I’m pleased to contribute to this debate because I do think that the community health councils do important work. I have spoken to both in my region, Hywel Dda and Powys, and part of Betsi is also within the region that I represent. I hope to express in this debate some sort of development on the community health councils, which builds upon the good things that they do: the ability to oversee, and the reliance on volunteers, which is both a strength and a weakness simultaneously in the current regime. But I also want to reflect on the fact that the community health councils have been in place since 1974 and haven’t developed a great deal since then. There are some very old-fashioned aspects to the way that they work. There has to be improvement and they have to be modernised.

I do want to focus on one thing specifically, which is a weakness in the Government’s paper at the moment, particularly in speaking to the residents of Powys—. There is no mention and no consideration given to the cross-border issues, with patients from Powys serviced in English hospitals, but can be overseen by the community health council in Powys. Therefore I want to ensure, and I hope that the Minister, in replying to the debate, can give an assurance, that the Government does wish to retain that patient voice in health services that are located in England but which provide services for patients from Wales.

As I discussed these issues with community health councils, I have seen a desire from them to develop, and they are developing an alternative model. They have responded to this consultation with their own ideas, and I very much hope that the Government will listen to them. There has been some discussion today on the basis that the consultation and the proposals of the consultation are to be implemented as they stand. I hope that this will be a true consultation and that the Government will listen to what the community health councils themselves have to say, because they do have an alternative model.

Now, placing health and social care together is something that is to be welcomed. Ensuring a patient voice is something that we should welcome. The question is: how do we achieve that?

First of all, any new pattern has to be entirely independent of Government—that is something that we should all stand firm on. And being independent does mean being independent in terms of structure, in terms of legal status, and in terms of appointments to the councils or to any new body that is established to replace them.

I don’t sense that the councils themselves are opposed to the concept of a national body. They haven’t told me that. What they have said is that what’s important is that the local voice and regional representation is maintained. So, there is a possibility here to have a national body that could merge some aspects, which may bring forward savings, if you like, in terms of bureaucracy, employment and staffing and so on, but also ensure that the community health councils’ structures are in place to reflect local needs and the local voice. Now, that’s not exactly what the Government is proposing, of course. That is some sort of compromise and a discussion that needs to happen. But I am open to listening to such ideas and to see what happens.

I do think, whatever does happen, it’s exceptionally important that local people have the right to go onto wards, to undertake visits where health and care is provided, and that that is strengthened, that there is sufficient support for laypeople to understand that situation, because I do think that it’s important that their status is enhanced when they visit wards or placements, and that they are treated with respect by professionals, and that support and training is available for them.

The final thing I want to say is that we must take this opportunity to enhance the membership of community health councils. Eluned says that she wasn’t aware of them and I accept her comments, of course, but I have been aware of them for some decades now, I have to be honest. Some of the people I was aware of 20 years ago are still on the local community health council, and I’m not quite sure if that is necessarily how these should develop in order to be entirely representative of the communities that they represent and representative of the people who now use our health and care services.