Health (Wales) bill
27th November 2002
Dr. Hywel Francis (Aberavon): I warmly welcome the Bill for several reasons, not least because it makes a major contribution to Welsh constitutional history, Welsh social history and—dare I say it?—Welsh socialist history. Most important of all, it makes a contribution to the future and well-being of the Welsh people. As a fervent campaigner for democratic devolution in Wales, I am proud to say that this is the first Wales-only Bill that has undergone pre-legislative scrutiny by the National Assembly for Wales and by this House, and as a member of the Welsh Affairs Committee, I am very proud to have participated in that process. What better first Wales-only Bill could there be than one that addresses the quality of life of our people and the health of our nation? It is also constitutionally important because it shows the benefits for Wales of the devolved and central Administrations working in partnership rather than engaging in confrontation and conflict.
The Bill is also important because it is the logical consequence of recent social history in Wales. The retention, democratising and strengthening of Welsh community health councils is the logical conclusion of our own recent struggles, particularly in relation to democracy and advocacy. We all know that the national health service was modelled on the democratic, socialist and grass-roots principles of the Tredegar Medical Aid Society by the founder of the NHS, Aneurin Bevan, rooted as it was in all the struggles of all the valleys of south Wales and, indeed, the whole of Wales.More recently, that advocacy and those democratic principles have been carried forward by such pioneers as the late Dr. Alistair Wilson and his Cynon valley patients committees and by Dr. Julian Tudor Hart of Glyncorrwg in my constituency. Dr. Hart's document "Going for Gold" inspired so much of the thinking behind the Welsh Office document "Better Health, Better Wales", which, like Dr. Hart's publication, addressed improving primary health care, democratising the health service and giving patients a voice.
It is a tribute to the Welsh Assembly Government's Minister for Health and Social Services, Jane Hutt, her deputy, Dr. Brian Gibbons, who was at one time a partner of Dr. Julian Tudor Hart, and my hon. Friend the Under-Secretary that the Bill, which has a consensual and sensible nature, has progressed with wide public support. It addresses the central questions of NHS reform, not only in Wales but more widely. I refer in particular to the nature of local democratic accountability and ensuring that we move from what Dr. Julian Tudor Hart once described as a "body repair service" and a "national disease service" to a genuinely democratic and effective NHS for the 21st century.
I commend two aspects of the Bill, the first of which is the continuation and strengthening of the community health councils in Wales. That welcome development is very much in the social justice tradition of Wales, and it is thoroughly appropriate that the CHCs have a strong democratic element that is achieved through local authority and other representation. That is a major local democratic reaffirmation and a return to the best values of the Tredegar Medical Aid Society and other similar voluntary health organisations of the past.
The CHCs will have a significant additional advocacy role in the complaints process. We do not need a confrontational complaints procedure. The new complaints system can also provide useful feedback to service providers. We know to our cost how stressful some of those procedures can be. For example, a Gower doctor tragically committed suicide after a complaint was lodged against him last year.
When matters proceed to a formal complaints stage, patients need assistance through a complex and difficult process that they might go through only once in their lives. I welcome the fact that CHCs will be able to have a remit on nursing and residential homes. May I make a final observation on CHCs? The public do not find that name easy to establish in their thinking as that of an NHS watchdog. No doubt the Welsh Assembly Government will address that matter through their own local consultation processes.
The second aspect that I wish to address is the creation of the Wales Centre for Health, which will promote well-informed public health policies across Wales and from which I am sure the whole UK will benefit. Of course, we need good, reactive health services, particularly for those parts of the UK that suffer disproportionately from serious ill health, such as the south Wales valleys and certain parts of rural Wales. However, we also need informed public health policies that take on board the wider agenda of identifying the causes and determinants of good and bad health, so that people can live healthier lives in the first place.
The A.J. Cronin novel "The Citadel", which is based on a south Wales mining valley, has already been mentioned. Its hero performed an extreme act in taking a public health initiative and blowing up a defective sewer system. A more benign and peaceful, but nevertheless powerful purpose of the new centre is to provide independent public health information to community health groups that are concerned about the health implications of public policy. We have noticed in recent times, for example, the deep concern at Nantygwyddon Tip in the Rhondda and Crymlyn Burrows in my constituency.
I understand that the Welsh Health Minister has pledged that the CHCs will have a statutory right to consult on major local changes in NHS provision and that she will address that matter in regulations. I believe that she is correct in doing that, as those issues should be addressed by the devolved Administration.
The health service is entering a bright new era in Wales. Next Saturday, I shall visit a new hospital in my constituency at Baglan Moors and I am reliably informed that my first visit may coincide with the birth of the first baby at the hospital—Labour delivering once again for Wales.
The two developments within the Bill—the strengthened, democratised CHCs and the new Wales Centre for Health—encapsulate democratic devolution in practice. They are policies made in Wales in partnership with Welsh representatives here in the House. I hope that we have been true to the needs and aspirations of the Welsh people in our deliberations. The representative and advocatory nature of the CHCs and the WCH is very much in accordance with the spirit and aspirations of the Welsh founder of the national health service, Aneurin Bevan.
I end with Aneurin Bevan's prophetic words, quoted in Dai Smith's admirable book, "Aneurin Bevan and the World of South Wales":
"The first function of a political leader is advocacy. It is he who must make articulate the wants, the frustration and the aspiration of the masses. Their hearts must be moved by his words, and so his words must be attuned to their realities . . . A representative person is one who will act in a given situation in much the same way as those he represents would act in that same situation. In short, he must be of their kind ... Thus a political party which begins to pick its personnel from unrepresentative types is in for trouble. Confidence declines."
I believe that that applies equally to public bodies, and for that reason the Bill enhances confidence. That is why I commend it to the House.
