Posted by: Witch Doctor | October 12, 2011

HSCB: Perhaps all is not lost


They say that Baroness Shirley Williams abstained from voting for Lord David Owen’s amendment to send part of the Bill to be considered separately at a special select committee.

If true, it seems a bit odd.

Or is it?

Lord Owen’s amendment would have been an unusual procedure and some considered it would have had the effect of delaying the Bill to the extent it would have finished it entirely.

The Lords and Ladies of this land are much more measured and sedate than the raucous MPs residing in “the other place.” It is even possible that many of the members of the Upper House are truly honourable and they will not have approved of using an amendment to slow the progression of a Bill through parliament until it withered on the vine.

Is it just possible the Lords might still vote with their feet?

Here is an extract from Baroness William’s speech in the House of Lords yesterday.

“I turn now to the four big issues that confront us, and in doing so I pay tribute to the noble Lords, Lord Darzi and Lord Owen, and to others who pointed to them. The first was referred to by the noble Baroness, Lady Jay. It flows from the findings of the Constitution Committee, which has specifically raised concerns about the responsibility of the Secretary of State. At the beginning of his remarks, the noble Earl, Lord Howe, whose empathy and understanding is known throughout the House, spoke as if there might still be some meeting of minds on this crucial issue. But the letter he sent us all this morning appears to sound a little different. Why are we so concerned about this issue? It is because it remains ambiguous, unclear and obscure. Let me give one example. I think that I have been pursuing the issue of the accountability and responsibility of the Secretary of State for at least a year, and time and again I have gone back to the Department of Health and talked about the need to make it absolutely clear. Why is it not absolutely clear?

Those noble Lords who have a copy of the Bill need only look at Clause 4, which sets out a specific commitment to the autonomy of the bodies, the quangos -Monitor and, even more important, the NHS Commissioning Board-which now have responsibility for our health. The Secretary of State makes a specific pledge to the autonomy of those bodies in the phrase:
“In exercising functions in relation to the health service, the Secretary of State must, so far as is consistent with the interests of the health service, act with a view to securing … that any other person exercising functions in relation to the health service … that it considers most appropriate, and … that unnecessary burdens are not imposed on any such person”.

In legal language, “any such person” is very wide indeed. The autonomy clause indicates that only in the rarest circumstances would the Secretary of State interfere in that autonomy. So where would he interfere? The answer is that he would interfere if there was evidence of a significant failure. But my legal colleagues tell me that “significant failure” is a difficult bar to reach and that it is normally interpreted by the courts as meaning almost totally essential.

We all know about the danger of reactions to such things as necessary hospital closures, mergers and so on. But if the Secretary of State is unable to take any part in those until the failure becomes significant, heaven help us in making the changes that lie in front of us as effectively, cheaply and sensibly as we can. I wish very much that I could ask the Minister of State to tell the House at the conclusion of this debate that the ministry will now reconsider the autonomy clause in the light of the responsibilities of the Secretary of State. To put it simply, the expenditure of £128 billion of taxpayers’ money requires the presence of a Minister who is responsible and accountable for that huge sum.

She is concerned about the responsibilities of the Secretary of State for Health.

This came up time and time again during the debate and many are not convinced by the reassuring noises being made by Lord Howe and Andrew Lansley.

It was stated today by one of the peers and I think also by a bishop yesterday that the SOS’s responsibility to “provide” was a “foundation” element of the Bill, and that this should be considered first and foremost by all members of the house rather than have this issue hived off to a special committee that is not part of the normal procedure.

If Peers have voted against Lord Owen’s amendment on this basis then things may not be as bad as they seem. He did after all secure 262 votes. It is just possible that there are another 68 peers who might be against the Bill but want to deal with their concerns in a different way.

It may well be that pressure will be put on the SOS to change the wording back to the original “duty to provide” before further consideration of all other issues.

This witch hopes so, because it might convince her that there might be some democracy still around in the country after all, and that The Upper House retains an important role in preserving it.

The Witch Doctor – Link to a random page





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