European Union (Withdrawal Agreement) Bill
Debate between Baroness Williams of Trafford and Lord WarnerTuesday 14th January 2020
(4 years, 3 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: HL Bill 16-II Second marshalled list for Committee - (14 Jan 2020)
Lord Warner
I am sorry to interrupt the Minister’s flow, but how many people who have already registered have sought hard copy or physical evidence of their registration and status?
Baroness Williams of Trafford
If you apply and are successful for either pre-settled status or settled status, you will receive a letter. That is not in itself proof of your status, because your status is a digital one, but you will receive a letter to confirm the success of your application.
Lord Warner
I am sorry, but that is not my point. How many people have applied for a document saying that they have settled status, which they can show to a GP or a landlord?
Baroness Williams of Trafford
I do not have the numbers for how many people have applied for a document that confirms settled status, but I can find out. The fact that 2.5 million people have been successful should partly satisfy noble Lords that the system is working well. Also, there have been only five rejections on the system so far. I will come to the point made by the noble Baroness, Lady Ludford, later, but that is quite a decent statistic when you think about the—
Baroness Williams of Trafford
The point I am making is that if you have a physical document which outlines everything, people have access to everything. When people go into banks, they do not necessarily know which documents to bring. Under the digital status, employers and landlords are entitled to see only the data which they need to see.
Lord Warner
Before the Minister moves on, sticking with this issue, I am totally confused—more than usual. The Minister said earlier that, if I have been sent my letter from the Home Office describing my status, I can then apply for another document of some kind that I can produce to other people who want the other document. That seems to be an alternative to the code. Will the Minister explain what is the difference between the letter and the other document that I can apply for, which apparently I can use to satisfy someone that I am entitled to something?
Baroness Ludford
Before the Minister gets up, I do not think I heard her answer the question about whether the settled status database is going to be available outside the Home Office, within government and to third-parties outside government. Will she answer that very precise point?
Baroness Williams of Trafford
I shall start with the point made by the noble Lord, Lord Warner. The letter is confirmation that you have been successful. It is not evidence of your status, but it is there for anyone who wishes to have a physical document to say that they have been successful.
On the digital status—this comes to the point made by the noble Baroness, Lady Ludford—if you want to rent, it could be accessed by the landlord. There is access to the data for people who need to see it for the purposes for which they need to see it.
Lord Warner
Regarding the document that I apply for after my first letter—the Minister is saying that there is a second document—why would I apply for something that I already have?
Baroness Williams of Trafford
My Lords, you automatically get a letter confirming that you have been successful. There are not two documents. You have online status and you get a letter confirming that you have been successful. There are not two documents.
Lord Warner
This is rather a critical issue. Is the Minister saying that the document I have can be used? It apparently cannot be used to satisfy landlords and GPs, so what is the person going to do if the landlord, the GP and everybody else is not satisfied with the Home Office document?
Baroness Williams of Trafford
My Lords, the document that the noble Lord refers to is a letter confirming that a person has been successful. Anyone who is successful in obtaining the status could show that letter to a landlord and say, “There. Go and look online to confirm that I have the status”. However, it is not a proof; it is a confirmation. Does that help the noble Lord? I see that it does. Thank goodness.
Cities and Local Government Devolution Bill [HL]
Debate between Baroness Williams of Trafford and Lord Warner
Baroness Williams of Trafford
My Lords, Amendment 11 makes specific provisions in relation to a transfer of health functions from a public authority to a combined authority or other public body. It requires that the Secretary of State responsible for such services must continue to be able to fulfil his statutory duties conferred by existing legislation. It also requires that the combined authority or other public body to which the functions are transferred should adhere to national standards and accountabilities which are attached to those functions under existing legislation.
As I have said in previous debates, and as is set out in the Greater Manchester memorandum of understanding for devolution of health and social care, there is absolutely no intention through this Bill to remove or undermine the core duties on the Secretary of State, or to dismantle accountabilities for health services as enshrined in existing legislation. Whatever bespoke devolution arrangements are agreed with a particular local area, that principle will remain.
I state this as a clear commitment to this House. Thus, nothing in the Bill changes the position of the Secretary of State under Section 1 of the NHS Act 2006, which provides that,
“The Secretary of State must continue the promotion in England of a comprehensive health service”.
The Secretary of State retains in all circumstances ministerial responsibility to Parliament for the provision of that health service.
Likewise, the Secretary of State must always adhere to the core NHS duties. These duties include, when exercising functions in relation to the health service: a duty to secure continuous improvement in quality of services; a duty to have regard to the NHS constitution; a duty to have regard to the need to reduce inequalities; and a duty to promote autonomy. These duties are set out in Sections 1A to 1F of the National Health Service Act 2006.
As I have made clear, there is no intention or possibility of the Bill changing these duties of the Secretary of State. Further, as I have said in previous debates, any decision the Secretary of State takes about using the order-making powers in this Bill to confer health functions must be taken in conformity with these duties. Without in any way affecting these duties of the Secretary of State, if a combined authority were, for example, to have conferred upon it a function to commission certain health services, the provision in Clause 8—which the House agreed on Report about conditions and limitations when conferring functions—would allow us to require that the combined authority, when exercising its commissioning functions, must likewise be subject to these core NHS duties, such as to promote the NHS constitution.
On Report, the noble Lord, Lord Hunt, commented that the issue we are discussing is more about symbolism, but he also recognised that one should avoid unnecessary legislation. I agree that this issue is one of symbolism. I am also very clear that symbolism is important and tempting. However, legislation is not the place for symbolism. The place for symbolism is in the discussions we are having and the commitments given to this House. For this reason, while I understand and strongly support the intention behind this amendment—that is, to make clear to all that the vital principles for the NHS will be upheld—I do not believe that it is necessary, nor do I consider that it is appropriate. As I have said a number of times, this Bill is an enabling Bill which includes general rather than service-specific powers. If this amendment were to be accepted, health functions would be specified on the face of the Bill, which would change the whole approach we have taken.
Noble Lords asked some specific questions—for example, on how to retain national standards where health powers are devolved. It is important to note that, when transferring functions to a combined authority or conferring functions on it, the Bill allows us to additionally place on a combined authority duties such as those held by the Secretary of State under new Sections 1A to 1F of the relevant legislation, as I have mentioned previously, or other duties held by NHS England or CCGs.
The noble Lord, Lord Warner, talked about the purpose and design of the Bill. We see it as a broadly enabling Bill, as I have just said. We have always said that we will devolve powers only where there is a clear accountable body. This applies equally to any health powers as to other powers that are devolved.
My noble and learned friend Lord Mackay and the noble Lord, Lord Patel, asked specifically about Amendments 3 and 4 as applying to regulatory functions such as those of the Care Quality Commission. Amendments 3 and 4, which we have just approved, mean that the regulatory functions of a national regulator such as the CQC cannot be devolved to, say, a combined authority exercising functions that the Care Quality Commission would have regulated.
The noble Lord, Lord Hunt, mentioned the importance of health in devolution. Health is absolutely an important element of devolution. As the Chancellor has said:
“We will hand power from the centre to cities to give you greater control over your local transport, housing, skills and healthcare”.
That is our aim and we will do that within a strong NHS. A strong NHS relies on a strong local economy and devolution will enable strong local economies with strong local governance. In areas with such accountabilities in place, such as Manchester, health devolution is something we support.
Given that I have placed those comments on the record, I hope that the noble Lord will feel able to withdraw the amendment.
Lord Warner
My Lords, the Minister’s response is deeply disappointing. There is a simple problem with this Bill and the way in which the Minister and her department have approached it: they simply do not understand the National Health Service’s national characteristics. It is not uncommon for Bills to contain statements of principle. That is not an unusual phenomenon. I have been in this House 15 years and I have sat through debates in which statements of principle have been put into Bills, so the idea that that is something we never put in legislation is simply untrue. We have to put this on the face of the Bill. It is what the NHS expects and what many of us think is essential if we are to successfully pursue the Government’s admirable policy of devolving more functions down to the local level. If the Government want to do that successfully and to take the NHS with them, I suggest to the Minister that they need to think again about this issue.
Throughout our deliberations on the Bill I have worked on the assumption that the Government did want to take the NHS with them. Certainly, the briefings I have received strongly suggest that the NHS is confused and baffled about precisely what the Government are up to. Simply relying on assurances from the Front Bench and a memorandum of understanding in Manchester is not good enough. I do not want to go banging on about this but I am unconvinced by what the Government are saying. There needs to be on the face of the Bill a provision of the kind included in this amendment. I wish to test the opinion of the House.
Cities and Local Government Devolution Bill [HL]
Debate between Baroness Williams of Trafford and Lord Warner
Baroness Williams of Trafford
I hope I can answer this satisfactorily. Let us take the example of York, within Yorkshire. If York was to become a constituent member of some sort of Yorkshire combined authority it could not then become a constituent member of another combined authority, but I think it would be perfectly possible for it to become a non-constituent member of another combined authority for certain purposes. So in other words, if Cheshire East decided that it would, with consent, have a combined authority with Cheshire West and Chester, would that then preclude it from being a non-constituent member of the Greater Manchester Combined Authority? I do not think that it would—but I can confirm that in due course, if it helps the noble Lord.
Lord Warner
May I suggest that the Minister responds to the perfectly sensible proposition of my noble friend Lord McKenzie that we curtail this set of discussions so that we can make some progress?
Baroness Williams of Trafford
I always try to answer noble Lords’ questions from the Dispatch Box. However, in this instance, I take the noble Lord’s point. With the leave of the House, I propose to withdraw Amendment 62 today and return to it at Third Reading.
Lord Warner
Before the Minister responds to that, perhaps I may add to it. I read from her statement on Monday evening, where she makes it absolutely clear that, under Amendment 28, we would be conferring on the combined authority many of the duties, such as,
“the duty to seek continuous improvement in the quality of services, reduce health inequalities, promote the NHS constitution”,
and to,
“seek to achieve the objectives in the NHS mandate”.—[Official Report, 13/7/15; col. 439.]
As I understand it, what she is saying openly and transparently is that those duties get transferred to the combined authority through the order. If someone then says to the Secretary of State, “I don’t like the way health inequalities are going on in Cornwall”, or wherever, presumably, the Secretary of State can say, “Tough. I passed an order through Parliament which enabled me to offload that duty to this group of people for a period of time”.
Is the Minister saying that she did not mean what she said on Monday, or have we got this wrong?
Baroness Williams of Trafford
My Lords, I am not going back on what I said on Monday. I think that I made clear on Monday that the accountability and functions of the bodies do not change.
Baroness Williams of Trafford
My Lords, I am trying to be helpful, although I am not sure that I am being very helpful. I indicated to the House on Monday that we are considering with a view, as appropriate, to returning at Third Reading to the question of whether to exclude from functions that can be transferred those regulatory and supervisory functions of national regulators responsible for regulating public authority functions. However, I would add that our consideration is not about how to exclude them on an order-by-order basis but whether to take these regulatory functions out of the scope of the Bill. This would put beyond doubt—whatever devolution deals, including health, were agreed—that the position of the regulators, such as Monitor and the Care Quality Commission, would be untouched, as indeed would the NHS constitution and mandate and all the NHS standards of care and access, as my noble and learned friend Lord Mackay pointed out.
With these perhaps not entirely satisfactory explanations, I hope the noble Lord will agree to withdraw his amendment.
Lord Warner
There was a lot of heat but not much light, I suggest, from that debate. I say to the Minister that I am still thoroughly confused as to whether the Government are talking about transferring duties, powers, functions or responsibilities—there is a raft of words that may look as though they are the same, but they are not. On Monday night, the Minister talked about the conferral of duties from the Secretary of State. If, as the noble and learned Lord, Lord Mackay, is suggesting, the Secretary of State’s duties in the 2012 Act are absolute and apply to the whole of England—I think he is probably right—I do not see how they can be transferred under an order-making power in this Bill. We need to come back to this at Third Reading. We need something specific about the NHS in the Bill. It may not be the detail of my amendment, but, at the moment, we are in danger of creating considerable confusion around the world in terms of the NHS and what is intended by the Bill in relation to its responsibilities. In the mean time, on that basis, I beg leave to withdraw my amendment.
Cities and Local Government Devolution Bill [HL]
Debate between Baroness Williams of Trafford and Lord Warner
Baroness Williams of Trafford
My Lords, we have talked about the Secretary of State’s ability to intervene, which in itself is also a check and a balance. The orders will be debated through both Houses of Parliament. I will make some progress on this, and if the noble Lord wants to intervene further, he is very welcome to.
For the debates it will be important that full details of the deal concerned, how it was arrived at and the outcomes expected of it will be fully available to Parliament. As I said in the earlier short debate, I am ready to consider whether the standard Explanatory Memorandums are sufficient to ensure that Parliament has all the information it needs in this unprecedented process of devolution. As to a requirement for a combined authority to publish an annual report on its deal in relation to health, there will be a process, as I said in one of our debates last week, for evaluating the progress on each deal agreed with each area. For example, the Greater Manchester deal has an extensive programme of evaluation, with evaluations being public documents available to all with an interest in the area and the progress being made. I do not believe that it is appropriate to make a requirement about the reporting or evaluation of some particular aspect of a deal—an aspect which may not be in all the deals that are agreed.
I turn to some specific points that noble Lords have made. The noble Lord, Lord Warner, talked about the Secretary of State for Health overturning decisions if he did not like them. It is a bit more than that. I think he could intervene if he thought that decisions would be detrimental to people’s health or well-being. That was the point I was hoping to convey, but perhaps I did not do it articulately enough.
Lord Warner
I am being totally confused by the Minister. If she is saying that the detail of a deal is enshrined in regulations, the Secretary of State has signed off that deal. That implies that if there are any controversial issues around in, say, Greater Manchester, they will be dealt with in the orders that come before both Houses of Parliament and which he will have signed off. If he has signed off those orders and they have covered the transfer of resources, for example, from hospitals to preventative services, why should he need to intervene on such a transfer from a hospital to these other services? The Secretary of State seems to want to have it every which way: you agree the deal, you put it in an order and you still reserve the right to veto things on a subsequent level. That is what the Minister seems to be saying.
Baroness Williams of Trafford
My Lords, it is what I am saying but I am also saying that the detail of the deal, which noble Lords have requested full sight of, will go through both Houses of Parliament. It is important that the Secretary of State, of whichever department, can intervene in any matter which he feels is to the detriment of the public. That is what I am saying but maybe we mean different things by “intervene”.
Lord Warner
My Lords, this really goes to the heart of this matter. The Secretary of State under my amendment would have to assure himself that having a deal in the first place was for the benefit of the population of the combined authority. He is actually guided in that—also by the 2012 Act—so he cannot agree a deal that is likely to adversely affect that population. He would be in breach of his own duties and responsibilities. If he has then agreed a deal that is not abrogating NICE responsibilities or access standards or anything else, but is merely shifting the balance of resource provision and service provision between one set of services currently and another set of services that better meet that population’s need—which is indeed what the Five Year Forward View says should be done—and he signed that all off in an order, why does he need a power to intervene again during the duration of that order because he thinks something is wrong? He has agreed what they are going to do.
Baroness Williams of Trafford
Perhaps I have not articulated this—in fact, I wonder if the noble Lord and I are talking at cross-purposes. I am not talking about the Secretary of State intervening in the process of the deal and of the order going through both Houses; I am talking about subsequently, if matters went awry in a particular area. However, that would be the obligation of the Secretary of State whether it was for local government or health or whatever area we will be talking about. Perhaps we can leave that there and return to it in due course.
The noble Lord, Lord Warner, also made the point that it will always be the Secretary of State’s view that prevails. The noble Lord suggests that however great the local consensus might be, the Secretary of State has the power to override this. This argument lacks the essential element, which is how the Secretary of State will exercise his powers. These powers will be exercised reasonably, having regard to all relevant considerations, including local views and the NHS’s own plans in the forward view. In terms of service reconfiguration, the Government have pledged that all service changes should be led by clinicians and patients and not be driven from the top down. The Government have outlined strengthened criteria that decisions on NHS service changes are expected to meet. The criteria are: support from GP commissioners; clarity about clinical evidence bases underpinning proposals; arrangements for public and patient engagement, including local authorities being further strengthened; and the need to develop and support patient choice.
The MoU between the NHS England and Greater Manchester makes it clear that plans for devolution will align and support the objectives set out in the Five Year Forward View. The forward view sets out the NHS’s own plan for the next five years, supporting local areas to take forward plans for transformation, including an increased focus on prevention and integration of services. On the aspect of the 2012 Act that noble Lords have asked about, we have been very clear that existing NHS standards and accountabilities will be upheld. The NHS Act 2006 as amended by the 2012 Act sets out clear duties held by the Secretary of State in relation to the health service. For example, the 2006 Act puts a duty on the Secretary of State to,
“have regard to improvement in quality and reducing inequalities”,
and the duty is exercised in a way that supports local areas. He and other noble Lords asked about the compatibility between the 2012 Act and what has been proposed here. I can confirm that they are compatible with each other.
The noble Lord, Lord Hunt, asked who actually takes the decisions in Greater Manchester. The memorandum of understanding between NHS England and Greater Manchester provides that decisions are to be taken by the partnership between the local authorities and the health bodies—in other words, the Greater Manchester joint commissioning board as a board would operate. This reflects the principle that decisions are devolved to the most local level that is most effective and beneficial for patients and communities.
Baroness Williams of Trafford
My Lords, I can confirm that the accountable body is the partnership board.
Lord Warner
We are going nowhere, my Lords. Let us have another go. Let us follow up the issue of the closure of 50 beds in a Manchester hospital because the money is going to be used for preventive services and more services in the community. The partnership board has agreed that, and the consultants in the hospital affected take umbrage at that. They wind the public up—this is a well-tried and tested form of action in the NHS—get some money from a pro-bono lawyer and, under the provision of the noble Lord, Lord Hunt, they sue somebody. The Secretary of State has signed off the partnership board’s deal. Are they going to sue the partnership board? Are they going to sue the chairman of the trust affected for letting his 50 beds go? Are they going to sue the Health Secretary? Or are they going to sue the chairman of NHS England for agreeing this deal? I think we need to know who. This is not an implausible case I am giving; it is everyday bread-and-butter stuff in our British NHS.
Baroness Williams of Trafford
My Lords, as I understand it, it is the partnership board. I cannot add any more to this. As I understand it, the accountable body is the partnership board.
Baroness Williams of Trafford
I thank the noble Lord very much indeed for that intervention.
Finally, the noble Lord, Lord Hunt, asked me to define “public authority”. It is any authority in the public sector, including all public bodies and NHS bodies, Ministers of the Crown and government departments. New subsection (4) in Clause 6 provides that, in the case of the Bill, it,
“does not include a county council or district council”.
With that, I ask the noble Lord to withdraw his amendment.
Lord Warner
My temptation is to say, “You must be joking”. This has been a very interesting and illustrative debate. I do not think that many people, not just on the Labour Benches but on this side of the House, have found illuminating some of the answers to the questions that we asked. I want to make a helpful suggestion to the Minister. I strongly suggest that she facilitates a meeting between some of us with herself and Health Ministers—and possibly even NHS England—to explore this issue as quickly as possible. We are in danger of creating total confusion, not just among ourselves but among people in the outside world and in the NHS, who will read these debates and be thoroughly confused as to what is going to happen to them in the coming years. I suggest that we have a meeting and, on that basis, I beg leave to withdraw my amendment.
Cities and Local Government Devolution Bill [HL]
Debate between Baroness Williams of Trafford and Lord Warner
Baroness Williams of Trafford
Yes, my Lords, I am. They would be done by order, and any orders will be scrutinised through the affirmative process in both Houses of Parliament.
As to reporting on how a deal is proceeding, as I said in one of our debates earlier this week, a process for evaluating the progress on each deal will be discussed and agreed with each area as part of the deal. For example, the Greater Manchester deal has an extensive programme of evaluation, with evaluations being public documents available to all Members of the House, as well as to all with an interest in the area and the progress it is making. But again, I do not believe it is appropriate in our enabling Bill to make a requirement about the reporting or evaluation of some particular aspect of a deal, indeed an aspect that may not be in all the deals that are agreed.
I turn to specific questions that noble Lords have asked. The noble Lord, Lord Bradley, asked whether I would support the view that joint board membership should include representatives of the police, et cetera. In any one place, this will be a matter for the area concerned. In Greater Manchester, for example, it is for those concerned to agree who should be on the joint boards, which will reflect the responsibilities that the combined authority has. He asked the very simple question of whether the Secretary of State for Health will be ultimately responsible to the public for the delivery of health and social care. The answer is yes. He also asked about the Manchester MOU. Greater Manchester and all the health bodies concerned, including national bodies such as NHS England, as well as the Greater Manchester clinical commissioning groups, continue to work on the full details of the arrangements that they have agreed.
Lord Warner
I am sorry to interrupt the Minister’s flow, but I am becoming extremely confused. Twice in her response the Minister has said that all decisions about Greater Manchester will be taken “with” Greater Manchester—in other words, not “by” Greater Manchester. In this last set of responses to my noble friend, she makes it clear that the Secretary of State is responsible for decisions about health in Greater Manchester. What I am struggling with is this: what is the purpose of devolving some of these health responsibilities to the Greater Manchester Combined Authority if the Secretary of State reserves a right to overrule or vet those decisions? I thought that when the Chancellor announced the Greater Manchester project with a great song and dance, a very strong emphasis was given to the ability of local people to take the decisions that affect their area.
Let me give the Minister one example to chew on. Greater Manchester is proposing to remove a significant number of beds from acute hospitals to put more money into preventive medicine and community- based services. The Minister will know that closing hospital acute beds is a very contentious issue up and down the country. Who will take that decision? Is not Greater Manchester at risk of saying, “Our population’s health would be improved by removing some of those acute beds and spending some of that money on preventive public health and community-based services”? Can the Secretary of State then simply overrule it, using his powers in the 2012 Act? That is a very practical, real example of where we could have conflict. I would like to know where the Government stand on that issue.
Baroness Williams of Trafford
My Lords, Greater Manchester would work with clinical commissioning groups, et cetera, but would not itself deliver NHS services.
Lord Warner
That was not my question. Perhaps I could explain to the Minister what it is. The clinical commissioning groups in Manchester could all agree that they should take a large number of beds out of acute hospitals in Manchester—not anywhere else—because it was in the best interests of and would achieve better health outcomes for that population. Could they—all the interested parties, clinical commissioning groups and even NHS England, with the combined authority—agree that that is sensible to do? Could we then have a situation in which the Secretary of State, under pressure from some bits of the local community or from the acute hospital, declined to approve that well thought-out plan by the combined authority with the clinical commissioning groups? It is a straightforward question. Is the answer yes or no to whether the Health Secretary can overrule them?
Baroness Williams of Trafford
My Lords, perhaps I may clarify what exactly is being devolved. Greater Manchester will have the powers necessary to participate in a collaborative partnership which will develop health strategies for the place and commission health services. It would be a partnership arrangement. If within that partnership the Secretary of State thought that all of them collectively were making the wrong decision, I am sure that he would have something to say about it.
Lord Warner
So the result is the Secretary of State reserving unto himself all the authority to overrule a locally reached decision. We can talk about partnership till the cows come home, but is not the reality—and this is a critical issue—that the Secretary of State, as one of the partners but the partner with the power under the 2012 Act, can simply overrule them because he thinks that is the right thing to do?
Baroness Williams of Trafford
My Lords, I was not saying that the Secretary of State would overrule them for overruling’s sake, but if it was fundamentally a wrong decision, I am sure that he would have the power to intervene. I think that that is what the case would be. Does the noble Lord want to respond?
Lord Warner
I will read Hansard and come back on Monday, because this issue seems to me an Exocet under some of the principles in the Bill.
Lord Woolmer of Leeds
My Lords, surely devolution means giving power to the local level; it does not mean doing that—as long as the Government at the centre agree. Surely devolved authorities must in principle have the right to take local decisions, otherwise it is not devolution.
Lord Warner
May I suggest to the Minister that we return to this on Monday afternoon because I do not think she will satisfy us this evening?
Baroness Williams of Trafford
I know that we will return to it, and I look forward to that.
The noble Lord, Lord Warner, asked what legal advice had been received about the relationship between the MOU and the 2012 Act. NHS England and Greater Manchester have developed the MOU, and any draft order that the Government bring before the House to implement any arrangements agreed will of course be compliant with the relevant primary legislation. The noble Lord also asked about further change to the terms of agreement with Greater Manchester. We can envisage that, with the agreement of all concerned, devolution in Greater Manchester will develop.
The noble Lord, Lord Beecham, asked what the statutory roles of health scrutiny committees are in the context of devolution. Health and well-being boards will continue to exercise their statutory functions.
Cities and Local Government Devolution Bill [HL]
Debate between Baroness Williams of Trafford and Lord Warner
Baroness Williams of Trafford
My Lords, I think we agree but have perhaps got our wires crossed. It is an entirely flexible process. If Norwich and the surrounding areas want to come up with what they see as the best proposal for that area, the Government are here and listening. I am saying that there cannot be combined authorities within combined authorities under the law, but the whole purpose of this enabling Bill is to allow areas to come forward with the proposals that they see as the best. There has to be agreement across the piece.
Lord Warner (Lab)
My Lords, can the Minister clarify one of her remarks? She talked about the Chancellor and the Secretary of State for Communities and Local Government being the accountable Ministers for these local deals. One of the great attractions of the Greater Manchester deal is that £6 billion is being transferred from the health budget to work within the Greater Manchester scheme. Where does the Health Secretary sit in the accountabilities for some of these schemes?
Baroness Williams of Trafford
My Lords, as I understand the health and social care aspect, Greater Manchester has agreed a memorandum of understanding with NHS England. The Secretary of State for Health runs the relevant department.