Health and Social Care Bill

Debate between Lord Hunt of Kings Heath and Lord Beecham

Monday 13th February 2012 Lords Chamber

[Lord Hunt of Kings Heath]

My Lords, I shall refer also to Amendments 21, 21A and 22. The amendments take us to a number of other matters in relation to the national Commissioning Board. I think that we are all agreed that the board will have an important role to play within the new arrangements, and its governance is a matter of considerable interest. My amendments, which follow closely amendments that I tabled in Committee, invite the noble Earl, Lord Howe, to give further consideration to how we can ensure that the governance of the national Commissioning Board is as effective as possible and that due parliamentary processes are involved.

The amendment would ensure that the chair of the national Commissioning Board was appointed only with the consent of the Health Select Committee. I am well aware that Professor Grant, the excellent chair of the board, gave evidence to the Health Select Committee and I am glad that that occurred. I should like to put the matter beyond doubt by putting this provision in statute for when future appointments of chairs need to be made. The noble Earl will know that I have followed precedent because this Government’s legislation that established the Office for Budget Responsibility makes it clear in statute that the appointment of its chair has to be agreed to or approved—or consent has to be given—by the appropriate Select Committee. My argument to the noble Earl is that the national Commissioning Board is as important as the Office for Budget Responsibility. I realise that one could look at a hierarchy of these organisations and I would understand if the noble Earl were to say that we cannot apply this provision to all bodies in a similar position. However, the responsibility of the national Commissioning Board is immense and there is a case for putting this in statute.

I sense that my Amendment 21 may not be necessary, but perhaps the noble Earl can confirm that the vice-chair of the national Commissioning Board would always be a non-executive appointment and that that person would always be the senior independent director.

Amendment 21A concerns public health specialist input. I should like some assurance from the noble Earl that the national Commissioning Board will have public health expertise. I understand that it is to have a medical director—and that is of course welcome—but, given the need to ensure that in the NHS, through the Commissioning Board and clinical commissioning groups, there is a good tie-in to the public health function, it would be good to know what arrangements the board will make to ensure that there is a strong enough link with public health. Having public health expertise around the board of the national Commissioning Board would, I should have thought, be very welcome indeed.

I come, finally, to my Amendment 22, which would remove the requirement for the appointment of the chief executive to be approved by the Secretary of State. I said in Committee that I had no problem with the provision that ensured that the first chief executive should be appointed by the Secretary of State. That is normal practice when new bodies are established. In order to get on with it, you clearly need to have a method by which the chief executive is put in place as soon as possible. I quite understand why it should be the Secretary of State in the first instance, but I do not understand why future appointments of chief executives should have to be approved by the Secretary of State.

Back in our debates on bureaucracy and the issue of the concurrent power of the national Commissioning Board with the Secretary of State in relation to the crucial parts of Clause 1, the noble Earl emphasised that the relationship between the Secretary of State and the national Commissioning Board should be seen principally through the mandate and the standing rules. He resisted my efforts to give Ministers powers of intervention other than the extreme power given under the Bill. If that is so, I cannot for the life of me see why the Secretary of State would want to approve the appointment of the chief executive. Surely the relationship should be between the Secretary of State and the chairman of the national Commissioning Board. Why must the Secretary of State have a veto on the appointment of the chief executive? That seems inconsistent with the general points that the noble Earl has been making about the need for the Secretary of State to have a hands-off approach.

The noble Earl may repeat what he said in Committee, which is that that is to do with the accountable officer status of the chief executive. With the greatest respect, is that very different from the accountable officer status in relation to many organisations within the NHS where the Secretary of State does not have to approve the appointment of the chief executive? I hope that at least on this one the noble Earl will recognise that Secretary of State approval for the appointment of a chief executive is wholly inconsistent with the general thrust of where the Government say that they are going, and will be sympathetic. I beg to move.

[Lord Beecham]

My Lords, I trust that my noble friend will not object if I claim at least parliamentary paternity of Amendment 21A—influenced, I must say, by the Faculty of Public Health and others interested in the public health dimension of the Bill. The Faculty of Public Health is a very respectable body, characterised, along with other opponents or critics of the Bill, by Mr Simon Burns, the Minister of State for Health, as zombies, a term that I cannot imagine emerging from the lips of the noble Earl. It is concerned about the degree to which the public health service and its interests and needs will be reflected in the structures that are being created. That interest is shared by the Health Select Committee.

The Health Select Committee also referred to its recommendation that the local director of public health should be a member of each clinical commissioning group. Having regard to the number of clinical commissioning groups, that is possibly asking a little much, although it would be sensible for clinical commissioning groups to consult the director or his representative from time to time in the course of their work. However, my noble friend is absolutely right to stress the importance of having a qualified public health professional on the national Commissioning Board. Public health is an enormously significant area of public policy, and we will discuss other aspects of it later this evening and subsequently during Report. The Health Select Committee was very clear that there should be a qualified public health professional on the NHS Commissioning Board and that the Commissioning Board should routinely take advice from qualified public health professionals when taking commissioning decisions.

The Government’s response to the Select Committee’s report is, to put it mildly, not very encouraging. While the board will be required to obtain clinical advice from a broad range of professionals, including those in public health—and the Government have stated their intention that there should be clinical and professional leadership on the board—they state explicitly that,

“it is an important principle … that it”—

that is, the board—

“should have autonomy of decision-making on matters such as its own membership and its structures and procedures, as far as possible, to determine how best to exercise its functions”.—[Official Report, 14/11/11; col. 514.]

That seems, frankly, to put an unnecessary degree of power in the hands of the national Commissioning Board. It again raises the issues of accountability that my noble friend dealt with so well earlier this evening. It is surely not acceptable to permit an organisation with this degree of power and influence—and, indeed, with the substantial resources at its disposal—simply to decide on its own membership, particularly when public health is not just a health service or Department of Health issue but goes much wider than that. It is important that those wider implications of the work of public health, which we will touch on later, are reflected in the board’s deliberations as a matter of course.

I hope that the Government will take the strong advice of the Health Select Committee and reconsider this position. I have no doubt that there will be a queue of other organisations wanting a place on the national Commissioning Board, but this is, in a sense, a unique function because of its reach into other areas of policy and administration, including, for that matter, other government departments. That voice, reflecting all those interests, is not likely to be represented directly in the way that other clinical interests probably will be in relation to the board. Therefore, I strongly support Amendment 21A, as well as the other amendments in the name of my noble friend. I hope that the Government will see their way to rethinking this matter and come back at Third Reading with a different position.

Police Reform and Social Responsibility Bill

Debate between Lord Hunt of Kings Heath and Lord Beecham

Monday 4th July 2011 Lords Chamber

[Lord Beecham]

My Lords, this group of amendments seeks simply to ensure that local authorities are consulted by the police and crime commissioner, along with the police and crime panel, in connection with any preparation or variation of a crime plan. Surely it is axiomatic that a close working relationship between the police and other authorities, particularly local authorities, is essential in dealing with matters of community safety and law and order. A wide range of local authority functions clearly impinge on the duties of the police and vice versa, so it is clearly desirable, if not essential, that in the preparation of any police and crime plan, given the commissioner’s responsibility to liaise and work with a wide range of statutory bodies, local authorities should be among the prime consultees.

The Minister has charmed the House over the past few weeks. I hope that her charm will be matched by a willingness to accept that this is a constructive amendment, designed to ensure the closest possible working relationship between the two most important arms in any approach to the issues which this Bill seeks to address and which the relevant authorities have to address on a day-to-day basis. I hope the Minister will accept these modest but important amendments to reinforce that relationship. I beg to move.

[Lord Hunt of Kings Heath]

As my noble friend inferred, we are debating the Localism Bill through which the Government wish to give more freedom to local authorities. As part of that we are seeing the Government present local authorities with an opportunity to have some of the constraints around their leadership role in a local area taken away from them so that the local authority is seen as having a leadership role which is not necessarily tied into statutory responsibilities. We are also seeing in that Bill a requirement on the 11 largest local authorities in England to hold referenda next year on whether there should be an elected mayor. The Government are therefore acknowledging the importance of local government and its place in the wider community. I support my noble friend’s amendments because they seek to ensure that when draft police and crime plans are prepared or varied, the local authority has a right to consultation. In our first discussion my noble friend referred to the potential of an elected mayor in Birmingham. I find it quite remarkable that we have the prospect of the elected mayor in Birmingham not having an ability to be statutorily consulted by the police and crime commissioner when it comes to a police and crime plan or a variation. This is a symbol of the importance of local government and I hope the noble Baroness will accept my noble friend’s amendment.

Police Reform and Social Responsibility Bill

Debate between Lord Hunt of Kings Heath and Lord Beecham

Wednesday 29th June 2011 Lords Chamber

[Lord Beecham]

My Lords, the noble Lord advances his argument with his customary eloquence, seductiveness and wit. Given the Government’s propensity to engage in deep cuts, I would not join him in proffering any sort of razor to them, Occam’s or otherwise. However, his argument is quite significantly flawed. First, he suggests the election of a completely separate body to administer part of the public services. That represents a rigidified fragmentation of local governance that takes us back in some respects to the 19th century of elected school boards and boards of that kind. That route does not commend itself to me or to many of us who are concerned to see local government strengthened and responsible for the strategic direction of affairs in a locality.

There are other significant arguments too. A single body constituted only of directly elected members would not include independent members, who have made a very significant contribution to the police service since they were introduced some years ago, as we have heard in earlier debates. There would also be great difficulty in securing a diversity of members, reflecting the ethnic and geographical diversity within police authorities. That would potentially weaken the effectiveness of the bodies that the noble Lord would seek to construct.

Furthermore, I cannot agree with him that it is unlikely that there would always be a degree of political balance. For example, in a region like the north-east, given the very limited number of members—11—that the noble Lord is proposing, in the case of the Northumbria force they would represent some 18 or 19 parliamentary constituencies. It is extremely likely that virtually all would be Labour members—if not all. That might have some appeal on this side of the House but it would not be recommended. Despite seeking to avoid the politicisation of the police force, one would see an authority constituted in such a way as to appear to reflect the views of one political party only. In other parts of the country there might be a similar situation with political parties of a different complexion. That is clearly something to be avoided.

The concern about politicisation of policing has been constantly referred to in your Lordships’ House on all sides and I fear that the noble Lord’s proposals tend—unintentionally—in that direction rather than otherwise. He relies on a democratic principle, and of course elections are important. But there is more than one way of construing the application of a democratic principle in the way in which a service of this kind is to be administered. If the majority of members of a police authority, as now, are elected councillors, they can claim legitimately that they are reflecting a democratic principle. They are not directly elected for that purpose only. That is a good thing because the police authorities have to relate to local government and take on board working relationships across a range of local services, which in their ordinary course of life as elected local councillors they will enjoy in any event. They are bringing that current experience to the position that they would hold. There are different ways of construing democratic principles. The noble Lord’s version, for the reasons that I have advanced, do not seem to fit the circumstances of this case and I hope that he will not press his amendment to the vote.

It might be argued that the noble Lord’s suggestion is preferable to that of a single police commissioner, which is arguably the case, but it is not in my view as good as relying on the proposals that have emanated from this side in the past, and which appear to have attracted a certain measure of support in the House, for an authority constituted, as now, of directly elected councillors serving their areas and of independent members. In my view, that is the best application of the democratic principle and secures also some of the other factors which should be taken into consideration. I do not expect the Minister to accept this amendment for different reasons from those which I have advanced but on this occasion she may find a degree of support, or at least acquiescence, which she might not otherwise gain over much of the rest of this Bill.

[Lord Hunt of Kings Heath]

My Lords, I am sure that we are all indebted to the noble Lord, Lord Carlile, for allowing us to have an almost Second Reading debate on the principles of the Bill. I must say that I feel that his unduly modest fees are almost always worth it. As I say, this takes us back to principles. I remain deeply puzzled about the merits of the legislation and am yet to be convinced that there are so many problems in policing as to warrant such a dramatic and potentially very damaging shake-up in the way that our police service will be run.

I was very interested to receive an email this morning from Liberty in which it says that it believes that the Bill’s premise is fundamentally wrong and that the Bill, if implemented as proposed, will cause irreversible damage to the relationship between the police and their communities. Indeed that is so. The noble Lord, Lord Carlile, did not really address that point. I understand his point about democratic accountability, but surely he will recognise that there are huge risks in the politicisation of our police force. There are very few guarantees that the elected police and crime commissioners will not seek unduly to influence the operational behaviour of chief constables.

I remain concerned that the construct of the Bill still provides too few safeguards against that undue exercise of authority by the elected police commissioner. Although I disagree with the noble Lord’s amendment, it is interesting that he has raised issues of good corporate governance. This is the problem of the concept of corporate soles: individuals—the elected police and crime commissioner on the one hand, and the chief constable on the other—who have enormous powers without being subject to effective corporate governance. I am with the noble Lord, Lord Carlile, to the extent that it would be much better if a group of people were collectively responsible, rather than leaving it to an individual. We will come on to issues of corporate sole later today but I welcome the noble Lord’s attention to the issue now. He is right to do so.

Ultimately the question is whether adding on an elected police authority to an elected police and crime commissioner would risk far too much politicisation of our police force. As the noble Lord will be aware, when we were in government we looked at this issue and originally made proposals for partly elected police authorities. However, we stepped back from that partly because of a lack of support out in the community and partly because of the risk of politicisation. We remain of the view that this is not the right way to go. However, the noble Lord has done us a service by raising some of the issues surrounding the lack of corporate governance in the Government’s approach.