Group 9 is the next group of amendments, and that relates to members of the citizen voice body. Amendment 5 is the main amendment in the group, and I call on the Minister to move and speak to the lead amendment, and to speak to the other amendments in the group. Vaughan Gething.

Amendment 5 (Vaughan Gething) moved.

Thank you. I'll speak first to the Government amendments that I move, and then turn to consider the other amendments that have been listed in this group. 

The Bill as introduced did not include provisions for the chief executive of the citizen voice body to be a board member. That was questioned during the scrutiny process by the board of CHCs, and I'm grateful to them for raising the matter. As the chief executive of the body will be its accounting officer, it is appropriate that the chief executive should be a member of the board. So, I'm therefore pleased to move this group of amendments that make the chief executive a board member and make consequential changes to reflect the fact that the board will now have a combination of one chief executive and six to eight non-executive members, plus a chair and deputy chair.

The Government amendments also make provision for the non-executive members of the body to invite any unions it has recognised to nominate an eligible candidate for appointment as the body's trade union associate member. A candidate is eligible for appointment if he or she is: a member of staff of the citizen voice body and a member of a trade union recognised by the body. Their role will be to provide advice to the board to ensure that workforce experience informs board discussion, activity and action. The aim is to strengthen the board connection with staff and improve the governance and service delivery of the body. The trade union member will have an advisory role, as opposed to a voting role. These are amendments that will strengthen the board leadership and governance and I ask Members to accept them.

I'll now deal with the non-Government amendments. The amendments keep the original membership structure set out in the Bill, but give the National Assembly for Wales the function of appointing the board of the body and performing functions such as approval of terms and conditions of the body's staff. I have made my position on appointment by the Assembly clear during Stages 1 and 2. The Welsh Ministers' appointment of the board members will be subject to the rules of the Commissioner for Public Appointments. That guarantees fair and open competition for the posts. I have already indicated that I am more than happy to include a stakeholder stage in the appointments process. In addition, as Members should be aware, the relevant National Assembly for Wales subject committee carries out pre-appointment scrutiny for certain chair appointments. I've already agreed that the appointment of the chair of the citizen voice body will be subject to that additional level of scrutiny by Members in this place.

The community health councils themselves said in their evidence that the new arrangement was significantly more independent than the current CHC model, and we should not lose sight of this. In the opening comments that were made, it was said that this was about taking away the independence of CHCs. For from it: it significantly strengthens their independence. As Members may be aware, there are numerous examples of bodies whose boards are appointed by Welsh Ministers, for example, Social Care Wales and Qualifications Wales. As everyone will know, the fact the Welsh Ministers appoint people to the boards of public bodies does not prevent those bodies from questioning or criticising the Government when they believe it is right to do so. The experience shows that ministerial appointment does not in any way stifle the voice of the body or inhibit its actions.

The Bill requires the body to lay a copy of its annual report before the National Assembly for Wales, which, of course, will soon be known by a different name. This was included precisely so that the annual report would be brought to the attention of Assembly Members. The Assembly will therefore have every opportunity to scrutinise the work of the body, and I fully expect the Assembly to debate the contents of the report. Therefore, I won't be supporting the non-Government amendments in this group.

Angela Burns to respond.

Thank you, Presiding Officer. What a surprise. I mean, let's be honest, we've now come to the heart of this bit of legislation in terms of the citizen voice body. Our current community health councils are extraordinary organisations. Some of them are absolutely outstanding in the work that they do. Some of them have gone out there and uncovered real problems, brought them to light, had them addressed, and sorted them out.

So, this next slew of amendments that run—where are we? I think we're on group 9—through to almost 20 are all about the citizen voice body: how it's going to operate; how it's going to be perceived by the public. And I want to remind you, before we get into the detail of these amendments, that the citizen voice body is for the people. And in the parliamentary review—which the Minister likes to remind us on an often basis we all collegiately said we would have a look at and sign up to—it was really crystal clear that, going forward, our health service would really involve people in the provision of the health service. That they would shape it; that they would help to decide the direction of travel; that they would have input; and that, going forward, their voices would really be heard.

So, how do you hear their voice? Do you hear their voice through a chief executive of a health board? I don't think so, not really. Do you hear their voice through Assembly Members who come here and raise individual cases? Yes, for sure, we all do it. We all do it for all of our constituents, wherever we are. Do you hear it through any other organisations? Not a lot. Occasionally, you get some of the professional colleges getting involved in a particular issue. You mainly hear it through the citizen voice body, or what will become the citizen voice body.

So, we've brought these amendments—amendments 48, 54 and 56—back before you again; we tabled them at Stage 2. Because it's not just the reality of independence we need to see here, but we have to affirm the public's perception of independence. I said this at Stage 2, and I'm going to say it again and remind the Minister, and it was a comment by the ombudsman who, actually, I have come to really respect for the work that he does for the people of Wales in that role as ombudsman, he said that without independence,

'there will be this perception that it's perhaps poodle-like for some; they won't have the teeth.'

And I couldn't agree more. I'm disappointed, Minister, that you've re-tabled your amendments for Stage 2—now numbered 5, 12 and 14. It was noted at Stage 2 that there isn't much to say that the public appointments process would be more suitable for the body's independence. Rather, using the Assembly as a way of guaranteeing independent members who'd be able to challenge the Minister and health boards without fear of recrimination or loss of office.

I asked the Minister several questions on independence at Stage 2, which I don't think have been sufficiently answered by the public appointments process, and especially when, here in Wales, we have a very small pool of people to choose from; people who are very often connected in other non-governmental organisation, third sector or governmental roles. You know, it's not something to be embarrassed about; it's a fact of life, we have to face it and make sure that we put the right processes in place to make sure that the citizen voice body has, as a chair, a totally independent person.

So, Minister, I note that you claim your approach offers safeguards, but I just don't believe it, and I would ask Members to seriously think about this. This is the voice of the citizen. This is their one and only place where they can really hold us, the health boards, the Minister, the whole of the NHS, to account. We must let them be independent. Please pass these amendments 48, 54 and 56.

These are very important amendments. We will be voting against the Government amendments, because that is necessary in order to have a vote on the other amendments in the group. Our view on this has been consistent throughout the discussion of this legislation. We believe quite simply that the citizen voice body should be appointed by the National Assembly for Wales and not by Welsh Ministers. The board, in reality, replaces the CHCs, and in that regard, it will play a key role in scrutinising the NHS and it is to be the patient's voice.

However you want to spin it, there will always be a perceived conflict of interest when the body that is most needed to stand up for the patients—in other words, be critical, where necessary, of the running of the service—is directly appointed by the Minister. This is one of the other key reasons why we cannot support this Bill. We know, at least in parts of Wales, the community health council has been prepared to stand up for patients and be critical of the service. Look at the work being done by the CHC in the north currently in relation to decisions taken on vascular. We remain extremely concerned that the consequence of this Bill will be to remove a vitally important layer of scrutiny within our health and care system.

While I cannot support the lead amendment in this group, I have some sympathy with what the Minister is seeking to do. However, I believe that this place, not Welsh Ministers, is best placed to appoint members to the citizen voice body. I therefore choose to support Angela's amendments.

The citizen voice body is one of the most important parts of this legislation. I never supported replacing the community health councils, but we are where we are. It is vital that this legislation results in a body that is a true champion of patients in health and social care. I do not believe that giving Ministers the ability to hire and fire sits right with the fact that the citizen voice body will need to challenge ministerial decisions as much as those by health and social care bodies, and therefore conclude that this is a conflict of interest. An independent patient's voice body needs to be free from any perceived or actual interference from Government. That includes hiring and firing, and I therefore reject amendments 5, 7, 8, 9 and 10. We will, however, be supporting the majority of the other amendments in this group. Diolch yn fawr.

The Minister to reply to the debate—Vaughan Gething.

I thank Members for their comments and I recognise that we may rehearse a number of points in the next groups of amendments.

I want to return directly to the points made about the independence or otherwise of the citizen voice body, as opposed to the current community health councils. Hearing the phrase, 'however you spin it, you can't have a body having its independence questioned', well, actually, if we look at the current group of community health councils that are being lionised by Members in this Chamber for their independence, it is worth us reflecting on the fact that they are a hosted body by Powys health board. The staff of community health councils are employees of Powys health board. We are creating a separate body where the leadership will be appointed through a public appointments process overseen by the Commissioner for Public Appointments. That is significantly more independent than the current process. Now, people may disagree with that, but to try and suggest that this somehow introduces an extra element of Government control just doesn't hold water from a logical point of view, and if you think about our current public appointments process, think about our commissioners, appointed by the Government. Well, I have never thought that any of the commissioners we have, whether the children's commissioner, the older person's commissioner or the future generations commissioner, ever felt restrained in the comments they wanted to make about the Government in public or private, and I can tell you that from a fairly long experience of dealing with people who've held all of those roles. I'm happy to take an intervention when I complete—

I'd just like to make the point that the Welsh Conservatives have argued for a very long time that all of our commissioners should be appointed by the National Assembly for Wales.

We're talking here about what happens when people argue about the appointments process at the start, and then the reality of it. Every one of those people who've held those commissioner roles have not felt constrained in their independence.

There is a case to be made, and you make it strongly, but commissioners and organisations like the new citizen voice body are there on scrutiny and accountability—naturally, the legislative side, because that's our role as well as legislating, to hold the executive to account. What you are doing by having, nominally, these appointments, is putting them firmly on the executive side, at least in their formal set-up, even if that isn't their working practice, and that really isn't elegant. We should respect the division of powers and have a better structure than the one you're proposing.

There's a fairly straightforward disagreement about whether the Assembly or, indeed, the Government should be the ultimate appointer of these people, but I don't accept that the practice of the way that we have run public appointments through Wales in the last 20 years, or indeed a range of posts, actually holds water for the argument that this would somehow undermine the independence of people in those roles. I'll take an intervention and then I'll complete.

Just to remind you of the words that I used in my contribution—however these bodies or individuals or commissioners act, I said that there is a clear perception of a conflict of interest, and that, too, is very important when we're trying to build trust with the electorate.

I think this is quite an extraordinary point. You say that there's a conflict of interest for new arrangements and an entirely separate body, but you're prepared to fight for a current position where those people are employees of the national health service. That, to me, is not a position that holds any kind of logical argument to it at all. I recognise that we don't agree in terms of the Government and opposition parties. I would ask Members to support the Government in the new process that we've introduced and to reflect the fact that the current community health council movement themselves recognise that there is significantly more independence and freedom of discretion in the Bill, as we provided in the amendments before you that I ask you to support today. 

We’ll vote, therefore, on amendment 5. If amendment 5 is agreed, amendment 48 falls. If amendment 5 is not agreed, amendment 14 falls. The question is that amendment 5 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 5. Open the vote. Close the vote. In favour 28, no abstentions, 22 against. Therefore amendment 5 is agreed and amendment 48 falls.

Amendment 5: For: 28, Against: 22, Abstain: 0

Amendment has been agreed

Amendment 48 fell.

Amendment 6 is the next amendment, which is to be moved by the Minister.

Formally being moved? 

Amendment 6 (Vaughan Gething) moved.

Yes. 

Yes, it is. 

The question is that amendment 6 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 65. Open the vote. Close the vote. In favour 38, no abstentions, 12 against. Therefore, amendment 6 is agreed.

Amendment 6: For: 38, Against: 12, Abstain: 0

Amendment has been agreed

Amendment 7 is the next amendment. Minister.

Amendment 7 (Vaughan Gething) moved.

Formally. 

The question is that amendment 7 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 7. Open the vote. Close the vote. In favour 34, five abstentions, 11 against. Therefore, amendment 7 is agreed.

Amendment 7: For: 34, Against: 11, Abstain: 5

Amendment has been agreed

Amendment 8, Minister. 

Amendment 8 (Vaughan Gething) moved.

Moved. 

If amendment 8 is agreed, amendment 49 falls. The question is that amendment 8 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 8. Open the vote. Close the vote. In favour 28, no abstentions, 22 against. Therefore, amendment 8 is agreed to and amendment 49 falls.

Amendment 8: For: 28, Against: 22, Abstain: 0

Amendment has been agreed

Amendment 49 fell.

Amendment 9, Minister. 

Amendment 9 (Vaughan Gething) moved.

Move. 

If amendment 9 is agreed, amendments 50, 51 and 52 will fall. The question is that amendment 9 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 9. Open the vote. Close the vote. In favour 28, no abstentions, 22 against. Therefore amendment 9 is agreed and therefore amendments 50, 51 and 52 fall.

Amendment 9: For: 28, Against: 22, Abstain: 0

Amendment has been agreed

Amendments 50, 51 and 52 fell.

We therefore move to amendment 10 in the name of the Minister.

Amendment 10 (Vaughan Gething) moved.

Formally. 

If amendment 10 is agreed, amendment 53 falls. The question is that amendment 10 be agreed to. Does any Member object? [Objection.] Open the vote on amendment 10. Close the vote. In favour 27, no abstentions, 21 against. Therefore, amendment 10 is agreed. Amendment 53 falls.

Amendment 10: For: 27, Against: 21, Abstain: 0

Amendment has been agreed

Amendment 53 fell.

Therefore, we move to amendment 11, Minister.

Amendment 11 (Vaughan Gething) moved.

Moved. 

The question is that amendment 11 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 11. Open the vote. Close the vote. In favour 38, one abstention, 11 against. Therefore, amendment 11 is agreed.

Amendment 11: For: 38, Against: 11, Abstain: 1

Amendment has been agreed

Amendment 12, Minister. 

Amendment 12 (Vaughan Gething) moved.

Formally. 

The question is that amendment 12 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 12. Open the vote. Close the vote. In favour 38, one abstention, 11 against. Therefore amendment 12 is agreed.

Amendment 12: For: 38, Against: 11, Abstain: 1

Amendment has been agreed

Amendment 54, Angela Burns. 

Amendment 54 (Angela Burns, supported by Caroline Jones) moved.

Formally, Llywydd. 

The question is that amendment 54 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 54 in the name of Angela Burns. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, the amendment is not agreed.  

Amendment 54: For: 22, Against: 28, Abstain: 0

Amendment has been rejected

Amendment 56, Angela Burns. 

Amendment 56 (Angela Burns, supported by Caroline Jones) moved.

Formally, Llywydd. 

The question is that amendment 56 be agreed. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 56 in the name of Angela Burns. Open the vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, the amendment is not agreed. 

Amendment 56: For: 21, Against: 29, Abstain: 0

Amendment has been rejected