NHS Reform and Health Care Professions Bill - Lords' Briefing


This briefing sets out the background to the patient and public involvement clauses of the NHS Reform and Health Care Professions Bill, considers the state of the Bill as it enters the Lords, and commends a number of amendments which would improve the Bill whilst remaining consistent with the framework set out by the government.


For the past 27 years Community Health Councils (CHCs) have been the most democratic and accountable part of the NHS. CHCs perform various functions on behalf of their local communities. These include:

CHCs have a substantial record of accomplishment within the NHS. Recent high profile successes have included playing a key role in helping to expose events at Alder Hey; providing help and support to the relatives of Harold Shipman's victims and highlighting the lengthy waits faced in the nations A&E departments through the 'Casualty Watch' surveys. In short CHCs have have been at the forefront of ensuring that the patientís voice is heard and their complaints listened to.

The NHS Reform and Health Care Professions Bill currently before Parliament proposes the abolition of CHCs and their replacement by a range of new bodies. The Bill's proposals on patient and public involvement have provoked widespread controversy. Concern about the proposed changes was reflected by a substantial backbench Labour rebellion during the Commons' stage of the Bill.

David Hinchliffe, Labour Chair of the Health Select Committee and the Liberal Democrat Health Team tabled an amendment to the Bill which would have ensured that there continued to be a community-led, independent NHS Watchdog at local health economy level called a "Patientsí Council". The amendment was supported by a range of organisations including the Association of Community Health Councils for England and Wales (ACHCEW), the National Pensioners' Convention, Action for Victims of Medical Accidents (AVMA), Age Concern, the Consumersí Association and the Patients Association. The rebellion by Labour MPs, including 4 former Ministers and the support of the Conservative Party resulted in the government's majority being reduced to only 74.

The NHS Reform and Health Care Professions Bill as it enters the Lords

Despite several welcome government amendments to the Bill, ACHCEW believes that the Bill remains fundamentally flawed. The key concerns are:



Limited remit and independence of the new bodies


Cost and administrative efficiency of the new bodies


Proposed improvements to the Bill

ACHCEW remains firmly of the opinion that the retention and reform of CHCs would be the preferable option. However ACHCEW has worked hard, in conjunction with politicians of all parties, to develop a number of amendments that would improve the Bill whilst remaining consistent with the framework set out by the government. These amendments will focus on a number of key areas:


If CHCs were abolished as the Bill proposes it would leave England as the only part of the UK without a robust network of local NHS Watchdogs. The Scottish Parliament and the Welsh Assembly have both signalled their intention to continue with a CHC, or equivalent, model.

Parliament is being asked to abolish a known quantity, CHCs, without sufficient detail about how the alternative structures will work in practice. Although it has been suggested that this detail will be dealt with by future regulations and guidance, we believe that if patients are to have a robust system of involvement and representation it must be established by statute. This will ensure that its independence is not compromised by the threat of changes in regulation and will guarantee that any future changes in this crucial area of public concern are subject to parliamentary scrutiny.

The Bill in its current form remains fundamentally flawed and the subject of much controversy. If amended to reflect the concerns outlined in this briefing paper, the result would be a much-improved Bill which could command a broad consensus and the confidence and trust of patients and the public.



January 2002