On 13th January 2022, during a debate on the Health & Care Bill, the Bishop of London spoke in support of an amendment to the Health & Care Bill that would allow for patients to be represented on Integrated Care Boards (ICBs):
The Lord Bishop of London: My Lords, I rose on the first day of this Committee to speak to the membership of NHS boards. I rise today for a similar reason: I think it is very difficult to stipulate the membership of boards, just as the noble Baroness has said. However, as I said with NHS boards, I say with ICB boards that I think the voice of the patient is central. Along with my role as the Government’s Chief Nursing Officer, I was director of patient experience while I was in the Department of Health. As a nurse at that time, I believed I had a patient focus. However, I learned that my default was always as a professional and that the patient needs a voice and empowerment. While I recognise the clinical voice and would always want it on the NHS board and the ICB board, it does not replace the voice of the patient and the carer.
I recognise that on the first day in Committee the Minister was not inclined to accept the amendment that related to patient and carer representatives on the board. If he is not inclined to accept Amendment 37H, can he explain to us how the voice of carers is threaded through this Bill to ensure we appropriately meet their needs? At the end of the day, if we give them a voice, they design the services better. In the long term, it saves money as well as giving them agency. I believe that if the voice the patient is threaded through this Bill, it would answer the concerns of the noble Baronesses, Lady Masham and Lady Hollins, and the noble Lord, Lord Bradley, by ensuring that it is focused, whether on the needs of those with learning disabilities or mental ill-health or other groups.
I recognise the difficulty of outlining and detailing names in the Bill, but I would be interested to know from the Minister how the voice of patients and empowering them and giving them agency is threaded through this Bill.
Extracts from the speeches that followed:
Lord Kamall (Con, Department of Health & Social Care): I turn to the point made by my noble friend Lord Hunt of Wirral about how provider input in the work of an ICB will be reconciled with assessing both the suitability and performance of providers. As my noble friend correctly noted, each ICB must make arrangements on managing the conflict of interest and potential conflicts of interest, such that they do not and do not appear to affect the integrity of the board’s decision-making processes. Furthermore, each appointee to the ICB is expected to act in the interests of the ICB. They are not delegates of their organisations, but are there to contribute their experience and expertise for the effective running of the ICB—a point made most eloquently by the noble Lord, Lord Mawson, my noble friend Lady Harding and the right reverend Prelate the Bishop of London. It is important that this is about expertise, not the trust or organisation that they are taken from, or their skills and knowledge, as the noble Lord, Lord Mawson, said.
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