Part 12 of the National Health Service (Wales) Act 2006 (NHSWA 2006) makes provision about public involvement and scrutiny. Its provisions are summarised below. See also the page on 'complaints'.
Community Health Councils
Section 182 of NHSWA 2006 provides that the Community Health Councils (CHCs) established for Wales continue in existence. They were established by section 9 of the National Health Service Reorganisation Act 1973 and came into operation throughout England and Wales in 1974 to represent the interests of patients and the public in the NHS, independently and without bias. CHCs were abolished in England in 2003 but continue to operate in Wales. Please note, however, that the Welsh Government is proposing that this be changed [link to consultation].
Section 182(2) provides that the Welsh Ministers may make subordinate legislation, to provide for a change in a CHC’s name, vary its area, abolish a CHC, or establish a new CHC.
Section 182(3) requires the Welsh Ministers to ensure that the areas for which CHCs are established together comprise the whole of Wales.
Schedule 10 to NHSWA 2006 makes further provision about CHCs. It provides at paragraph 1 that each CHC must represent the interests in the health service of the public in its district, and perform such other functions as may be conferred on it by regulations
Paragraph 2 of Schedule 10 provides that the Welsh Ministers may make regulations about:
- the membership of CHCs,
- the proceedings of CHCs,
- the staff, premises and expenses of CHCs,
- the discharge of any function of a CHC by a committee of the CHC or a joint committee,
- the appointment, as members of a committee or joint committee, of persons who are not members of the CHCs,
- the consultation of CHCs by Local Health Boards (LHBs) and NHS Trusts with respect to such matters as may be prescribed,
- the consideration by CHCs of matters relating to the operation of the health service within their districts, and the giving of advice by CHCs to LHBs and NHS Trusts on such matters,
- the preparation and publication of reports by CHCs,
- matters to be included in any such report,
- the furnishing and publication by the LHBs and NHS Trusts of comments on reports of CHCs,
- the provision of information by CHCs to other persons,
- the provision by CHCs of independent advocacy services,
- the functions to be exercised by CHCs in addition to those exercisable otherwise than by virtue of Schedule 10.
Paragraph 4 provides that the Welsh Ministers may by regulations provide for the establishment of a body to advise CHCs with respect to the performance of their functions, to assist CHCs in the performance of their functions, and to perform such other functions as may be prescribed, and to provide for the membership, proceedings, staff, premises and expenses of that body.
The Welsh Ministers have made the Community Health Councils (Establishment, Transfer of Functions and Abolition) (Wales) Order 2010 in exercise of their powers under section 182 of, and Schedule 10 to, NHSWA 2006. The Order established six new CHCs, provided for the continued existence of the two CHCs operating in the Powys local authority area, and abolished seventeen CHCs.
The Community Health Councils (Constitution, Membership and Procedures) (Wales) Regulations 2010 (CHCR 2010) were made partly in exercise of the Welsh Ministers’ power under paragraphs 2 to 4 of Schedule 10 to NHSWA 2006. These Regulations set out the detailed functions of the CHCs and establish the CHC Board as a body to advise CHCs with respect to the performance of their functions, and to assist CHCs in the performance of their functions.
Part 2 of CHCR 2010 provides for the establishment and membership of the CHCs, including the term of office, the appointment of members by local authorities, voluntary organisations and the Welsh Ministers, appointment procedures, suspension, resignation and disqualification.
Part 3 makes provision about CHC proceedings, and Part 4 makes provision about how CHCs perform their functions. Under regulation 27(1), each LHB and NHS Trust in Wales is under a duty to involve a CHC in planning the provision of health services, the development and consideration of proposals for changes in the way those services are provided, and in decisions affecting the operation of those health services. It is a duty on each LHB and NHS Trust to consult a CHC at the inception and throughout any such planning, development or decision-making process in accordance with any directions issued by the Welsh Ministers. Regulation 27(3) further provides that where a relevant NHS body has under consideration any proposal for a substantial development of the health service in the district of a CHC, or for a substantial variation in the provision of the health service, it must consult that CHC at the inception and throughout any such consideration or variation process.
Regulation 27(7) provides that if a CHC is not satisfied that consultation by a LHB or NHS Trust has been adequate, it may report to the Welsh Ministers in writing, and the Welsh Ministers may require the relevant Welsh NHS body to carry out such consultation, or further consultation, with a CHC as they consider appropriate.
Finally, regulation 27(9) provides that where a CHC considers that a proposal by a LHB to change the way in which health services are being provided, or to make a substantial development, would not be in the interests of the health service in its district, the CHC may report to the Welsh Ministers in writing and the Welsh Ministers may make a final decision on the proposal and require the relevant LHB to take such action, or desist from taking such action, as the Welsh Ministers may direct.
Part 5 of CHC 2010 establishes the CHC Board and provides for its functions.
Public involvement and consultation
Section 183 of NHSWA 2006 provides that each LHB must make arrangements with a view to securing, as respects health services for which it is responsible, that persons to whom those services are being or may be provided are, directly or through representatives, involved in and consulted on:
- the planning of the provision of those services,
- the development and consideration of proposals for changes in the way those services are provided, and decisions to be made by the LHB affecting the operation of those services.
For the purposes of section 183, a LHB is responsible for health services if it provides or will provide those services to individuals, or if another person provides, or will provide, those services to individuals:
- at the LHB’s direction,
- on its behalf, or
- in accordance with an agreement or arrangements made by the LHB with that other person.
Overview and scrutiny committees
Sections 184 and 185 of NHSWA 2006 confer power on the Welsh Ministers to make regulations to provide for local authority overview and scrutiny committees in Wales (or joint committees for the areas of two or more local authorities) to have a scrutiny role in relation to NHS matters in Wales.
No relevant regulations are in force in Wales in relation to this.