Parliamentary Debates House of Commons Official Report General Committees

PARLIAMENTARY DEBATES HOUSE OF COMMONS OFFICIAL REPORT GENERAL COMMITTEES Public Bill Committee HEALTH AND SOCIAL CARE BILL Eighth Sitting Thursday 17 February 2011 (Afternoon) CONTENTS CLAUSE 2 agreed to. CLAUSE 3 under consideration when the Committee adjourned till Tuesday 1 March at half-past Ten o’clock. PUBLISHED BY AUTHORITY OF THE HOUSE OF COMMONS LONDON – THE STATIONERY OFFICE LIMITED £5·00 PBC (Bill 132) 2010 - 2011 Members who wish to have copies of the Official Report of Proceedings in General Committees sent to them are requested to give notice to that effect at the Vote Office. No proofs can be supplied. Corrigenda slips may be published with Bound Volume editions. Corrigenda that Members suggest should be clearly marked in a copy of the report—not telephoned—and must be received in the Editor’s Room, House of Commons, not later than Monday 21 February 2011 STRICT ADHERENCE TO THIS ARRANGEMENT WILL GREATLY FACILITATE THE PROMPT PUBLICATION OF THE BOUND VOLUMES OF PROCEEDINGS IN GENERAL COMMITTEES © Parliamentary Copyright House of Commons 2011 This publication may be reproduced under the terms of the Parliamentary Click-Use Licence, available online through the Office of Public Sector Information website at www.opsi.gov.uk/click-use/ Enquiries to the Office of Public Sector Information, Kew, Richmond, Surrey TW9 4DU; e-mail: [email protected] 277 Public Bill Committee17 FEBRUARY 2011 Health and Social Care Bill 278 The Committee consisted of the following Members: Chairs: †MR JIM HOOD,MR MIKE HANCOCK † Abrahams, Debbie (Oldham East and Saddleworth) † Morris, Grahame M. (Easington) (Lab) (Lab) † Poulter, Dr Daniel (Central Suffolk and North † Barron, Mr Kevin (Rother Valley) (Lab) Ipswich) (Con) † Blenkinsop, Tom (Middlesbrough South and East † Pugh, John (Southport) (LD) Cleveland) (Lab) Shannon, Jim (Strangford) (DUP) † Brine, Mr Steve (Winchester) (Con) † Smith, Owen (Pontypridd) (Lab) † Burns, Mr Simon (Minister of State, Department of † Soubry, Anna (Broxtowe) (Con) Health) † Sturdy, Julian (York Outer) (Con) † Burstow, Paul (Minister of State, Department of † Thornberry, Emily (Islington South and Finsbury) Health) (Lab) † Byles, Dan (North Warwickshire) (Con) † Turner, Karl (Kingston upon Hull East) (Lab) † Crabb, Stephen (Preseli Pembrokeshire) (Con) † Twigg, Derek (Halton) (Lab) † de Bois, Nick (Enfield North) (Con) † Wilson, Phil (Sedgefield) (Lab) † James, Margot (Stourbridge) (Con) † Kendall, Liz (Leicester West) (Lab) Chris Stanton, Mark Etherton, Committee Clerks † Lefroy, Jeremy (Stafford) (Con) † Morgan, Nicky (Loughborough) (Con) † attended the Committee 279 Public Bill CommitteeHOUSE OF COMMONS Health and Social Care Bill 280 Liz Kendall: On that point, I wish to press the amendment Public Bill Committee to a vote. Question put, That the amendment be made. Thursday 17 February 2011 The Committee proceeded to a Division. Stephen Crabb (Preseli Pembrokeshire) (Con): On a (Afternoon) point of order, Mr Hood. Will time be allowed for Members who are not here yet to arrive? [MR JIM HOOD in the Chair] The Chair: Yes, the doors will not be locked for two minutes, or until the Whips have identified to me that Health and Social Care Bill they wish them to be locked. The Committee having divided: Ayes 10, Noes 12. Clause 2 Division No. 7] THE SECRETARY OF STATE’S DUTY AS TO AYES IMPROVEMENT IN QUALITY OF SERVICES Abrahams, Debbie Smith, Owen Amendment proposed (this day): 36, in clause 2, page 2, Barron, rh Mr Kevin Thornberry, Emily line 23, leave out ‘with a view to securing’ and insert ‘to Blenkinsop, Tom Turner, Karl secure’.—(Liz Kendall.) Kendall, Liz Twigg, Derek Morris, Grahame M. (Easington) Wilson, Phil 1pm NOES The Chair: I remind the Committee that with this we Brine, Mr Steve James, Margot are discussing the following: amendment 37, in clause 2, Burns, rh Mr Simon Lefroy, Jeremy page 2, line 29, leave out ‘with a view to securing’ and Burstow, Paul Morgan, Nicky insert ‘to secure’. Byles, Dan Poulter, Dr Daniel Amendment 39, in clause 2, page 2, line 38, leave out Crabb, Stephen Soubry, Anna ‘have regard to’ and insert ‘seek to deliver’. de Bois, Nick Sturdy, Julian Question accordingly negatived. Liz Kendall (Leicester West) (Lab): To recap, the reason we have tabled the amendments is not semantics, but real concern that there needs to be clear and strong duties for the Secretary of State and, I remind Members, Liz Kendall: I beg to move amendment 38, in clause 2, the national quality board and the commissioning consortia page 2, line 33, leave out from ‘show’ to end of line 36 to improve quality. and insert— My final point relates to what the Minister said about ‘(a) the effectiveness of services, education, training and strategic health authorities. I (b) the safety of services, am well aware that the Government are consulting on (c) that services are patient-centred, the proposed changes to education and training. My concern is that SHAs will be abolished under clause 28 (d) the timeliness of services, before we know what is to happen in education and (e) the efficiency of services, and training. As that is so important to quality, I urge the (f) the equity of services.’. Minister to be clear about the implications. I know that members of the Committee are keen to make progress, so I shall be swifter in speaking to the Dr Daniel Poulter (Central Suffolk and North Ipswich) amendment than to the previous group. (Con): Will the hon. Lady explain what role SHAs play in training at the moment? I am not aware of any. New section 1A(3) of the National Health Service Act 2006, inserted by clause 2, lists three outcomes that the Secretary of State should seek to deliver when Liz Kendall: There is regional co-ordination on education, having a view and having regard to securing continuous training and workplace planning. The deaneries are improvements in quality: the effectiveness of services, closely involved at that level. That point was raised with the safety of services and the quality of patient experience. us by the junior doctors committee of the British Medical Effectiveness, safety and patient experience are crucial Association. elements of a high-quality service, but they are not the whole story. Amendment 38 would more clearly define The Minister of State, Department of Health (Mr Simon the factors that make up a high-quality service. Burns): The hon. Lady rightly raises an important subject. Members of the Committee will recall that several We all want to ensure that the highest standards of witnesses who gave evidence last week emphasised how education and training are maintained and that, where difficult it is define and measure quality. My right hon. need be, standards are improved. As she rightly says, Friend the Member for Rother Valley rightly asked consultation is ongoing. I assure her that the matter will Stephen Thornton of the Health Foundation, Jennifer be resolved before the SHAs are abolished, because we Dixon of the Nuffield Trust and Julian Le Grand of the do not want any hiatus whatsoever. London School of Economics, 281 Public Bill Committee17 FEBRUARY 2011 Health and Social Care Bill 282 “what evidence do we have…that quality is something that can be worse than others. In fact, it is on the very first set of measured, something we can put faith in, as opposed to a target, diagnoses that we often fall behind. Timeliness is vital and something that is going to improve services?” not only in clinical care, but because patients want The responses to that question are important when it—at the top of their list of concerns and priorities is considering clause 2 and the amendment. Stephen Thornton the wish for care to be timely. replied: The fifth element of quality care—I am surprised “As everyone knows, quality in health service delivery is notoriously that it has not been specified by a Government who are difficult to get your head around and to define.” rightly concerned with spending—is the concern that He referred to standardised mortality ratios. Surely services should be efficient and avoid waste, not only whether some is dead or alive is clear, but in fact, the waste through bureaucracy but the waste of equipment, point emphasised by Nigel Edwards was that it is difficult supplies, ideas and energy. to get from those standardised mortality ratios a clear understanding of whether, for example, the issue is the The sixth element of quality is that care should be case mix of a particular hospital. If a hospital deals equitable. It should not vary in quality because of a with very difficult cases, its standard mortality ratio will personal characteristic such as gender, ethnicity, geographic be much higher. Dr Jennifer Dixon said that location and socio-economic status. I am sure that we discuss equality and the duty to promote it at greater “quality is not very observable”, length under the next clause. Although the new and Julian Le Grand, who, as I am sure Government section 1A(3) that clause 2 would insert into the 2006 Members know, is in many ways a champion of the Act attempts to set out the key features of quality, I Government’s reforms, said that firmly believe that it does not go far or deep enough. “it is so difficult to measure quality. To some extent, we have to rely upon inferring improvements in quality from changes in A health care system that made improvements in other areas.”––[Official Report, Health and Social Care Public Bill those six key areas would be far better at meeting Committee, 8 February 2011; c. 22-23, Q47.] patients’ needs. If quality is really at the heart of the We need to look at inputs and processes as well as Government’s plans for the NHS, clause 2 should spell outcomes.

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