Group 15 is the next group of amendments, and they relate to joint complaints. Amendment 43 is the lead amendment in the group and I call on Angela Burns to move the amendment.

Amendment 43 (Angela Burns, supported by Caroline Jones) moved.

Thank you, Llywydd. I'd like to formally move the amendments 43 and 47, tabled in my name. Amendment 43, Minister, is a probing amendment and it relates to requiring NHS bodies and local authorities to work together where a complaint is raised, which relates to both of them, and amendment 47 is consequential to amendment 43. 

Now, these amendments are based on evidence submitted by the Public Services Ombudsman for Wales to the committee during Stage 1 and further discussions that we've had at Stages 2 and 3. In written evidence, the ombudsman noted his disappointment that the Welsh Government did not proceed with its proposals on joint investigations and the alignment of NHS social services complaints procedures within its White Paper. And I know that this has raised concern with a number of Members, because more often, now, people are having support from the NHS and from social services. And if there is an issue, sometimes it's extremely difficult to say whether the issue is on the health bit or the social services bit, or it might be an issue that actually connects with both. Then to ask the citizen to start two separate complaints processes or raising their concerns via two separate processes for the same issue is actually a big ask, and this is all about making the life of the citizen more direct, easier to manage and less confrontational. That's why I've tabled these amendments, because what we want to see is a joint system only on the instances where the complaints that are being raised are about something that affects both NHS and social services.

Now, I did listen very carefully to the Minister, and that's why this is a probing amendment, because you have said that you want to have a unified complaints process. And I've also heard you say that it will take time to put in place, but it's actually very complicated in that the way an NHS complaint is processed is very different to the way a social services complaint is processed and that, very often, the NHS complaint, because it tends to be much more clinical, will often take much longer because there are far more people who have to be brought in to play and you've got to listen to the consultants and everybody who is involved in it. Whereas, quite often, a social services case might be much more direct and easier to deal with, and marrying the two different types of complaints processes can be very hard. So, I understand that and I agree with you. But what I'm concerned about is how long it might take.

We already heard in the previous amendment that we're seven years on and things that were vital that had been promised still haven't happened. When we discussed this, we did talk about an anticipatory amendment, and the point of an anticipatory amendment is to have, within this Bill, the ability for the Welsh Minister to say, 'At a point in the future, guess what, health and social care, I've given you all this time to get your act together, to put your complaints processes together, to help the citizen'—and this is all about helping the citizen—'you still haven't done it, so now I'm going to enact this bit of the Bill that will make you get on and do it.' This is what amendments 43 and 47 are about. 

I am concerned that there's been a row-back on our discussions over an anticipatory amendment. I do accept you haven't given up on the ambition to have a more unified complaints process. I do welcome your promise that officials will look to arrange a round-table discussion before the summer recess, with the relevant departments. I do think this is still in danger of being kicked into the long grass again, without a statutory commitment. 

This is why I've put these amendments forward. I'd be interested to hear, Minister, what you have to say. These amendments allow you to draw together all the stakeholders that need to be consulted. They allow you to drive a future joint complaints process forward through a regulatory framework. In consultation with the Public Services Ombudsman for Wales, we believe that agreement can be reached within six months of this section coming into force, and I would urge Members to support these amendments. 

I can confirm that I and the group will be supporting these amendments. The reason for that is that I think that there is a means here of encouraging better joint working, particularly where complaints relate to that space where the interaction truly happens between health and social care.

The Minister to reply.

I'm sorry to have to disappoint Angela Burns again, but as Members will know, there were identical amendments on joint complaints tabled at Stage 2, as Angela Burns has indicated. I still don't believe the Bill would be a suitable vehicle to bring these changes forward. Responses to the White Paper consultation and subsequent  consideration have indicated further engagement in the area is needed with a range of stakeholders to help develop the policy in the area.

In terms of what the proposed amendment does, my concern is that it is potentially too restrictive. For instance, it requires NHS bodies and local authorities to conduct a joint investigation into concerns raised under the NHS complaints procedure and under the social services complaints procedure regulations. That does not cover the large number of social services complaints made by children under the Representations Procedures (Wales) Regulations 2014, nor does it take account of complaints that are made directly to providers of regulated social care services, such as care homes and domiciliary care providers. This route is particularly relevant for those whose care and support is not managed or arranged by a local authority.

The committee itself recognised that considering the best approach for joint complaints,

'is not a straightforward piece of work',  and urged the Government to continue to work with stakeholders to find ways to simplify the process. I have, as Angela Burns has mentioned, committed to convening a round-table discussion with that wide range of stakeholders to consider how the process could apply to NHS complaints, local authority complaints as well as complaints brought against providers of regulated social care.

There are a number of key stakeholders that need to be involved in delivering on this ambition and work to be undertaken to ensure we deliver effective joint complaints arrangements. Officials are already working to arrange that round-table discussion before summer recess. But I do think that the six-month time frame that Angela Burns refers to in the amendment would be an overly optimistic time frame to be able to complete all of this in good time, even if we were in normal times, and, of course, we're not, in terms of the particular challenges that we know that we're going to face.

But we're taking this approach in this area of joint complaints to bring together a number of different strands that we know have to be in the same place at the same time. As I outlined during Stage 2, the fact that the body will have the ability to assist someone bringing a complaint about health and social care, demonstrates our commitment to making things easier for people who have complaints that span these two areas.

To reiterate, our approach remains to continue to work with NHS Wales organisations, local government and other bodies to discuss ways of making the process simpler for people who have those complaints across health and social care. I hope that Members do recognise the genuine and clear determination of the Government to achieve that goal as part of a more integrated health and social care system that is genuinely people-centred, and developed in partnership with key stakeholders. We will be reviewing and updating our putting things right regulations and associated guidance to ensure that they properly effect the changes we're making through this Bill to introduce a duty of candour.

I have listened to the points that Angela Burns has raised and whilst I think we agree on the ultimate destination for it, I'm afraid that I can't support the amendment that she moves today.

Angela Burns replying.

You have disappointed me, because we did talk about anticipatory amendments, and because I am worried that it will get kicked into the long grass, or it'll be allowed to drag on and on. I've been an Assembly Member for 10 years and one of the first cases I ever had to deal with was of a young man who had been run over by a car and was paralysed from his neck down, and he had healthcare provided to him 24-hour a day, seven days a week, but he was also fostered out—when I say he was a young man, he was a child, a boy—he was fostered out and therefore had social services intervention. That young boy was tortured by the health team. They used to do jokes on him, like take off his incontinence pad and hold it up against his nose, and laugh. He actually had a tracheotomy, and they'd have to change various tubes over and when he—through frustration—used to shout and scream, they'd take it out and then dance around with a new one before they put it back in again, to teach him a lesson. This is a kid who is completely paralysed from his neck down: I've never forgotten him; it was one of my first cases. I worked on his case for two years; it is seared into my soul.

What's really seared into my soul isn't just what happened to him, but the way all of those services slip-shouldered their way. It wasn't NHS; it wasn't social services. I chased around and I had everybody involved: CSSIW; I had health inspectors; the works, and it was extraordinary the wriggle room that was in that complaint process. It was extraordinary how people managed to avoid being responsible, and I vowed then that whatever else I would try and do, I'd try and bring it all together, so that his foster carers, the health professionals who did care about him, the doctor, the GP, could actually chase after the right people and say, 'Oi. You're culpable, you sort it out. You reprimand those people. You retrain those people. You fire that person, and you make that kid's life better again.'

But it didn't happen, because we had to go everywhere with our complaints process. And it's been a nightmare, and that's why—. I'm not asking for you to rewrite it, and this is what I'm worried about, that on the round-table you're talking about doing it all. I'm not asking you to rewrite the NHS complaints process. I'm not asking you to rewrite the social care complaints process. I'm asking you to develop a brand-new system, where on the occasions where it's a joint issue, where there's joint responsibility, then there is a process where the poor citizen who's been hard done by only has to make one phone call, talk to one person and get the whole thing resolved. That you can do in six months. You've got enough stripes on your shoulder, you're a highly intelligent individual, and you can drive that team when you want to, and I do not think that this amendment is unreasonable, because it is about protecting the citizen, and I ask Members to support amendments 43 and 47.

If amendment 43 is not agreed, amendment 47 will fall. The question is that amendment 43 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 43. Open the vote. Close the vote. In favour 20, no abstentions, 28 against. Therefore, amendment 43 is not agreed.

Amendment 43: For: 20, Against: 28, Abstain: 0

Amendment has been rejected

Amendment 47 fell.