The House of Lords voted against a proposal to insert a new first clause to the Bill setting out the principles of the health service.
Amendments concerning the responsibilities of the Secretary of State for Health towards the NHS were also discussed.
Discussion also covered clause 1 of the Bill – the duty of the Secretary of State for Health to promote a comprehensive health service. Committee stage is due to continue on Wednesday 2 November.
Baroness Thornton moved Amendment 1, which sought to set out in law principles for the health service in England, including making patient care a primary concern that ‘shall not be compromised’ by organisational and commercial considerations.
Moving the amendment, Baroness Thornton explained: ‘This first amendment kicks off Committee stage and concerns the principles that ought to underpin the health service in England. The amendment stresses the rights and pledges, values and principles, as outlined in the NHS constitution produced by Labour when in government. The amendment also places protection and promotion of patient care above structural or financial reorganisation. It calls for transparency and openness in decision-making, especially those decisions on funding, to ground proper accountability at the heart of our National Health Service. It seeks to set a framework around which the debate on the rest of the Bill can follow.’
Lord Rea, a former lecturer at St Thomas’ Hospital Medical School and GP, and member of the National Heart Forum, who moved an amendment at second reading seeking to halt the Bill, and Lord Owen, physician and Parliamentary Under-Secretary for Health (1974-76) and Lord Hennessy of Nympsfield, contemporary British historian, who moved an amendment at second reading seeking to send the Bill for extra scrutiny, spoke in support of the amendment.
Other Members of the Lords who took part in the discussion of Amendment 1 included:
Baroness Williams of Crosby, Professor Emeritus of Elective Politics at the John F Kennedy School of Government, Harvard University; Baroness Murphy, former chair of City and Hackney Community Services NHS Trust, East London and City and North East London Strategic Health Authorities and St George’s Hospital Medical School; Baroness Jolly, non-executive director, Mental Health and Learning Disability NHS Trust (1997), former chair, North and East Cornwall NHS Primary Care Trust, former lay member, Commission for Health Improvement; Lord Mawhinney, Minister of State, Department of Health (1992-94), lecturer at the Royal Free Hospital School of Medicine (1970–84); Baroness Finlay of Llandaff, physician, Professor of Palliative Medicine at Cardiff University, chair of the Palliative Care Strategy Implementation Board for Wales, member of the End of Life Care Strategy Board, Department of Health (2007-09); Lord Ribeiro, President of the Royal College of Surgeons (2005-08); Lord Alderdice, former consultant psychiatrist; and Lord Newton of Braintree (Conservative), Under-Secretary of State 1982-83, Minister of State 1983-86 and Minister for Health 1986-88 at the Department of Health and Social Security.
Seeking to test the opinion of the House, Baroness Thorton said: ‘It is not about changing the NHS Constitution. We are seeking to put some of the principles of the constitution in the Bill. We think that that is a perfectly proper thing to do.’
The amendment was defeated by 212 votes to 244.
The Health and Social Care Bill, which aims to modernise the NHS:
- changes how NHS care is commissioned through the greater involvement of clinicians and a new NHS Commissioning Board
- introduces new mechanisms to improve accountability
- empowers patients to increase their voice and involvement in their care
- gives NHS providers new freedoms to improve quality of care
- establishes a provider regulator to promote efficiency.
In addition, the Bill will underpin the creation of Public Health England – a new integrated national public health organisation that will support the provision of local services, and take forward measures to reform health public bodies.
Two of the largest House of Lords votes for over a decade took place during the second reading – debate on the principles of the Bill, which took place over two days with 102 Members of the Lords taking part – on 12 and 13 October.
Detailed line by line examination of the separate parts (clauses and schedules) of the Bill takes place during committee stage. Any Member of the Lords can table amendments to make changes to the Bill.
Amendments can allow the House of Lords to make revisions to Government Bills (plans for laws). Members of the Lords, often with specialist knowledge or experience of the subject, submit amendments to explore possible effects of the planned law and the policy that lies behind it.
Members of the public can attend House of Lords debates and follow proceedings from the public gallery.