Service.

§ Baroness Cumberlege
My Lords, I wish to pick up some of the points made by the noble Baroness, Lady Jay. I understand her feelings about the one amendment that has been passed in your Lordships' House. However, I would not want the noble Baroness to think that all her hard work and that of her colleagues on the Benches opposite has not made an impact in another place.
We take the issue of evaluation seriously. However, as the noble Baroness has said on the Floor of the House it is hard to work out the details. Indeed, we felt it was not appropriate to put that on the face of the Bill. As your Lordships will know, we have set a high priority on working with those in the National Health Service who provide the services.
In the intervening period since your Lordships had the Second Reading of this Bill we have set up national consultative groups. They have a wide-ranging membership which guarantees their representative nature. They are looking at local criteria. They are looking to see the principles which need to be established. When the initial pilot schemes are set up, they will set out detailed requirements for evaluation. They will cover the principles of the wider impact that the pilots may have on local services. That is the important point. They will need to ensure that there is improvement in quality; that there is a wide range and accessibility of services; and that value for money is provided by the pilot. Those will be the principles but clearly every scheme will need to have its much more detailed criteria against which it can be measured.
I am aware that I did not reply to the noble Baroness, Lady Hayman, on LMCs. We consider that they also have an important role to play in terms of evaluation and consultation. In the new developments health authorities will need to seek their views on the impact of pilots and on existing arrangements before the piloting and during evaluation stages. We very much value LMCs but we felt that it was time for a change in that there will not be a statutory duty for LMCs to be funded specifically relating to contracts. However, we still think that they will have an important part to play. It will be up to GPs to decide whether they want to use the LMCs or seek an alternative in terms of the full consultation necessary.