I beg to move amendment No. 203, in

clause 8, page 6, line 34, at end insert—

'(ca) a Special Health Authority, so far as exercising functions in relation to England, designated by order made by the Secretary of State for the purposes of this section;'.

With this it will be convenient to discuss the following:

Amendment No. 27, in

clause 8, page 6, line 35, at end insert

'and its practitioners, and other health related bodies or individuals that provide services on their behalf.'.

Amendment No. 28, in

clause 8, page 6, line 37, at end insert

'and its practitioners, and other health related bodies or individuals that provide services on their behalf.'.

Amendment No. 29, in

clause 8, page 6, line 38, at end insert

'and its practitioners, and other health related bodies or individuals that provide services on their behalf.'.

Amendment No. 32, in

clause 8, page 7, line 4, leave out from 'children' to end of line 7.

Government amendment No. 208.

Government amendment No. 203 and the technical amendment associated with it—amendment No. 208—include special health authorities in the Bill. When we first drafted the Bill, we excluded those authorities, in error, because we did not envisage their having a role in supporting children. However, it then occurred to us that NHS Direct is a special health authority and might have an important role in supporting children. We tabled the amendment to include special health authorities in the Bill, so that NHS Direct could be included, but we have not named NHS Direct explicitly, because a future Government might envisage the creation of new special health authorities that would equally have a role. If the Opposition are foolish enough to insist on the other amendments grouped with Government amendment No. 203, I shall discuss those later in the debate.

I am alarmed that the Minister appears to be prejudging the foolishness of what I am about to say. That is unjust and uncharitable of him.

Our amendments are probing; their aim is to achieve greater clarity in the Bill. As it stands, the set of bodies for which the duty to safeguard and promote welfare exists is very general. Amendments Nos. 27 to 29 would add the word ''practitioners'' after the various health bodies that are mentioned: a primary care trust in subsection 1(d), an NHS trust in subsection 1(e) and an NHS foundation trust in subsection 1(f).

How do the provisions of the Bill include private practitioners? Do they include a private physiotherapist or any other allied professionals who may be working part-time privately or part-time contracted to a primary care trust? How does it affect people who are working entirely in the independent sector?

Health care in this country is becoming increasingly fragmented. I make no criticism of that—it is the way it is going—but as the clause stands, we are talking only about a primary care trust. By its narrowest definition, one might take it to mean purely the directors of a primary care trust, the NHS trust to which it may be responsible and the NHS foundation trusts. Would a single-handed physiotherapist who did some contracted work for a hospital department but had a private practice, or an osteopath with a mainly private practice, be included under the Bill as having a duty to safeguard and promote the welfare of children?

I make no disparaging comments about privately practising osteopaths or physiotherapists, but they are just as likely to come into contact with young people, and cases of child abuse or neglect may come to light as a result of contact with those professionals. Amendments Nos. 27 to 29 are designed to ensure that all practitioners are involved, regardless of whether they are directly part of a hospital trust, directly employed by a primary care trust, occasionally work for it, or look after patients who come under a primary care trust but do so on an entirely private basis.

Amendment No. 32 would delete subsection (2)(b). We wanted to replace it with another subsection that we discussed earlier. We will not push that amendment but we seek clarification on amendments Nos. 27 to 29 which are probing amendments to ensure that everyone is included in the scope of the Bill, as we all intend.

I can give the hon. Gentleman the assurances that he seeks. Subsection (2)(b) states that it must be ensure that

''any services provided by another person pursuant to arrangements made by the person or body in the discharge of their functions are provided having regard to that need.''

In other words, anybody who is contracted or employed under an arrangement by, for example, a PCT to deliver services is explicitly brought within the ambit of the Bill and will have a duty to co-operate in the interests of children.

When I read that originally I had assumed that it included national health service trusts because they provide services pursuant to

arrangements made by a primary care trust. Is there not some duplication? The Minister criticises my hon. Friend for duplicating but has he not done so himself?

I do not believe that the hon. Gentleman's concerns are legitimate. The principle is clear. We have established a number of partners who we believe have a duty to safeguard and maintain the well-being of children. We have not been explicit in stating all the partners that those people may employ to fulfil this duty because the duty is on the person who is organising the service. For example, the reason we included primary care trusts rather than individual GPs is that PCTs may decide to discharge their duties in respect of the Bill in several ways by commissioning services from a variety of people. It is important that those responsible for commissioning the services are in the Bill; anyone whom they might use to discharge their duties and responsibilities under this and other Bills is therefore automatically included.

I am following carefully what the Under-Secretary has said. Can he give us some examples of the people he envisages will be employed by PCTs to discharge the duties on their behalf?

Certainly. PCTs might use nurse practitioners, rather than general practitioners, for some functions, which would be a legitimate choice for them. They might even choose to commission services from private providers under the terms of agreements that the health service is pursuing to increase the range of capacity and improve services in local areas. If they are contracting with anybody, they are ultimately brought within the ambit of the Bill, because the duty is on the PCTs, the commissioners of services, to discharge the duties that the Bill gives them.

When a PCT is dealing with the parties that the Under-Secretary described, will it be responsible for informing them that they are discharging their duties under the Children Bill?

Absolutely. It is the responsibility of anyone who commissions services to ensure that the people from whom they commission them understand all their duties, not just under this measure but under all legislation. In particular, so far as children and the national health service are concerned, it will be their duty to ensure that they understand best practice as set out in the national service framework, and that all those from whom they commission services work together to ensure that that framework is implemented in the local area.

I am still not clear where private practitioners come in, because a PCT is not, for example, commissioning the services of a private physiotherapist to whom a young person chooses to go. How does the Bill therefore cover that private physiotherapist?

The hon. Gentleman makes the good point that the Bill refers only to those services that are commissioned by the partners mentioned in the Bill. If a child uses services through any other route, whether from a private practitioner or from McDonald's, their duties will be set out in the wide range of children's welfare legislation. I undertake to reflect on the paragraph and consider whether it is necessary to include a duty on those people who are not commissioned by any of the partners to fulfil a function that is not already covered by legislation. My understanding is that their duties to safeguard the well-being of children will be protected elsewhere, but I shall have another think to ensure that we are not missing anything.

In answering my hon. Friend, the Under-Secretary did not deal with a PCT securing the services of a national health service trust, which is understandable, because it is covered by subsection (1)(e). However, I wonder whether subsection (1)(d) would cover an NHS trust in Wales, the services of which had been secured for a child resident in England. Is there a lacuna in the Under-Secretary's thinking in that respect?

No, I do not believe there is a lacuna, because the services commissioned by the PCT are covered in the Bill; it does not matter from where those services are commissioned. Whether they are commissioned from a trust in Wales or a private practitioner, as has been suggested, it is the duty of the primary care trust to ensure that the people providing the services understand their duties under both the Bill and the national service framework to ensure that children's well-being is protected. It might be worth our reflecting on the situation in which a child goes to a private practitioner completely outside the range of the services commissioned by the partners in the Bill, and I have undertaken to do that.

Amendment agreed to.

Before we proceed further on clause 8, there is a technical point that requires a meeting of the Programming Sub-Committee. There is no need for Members to leave the Room, but I will suspend the Committee for a few minutes.

Sitting suspended.

On resuming—

Ordered,

That the Order of the Committee of 12th October be amended, in paragraph 2, by leaving out the words ''clauses 2 to 14, schedule 2, clauses 15 to 34, schedule 3, clauses 35 to 41'' and inserting the words ''clauses 2 to 8, 10 to 14, schedule 2, clauses 15 to 34, schedule 3, clauses 35 and 36, 9 and 37 to 41''.—[Margaret Hodge.]

The Chairman: In effect, that means that we are putting clause 9 back so that it will be debated on Thursday after clause 36.