Cities and Local Government Devolution [Lords] Bill

Debate between Lord Mann and Alistair Burt

Wednesday 21st October 2015 Commons Chamber

[John Mann]

Is there anything in the Government’s proposal that would impact on a district such as Bassetlaw —the hospital trust crosses the border into south Yorkshire, but the clinical commissioning group money remains entirely within the district—electing to join Sheffield city region, in another region, where other decisions will be needed? Are there any hidden nasties we should be aware of?

[Alistair Burt]

No, I do not think so. There are neither hidden nor unhidden nasties. Local decisions will still be made, and CCGs will still be monitored for quality, effectiveness and the like. I am just coming on to talk about the regulation.

Clause 19 provides that the regulatory functions of national bodies held in respect of health services will not be available for transfer to a combined or local authority. This makes it clear that local devolution settlements will not devolve the regulatory functions of Monitor, the Care Quality Commission or other health service national regulatory bodies as defined. This means that a transfer order may not change the way in which our national health service regulators operate to protect the interests and safety of patients. Amendment 38 inserts a provision clarifying that a “health service regulatory function” means a regulatory function within the meaning given by section 32 of the Legislative and Regulatory Reform Act 2006, in relation to the health service. Amendment 35 omits the word “supervisory” but clarifies that the supervisory functions of NHS England in relation to CCGs are also expressly protected from transfer.

The safeguards set out in clause 19 would support the Secretary of State in ensuring in a transfer order that where a combined authority or local authority was to exercise transferred health functions, using the Bill’s new powers, that authority could be held to account as to the exercise of its health service functions, just as NHS commissioners are currently held accountable. Amendment 36 amends clause 19 to require that in a transfer of functions to a combined authority or a local authority, provision must be made about standards and duties to be placed on the authority.

Amendment 38 provides further explanation of the national service standards to which the Secretary of State must have regard when making such provision. These include, for example, those in the standing rules set for NHS England and CCGs, recommendations and quality standards published by the National Institute for Health and Care Excellence, and of course the standards set out in the NHS constitution, which sets out pledges and codifies requirements, statutory duties and rights that NHS services in England must, as a minimum, meet. These include national access standards, including waiting times. Amendment 38 also provides definitions for “national information obligations” and “national accountability obligations”.

As amended, clause 19 provides further clarity about the role of the Secretary of State for Health and what will and will not be included in any future transfer order giving local organisations devolved responsibility for health services. This clear statement in legislation, making provision for the protection of the integrity of the NHS, is intended to provide further confidence for future devolution deals. In essence, they will be underpinned by the basic core duties of the NHS, and that cannot be shifted. Amendments 32 to 38 give further definition and clarity to support the valuable principles behind this clause.

New schedule 1, which inserts schedule 3A in the Bill, provides for amendments to the National Health Service Act 2006, and new clause 8 is a clause to introduce that schedule. These amendments concern the making of arrangements with combined or local authorities for the exercise of health commissioning functions under the 2006 Act, including provisions allowing greater flexibility over how partners to such arrangements may work together. This will enable greater integration of health and care services and support local leaders to take collective steps towards better health and care for their local population.

New schedule 1 also makes small amendments to the 2006 Act concerning the provision that may be made in regulations concerning local authorities’ social care information.



Places such as Greater Manchester and Cornwall are calling for the ability to design and deliver better health and care services, and the ability to make decisions at a level that works best for their communities—locally or, where it makes more sense, at a regional or sub-regional level. As we know, devolution deals will be tailored to the needs and circumstances of a local area. The Bill will already allow the Government to make orders to devolve to a combined authority or a local authority a range of powers and functions currently carried out by Whitehall Departments or bodies such as NHS England.