The government has tabled 137 amendments to its Health Bill.

They are the latest series of changes to the legislation which had a difficult passage through parliament since it was introduced over a year ago.

There are no major policy changes but they give some ground to members of the House of Lords who have challenged the government. Ministers will hope they mean the bill can pass easily when it returns to the Lords for report stage on Wednesday. Report stage will last just over a month.

The amendments cover eight main areas:

  • Clearer ministerial accountability. As revealed by HSJ last month, health minister Earl Howe has agreed changes with peers concerned about this area. They include making the health secretary’s duty to promote autonomy subsidiary to main duties - which are also amended - “to promote the comprehensive health service and to exercise their functions so as to secure the provision of services”.
  • Education and training – including a new duty on the NHS Commissioning Board and clinical commissioning groups to promote education and training; and strengthening the duties of the health secretary, commissioning board and clinical commissioning groups to “promote research”.
  • Integration and competition – including allowing Monitor to impose conditions on providers’ licences with the intention of, “enabling health care services… to be provided in an integrated way…[or to be] integrated with the provision of health-related services or social care services…[or for] enabling co-operation between providers”. Another change is that in the bill’s proposed seven-yearly reviews of the healthcare sector, the Competition Commission will look at the “effectiveness” rather than “development” of competition.
  • Health inequalities – including requiring the health secretary, commissioning board and CCGs to report annually on how well they have fulfilled their duties to reduce health inequalities,
  • Patient involvement – changes commissioning board and CCG duties to say they must promote the patient involvement in “the prevention and diagnosis of [their] illness [and] their care and treatment”.The commissioning board must publish guidance on how they do so. The changes have been welcomed by patient group National Voices.
  • * Another change sets out that HealthWatch England, which will be a committee of the Care Quality Commission, must not be made up of a majority of people from the CQC. It is intended to protect its independence.
  • Conflicts of interest – requires all members of committees or subcommittees of CCGs to declare their interests.
  • Public health – including that local councils must make directors of public health a “statutory chief officer”, like directors of children’s services and adult social care.
  • Patient confidentiality – limits use of the NHS Information Centre’s new powers to collect, analyse and publish information. The IC will also publish a code of practice for organisations dealing with person-identifiable information.