Open Public Services White Paper

Debate between Baroness Verma and Lord Beecham

Monday 11th July 2011 Lords Chamber

[Baroness Verma]

I will reassure my noble friend. We are working against a really difficult economic backdrop, and we will have to make some incredibly difficult choices. Having said that, it is also an opportunity for us to open up to a variety of providers and see if services are then better delivered, with best value incorporated into how those services are delivered. As with personal budgets, delivery will not just be left to one set of providers. What is important is working in partnership—in this case, personal budgets and local government. It is about being able to deliver services far better and with greater choice. Those who have access to personal budgets have said to us in consultations that they feel relieved that they are going to be able to make choices on how their care is delivered.

[Lord Beecham]

My Lords, is it not ironic on the day that Southern Cross has collapsed—closing 560 residential homes, which account for over 30 per cent of residential care places—that the Government are proclaiming the virtues of diversity? How diverse is a system that allows a single private operator to provide such a high proportion of places, with the results that we can now see? In talking about diversity, how many organisations, particularly voluntary ones, have been contracted on the welfare to work programme? It seems to have been commandeered by a handful of national organisations.

Can the Minister also explain the relevance of the passage in the Statement that talks about,

“open, real-time data on road conditions, speeds and accidents along our motorways”?

Is she suggesting that motorists can then find another supplier of roads on which to travel or is this a question of diversity in the provision of satellite navigation?

More seriously, on the health premium paid to local authorities achieving the greatest improvements in public health, clearly one shares the objective of incentivising the improvement of public health. Is it not going to be difficult for authorities such as my own—the noble Lord, Lord Shipley, is also a member—to improve the very serious and long-standing conditions in public health? There are areas where it will be easier to do that and they will be rewarded for achieving targets while authorities that may need investment to secure improvements will presumably struggle to get it. Will that not have to be reconsidered to ensure that the investment goes in the right place to achieve public health objectives? Those are not in any event entirely under the control of local authorities.

[Baroness Verma]

My Lords, it is a great disappointment that Southern Cross has had to go down the route that it has gone in. The noble Lord is of course aware that many providers perform excellent work and have greater safeguards in place. We do not want to take one example and judge all private providers on it.

I am not quite sure that the significance of the roads question will be answered as fully as the noble Lord would like. I assume that those data are so that the public—the people who use those roads—are able to question why there is not greater improvement and how greater improvement can be brought about. It is not about avoiding roads but being able to say, “Where judgments are to be made about mapping on those roads, how do we deliver better services? Is it about speed or variable speeds”? I suspect that that is what it is, incorporated into that response.

On health premiums, it is absolutely right that those healthcare providers dealing with very difficult health issues in their areas should be given extra support and rewarded if they deliver better outcomes. It is only right that we work in partnership—sometimes with local authorities or across a range of providers. We must not put a full-stop block on this, so that we are driven by the same service that has gone on for many years and that has not delivered the sort of outcomes that we would like everyone to have—and not because they can buy it. It has to be available for everyone.