Community Health Councils: Abolition (Hansard, 3 February 2003)

§ Earl Howe
My Lords, I beg leave to ask a Question of which I have given private notice; namely:
Whether, in the light of Her Majesty's Government's announcement that community health councils are to be abolished on 1st September 2003, every NHS trust and primary care trust will have a fully functioning patients forum and independent complaints advocacy service by that date.

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)
My Lords, the intention of the Commission for Patient and Public Involvement in Health is to have patients forums in place as soon as possible from 1st September. From that date there will be: new, different and better ways of supporting patients; patients' advice and liaison services; overview and scrutiny committees; expert patient programmes; patient environment access teams; and a duty on the NHS to involve and consult independent complaints advocacy services and the commission itself.

§ Earl Howe
My Lords, does the Minister recall that during the Committee stage of the National Health Service Reform and Health Care Professions Bill last April he gave an explicit assurance that CHCs would not be abolished until patients forums were in place and that no gaps would be left in the system? Am I right in understanding from his reply that some areas 11 of the country may not in fact be served by a fully functioning patients forum or advocacy service until some indefinite time after 1st September? Is that not a very serious matter? Will the Minister take it upon himself to ensure that the Government's decision about the abolition date is revisited with the utmost urgency?

§ Lord Hunt of Kings Heath
My Lords, it was certainly the intention to ensure that CHCs remained in place and that there would be a smooth transition programme. The fact is that it is becoming clear that many CHCs are facing problems in terms of losing both their staff and their membership. The judgment has been made that it would be better to give people a clear date for the winding up of community health councils, at the same time ensuring that the mechanisms that we are putting in place—including patient advice and liaison services, overview and scrutiny committees of local government and all other mechanisms—will be put in place as quickly as possible.

§ Lord Clement-Jones
My Lords, is the Minister aware that our suspicions are being confirmed by what he and his colleagues have said over the past few days, with under-resourcing and delay taking place in the formation of PALS and ICAS. What are the Government doing to secure the continuing services of experienced CHC staff in the gap between 1st September and the creation of PALS? What assurance can the Minister give about the creation of the independent complaints advocacy service, which is vital and on which no information has been given?

§ Lord Hunt of Kings Heath
My Lords, in terms of funding, the noble Lord will know from our previous debates that we are still discussing the exact amount of funding to be made available, but that it will undoubtedly be more than CHCs are currently allocated. So far as concerns independent advocacy services, of course it is our intention that those services will be available to all people in England from 1st September. The Commission for Patient and Public Involvement in Health will be operating a national helpline. We will, of course, ensure that any paperwork in relation to individual complaints will be transferred to the appropriate body around 1st September.

§ Lord Astor of Hever
My Lords, why have the Government put the cart before the horse? If there is to be a seamless transition from CHCs to the new arrangements, what is the sense of abolishing CHCs before knowing whether those new arrangements can be delivered on time?

§ Lord Hunt of Kings Heath
My Lords, many of the new arrangements are either in place or being put in place. If we were to maintain community health 12 councils beyond 1st September this year, there would be real problems in relation to the employers, the people employed by those organisations and their members. It makes much greater sense to have a clear date for the winding down of CHCs and to get on as speedily as possible with the appointment of the patients forums—but that will take a little time—and to ensure that services such as independent advocacy, patient advice and liaison services and the role of local government in independent scrutiny are indeed in place as much as possible.

§ Baroness Noakes
My Lords, does the Minister recall giving an assurance when the House was in Committee considering the National Health Service reform Bill last April that arrangements would be in place to involve and consult all stakeholders? Therefore, will the Minister explain why it is that neither CHCs nor ACHCEW have been consulted about the date of their abolition?

§ Lord Hunt of Kings Heath
My Lords, in the end, Ministers make these decisions. There have been many discussions with CHCs and their association about these issues. The distinct view that was expressed to us was that there was a need for an early announcement. That is why we made the announcement—so that people know when the due date is and have time to prepare for it.

§ Baroness O'Cathain
My Lords, does the Minister mean that by 1st September there will be no gap between the current situation and the new regime? Secondly, following the question put by my noble friend Lady Noakes, is the Minister saying that consultation will not take place, that a decision has been made; or will consultation have taken place and will everyone be happy by 1st September?

§ Lord Hunt of Kings Heath
My Lords, I think I have made it clear that the decision has been made by Ministers that 1st September should be the date on which CHCs are to be abolished. It is to everyone's advantage that the date is known. We will of course be working very hard to ensure that there are no gaps. I have said that independent advocacy will be available from that date throughout the country. The paperwork that CHCs are involved in will be transferred to relevant organisations. Some 75 per cent of all NHS trusts already have patient advocacy liaison services in operation, and that number is rising every week. Local authorities have the powers they need to make sure that their overview and scrutiny committees are working effectively. So while patients forums will not all come into operation on 1st September, I am assured that sufficient and adequate services will be available to ensure that the public can make complaints and be supported, and that there are areas where they can express concerns about NHS services.

Lord Carlile of Berriew
My Lords, will the Minister give an undertaking that the specialist advocacy services available to patients suffering from mental illness and to children will continue in force seamlessly after the reforms? Does he recognise how welcome the retention of community health councils in Wales has been because it will ensure the seamless continuation of those very services?

§ Lord Hunt of Kings Heath
My Lords, it is a matter for Wales to decide what it wishes to do about community health councils, and the Assembly has made its decision. For the English NHS, I believe that the improvements, the advocacy arrangements and the role of local government add up to a much more powerful involvement of the public in the NHS than CHCs. with their patchy record, have ever been able to provide. On specialist advocacy, I agree with the noble Lord, Lord Carlile. The intention is that, in providing an independent advocacy service throughout the country, there will be sufficient specialist services available for the very care groups that the noble Lord has mentioned.

§ Lord Tebbit
My Lords, when did the noble Lord discover that the undertakings he gave in Committee could not be fulfilled?

§ Lord Hunt of Kings Heath
My Lords, these matters have been under discussion for some time. The department has been involved in discussions with the new chair of the Commission for Patient and Public Involvement in Health. The decision on whether and on what date CHCs were to be abolished was finally made last week. A written Statement was made in the House of Commons on Friday. I made this known to opposition spokesmen on Thursday. I believe that every consideration has been given and the right decision has been reached.

§ Baroness Carnegy of Lour
My Lords, the fact remains that despite all the Minister's words justifying what has happened, the Government made a promise to Parliament and Parliament made a decision to allow them to have their way because of that promise. They have now broken that promise. Are the Government not the slightest bit ashamed?

§ Lord Hunt of Kings Heath
My Lords, the noble Baroness ignores the fact that most of the elements concerned with improving patient and public involvement will be in place. The problem with the abolition date is that community health councils are haemorrhaging staff and members. It would not make sense to go for an extended date; it is better to go for 1st September and to do everything that can be done. The new independent Commission for Patient and Public Involvement in Health is the key agency in ensuring that patients forums are in place. It is better to concentrate on moving as speedily as we can, but it would serve nobody to keep CHCs in being after 1st September.