Contribution
My Lords, I thank the Minister for setting out the purpose of these regulations. I reflect that in politics there are times when you have some difficult days, but there are also days when you feel it is worth while. I remember when we passed the Down Syndrome Act. I was a Health Minister at the time, and it was one of the most rewarding days I have had as a politician. The credit was not to me; it was to all the legislators who got involved, as well as the many charities, but it is at such times that you feel the work we do here is incredibly worth while.
As the Minister explained, these are technical measures, and we understand that they update references in the Down Syndrome Act 2022 to reflect the changes in the Health and Care Act. As the Minister said, this particularly concerns the establishment of ICBs, or integrated care boards, to replace the clinical commissioning groups. Clearly, the current wording is out of date. For that reason these are sensible regulations, and we are obviously happy to support them. We also welcome the Government’s commitment to help those with disabilities and learning disabilities, which the Minister outlined.
While the changes are technical, they take place against a backdrop of significant structural change. Only yesterday I was contacted by the Minister to discuss some of the changes that will happen when NHS England is abolished and where some of those responsibilities will lie—I understand that there will be a Bill before Parliament.
The Government have announced plans to abolish NHS England by April 2027, but there is as yet no clarity on when the required health Bill will be introduced—I hope we can get something on that—and how the statutory functions under the Down Syndrome Act will be transferred or continued. I completely appreciate that these are early days, but I wonder whether the Minister can answer now or in writing what input there has been and what the thinking is behind transferring some of these statutory functions when that restructure takes place. We would welcome some reassurance that the duties currently held by NHS England ICBs in relation to the Down Syndrome Act will be maintained until the future health Bill provides a new framework. I think that is obvious, but we need some sort of reassurance. We believe that people with Down syndrome and their families deserve that certainty and want to make sure that they are not disrupted by the organisational change.
We also note that the Explanatory Memorandum confirms that there is no statutory review clause for these regulations and, while the technical amendments themselves are straightforward, the absence of a formal review means that there is no mechanism to ensure that these provisions are revisited. I understand that the Minister said that they have come to a stage where they do not necessarily believe that further consultation is required, but I just wonder about some of the reviews. The absence of a formal review could mean that there is no mechanism to ensure that these provisions continue when they are revisited, such as when NHS England is abolished or when the ICBs’ responsibilities are altered. We want to ensure that the statutory duties continue and so we would welcome some clarification on that. Also, how do you monitor the continued effectiveness of statutory guidance and make any more adjustments if required?
Finally, we note that the consultation is ongoing and welcome the fact that the Government have continued to engage with stakeholders throughout this period, ensuring that the guidance remains practical and responsive. I understand that it might be felt that there is no need for any further consultation because all views have been heard, but I think that would give some reassurance in case there are views that need to be heard and have not been. We may say with certainty that there are no more views, but we just do not know what will happen in the future. Also, both the Health and Care Act 2022 and the Down Syndrome Act mandated responsibilities for the ICBs but there is a difference between having responsibilities and ensuring that they are carrying out those responsibilities, and how we monitor that.
Aside from those questions, we support these regulations. We recognise their technical purpose and necessity. At the same time, we hope that the Government will provide reassurance regarding the transitional arrangements and the ongoing oversight of statutory functions so that the objectives of the Down Syndrome Act 2022 are fully realised for the people it is designed to support. We recognise that when the Act was passed it was only the first step to make more people in the system aware and make sure that they are aware of their statutory duties. I am not going to comment on the merits of the changes that are coming—some are positive and some will cause concerns—but we have to ensure that those statutory functions continue so that people with Down syndrome continue to be served in the way that the Act was originally intended. I look forward to the response from the Minister.