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My Lords, fancy having to follow that. I first congratulate the noble Lord, Lord Stevens, on his excellent maiden speech. I have known him, on and off, for several decades, and am pleased to see that, after seven years of managing the NHS, he retains his sense of humour.
I declare...
My Lords, fancy having to follow that. I first congratulate the noble Lord, Lord Stevens, on his excellent maiden speech. I have known him, on and off, for several decades, and am pleased to see that, after seven years of managing the NHS, he retains his sense of humour.
I declare...
My Lords, this is an important Bill but, if I may say so, it is also something of a ragbag of a Bill, requiring careful and detailed scrutiny, given the concerns that have been expressed today.
Before turning to my concerns, I want to say a couple of words about my...
My Lords, this is an important Bill but, if I may say so, it is also something of a ragbag of a Bill, requiring careful and detailed scrutiny, given the concerns that have been expressed today.
Before turning to my concerns, I want to say a couple of words about my...
I am sorry to interrupt the Minister in his flow, but he has had a good run at it. Could he say a little more about how the Government are going to answer the very specific question that a number of
us raised about Part 2? Could he ensure that...
I am sorry to interrupt the Minister in his flow, but he has had a good run at it. Could he say a little more about how the Government are going to answer the very specific question that a number of
us raised about Part 2? Could he ensure that...
My Lords, before speaking to this amendment tabled in my name and those of the noble Baroness, Lady Walmsley, and the noble Lord, Lord Patel, let me declare my interest as an adviser on health and care to Capsticks Solicitors.
This is the last time that the Minister will have to...
My Lords, before speaking to this amendment tabled in my name and those of the noble Baroness, Lady Walmsley, and the noble Lord, Lord Patel, let me declare my interest as an adviser on health and care to Capsticks Solicitors.
This is the last time that the Minister will have to...
To ask Her Majesty’s Government what is the 2013–14 budget for NHS Property Services Ltd; how many staff it employs; who are the shareholders of that company; what assets it holds; what are its sources of income; and who is accountable for ensuring that the company operates in accordance with...
To ask Her Majesty’s Government what is the 2013–14 budget for NHS Property Services Ltd; how many staff it employs; who are the shareholders of that company; what assets it holds; what are its sources of income; and who is accountable for ensuring that the company operates in accordance with...
The expected annual revenue costs (budget) of NHS Property Services (NHS PS) are approximately £800 million for 2013-14. With regard to staff, on 1 April 2013 some 3,000 staff formerly employed by primary care trusts (PCTs) and strategic health authorities (SHAs) transferred to NHS PS. The number of staff employed by the company as at 11 October 2013 is 3,112.
The Secretary of State is the sole shareholder, represented by a senior Departmental director who is a non-executive director on the company's Board. NHS Property Services, a limited company wholly owned by the Secretary of State, was created to take that part of PCT's estate which did not transfer to NHS providers or Community Health Partnerships, another limited company wholly owned by the Secretary of State, on 1 April 2013. On that date, around 4,000 properties previously owned by PCTs and SHAs were inherited by the company, at a value of just over £3 billion. The property portfolio transferred to the company includes care homes, community centres, general practitioner surgeries, health centres, support buildings, offices and land. The Company's income is derived from its tenants, asset disposals and from NHS commissioners.
NHS PS is committed to achieving high standards of corporate governance and is accountable to the shareholder in this respect. The company's board comprises a non-executive chairman, five non-executive directors (one of which is the shareholder's representative), a chief executive and five executive directors. The board is supported by an audit and governance committee. The board is ultimately responsible for ensuring that the company meets company law. Legal advice is sought as required and company activities are subject to both internal and external audit. The governance programme includes an internal review, scheduled for January 2014, to evaluate compliance with the Articles of Association that are registered with Companies House.
With regard to whether the Company has conducted an audit of NHS land and buildings an initial audit has been undertaken and further, more detailed audits are underway. The company is building a detailed database of its assets to ensure it has a comprehensive understanding of its estate, its use and precisely how much it costs to run.
With regard to any change of ownership or control of NHS land or buildings, and which bodies have the authority to sell NHS land or buildings or change their use, the creation of NHS PS did not change any existing powers of NHS bodies to control NHS land or buildings. The company was established to take over responsibility for the estate that transferred to it on 1 April 2013.
NHS PS is only responsible for the properties within its portfolio and not the wider NHS. There are currently 276 properties in the ownership of NHS PS earmarked for disposal by March 2015, including the sale of 91 freehold properties during the current financial year. The values are currently being assessed. The decision as to whether properties or land is surplus to NHS operational requirements resides with commissioners.
Turning finally to the Company's mandate and its accountability, the company's strategic objectives are outlined in its business plan on its website at:
www.property.nhs.uk/about-us/publications/.
In summary, these are: maintaining continuity of service and keeping buildings safe, warm and clean for service users, visitors and staff; placing patients and the taxpayer at the heart of the business by supporting service transformation; using the company's scale and effective management of its portfolio to keep costs to a minimum and pass back savings to the NHS; ensuring the estate is managed sustainably.
Accountability for the actions and expenditure of NHS PS is via the Department, and its Permanent Secretary to Parliament. As such, the company can be held to account via the Department through the parliamentary committee system, and parliamentary questions.
As a public sector body (100% owned by the Secretary of State) it is subject to requests for information made under the Freedom of Information Act (2000).
As a limited company, NHS PS is required to file an annual report and accounts with Companies House.
To ask Her Majesty’s Government what mandate has been given to NHS Property Services Ltd; and to whom it will be accountable for delivering that mandate.[HL2481]
To ask Her Majesty’s Government what mandate has been given to NHS Property Services Ltd; and to whom it will be accountable for delivering that mandate.[HL2481]
The expected annual revenue costs (budget) of NHS Property Services (NHS PS) are approximately £800 million for 2013-14. With regard to staff, on 1 April 2013 some 3,000 staff formerly employed by primary care trusts (PCTs) and strategic health authorities (SHAs) transferred to NHS PS. The number of staff employed by the company as at 11 October 2013 is 3,112.
The Secretary of State is the sole shareholder, represented by a senior Departmental director who is a non-executive director on the company's Board. NHS Property Services, a limited company wholly owned by the Secretary of State, was created to take that part of PCT's estate which did not transfer to NHS providers or Community Health Partnerships, another limited company wholly owned by the Secretary of State, on 1 April 2013. On that date, around 4,000 properties previously owned by PCTs and SHAs were inherited by the company, at a value of just over £3 billion. The property portfolio transferred to the company includes care homes, community centres, general practitioner surgeries, health centres, support buildings, offices and land. The Company's income is derived from its tenants, asset disposals and from NHS commissioners.
NHS PS is committed to achieving high standards of corporate governance and is accountable to the shareholder in this respect. The company's board comprises a non-executive chairman, five non-executive directors (one of which is the shareholder's representative), a chief executive and five executive directors. The board is supported by an audit and governance committee. The board is ultimately responsible for ensuring that the company meets company law. Legal advice is sought as required and company activities are subject to both internal and external audit. The governance programme includes an internal review, scheduled for January 2014, to evaluate compliance with the Articles of Association that are registered with Companies House.
With regard to whether the Company has conducted an audit of NHS land and buildings an initial audit has been undertaken and further, more detailed audits are underway. The company is building a detailed database of its assets to ensure it has a comprehensive understanding of its estate, its use and precisely how much it costs to run.
With regard to any change of ownership or control of NHS land or buildings, and which bodies have the authority to sell NHS land or buildings or change their use, the creation of NHS PS did not change any existing powers of NHS bodies to control NHS land or buildings. The company was established to take over responsibility for the estate that transferred to it on 1 April 2013.
NHS PS is only responsible for the properties within its portfolio and not the wider NHS. There are currently 276 properties in the ownership of NHS PS earmarked for disposal by March 2015, including the sale of 91 freehold properties during the current financial year. The values are currently being assessed. The decision as to whether properties or land is surplus to NHS operational requirements resides with commissioners.
Turning finally to the Company's mandate and its accountability, the company's strategic objectives are outlined in its business plan on its website at:
www.property.nhs.uk/about-us/publications/.
In summary, these are: maintaining continuity of service and keeping buildings safe, warm and clean for service users, visitors and staff; placing patients and the taxpayer at the heart of the business by supporting service transformation; using the company's scale and effective management of its portfolio to keep costs to a minimum and pass back savings to the NHS; ensuring the estate is managed sustainably.
Accountability for the actions and expenditure of NHS PS is via the Department, and its Permanent Secretary to Parliament. As such, the company can be held to account via the Department through the parliamentary committee system, and parliamentary questions.
As a public sector body (100% owned by the Secretary of State) it is subject to requests for information made under the Freedom of Information Act (2000).
As a limited company, NHS PS is required to file an annual report and accounts with Companies House.
I am sorry to interrupt the noble Earl. I waited patiently until he had been through the research arguments but I am still not clear. He said earlier that Public Health England would be master of its own destiny in terms of research. The point that I and, I think,...
I am sorry to interrupt the noble Earl. I waited patiently until he had been through the research arguments but I am still not clear. He said earlier that Public Health England would be master of its own destiny in terms of research. The point that I and, I think,...
My Lords, I have put my name to the amendment and pay tribute to the hard work put in by the noble Baroness, Lady Cumberlege, on making progress in this area. It has occasionally seemed a little like trudging through the Somme mud, but we have made some progress. I...
My Lords, I have put my name to the amendment and pay tribute to the hard work put in by the noble Baroness, Lady Cumberlege, on making progress in this area. It has occasionally seemed a little like trudging through the Somme mud, but we have made some progress. I...
My Lords, I commend the Government on making a move in the right direction with these amendments. At earlier stages in the Bill, I tried to raise the whole issue of barriers to entry for new providers of services. This amendment helps in some respects but the noble Lord, Lord...
My Lords, I commend the Government on making a move in the right direction with these amendments. At earlier stages in the Bill, I tried to raise the whole issue of barriers to entry for new providers of services. This amendment helps in some respects but the noble Lord, Lord...
My query is a point of fact. The Minister is putting great emphasis on the role of the chief executive. Could she tell the House if the chief executive has a scientific background which is relevant to public health?
My query is a point of fact. The Minister is putting great emphasis on the role of the chief executive. Could she tell the House if the chief executive has a scientific background which is relevant to public health?
My Lords—
My Lords—
My Lords, I rise because I have added my name to the amendment of the noble Baroness, Lady Cumberlege. I did so because there is a part of me which actually wants to save the Health Secretary from himself. He is going down a path—for good reasons, in some ways—by...
My Lords, I rise because I have added my name to the amendment of the noble Baroness, Lady Cumberlege. I did so because there is a part of me which actually wants to save the Health Secretary from himself. He is going down a path—for good reasons, in some ways—by...
My Lords, I have added my name to Amendment 125, and I had intended to add my name to Amendment 123, but somehow that did not work out. I speak in support of the excellent presentation by the noble Lord, Lord Patel. I am still concerned about whether we will...
My Lords, I have added my name to Amendment 125, and I had intended to add my name to Amendment 123, but somehow that did not work out. I speak in support of the excellent presentation by the noble Lord, Lord Patel. I am still concerned about whether we will...
Better late than never, my Lords. This brings us back to the issue of integration that we discussed in Committee. Since those discussions, which themselves followed the report of the Future Forum, we have had two important and relevant reports from the Commons Health Select Committee, one on public expenditure...
Better late than never, my Lords. This brings us back to the issue of integration that we discussed in Committee. Since those discussions, which themselves followed the report of the Future Forum, we have had two important and relevant reports from the Commons Health Select Committee, one on public expenditure...
Before the noble Lord sits down, perhaps I may ask him and his noble friend behind him whether they have seen Amendment 161A, which would introduce a new clause on standards of adult social care.
Before the noble Lord sits down, perhaps I may ask him and his noble friend behind him whether they have seen Amendment 161A, which would introduce a new clause on standards of adult social care.
My Lords, I rise briefly to lend my support to Amendment 64ZA in the names of the noble Baroness, Lady Finlay of Llandaff, and my noble friend Lord Hunt. I do so on the basis of my experience as chairman of the provider agency in London after my time as...
My Lords, I rise briefly to lend my support to Amendment 64ZA in the names of the noble Baroness, Lady Finlay of Llandaff, and my noble friend Lord Hunt. I do so on the basis of my experience as chairman of the provider agency in London after my time as...
My Lords, I have added my name to Amendment 66 from the noble Lord, Lord Patel. Given all the hard work that has gone into trying to improve knowledge about medical and other areas, to improve patient safety, it seems extraordinary that in this Bill there is a provision to...
My Lords, I have added my name to Amendment 66 from the noble Lord, Lord Patel. Given all the hard work that has gone into trying to improve knowledge about medical and other areas, to improve patient safety, it seems extraordinary that in this Bill there is a provision to...
My Lords, I had not intended to speak for very long on this set of amendments but some issues have cropped up which are worth reflecting on, particularly by those of us who have sat in Richmond House and have had to deal with them. It is easy to assume...
My Lords, I had not intended to speak for very long on this set of amendments but some issues have cropped up which are worth reflecting on, particularly by those of us who have sat in Richmond House and have had to deal with them. It is easy to assume...
My Lords, I shall speak also to Amendment 143.
My Lords, I shall speak also to Amendment 143.
38C: After Clause 19, insert the following new Clause— ““Integration of services (1) In discharging any duties under this Act, or any related regulations or guidance, ““integration”” means the integration of health and social care commissioning, assessment, service provision or payment arrangements with the primary purpose of improving the delivery...
38C: After Clause 19, insert the following new Clause— ““Integration of services (1) In discharging any duties under this Act, or any related regulations or guidance, ““integration”” means the integration of health and social care commissioning, assessment, service provision or payment arrangements with the primary purpose of improving the delivery...
I am the mover of the amendment and I was interrupting with a short question to the noble Lords, who seem to be unaware of a part of the Bill which addresses their concern. Before I was interrupted, I was going to ask them whether they had seen Amendment 161A,...
I am the mover of the amendment and I was interrupting with a short question to the noble Lords, who seem to be unaware of a part of the Bill which addresses their concern. Before I was interrupted, I was going to ask them whether they had seen Amendment 161A,...
My Lords, so near, yet so far. Amendment 42 is very simple. It requires the Secretary of State to include in his mandate to the national Commissioning Board the requirement to set out two things. First, "““the priority and scope for … service redesign and reconfiguration””," in the NHS, "““in...
My Lords, so near, yet so far. Amendment 42 is very simple. It requires the Secretary of State to include in his mandate to the national Commissioning Board the requirement to set out two things. First, "““the priority and scope for … service redesign and reconfiguration””," in the NHS, "““in...
42: Clause 22, page 16, line 22, after ““appropriate”” insert— ““( ) the priority and scope for commissioning service redesign and reconfiguration in the light of the best clinical advice available, ( ) the priority and scope for transferring resources to adult social services to improve service integration and achieve...
42: Clause 22, page 16, line 22, after ““appropriate”” insert— ““( ) the priority and scope for commissioning service redesign and reconfiguration in the light of the best clinical advice available, ( ) the priority and scope for transferring resources to adult social services to improve service integration and achieve...
My Lords, there have been some extremely powerful speeches of support for this amendment for which I am extremely grateful. I am grateful in particular to my co-signatories and I noted the powerful speeches of the noble Lords, Lord Owen and Lord Sutherland, and the noble Baroness, Lady Young. They...
My Lords, there have been some extremely powerful speeches of support for this amendment for which I am extremely grateful. I am grateful in particular to my co-signatories and I noted the powerful speeches of the noble Lords, Lord Owen and Lord Sutherland, and the noble Baroness, Lady Young. They...
I guess I am more of a risk taker than the noble Earl and I believe that we could put a definition of this kind in the Bill. It would cause no confusion—indeed, it would remove it—in the minds of many people working day in, day out in the NHS....
I guess I am more of a risk taker than the noble Earl and I believe that we could put a definition of this kind in the Bill. It would cause no confusion—indeed, it would remove it—in the minds of many people working day in, day out in the NHS....
My Lords, I am grateful to the Minister for his explanations and reassurances. I certainly think that Amendment 148B is a better amendment than my provision on social care in Amendment 42. I am very happy also to accept his broad assurances that we will have a discussion and dialogue...
My Lords, I am grateful to the Minister for his explanations and reassurances. I certainly think that Amendment 148B is a better amendment than my provision on social care in Amendment 42. I am very happy also to accept his broad assurances that we will have a discussion and dialogue...
My Lords, before the Minister responds to that question, will he consider later—if he cannot answer now—the budgets for clinical commissioning groups? I understand from a meeting of the national Commissioning Board, which was held in open session on 2 February, that Sir David Nicholson is reported as having said...
My Lords, before the Minister responds to that question, will he consider later—if he cannot answer now—the budgets for clinical commissioning groups? I understand from a meeting of the national Commissioning Board, which was held in open session on 2 February, that Sir David Nicholson is reported as having said...
My Lords, I intervene briefly to echo everything that the noble Lord, Lord Willis, has said. We should not rest on our laurels as regards research. I do not want to go over the ground of micromanagement, but the NHS is very quick indeed to forget its responsibilities on research—and...
My Lords, I intervene briefly to echo everything that the noble Lord, Lord Willis, has said. We should not rest on our laurels as regards research. I do not want to go over the ground of micromanagement, but the NHS is very quick indeed to forget its responsibilities on research—and...
My Lords, I had not intended to intervene in this group of amendments, but I want to make a couple of points and leave a question with the Minister. I have always been in the camp that feels that Clause 4 was misguided and should be abandoned. I can see...
My Lords, I had not intended to intervene in this group of amendments, but I want to make a couple of points and leave a question with the Minister. I have always been in the camp that feels that Clause 4 was misguided and should be abandoned. I can see...
My Lords, I was not going to speak in the debate and I certainly do not want to speak on the subject of the cap, in case I get into too much trouble from my Front Bench. I would like to pick up the point made by the noble Baroness,...
My Lords, I was not going to speak in the debate and I certainly do not want to speak on the subject of the cap, in case I get into too much trouble from my Front Bench. I would like to pick up the point made by the noble Baroness,...
The Minister will be pleased that it will be the noble Lord who pulls his punches, as my noble friend said earlier. I wish to pursue this issue of how much money the Government think they need to spend on funding HealthWatch England. This is the real issue: say, for...
The Minister will be pleased that it will be the noble Lord who pulls his punches, as my noble friend said earlier. I wish to pursue this issue of how much money the Government think they need to spend on funding HealthWatch England. This is the real issue: say, for...
I am still struggling. I am sorry to keep interrupting the noble Baroness, but let me give her an example. Could HealthWatch England, as a sub-committee of the CQC, run a national campaign against what is being done by that regulator on an issue such as feeding elderly people in...
I am still struggling. I am sorry to keep interrupting the noble Baroness, but let me give her an example. Could HealthWatch England, as a sub-committee of the CQC, run a national campaign against what is being done by that regulator on an issue such as feeding elderly people in...
My Lords, my name, too, is on the amendments. I support what my noble friend Lady Massey and the noble Baroness, Lady Finlay, have said. I want to refer to adolescent health services. We know that primary care services are not often very user-friendly in relation to adolescent health needs....
My Lords, my name, too, is on the amendments. I support what my noble friend Lady Massey and the noble Baroness, Lady Finlay, have said. I want to refer to adolescent health services. We know that primary care services are not often very user-friendly in relation to adolescent health needs....
My Lords, this has been an interesting and spirited debate. I will certainly reflect on the Minister’s willingness to consider some of these issues further. My noble friend Lord Harris and I will certainly be considering this further and I would not rule out the possibility that we might come...
My Lords, this has been an interesting and spirited debate. I will certainly reflect on the Minister’s willingness to consider some of these issues further. My noble friend Lord Harris and I will certainly be considering this further and I would not rule out the possibility that we might come...
I just want to pursue the issue of the campaign, because it is very important. Currently, there has been a very effective campaign about literacy run by the Evening Standard. That has attracted lots of voluntary money to run it and led to some interesting changes and the Government supporting...
I just want to pursue the issue of the campaign, because it is very important. Currently, there has been a very effective campaign about literacy run by the Evening Standard. That has attracted lots of voluntary money to run it and led to some interesting changes and the Government supporting...
I am not talking about flagging up; I am talking about a campaign. A campaign means that you take action, using the media, to put serious pressure on the Government in relation to their record in running the NHS for elderly people. I am not saying that that should happen;...
I am not talking about flagging up; I am talking about a campaign. A campaign means that you take action, using the media, to put serious pressure on the Government in relation to their record in running the NHS for elderly people. I am not saying that that should happen;...
306: Clause 178, page 175, line 17, leave out subsections (2) and (3) and insert— ““(2) Healthwatch England is to be appointed in accordance with regulations made by the Secretary of State.””
306: Clause 178, page 175, line 17, leave out subsections (2) and (3) and insert— ““(2) Healthwatch England is to be appointed in accordance with regulations made by the Secretary of State.””
My Lords, unfortunately the noble Lord, Lord Patel, had to leave before we could get to this amendment so I shall speak on his behalf in moving Amendment 306. The amendment brings us to Clause 178, which is about HealthWatch England. In simple terms, the amendment seeks to make HealthWatch...
My Lords, unfortunately the noble Lord, Lord Patel, had to leave before we could get to this amendment so I shall speak on his behalf in moving Amendment 306. The amendment brings us to Clause 178, which is about HealthWatch England. In simple terms, the amendment seeks to make HealthWatch...
My Lords, I will just raise a couple of points about Amendments 300 and 301, tabled by the noble Baroness, Lady Williams, in relation to the Secretary of State's role in mergers. The other day, I tried to express a little about my concerns, which I continue to have, about...
My Lords, I will just raise a couple of points about Amendments 300 and 301, tabled by the noble Baroness, Lady Williams, in relation to the Secretary of State's role in mergers. The other day, I tried to express a little about my concerns, which I continue to have, about...
I totally support the idea of getting everybody into foundation trusts. I am questioning whether the processes that we have in place will actually deliver that in the time scales that are being set by the Government. I suspect that in practice you can make the kind of progress required...
I totally support the idea of getting everybody into foundation trusts. I am questioning whether the processes that we have in place will actually deliver that in the time scales that are being set by the Government. I suspect that in practice you can make the kind of progress required...
My Lords, I also support the amendment of the noble Baroness, Lady Greengross. I do so from the perspective of someone who as a special adviser was involved in the framing of the Human Rights Act in 1998. At that time, much of the thinking in the devising of that...
My Lords, I also support the amendment of the noble Baroness, Lady Greengross. I do so from the perspective of someone who as a special adviser was involved in the framing of the Human Rights Act in 1998. At that time, much of the thinking in the devising of that...
My Lords, I rise to a rapt audience to move Amendment 295AA, which will really test the concentration powers of your Lordships’ House. The amendment would insert a new clause on actions that could be taken to reconfigure services in the interests of sustainability before the Bill’s failure regime kicks...
My Lords, I rise to a rapt audience to move Amendment 295AA, which will really test the concentration powers of your Lordships’ House. The amendment would insert a new clause on actions that could be taken to reconfigure services in the interests of sustainability before the Bill’s failure regime kicks...
295AA: After Clause 130, insert the following new Clause— ““Prior actions to health special administration orders (1) Monitor shall produce annually a report to the National Commissioning Board setting out those trusts and their associated health economies where it considers that, on the evidence available, trusts are at serious risk...
295AA: After Clause 130, insert the following new Clause— ““Prior actions to health special administration orders (1) Monitor shall produce annually a report to the National Commissioning Board setting out those trusts and their associated health economies where it considers that, on the evidence available, trusts are at serious risk...
My Lords, I am grateful to everyone who has spoken in this debate for the support that the thrust of the amendment has received. I reassure the Minister that it is not the purpose of the amendment to exclude local commissioners or local people from involvement in reshaping their services....
My Lords, I am grateful to everyone who has spoken in this debate for the support that the thrust of the amendment has received. I reassure the Minister that it is not the purpose of the amendment to exclude local commissioners or local people from involvement in reshaping their services....
My Lords, this amendment is in my name and that of the noble Lord, Lord Patel. I begin by briefly making clear my position on competition, which underpins this amendment. I am sorry that I had to miss the discussion on the first group of amendments. However, my position on...
My Lords, this amendment is in my name and that of the noble Lord, Lord Patel. I begin by briefly making clear my position on competition, which underpins this amendment. I am sorry that I had to miss the discussion on the first group of amendments. However, my position on...
I beg your pardon. I am rather dozy this afternoon on this group of amendments. I beg leave to withdraw the amendment. Amendment 266 withdrawn. Amendment 266A had been withdrawn from the Marshalled List. Amendment 267 not moved. Amendments 267ZA to 267ZD had been withdrawn from the Marshalled List. Amendment...
I beg your pardon. I am rather dozy this afternoon on this group of amendments. I beg leave to withdraw the amendment. Amendment 266 withdrawn. Amendment 266A had been withdrawn from the Marshalled List. Amendment 267 not moved. Amendments 267ZA to 267ZD had been withdrawn from the Marshalled List. Amendment...
I want to briefly respond to what the noble Earl said about Amendment 266, particularly in the light of the points that the noble Baroness, Lady Murphy, made about a good deal of anti-competitive behaviour being already quite well entrenched in the NHS. Simply waiting longer to get it even...
I want to briefly respond to what the noble Earl said about Amendment 266, particularly in the light of the points that the noble Baroness, Lady Murphy, made about a good deal of anti-competitive behaviour being already quite well entrenched in the NHS. Simply waiting longer to get it even...
Perhaps I could pursue this a little further. Is the Minister saying that the current legislation is insufficient and therefore the Government are consulting on what strengthening might be needed? Surely it is possible that this great and glorious machine, the Department of Health and its lawyers, can tell Ministers...
Perhaps I could pursue this a little further. Is the Minister saying that the current legislation is insufficient and therefore the Government are consulting on what strengthening might be needed? Surely it is possible that this great and glorious machine, the Department of Health and its lawyers, can tell Ministers...
Perhaps I could ask the noble Baroness to go a little further. Does she envisage that after this consultation, the Government are going to require primary legislation to take effective action in this area, or are the Government confident that there are sufficient powers to enable them to deal with...
Perhaps I could ask the noble Baroness to go a little further. Does she envisage that after this consultation, the Government are going to require primary legislation to take effective action in this area, or are the Government confident that there are sufficient powers to enable them to deal with...
My Lords, I apologise that my enthusiasm for Amendment 274ZZB caused me to move it partially in an earlier group. The amendment in my name and that of the noble Baroness, Lady Pitkeathley, was put down because we regard it as a probing amendment to the end of Clause 62...
My Lords, I apologise that my enthusiasm for Amendment 274ZZB caused me to move it partially in an earlier group. The amendment in my name and that of the noble Baroness, Lady Pitkeathley, was put down because we regard it as a probing amendment to the end of Clause 62...
My Lords, I have some sympathy with some of the remarks made by my noble friend Lord Davies of Stamford in the sense that a blanket ban on price competition seems rather misguided in the situation the NHS faces. To give one example, under the last Government the price we...
My Lords, I have some sympathy with some of the remarks made by my noble friend Lord Davies of Stamford in the sense that a blanket ban on price competition seems rather misguided in the situation the NHS faces. To give one example, under the last Government the price we...
I thought there was going to be an intervention from my left. I was not going to intervene in the debate on this group. I am sorry if I missed something by missing the debate on the first group of amendments. I have some concerns about the dual role of...
I thought there was going to be an intervention from my left. I was not going to intervene in the debate on this group. I am sorry if I missed something by missing the debate on the first group of amendments. I have some concerns about the dual role of...
Is the Committee happy for me to continue? I consider that research evidence as is available, such as that carried out by Dr Zack Cooper at the LSE, shows the benefits of competition and supports the view that competition, when used sensibly, improves services for patients and can indeed save...
Is the Committee happy for me to continue? I consider that research evidence as is available, such as that carried out by Dr Zack Cooper at the LSE, shows the benefits of competition and supports the view that competition, when used sensibly, improves services for patients and can indeed save...
266: Clause 59, page 87, line 21, at end insert ““and in discharging this duty will conduct and publish within one year of Royal Assent a review of the anti-competitive barriers that restrict NHS patients from benefiting from new or existing organisations providing new or extended NHS services that defined...
266: Clause 59, page 87, line 21, at end insert ““and in discharging this duty will conduct and publish within one year of Royal Assent a review of the anti-competitive barriers that restrict NHS patients from benefiting from new or existing organisations providing new or extended NHS services that defined...
I asked a very straightforward question. I am quite happy to pursue this through a Written Question. I just want to know whether the Government consider that the current primary legislation is adequate to deal with this particular issue. That seems to me a yes or no answer, but if...
I asked a very straightforward question. I am quite happy to pursue this through a Written Question. I just want to know whether the Government consider that the current primary legislation is adequate to deal with this particular issue. That seems to me a yes or no answer, but if...
My Lords, I support the thrust of most of the amendments in this group and have added my name to Amendments 226, 259 and 339. As others have said, it is essential to have in the Bill a clear commitment from the Government, and indeed from Parliament, that three things...
My Lords, I support the thrust of most of the amendments in this group and have added my name to Amendments 226, 259 and 339. As others have said, it is essential to have in the Bill a clear commitment from the Government, and indeed from Parliament, that three things...
I suggest that this group of amendments has been provoked by the extremely unconvincing nature of the Government’s organisational structure for delivering the reforms they consider necessary to the NHS; they would in themselves, I suspect, attract a wide range of support. I want to address my remarks to Clauses...
I suggest that this group of amendments has been provoked by the extremely unconvincing nature of the Government’s organisational structure for delivering the reforms they consider necessary to the NHS; they would in themselves, I suspect, attract a wide range of support. I want to address my remarks to Clauses...
Could the Minister give us an assurance that before Report he will give us some idea of the extent to which the current arrangements are going to meet the targets set by the Government for delivering the Nicholson challenge for this coming year, so that we can see the extent...
Could the Minister give us an assurance that before Report he will give us some idea of the extent to which the current arrangements are going to meet the targets set by the Government for delivering the Nicholson challenge for this coming year, so that we can see the extent...
I am sorry to interrupt, but I am really bemused by what the noble Earl has just said about the accountability of the local entity of the national Commissioning Board to health and well-being boards. Health and well-being boards have no budgetary responsibility whatever, as I understand what the Government...
I am sorry to interrupt, but I am really bemused by what the noble Earl has just said about the accountability of the local entity of the national Commissioning Board to health and well-being boards. Health and well-being boards have no budgetary responsibility whatever, as I understand what the Government...
I thank the noble Baroness for giving way. I encourage her to reflect on what she might experience in terms of surprise on Report if we do not see a little more flexibility.
I thank the noble Baroness for giving way. I encourage her to reflect on what she might experience in terms of surprise on Report if we do not see a little more flexibility.
Can the Minister explain something to us, if necessary in writing in order not to detain the House. I am very confused about what happens in areas where historically there have been great problems with health inequalities in securing a volume of primary medical services to meet the needs of...
Can the Minister explain something to us, if necessary in writing in order not to detain the House. I am very confused about what happens in areas where historically there have been great problems with health inequalities in securing a volume of primary medical services to meet the needs of...
Can the noble Baroness write to us about central government approval of people who are employees of the local authority? There are three areas where I should certainly like to be a lot clearer. The first is what the position with medical officers for health was in the past. My...
Can the noble Baroness write to us about central government approval of people who are employees of the local authority? There are three areas where I should certainly like to be a lot clearer. The first is what the position with medical officers for health was in the past. My...
My Lords, I am beginning to feel sorry for the Minister. He is getting a kicking from both sides of him, left and right, and in front. I am puzzled by this amendment and the arguments being put forward, both the one by my noble friend Lord Hunt, and the...
My Lords, I am beginning to feel sorry for the Minister. He is getting a kicking from both sides of him, left and right, and in front. I am puzzled by this amendment and the arguments being put forward, both the one by my noble friend Lord Hunt, and the...
I thought I would get my question in before the noble Lord gets warmed up again. He said there is no indication from the evidence from the past of what the right size for a PCT was, but there is some evidence from the past. I do not think that...
I thought I would get my question in before the noble Lord gets warmed up again. He said there is no indication from the evidence from the past of what the right size for a PCT was, but there is some evidence from the past. I do not think that...
I speak to Amendment 157 which is aimed at containing the number of clinical commissioning groups and their total operating costs. I have some sympathy with the remarks made by my noble friend, but before I go into the detail of these particular amendments, I want to give a little...
I speak to Amendment 157 which is aimed at containing the number of clinical commissioning groups and their total operating costs. I have some sympathy with the remarks made by my noble friend, but before I go into the detail of these particular amendments, I want to give a little...
There are very few things in health policy on which I disagree with the noble Baroness. However, this House needs to look at what the evidence base from GP fundholding and practice-based commissioning shows us. The evidence base shows that GPs did quite well in commissioning some services. However, their...
There are very few things in health policy on which I disagree with the noble Baroness. However, this House needs to look at what the evidence base from GP fundholding and practice-based commissioning shows us. The evidence base shows that GPs did quite well in commissioning some services. However, their...
My Lords, I was not convinced by the noble Earl’s views on the number of clinical commissioning groups in our earlier debate. I was even less convinced by what he had to say about competencies. There was a lot of talk about, ““The board may wish to do this””, and,...
My Lords, I was not convinced by the noble Earl’s views on the number of clinical commissioning groups in our earlier debate. I was even less convinced by what he had to say about competencies. There was a lot of talk about, ““The board may wish to do this””, and,...
My Lords, I just wanted to make a couple of observations and ask the Minister a question on this group of amendments. First, this is a not a new area that we are getting into. The same issues arose with GP fundholding and with practice-based commissioning. We have managed, as...
My Lords, I just wanted to make a couple of observations and ask the Minister a question on this group of amendments. First, this is a not a new area that we are getting into. The same issues arose with GP fundholding and with practice-based commissioning. We have managed, as...
In moving Amendment 159 I shall also speak to Amendments 160 and 164 in my name. I start by emphasising that this is a package of amendments that relates to many concerns that have been expressed to me and others—namely, that we need to make very sure that we ensure...
In moving Amendment 159 I shall also speak to Amendments 160 and 164 in my name. I start by emphasising that this is a package of amendments that relates to many concerns that have been expressed to me and others—namely, that we need to make very sure that we ensure...
159: Clause 22, page 29, line 33, at end insert ““providing that it can demonstrate that it can meet the requirements of commissioning competence specified by the Board””
159: Clause 22, page 29, line 33, at end insert ““providing that it can demonstrate that it can meet the requirements of commissioning competence specified by the Board””
My Lords, I rise to speak to Amendments 146, 148 and 149 in my name, and in support of Amendment 151, which the noble Lord, Lord Patel will speak to. These amendments are about keeping in check the cost of running the biggest quango in the country and holding it...
My Lords, I rise to speak to Amendments 146, 148 and 149 in my name, and in support of Amendment 151, which the noble Lord, Lord Patel will speak to. These amendments are about keeping in check the cost of running the biggest quango in the country and holding it...
146: Clause 20, page 21, line 19, at end insert ““including its annual operating costs as defined in subsection (6)””
146: Clause 20, page 21, line 19, at end insert ““including its annual operating costs as defined in subsection (6)””
Can the noble Earl explain to us, in writing, the comparison between the current costs of the bodies carrying out functions that are going to be transferred to the board, and what the Government’s current estimate is of the first year’s fully fledged activities of the board in discharging those...
Can the noble Earl explain to us, in writing, the comparison between the current costs of the bodies carrying out functions that are going to be transferred to the board, and what the Government’s current estimate is of the first year’s fully fledged activities of the board in discharging those...
That was not the point of my question. It was what the board budget was going to be, so that we knew what this authority was preparing itself for. I am not frankly very fussed about the odd million or two going to this authority. I am more concerned about...
That was not the point of my question. It was what the board budget was going to be, so that we knew what this authority was preparing itself for. I am not frankly very fussed about the odd million or two going to this authority. I am more concerned about...
My Lords, I agree with everything my noble friend has said. In particular, I would like to know when the shadow becomes substance. It is unfortunate that we are considering these statutory instruments before we have had a chance in Committee to discuss the clauses of the Bill relating to...
My Lords, I agree with everything my noble friend has said. In particular, I would like to know when the shadow becomes substance. It is unfortunate that we are considering these statutory instruments before we have had a chance in Committee to discuss the clauses of the Bill relating to...
My Lords, I am a bit confused as to whether we are making speeches or asking questions of the noble and learned Lord, Lord Mackay, who seems to have volunteered to conduct seminars for us on many of these issues. In making some points I shall, in a way, be...
My Lords, I am a bit confused as to whether we are making speeches or asking questions of the noble and learned Lord, Lord Mackay, who seems to have volunteered to conduct seminars for us on many of these issues. In making some points I shall, in a way, be...
I cannot resist responding to that. I do not accept that position. I was trying to say that what the putative chairman is saying seems to be in conflict with what is provided for in the legislation, which requires the Secretary of State to produce a mandate before the start...
I cannot resist responding to that. I do not accept that position. I was trying to say that what the putative chairman is saying seems to be in conflict with what is provided for in the legislation, which requires the Secretary of State to produce a mandate before the start...
I am sorry to interrupt the Minister’s flow, but he has been interrupted, so I thought I would ask my question now. The Minister has given us quite a lot of assurances about what the government amendment would cover, but I put to him a particular issue that came up—not...
I am sorry to interrupt the Minister’s flow, but he has been interrupted, so I thought I would ask my question now. The Minister has given us quite a lot of assurances about what the government amendment would cover, but I put to him a particular issue that came up—not...
I ought to make clear that I was not launching an attack on the noble Lord, Lord Ribeiro, with whom I had an excellent relationship as a Minister when he was president of the Royal College of Surgeons. I finish by saying that although we are making progress on this...
I ought to make clear that I was not launching an attack on the noble Lord, Lord Ribeiro, with whom I had an excellent relationship as a Minister when he was president of the Royal College of Surgeons. I finish by saying that although we are making progress on this...
My Lords, I support Amendments 2, 6 and 44 in particular in this group. However, I am sympathetic to and support the other amendments. The debate is going downhill. Following the eminent doctors, noble Lords will now get the perspective of a jobbing ex-Minister who was responsible for workforce matters...
My Lords, I support Amendments 2, 6 and 44 in particular in this group. However, I am sympathetic to and support the other amendments. The debate is going downhill. Following the eminent doctors, noble Lords will now get the perspective of a jobbing ex-Minister who was responsible for workforce matters...
My example was not hypothetical—it actually happened.
My example was not hypothetical—it actually happened.
My Lords, it is always a pleasure to follow the noble Baroness, Lady Murphy. I detect from her remarks that I may have been forgiven for her old SHA being one of the 18 that I abolished five years ago. As you walk into Parliament from the Underground, you see...
My Lords, it is always a pleasure to follow the noble Baroness, Lady Murphy. I detect from her remarks that I may have been forgiven for her old SHA being one of the 18 that I abolished five years ago. As you walk into Parliament from the Underground, you see...
I am sorry to interrupt the Minister. I have been listening intently to what he has said. I am extremely confused about the order in which things are going to be done. As I understood what he was saying, we are going to get a series of orders that transfer...
I am sorry to interrupt the Minister. I have been listening intently to what he has said. I am extremely confused about the order in which things are going to be done. As I understood what he was saying, we are going to get a series of orders that transfer...
My Lords, I have added my name to Amendments 92 and 93 in part in a spirit of helpfulness—I hope that is the case—to the Minister as I have traversed the same ground as him on Department of Health arm’s-length bodies. In 2003-04, I was the Minister who reviewed DH...
My Lords, I have added my name to Amendments 92 and 93 in part in a spirit of helpfulness—I hope that is the case—to the Minister as I have traversed the same ground as him on Department of Health arm’s-length bodies. In 2003-04, I was the Minister who reviewed DH...
I am sorry to interrupt the Minister in full flow. I have listened very carefully to this. He has made much of the fact that the Ministry of Justice will take on a series of roles and functions that noble Lords seem to be mistaken in thinking that the advisory...
I am sorry to interrupt the Minister in full flow. I have listened very carefully to this. He has made much of the fact that the Ministry of Justice will take on a series of roles and functions that noble Lords seem to be mistaken in thinking that the advisory...
To ask Her Majesty's Government how strategic health authorities will assess the commissioning competency of primary care trusts.
To ask Her Majesty's Government how strategic health authorities will assess the commissioning competency of primary care trusts.
My Lords, it is 10 years since I spoke here on House of Lords reform. I did so shortly after finishing my stint as the Home Secretary’s senior policy adviser, when constitutional reform was part of my brief. At that time, I was word perfect on the 1997 manifesto commitments...
My Lords, it is 10 years since I spoke here on House of Lords reform. I did so shortly after finishing my stint as the Home Secretary’s senior policy adviser, when constitutional reform was part of my brief. At that time, I was word perfect on the 1997 manifesto commitments...
I cannot resist rising on this issue. Having been on the receiving end of many lectures over the years from the noble Earl, Lord Howe, about how the Government have created bureaucracy in the NHS, this looks like a crackingly good way of having returns from NHS authorities to show...
I cannot resist rising on this issue. Having been on the receiving end of many lectures over the years from the noble Earl, Lord Howe, about how the Government have created bureaucracy in the NHS, this looks like a crackingly good way of having returns from NHS authorities to show...
For the sake of clarity, I did not say that Governments should willy-nilly be able to change principles; I said—I want to be very clear about this—that the circumstances in which Governments govern may change, making it necessary for a Government to respond to those circumstances. I think that that...
For the sake of clarity, I did not say that Governments should willy-nilly be able to change principles; I said—I want to be very clear about this—that the circumstances in which Governments govern may change, making it necessary for a Government to respond to those circumstances. I think that that...
I apologise to the Committee for not being at Second Reading but I was out of the country. I apologise to the noble Earl, Lord Howe, for missing the beginning of his remarks but I got the thrust of his arguments when I came in. He will not be surprised...
I apologise to the Committee for not being at Second Reading but I was out of the country. I apologise to the noble Earl, Lord Howe, for missing the beginning of his remarks but I got the thrust of his arguments when I came in. He will not be surprised...
My Lords, as a long-standing and committed Londoner, I am glad to have the chance to speak on this Bill, given its aim to strengthen devolved powers in London. The main focus of my remarks will be the health provisions at Clauses 21 to 24. However, I should first declare...
My Lords, as a long-standing and committed Londoner, I am glad to have the chance to speak on this Bill, given its aim to strengthen devolved powers in London. The main focus of my remarks will be the health provisions at Clauses 21 to 24. However, I should first declare...
My Lords, I am sure that we are all grateful to the noble Baroness, Lady Walmsley, for giving us this opportunity to discuss the important issue of how we monitor our public services. However, the issues that she raised in her speech and that are implicit in her Motion on...
My Lords, I am sure that we are all grateful to the noble Baroness, Lady Walmsley, for giving us this opportunity to discuss the important issue of how we monitor our public services. However, the issues that she raised in her speech and that are implicit in her Motion on...
My Lords, I will do my best to respond to the points made by noble Lords. The amendment to which we are asking noble Lordsto agree is Amendment No. 16B, not AmendmentNo. 16A. The amendment in lieu of the amendment made in this House, which was passed earlier today in...
My Lords, I will do my best to respond to the points made by noble Lords. The amendment to which we are asking noble Lordsto agree is Amendment No. 16B, not AmendmentNo. 16A. The amendment in lieu of the amendment made in this House, which was passed earlier today in...
My Lords, I beg to move that the Commons amendments be now considered. Moved accordingly, and, on Question, Motion agreed to. [The page and line references are to Bill 137 as first printed for the Commons.]"4: Clause 6, Page 4, line 13, leave out from ““scheme”” to end of line...
My Lords, I beg to move that the Commons amendments be now considered. Moved accordingly, and, on Question, Motion agreed to. [The page and line references are to Bill 137 as first printed for the Commons.]"4: Clause 6, Page 4, line 13, leave out from ““scheme”” to end of line...
My Lords, I beg to move Motion A, that the House do not insist on its Amendment No. 4A to which the Commons have disagreed, do not insist on its disagreement to Commons Amendments Nos. 5 and 16 on which the Commons have insisted, and do agree with the Commons...
My Lords, I beg to move Motion A, that the House do not insist on its Amendment No. 4A to which the Commons have disagreed, do not insist on its disagreement to Commons Amendments Nos. 5 and 16 on which the Commons have insisted, and do agree with the Commons...
Whether the duties of local authorities with regard to food cover airports and airfields within their jurisdiction; and, if so, why ports have separate health authorities as indicated in the Contaminants in Food (England) Regulations 2006 (SI 2006/1464).
Whether the duties of local authorities with regard to food cover airports and airfields within their jurisdiction; and, if so, why ports have separate health authorities as indicated in the Contaminants in Food (England) Regulations 2006 (SI 2006/1464).
Let me begin by clearly stating the Government’s position. We believe that the general rule should be one responsible pharmacist for one pharmacy. This will allow the pharmacist to exercise fully his or her important responsibility to secure the safe and effective running of the pharmacy. We see a pharmacist...
Let me begin by clearly stating the Government’s position. We believe that the general rule should be one responsible pharmacist for one pharmacy. This will allow the pharmacist to exercise fully his or her important responsibility to secure the safe and effective running of the pharmacy. We see a pharmacist...
I congratulate Members of the Committee on ensuring that we have had a good debate on palliative care during the course of the Bill. I pay tribute to the persistence of the noble Earl, Lord Howe, on the subject of hospices—particularly children’s hospices—and his willingness to keep plugging away. I also acknowledge and recognise...
I congratulate Members of the Committee on ensuring that we have had a good debate on palliative care during the course of the Bill. I pay tribute to the persistence of the noble Earl, Lord Howe, on the subject of hospices—particularly children’s hospices—and his willingness to keep plugging away. I also acknowledge and recognise...
On that latter point we are, as I have tried to say in my rapid canter through this complex and important subject area, taking the end-of-life issues forward through the end-of-life networks that are being established. They are a way forward in this area and a good way of spreading good...
On that latter point we are, as I have tried to say in my rapid canter through this complex and important subject area, taking the end-of-life issues forward through the end-of-life networks that are being established. They are a way forward in this area and a good way of spreading good...
Amendments Nos. 83 to 85 seek to amend Clause 33 so that the Secretary of State may set charges only by means of an order rather than by directions to primary care trusts. The noble Earl has said that the reason for the amendments is to give Parliament the opportunity to scrutinise the level of...
Amendments Nos. 83 to 85 seek to amend Clause 33 so that the Secretary of State may set charges only by means of an order rather than by directions to primary care trusts. The noble Earl has said that the reason for the amendments is to give Parliament the opportunity to scrutinise the level of...