This brings us to group 14, which relates to representations to public bodies by the citizen voice body. The lead amendment in this group is amendment 41, I call on Angela Burns to move the amendment and speak to the other amendments in the group. Angela Burns.

Amendment 41 (Angela Burns, supported by Caroline Jones) moved.

Thank you, Llywydd. I'd like to formally move amendments 41 and 42, tabled in my name. This issue was first raised, or amendment 42 was first raised, at Stage 2 by Plaid Cymru spokesperson Helen Mary Jones with my full support. It's in line with committee recommendation 13 at Stage 1. During our evidence sessions, it became very apparent that the body should be able to make representations to Welsh Ministers as this would enable the body to become actively involved in and influence the design of future health and care systems in particular.

The board of community health councils noted that if 'A Healthier Wales' was aimed at putting the citizen's voice at the centre of healthcare, to drive development and delivery of health and social care, the new body should have the right of representation at a national level. Specifically, it was stated that it's more than about making written representations and getting written answers. It's about being in the room when the conversation takes place. It's about being around the table. It's about driving that agenda with policy makers and planners.

The Royal College of Nursing felt that it was important that the citizen voice body should be able to influence the provision of health services. And it's very disappointing that the Minister has continually rejected this recommendation wholesale, on the grounds that Welsh Ministers do not commission or provide services. But of course, Minister, what you do do is you set the direction of travel. That's what the parliamentary review was about. That's what 'A Healthier Wales' is about, and all the iterations that will follow it over the years. We make a lot, don't we, about listening to the voice of the citizen, about staff engagement, about all these soft, fuzzy things, but we actually have to start delivering it, and we have to start engaging with people.

I tabled amendment 42 after further consultation with the board of community health councils at Stage 2, because the amendment as drafted imposes both a duty to respond to the representations, as well as a duty to comply with guidance issued by the Welsh Ministers relating to the representations made. 

We would reject amendment 1, again on the basis that this is too weak to be able to respond to the strength of concerns that we received during Stage 1. Guidance alone is not enough in these circumstances. At Stage 2, the Minister was keen to reject the right on the basis that these representations would have to be made public, and that a response to a representation may not be something that should be provided in writing. I would contend that this amendment also clearly states that guidance would be issued about how listed persons would respond. We can also see where guidance fits in, but we're adamant the duty to respond must remain on the face of the Bill.

Amendment 41 amends section 15 on the citizen voice body representation to public bodies, extending it to Welsh Ministers and any other person who makes decisions on behalf of a local authority or NHS body, and we think that this provides a broader approach to representations made.

We do oppose amendment 76, on the basis that amendment 41 widens the list of bodies that the citizen voice body can make representations to. Again, it's the same argument I made at Stage 2; in fact, a similar amendment that was limited to Welsh Ministers was withdrawn at Stage 2 in favour of this amendment.

Our amendments here specify that not only should Welsh Ministers be able to be recipients of representation by the CVB, as is proposed by the Conservatives, but that if they do receive representation the Government then has to provide a response. So, I would ask the Conservatives to perhaps look at ours as an improvement on their amendment—or at the very least, if your amendments fall, that you consider supporting ours as having another crack at it. I do appeal for support from across the Senedd.

I'm starting to think that we're talking about a dental Bill here, because I'm going to talk about teeth again. [Laughter.] This is another one of those elements where we're calling for this Bill to have real teeth; rather than talk about raising standards in ambiguous terms, that there are actual steps that are supported through legislation to make sure that improvements happen and, when concerns are raised, that they are acted upon. That is precisely what our amendments here are designed to do.

This is vitally important, I think, to ensure the CVB does have teeth and is able to hold the Minister to account. I know he doesn't like to be reminded of the fact too often, but he is actually responsible for running the health service in Wales, and I think it's pretty relevant, therefore, to provide the CVB with the power to make representations to him and to his successors. And, of course, it's also important that any body in receipt of a submission provides a written response, otherwise the CVB will just be on a list of organisations that perhaps feel that they are being ignored. So, we think that this is extremely important. A failure to back these amendments today would simply add further evidence to our view that this legislation is really about removing an effective scrutiny body, replacing it with a toothless body, and, again, another reason why we can't support the Bill. 

Diolch, Llywydd. To be an effective champion, the citizen voice body must be heard. The community health councils have been an effective champion for Welsh patients, in part, because of their right to be heard. Public bodies have to take notice of representations made by CHCs. The amendments tabled by Angela and Rhun extend this duty to the citizen voice body. If this new body is to be our voice, public bodies should have to listen to what they have to say. We no longer live in an era when healthcare was dictated to us; patients have a right to be involved in their own health and care. It is therefore essential that the citizen's voice be heard when it comes to planning and delivering services and changes to those services. Without amendments 41 and 42, the new body is a citizens' body, but without a voice. 

The Minister, Vaughan Gething. 

Thank you, Llywydd. All of the amendments in this group relate to representations being made by the citizen voice body and the response that should be provided to them, but they, of course, have different permutations. And I do want to make clear again that, despite the language being used, refusing to agree to amendments 42 or 77 are not examples or evidence of bad faith, or a deliberate desire on the part of the Government to emasculate the current CHC movement and replace them with a toothless body. There is room for honest disagreement, as I recognise both within my own party, and across this Chamber as well. And we have drafted the Bill to enable the citizen voice body to make representations to NHS bodies and local authorities, as organisations that provide or commission the vast majority of health and social care in Wales. As such, they are best placed to take an overview of services in their area, and be most effective in compelling changes on the ground, and responding to the matters related to their representations. 

Both of the amendments in this group seek to add Welsh Ministers to the list of bodies to whom the citizen voice body may make representations. I've been clear that there is nothing to prevent the citizen voice body from corresponding with Welsh Ministers, and, as with any key stakeholders, we don't just take that body's views into account in exercising our relevant functions, including policy and legislation, but we already ensure that we do respond to people who write to Welsh Ministers. Any and every Welsh Government-sponsored body that writes to Ministers receives a response, and that would be exactly the same in terms of the normal ongoing dialogue with Welsh Ministers and the new citizen voice body.

Amendment 41 also refers to representations to be made to any other person or body who makes decisions or exercises functions on behalf of a local authority or an NHS body. And that was not, of course, a Health, Social Care and Sport Committee recommendation. It is, though, incredibly broad. It could be particularly onerous for smaller providers of social services, especially in view of the requirement in amendment 42 for providers to publish their response on their website—not all providers actually have websites. But I do have real concern about the requirement to publish all responses.

The body's ability to make representations is deliberately very broad. This does mean, however, that it may not be appropriate in some instances to publish responses. The person or people who the citizen voice body are making representations on their behalf may not want to have representations published. However, the amendment that Members are asked to vote for gives absolutely no flexibility in respect of amendments 42 and 77, and the drafting of the amendments really does matter. It doesn't say that they 'may' publish, or 'should consider' publishing; the amendments make very clear, in either version, that they 'must' publish their response on their website. And you can't amend that clear and unambiguous statutory requirement in guidance. 

Placing these duties on service providers runs contrary to the approach taken under the Regulation and Inspection of Social Care (Wales) Act 2016 that this place has already passed—to place proportionate duties on service providers, empowering them to find the best ways of meeting regulatory requirements. It is appropriate that representations are made to the bodies that have statutory responsibility to the public for providing health and social care—local authorities and our NHS. And that is what the Bill provides for. I don't agree that there is a need for further provision on this—the citizen voice body will have ample opportunity to shape national policy and highlight best practice, as the body is being designed to do.

In terms of the requirement for a response to representations that sets out the extent to which the recipient accepts the representation, and any actions that the recipient intends to take, that is formulaic and potentially, encourages an adversarial rather than a co-operative approach. And it doesn't take account of the fact that it may be more appropriate—within the context of the particular circumstances of the kind of representation being made—to deal with matters as part of an outcome-focused discussion, rather than formal written correspondence, through a prescribed process, as amendments 42 and 77 would require.

The Government amendment in this group seeks to resolve what we understand is the chief concern and desire: for NHS bodies and local authorities to have a clear system for dealing with representations received from the citizen voice body that is proportionate to the issues raised in the representation; for the citizen voice body to be kept appraised of progress in dealing with their representation; and, crucially, to make sure that they are advised of the outcome to their representation. The Government amendment will ensure—through statutory guidance—that NHS bodies and local authorities have that proportionate and operational procedure in place for considering and responding to representations. And I believe that that will be conducive to ongoing working relationships between the parties, and will mean that the body is advised of the eventual outcome of making any representation. And I ask Members to support the Government amendment in this group.

Angela Burns to reply.

Thank you very much indeed. There is a bit of an issue here, really, isn't there? I didn't just sort of sit down and knock out these amendments in the dark one night; I actually had a lawyer team who worked on it. So when you stand there and say, as you have done a couple of times throughout this, 'This isn't written very well, this isn't in the right terminology, this says this, that or the other', I want to make it very clear that I also—it's not just your lawyers in the room, there are our lawyers in the room. And they are very clear that these amendments actually allow that element of discretion. They're very clear that the guidance could be issued about how listed persons would respond. So you don't have to actually put out in the public sphere exactly what is said.

Can I just refer to amendment 42(6)?

'As soon as reasonably practicable, the recipient of the representation must publish the response prepared under subsection (4) on their website'.

That leaves no room for any discretion whatsoever; the word 'must' in this drafting is very clear and unambiguous.

Yes, but you don't have to put their name, their address, their rank and serial number. So I think you are being a tad disingenuous here. And that's what the guidance can lay out. And this is taking legal advice; all opposition parties work with teams of lawyers—it isn't just the Government that has these guys who know what they're talking about. So that's my first observation on this.

My second observation on this is that it's more than just about writing in and getting you to write back. This is about the citizen voice body actually being able to engage with Welsh Ministers, and start to help formulate the direction of travel for the delivery of health services in Wales, how it reflects in their local areas. And that's why we've tabled these amendments, and that's why we're asking Members to support them.

If amendment 41 is agreed, amendment 76 falls. The question is that amendment 41 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 41. Open the vote. Close the vote. In favour 15, no abstentions, 33 against. Therefore, amendment 41 is not agreed.

Amendment 41: For: 15, Against: 33, Abstain: 0

Amendment has been rejected

Amendment 76 is next. Rhun ap Iorwerth.

Amendment 76 (Rhun ap Iorwerth) moved.

Formally.

The question is that amendment 76 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 76 in the name of Rhun ap Iorwerth. Open the vote. Close the vote. In favour 21, no abstentions, 27 against. Therefore, amendment 76 is not agreed.

Amendment 76: For: 21, Against: 27, Abstain: 0

Amendment has been rejected

Amendment 1 is the next amendment. Minister. 

Amendment 1 (Vaughan Gething) moved.

Move. 

The question is that amendment 1 be agreed to. Does any Member object? [Objection.] We therefore move to a vote on amendment 1 in the name of Vaughan Gething. Open the vote. Close the vote. In favour 37, no abstentions, 11 against. Therefore, amendment 1 is agreed.

Amendment 1: For: 37, Against: 11, Abstain: 0

Amendment has been agreed

Amendment 42 is the next amendment. Is it being moved by Angela Burns?

Amendment 42 (Angela Burns, supported by Caroline Jones) moved.

Formally, Llywydd. 

If amendment 42 is agreed, amendment 77 falls. The question is that amendment 42 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 42. Open the vote. Close the vote. In favour 15, no abstentions, 33 against. Therefore, amendment 42 is not agreed.

Amendment 42: For: 15, Against: 33, Abstain: 0

Amendment has been rejected

Amendment 77, Rhun ap Iorwerth. 

Amendment 77 (Rhun ap Iorwerth) moved.

Formally. 

The question is that amendment 77 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 77, in the name of Rhun ap Iorwerth. Open the vote. Close the vote. In favour 21, no abstentions, 27 against. Therefore, the amendment is not agreed.

Amendment 77: For: 21, Against: 27, Abstain: 0

Amendment has been rejected

Amendment 20 is next—Angela Burns. 

Amendment 20 (Angela Burns, supported by Caroline Jones) moved.

Formally, Llywydd. 

The question is that amendment 20 be agreed to. Does any Member object? Amendment 20 is agreed, therefore. 

Amendment agreed in accordance with Standing Order 12.36.