Health and Social Care Bill

Debate between Baroness Finlay of Llandaff and Lord Shipley

Thursday 8th March 2012 Lords Chamber

[Lord Shipley]

My Lords, I rise to speak to Amendments 238AA, 238AB, 238BZA and 238BA and to declare my interest as a member of Newcastle City Council.

These amendments relate to the membership of health and well-being boards. As currently proposed, the boards will have at least one councillor of the relevant local authority—so it could be one councillor, or it could be more. The choice will be with the council. However, several other people who have membership will be officers or unelected co-optees. This means that the board as currently proposed is effectively a board of directors, not a council committee which—unlike all other council committees—is made up of those who are publicly elected. Yet the board as proposed is legally a council committee; and because it is legally a council committee, only councillors can vote—officers must advise. For officers to vote, specific regulations will have to be put in place, and of course they can be. However, I hope that the Minister is willing to think further about this. Councillors, being elected, have both a democratic mandate—unlike officers—and a perception of service provision which comes from a geographical perspective as well as a service perspective. At times that can be very valuable, particularly in a geographically large council area.

To have just one councillor—which is what the Bill permits—would be a mistake. It would mean a council committee, the health and well-being board, would be dominated by officers and co-optees. It would also mean that only one political group was in membership of the board, which in my view would be deeply unwise.

Given the board’s terms of reference, I do not argue that councillors have to be in majority. However, I do argue that councillors are important; that geographical differences in a council area should be acknowledged; and that more than one political group should be fully represented on a board. Amendment 238AA solves this problem. It defines the minimum number of councillors as three. That would give the board greater breadth and enable political proportionality to be effective. Amendment 238AB states that where a council is a county council and part of a two-tier system of local government, there should be a district council representative as well as county representatives because district councils have statutory duties in relation to health and well-being. Having one district councillor appointed in this way as a representative of several district councils is normal procedure for those councils when duties span the two tiers. The other two amendments are simply enabling amendments assuming that Amendments 238AA and 238AB are agreed.

In Committee there was a discussion about councillor membership—how many there should be, whether they should be in a majority and whether they should have powers over the budgets of other health organisations not managed by the council. There was no conclusion to that debate, but I have thought long and hard about it. I have concluded that the amendments in my name and those of the noble Lord, Lord Bichard, and the noble Baronesses, Lady Eaton and Lady Henig, which reflect all parts of this Chamber, give a solution to this problem and would enable us to balance professional knowledge with the necessary democratic accountability.

I do not propose to press this to a vote, but I hope that the Minister will be willing to engage in discussion on it. What is being proposed from all parts of the House is a solution to a problem that needs to be resolved. It will prevent difficulties arising further down the line should a council decide to have only one councillor as a member of the board.

[Baroness Finlay of Llandaff]

My Lords, I shall speak briefly to Amendment 238A, which is in the name of my noble friend Lord Ramsbotham. I rather hope that the Government will take on board its spirit, if not its actual wording. The reason is that in creating a joint strategic needs assessment, there will be a requirement for those involved to begin to work in a completely new way. Human nature is such that people tend to repeat the patterns of things they have done before. In addition, they do not know what they do not know. When they feel insecure, they are less—not more—likely to consult, because it is quite threatening to have to consult and go beyond the boundaries of what you thought you knew and discover all the things that you did not know.

The beauty of the amendment is that it creates an obligation to,

“consult relevant health professionals and any other”

person, without specifying who they are. It leaves it very broad but it pushes forward the boundaries. We have already discussed the problem of children. The difficulty, if people do not consult widely, is that if children miss out at a developmental stage and one aspect of their development—for example, motor development, speech and language development or emotional development—does not occur, they never catch up. It is missed out for good; they always lag behind.

It is really important to make sure that the provisions are there right the way through the trajectory from birth onwards to make sure that the needs of children as they develop are met, that deficits are identified early and that interventions take place immediately.

Police Reform and Social Responsibility Bill

Debate between Baroness Finlay of Llandaff and Lord Shipley

Thursday 9th June 2011 Lords Chamber

[Baroness Finlay of Llandaff]

My Lords, I apologise to the Committee. I was part of the discussions, but I did not double-check that everybody knew. I apologise to the Benches opposite.

[Lord Shipley]

I shall speak first to Amendment 237A. It is an extremely important amendment because it defines not just the responsibility of a local council—here I declare an interest as a member of Newcastle City Council and as chair of the regional advisory group for public health in the north-east of England. The amendment builds in to the general duty of a licensing authority, which has a quasi-judicial role, the responsibility to protect and, crucially, to improve public health. Through other legislation, local authorities are being given enhanced responsibilities for public health. The responsibilities relate to a range of things around smoking, obesity, road safety and so on, but given some of the evidence we have heard this afternoon, not least the fact that the latest figures seem to show that at the weekends 50 per cent of hospital admissions are alcohol related, the cost to the National Health Service and the economy is very great, and the responsibility for addressing that problem has to lie with some democratic structure. In general terms, it lies with the local authority but critically, because a licensing authority is quasi-judicial, it is important to have a general duty applying to that licensing authority to protect and improve public health. I think this very clear statement will make a difference in the way in which licensing authorities operate in future.

I referred to regional advisory groups on public health. One of the consequences of the abolition of government offices in England is that a range of regional structures are no longer in existence or are about to go out of existence. One of the things we are having to address at the moment is how issues of public health can be discussed and how research evaluation and good practice can be spread in a context bigger than a single local authority.

I hope that the Government might look at ways in which we can develop this general duty to protect and improve public health so that local authorities are required to work together more closely on that agenda. Reducing the consumption of alcohol, reducing the incidence of smoking, improving road safety figures and so on all apply to more than just one local authority in a given part of the country. However, this is a very important amendment and its impact should not be underestimated.