Reform of Community Health Councils in Wales

Members will know that we decided some time ago to retain the 20 Community Health Councils in Wales and to strengthen their functions and standing as independent bodies.  CHC staff and members are committed to representing patients and we are grateful for their service.  It has long been accepted however, that with development, CHCs have the potential to become even more effective on behalf of patients.  This is why we decided to pursue additional powers through the Health (Wales) Bill, which received Royal Assent in April 2003.  

This Act passed through Parliament unamended – a great achievement and testament to the successful working relationship between the Assembly and the Wales Office.  It was also one of the first Wales-only Bills to undergo thorough pre-legislative scrutiny, which gave a wide range of stakeholders, the opportunity to comment on the Bill in draft.  

The Act gives the Assembly powers to make regulations on CHCs’ functions.  I will shortly be presenting for public consultation a new set of regulations, to come into force towards the end of the year, designed to enable CHCs to carry out their strengthened functions and providing a comprehensive framework for CHCs in the future.

The major changes include the provision of an independent complaints advocacy service across Wales, working to common standards, and entry into primary care premises and other places where NHS care is provided.  The Act also allows for the setting up of a statutory all-Wales body to support and advise CHCs in their roles, and for the name of CHCs to be changed, if it is decided that would be beneficial for patients and users.  The other major change is that the Act allows the Assembly to make regulations about CHC membership.  Other issues to be set out in Regulations include arrangements for proceedings and meetings; the appointment of officers; reports; the performance of functions including consultation of CHCs by health bodies, and information to be given to CHCs.

Complaints advocacy

The regulations will set out a new statutory function for complaints advocacy.  On 12th June I launched the CHC complaints advocacy service which will provide help and support to people who wish to make a complaint against the NHS.  Many CHCs have over the past years provided support of this kind for people.  In order to ensure a consistency of service across Wales, national standards for complaints advocacy service delivery have been developed, which are similar to those developed for advocacy services for children and young people in Wales.

Entry and inspection

The regulations will also set out enhanced rights of entry and inspection for CHCs which will, for the first time, be given the right to enter premises where family health services are provided.  This will include doctors’ and dentists’ surgeries and private nursing homes where NHS care is being provided.  This is an important new power, which means that CHCs can now, in the interests of patients, visit anywhere that NHS care is provided.   If a situation arose where a Welsh CHC wished to inspect facilities in England used by Welsh patients, then it would be able to do so. Patients’ Forums would have reciprocal powers to do the same in respect of premises in Wales used by patients resident in England. In practice, it would be likely that the CHC would liaise with its English counterpart to arrange for such an inspection.

Membership

We will also make provisions for improvements to CHC membership.  The regulations will set out a reduced proportion of members nominated by the local government and voluntary sectors, and an increased number of members drawn from open advertisement arrangements. Many local authority and voluntary group members play an important role in their CHCs and we need to build on this expertise and support . But we need to create new opportunities for other people, particularly those from under-represented groups, to serve on CHCs.  We are looking at ways to do this in accordance with the code of practice on public appointments, in order to ensure that the arrangements will be open and transparent.  I hope it will be possible to pilot some direct election arrangements in a small number of CHCs.  We will also provide the local government and voluntary sectors with consistent good practice guidance to aid them in their selection of candidates.  

All-Wales body

The regulations will also establish a new all-Wales body for CHCs in Wales, known as the Community Health Council Board.  This has already been set up in shadow form and is comprised of the CHCs themselves.  The Board will advise and assist CHCs in the performance of their functions, and its Director will provide a consistent level of individual support for CHC Chief Officers.   Through such a body, we can put mechanisms in place to make sure that CHCs are representing patients and the public in a consistent way across Wales, whilst preserving CHCs’ independence and ability to deal with local priorities as they see fit.  The new body will also be able, more effectively, to represent the patient’s perspective at an all-Wales level.

Change of name for CHCs

The regulations will not address the issue of a change of name, which has been discussed by CHCs at length.  The current feeling is that a change of name is not required, but this could be achieved through the making of an order at a later date, should this prove desirable.

I look forward to receiving comments from the forthcoming consultation and to returning to the Health and Social Services Committee and the Assembly in the autumn with a final set of regulations.  I firmly believe that CHCs’ new and strengthened functions and involvement with the new local health boards, will be the springboard for the full and active involvement of patients and the public in decision making at all levels.