English Devolution and Community Empowerment Bill

Baroness Scott of Bybrook Excerpts

Committee stage
Monday 9th February 2026 Grand Committee

[The Deputy Chairman of Committees (Baroness Scott of Needham Market) (LD)]

If I can help the noble Lord, at this point I think that we are expecting the two Opposition Front-Benchers to speak and then the Minister.

[Baroness Scott of Bybrook (Con)]

My Lords, I will speak on a number of amendments in this group that relate to health. They illustrate just how far this Bill stretches and the breadth of its potential impact on matters of public interest. Health is now firmly brought to the fore. Clause 44 inserts new provisions into existing legislation to place a duty on all combined authorities and combined county authorities to have regard to the need to improve the health of the people in their areas and to reduce health inequalities when they exercise their functions. The same duty is applied to mayors of mayoral combined authorities and mayoral combined county authorities.

This represents a welcome shift. It means that health and health inequalities are no longer seen as an issue solely for the NHS or public health bodies, but I hope that the Department of Health and Social Care is aware of these proposals. If it is not and is not fully engaged, we will not get too far. Instead they must be taken into account across the full range of decisions made by combined authorities, whether they relate to transport, housing, planning, skills or economic development. That is an important change, because many of the factors that shape health outcomes sit well beyond the health system itself.

I thank the noble Baroness, Lady Bennett, for her Amendment 159, which seeks to broaden the list of health determinants and health outcomes to be considered as part of this new duty. The concerns that she raises are understandable and I am sympathetic to the desire to reflect the full complexity of what really drives health inequality. However, I ask the Minister whether she believes that combined authorities will have both the capacity and the practical power and resources to deliver against such an expanded list. In the Government’s view, is this expansion feasible? While ambition is welcome, we must ensure that any duty placed on local institutions is deliverable and affordable, rather than well intentioned and unrealistic.

In opening this group, the noble Lord, Lord Addington, spoke about public access to fitness, sport and recreational facilities. These issues are clearly important and, as always, he made a compelling case for the role that access to physical activity plays in improving health outcomes. Many noble Lords will agree with the principles that he set out. It will be interesting to hear from the Minister whether she believes that placing such matters in the Bill is either necessary or proportionate.

The amendments to Clause 44 tabled by the noble Baroness, Lady Freeman of Steventon, seek to align the list of health determinants more closely with academic research. The points that she raises are thoughtful and well made. I would be grateful if the Government could explain how the existing list of health determinants was arrived at. Who decided what should be included and by what process? Was there any consultation and were academic experts involved? Understanding how this list was developed is important so that we have confidence that it is robust and evidence based. In particular, I found the reference to “educational opportunities and attainment” in Amendment 161A especially interesting. Education is widely recognised as a key driver of long-term health outcomes and I will listen carefully to what the noble Baroness has to say on this matter.

I also note the amendments tabled by the noble Baroness, Lady Boycott, particularly those that relate to climate and pollution. These amendments raise issues that are often cited as having implications for public health. However, they also serve to underline a broader issue that runs through this group. The difficulty is not simply whether individual factors can be linked to health outcomes but how far such a list should extend. If climate-related risks and pollution are included, should the same apply to noise pollution, as raised by the noble Baroness, Lady Freeman? What about resilience to heat waves, which was also raised in this group? Each of these can be argued to have relevance but, taken together, they illustrate the challenge of scope. At some point a judgment must be made on where the boundary of general health determinants is drawn. That judgment is important for maintaining clarity and focus within the Bill and ensuring that the resulting duties are workable.

This returns me to the underlying question raised by the group. Who determined which health determinants should be included and on what criteria? What evidence or metrics were used to reach these conclusions? Without greater clarity on this point, it is difficult to assess whether the approach taken is sufficiently defined and proportionate. In that context, will the Government commit today to publishing an explanation as to how these decisions were reached? In particular, will the Minister set out who was consulted in the development of this list, what evidence was relied on and what criteria were used to determine inclusion or exclusion? Providing that clarity would assist the Committee in understanding the rationale behind the approach taken and assessing whether the duty, as framed, is appropriately defined and justified.

Before I sit down, I go back to my plea in the last group. As I have said before, if any of this is going to work, the Department of Health and Social Care will have to be involved. It will also have to work with local government and, by working with it, be willing to devolve power and moneys locally. I look forward to the Minister’s response.

[The Parliamentary Under-Secretary of State, Ministry of Housing, Communities and Local Government (Baroness Taylor of Stevenage) (Lab)]

My Lords, I thank all noble Lords who have submitted amendments on health improvement, which is an important topic. I am pleased that we will have this duty on local authorities at mayoral combined authority and combined county authority level. As other noble Lords have said, it is an important step forward.

The Government are committed to building a fairer Britain. To do that, we must ensure that people can live well for longer and spend less time in ill health. Our response, our reimagined NHS, will be designed to tackle inequalities in both access and outcomes, as well as to give everyone, no matter who they are or where they come from, the means to engage with the NHS on their terms.

With our colleagues in the Department of Health and Social Care, we remain committed to reducing the gap between the richest and poorest in healthy life expectancy—an ambitious commitment that shows that the Government are serious about tackling health inequalities and addressing the social determinants of health. We support NHS England’s Core20PLUS5 approach, which targets action to reduce health inequalities in the most deprived 20% of the population and improve outcomes for the groups that experience the worst access, experience and outcomes in the NHS. As the noble Baroness, Lady Scott, said, tackling health inequalities requires a whole-government effort, as does making sure that the best facilities are available across the country. That is why we are working across departments, from housing and education to employment and welfare, to make sure that health is built into all policies and runs as a golden thread through everything taking place.

I now come to the specific amendments, a number of which would make additions to the list of general health determinants. Before I turn to the individual amendments, I note that the scope and definition of “general health determinants” in the Bill has been intentionally and carefully crafted to be broad and flexible. I will write to noble Lords in answer to the questions from the noble Baroness, Lady Scott, about how those determinants have been drawn up and what consultations have been done on them.

The Bill lists some of the broad and interconnected factors that shape health, life expectancy and healthy life expectancy. Combined authorities, combined county authorities and mayors can directly impact these factors, such as standards of housing, employment prospects and environmental factors, through the delivery of their wider functions. Given the importance of these factors as inarguable determinants of health, the Bill strengthens the duty and adds clarity by listing them explicitly. Although some examples are provided, it is not our intention to set out a definitive list—we feel that that would be constraining. We recognise that combined authorities and combined county authorities are experts in their local areas and are therefore best placed to decide how to determine and act on the factors most relevant to improving health and reducing health inequalities in their own areas.

I am grateful to the noble Lord, Lord Addington, for tabling Amendment 158 and, as ever, for championing the importance of public access to fitness, sport and recreational facilities. This amendment would require combined authorities to consider the level of public access to fitness, sport and recreational facilities when exercising their functions. The general health determinants already include matters affecting lifestyle, access to services and environmental factors, and explicitly allow for consideration of any other matters that affect life expectancy or the general state of health. I am not being pedantic—nobody loves a clever clogs—but, to be specific and clear, I note that the amendment would apply only to combined authorities and not to combined county authorities, thereby creating inconsistency in how the duty operates. I apologise that I shall have to point that out with a number of these amendments, but it is important to clarify that.

I now turn to Amendments 159 and 167 in the name of the noble Baroness, Lady Bennett of Manor Castle. I appreciate that her intention is that the health improvement and health inequalities duty, and the definition of general health determinants within the duty, are broad and impactful. A driving purpose behind the health improvement and health inequalities duty is to support combined authorities and combined county authorities in reducing health inequalities and adopting a “health in all policies” approach. The effect the amendments would have is unclear because of the potential interactions with both “health inequalities” and “general health determinants” in Clause 44.

As I mentioned, the Bill has been drafted to provide a broad and flexible definition of “health inequalities” to ensure that differences in aspects such as life expectancy, general health, mental health and disabilities can all be captured in its scope. This allows combined authorities, combined county authorities and mayors to focus on the broad underlying causes of health inequalities and to tailor their responses to key local issues. Similarly, the framing of “life expectancy” or “general state of health” is intentionally broad and does not exclude mental health, disability or healthy life expectancy, all of which are legitimate dimensions of what one might regard as health and are reflected in mainstream methods for describing health states or health impacts.

I turn now to the large group of amendments: Amendments 159B, 160A, 161A, 163A, 163B, 165ZA, 165B, 167A, 167B, 167C, 167D, 167E, 167F and 167G. I am grateful to the noble Baroness, Lady Freeman of Steventon, for her diligence in tabling them and recognise her assured intention to ensure that the definition of general health determinants reflects academic research and is impactful.

As drafted, the list of general health determinants already requires combined authorities and combined county authorities to have regard to environmental factors, employment prospects, earning capacity and access to public services, and explicitly allows for consideration of any other matters that affect life expectancy or the general state of health. Health inequalities are already defined within the duty as inequalities between people of different descriptions living in an area, and it is therefore not necessary to restate this within the general health determinants.

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[Baroness Taylor of Stevenage (Lab)]

I do not disagree with the noble Baroness. I am saying that this is a local authority duty, and it does not need to go up to the strategic level of a mayoral combined authority. That is why we do not need the amendment for combined authorities, but I accept her point about local authorities. A statutory duty is probably not applicable anyway, but I will give that some further thought, if she is happy for me to do so.

We recognise all the benefits of allotments and community gardening, but we do not want to duplicate existing legal responsibilities or place burdens at the wrong tier of government, which would run counter to the Government’s approach to devolution. I am sorry for going on for so long, but there were a lot of amendments in this group. As I have explained the Government’s rationale for resisting these amendments in detail, I request that they are not pressed.

[Baroness Scott of Bybrook (Con)]

This is an important group of amendments, particularly if health does decide to devolve down either power or money in the future. But if local areas have specific health needs that the Government identify, and if they are not seen by the Government as dealing with them, do the Government intend to take a power to intervene?

[Baroness Taylor of Stevenage (Lab)]

I am not sure about powers of intervention. We have a very specific competence that points our combined authorities towards health issues. The Government have made it very clear that we want to see mayors, in particular, sitting on ICBs; I hope that this will start to address some of the issues raised by noble Lords about not having a voice around the table with health colleagues. I know that Manchester has new powers relating to health issues. We will want to monitor those, have a look at them and watch what is working. We will then decide whether we need to take any further action.

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[Lord Fuller (Con)]

My Lords, some time ago in the teens, from 2015 until about 2022, I was a member of the fire services pension fund, which exposed me to a world that I had had no real previous experience of. I learned that there were 40 fire and rescue authorities in the UK and it astonished me that, of the 40 fire and rescue authorities, there were seven different structural constructs within them. I am speaking in violent agreement with the noble Lord who has just spoken.

For example, there were the single county authorities such as Norfolk or Suffolk, and there were the joint county authorities such as Dorset and Wiltshire, working together under a single canvas. There were joint committees, for example, as you might find in the West Midlands—I am not quite sure whether the Yorkshire ones that the noble Lord just referred to are in the same bucket as the West Midlands or indeed whether they form an eighth different variant. There are the mayoral ones in Manchester, the London Fire Brigade stands alone and, of course, within the police and crime commissioners there is the one in Essex, for example, which is different from the one in Hertfordshire. We are now going to add combined county authorities, so I think that makes eight, and now within the mayoralties there will be a case A or a case B, each of which may have in addition a commissioner or a deputy mayor.

This is crazy. For 40 types of authority there are—I have nearly run out of fingers—10 different constructs, I think. The Bill should be bringing order to that complexity. Instead, it is obfuscating and adding a further cat’s cradle of complication. I know that we are in Committee and that we will come back on Report, and I understand the complexity and the interaction with the police, because the police and fire and rescue work together in so many cases, but we have to bring some order to this chaos.

Although I do not necessarily support the entirety of the text of Amendment 170, it has probed the necessity of bringing some sensibility to what is a nonsense in the way in which our brave fire and rescue firefighters deal with not just fires. During my tenure as a trustee of the fire service’s pension scheme, I learned that the average fireman goes to a fire once every 12 days or so; this is about the other important work they do, in prevention and in attending road accidents and other national emergencies. They deserve better than the structures they have today.

[Baroness Scott of Bybrook (Con)]

My Lords, Amendment 170 would require a mayor who holds fire and rescue authority functions to delegate those functions to a deputy mayor for fire and rescue, creating governance arrangements that mirror those already in place for policing.

The noble Baroness, Lady Pinnock, on behalf of the noble Lord, Lord Goddard, raises a number of interesting and important points, as we have heard from this short debate. I look forward to the Minister’s response, particularly on the issue of democratic accountability, as raised by my noble friend Lord Trenchard, and on my noble friend Lord Fuller’s point about making sure that public services all work from the same geographic area. This is a once-in-a-lifetime opportunity to ensure that; it might take a little longer, but I am sure it is worth doing.

During our consideration of the Bill, it has become clear that fire and rescue services are not listed as statutory consultees in the devolution framework. For me, that raises a number of important questions for the Government. As we have heard, fire and rescue services play a central role in public safety, resilience, planning and emergency responses, yet when decisions affecting land use, building standards, transport corridors or climate adaptions are taken without any requirement for fire service input, there is a risk of the safety and resilience considerations being added only after decisions have been made, rather than being embedded right from the outset.

In that context, I would be grateful if the Minister could explain why fire and rescue services are not statutory consultees, whether the Government consider this omission appropriate, and whether steps are being considered to strengthen their formal role in devolution and governance arrangements.

[Lord in Waiting/Government Whip (Lord Wilson of Sedgefield) (Lab)]

I thank the noble Baroness, Lady Pinnock, for moving Amendment 170, which would require a mayor with fire and rescue authority functions to delegate those functions to a deputy mayor for fire and rescue.

Mayors are best placed to determine how to use the people and resources at their disposal to deliver for their communities. This amendment would prevent that by mandating the delegation of these functions specifically to a deputy mayor for fire and rescue. It would also, therefore, prevent mayors delegating these functions to a public safety commissioner. The effective delegation of fire and rescue functions to a commissioner can ease capacity constraints, ensuring that there is a dedicated individual with the time and expertise to focus on executing those functions. Fire and rescue functions are already held by deputy mayors for policing and crime in Greater Manchester and York—and in North Yorkshire, as mentioned by the noble Baroness, Lady McIntosh. She seemed to say that she was not quite sure where it sat, so I will definitely write to her to explain how it works.

If they wish, mayors will be able to make an existing deputy mayor for policing and crime the public safety commissioner, meaning that that individual could lead on both policing and fire. However, certain functions should be the sole responsibility of the elected mayor as the head of the fire and rescue authority. Functions with the most significant bearing on the strategic direction of the fire service—such as the budget, the risk plan and the appointment or dismissal of the chief fire officer—are, therefore, retained by the mayor. On statutory requirements, fire and rescue services still have the right to respond to any planning application at the moment, for example, so they play a key role in that area. It is important that decisions in these areas are taken right at the top and that the person taking them is accountable at the ballot box.

To answer the noble Lord, Lord Wallace, every effort is made to make coterminous the public service boundaries when we lay out these plans. The position we have taken provides strong accountability and operational flexibility for the mayors, and I therefore ask the noble Baroness to withdraw the amendment.

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[Lord Wilson of Sedgefield (Lab)]

The noble Lord’s point about whole-society resilience in the security review is quite right in the circumstances in which we find ourselves. There are resilience plans in all local authorities for such an incident, so these things are taken into consideration and reviewed constantly.

[Baroness Scott of Bybrook (Con)]

I have two comments on the noble Lord’s response. First, the fire and rescue service is no longer a statutory consultee. Anybody can respond to a planning application, but that is slightly different from being a statutory consultee. Secondly, commissioners are not accountable at the ballot box. Therefore, why would we allow the role to go down to not deputy mayors—I do not think there are such things—but the commissioners responsible, when they are not accountable at the ballot box?

[Lord Wilson of Sedgefield (Lab)]

I am not sure whether there were any questions there.

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[Baroness Pinnock (LD)]

My Lords, these two amendments are enabling amendments in response to the previous issue that was raised with Amendment 170 about absorbing fire and rescue services into a mayoral authority.

It has long been the objective of previous Governments to combine police services and fire and rescue services into one model by arguing that they were both emergency services and, therefore, would be better combined. That has always been resisted, with support from these Benches, because police and fire and rescue services have very different objectives. This Bill is seeking to absorb policing and fire and rescue into the ambit of the directly elected mayor, without having this discussion about whether it is appropriate.

I accept that four mayoral authorities have already combined policing and fire and rescue. Whether or not that has been a success is yet to be tested. The argument against these two amendments—I will reprise a bit of what I said on Amendment 170—is that it is an erosion of transparency and public accountability for what is, after all, a critical emergency service.

It is always interesting to me when we have government amendments—it points to pressure somewhere that new powers are needed to make this work. Amendment 172 removes the inspection of the fire service from the inspection regime and puts it into a mayoral regime. This means that, for instance—these are within the amendment—an inspector cannot challenge the budget of fire and rescue, challenge the appointment or dismissal of the chief fire officer, hold the chief fire officer to account or approve an emergency performance and reinforcement scheme.

All those are critical to ensure public accountability of the fire and rescue service, but suddenly they will not be available for its inspection regime. That will not do. The fire and rescue service plays a vital role as first responders to serious road traffic accidents. They are always the first there, not the police, and they are often at terrorist incidents. We need to have accountability for the public and the existing inspection regime, to ensure that it works well.

My argument with this amendment, as with Amendment 170, is that this is happening by stealth, by absorbing fire and rescue into the police service. Combining them ensures that the mayor has responsibility for those functions. The inspection regime does not apply to the mayor, therefore public accountability for the fire and rescue service lies in holding the mayor to account. As I have said, the mayor is now the sole Lord High Everything of a huge number of strategic functions, so holding them to account on any one of them will be a challenge. I hope that the Minister will think again on this proposal to change the way that fire and rescue services are democratically accountable and inspected, because I fear that failing to do so could have serious consequences.

[Baroness Scott of Bybrook (Con)]

My Lords, as I understand it from the Minister, the inspectors in question inspect only operational matters and not governance matters. Therefore, to not inspect the governance of mayoral combined authorities and combined county authorities is in keeping with the approach that the inspectors already take to existing fire services. Will the Minister please confirm that I have that right? If I do not, will she please explain why the Government’s arrangements for these new authorities will be subject to less scrutiny than already exists in the fire services? If my understanding is correct, I still have concerns about the need for effective scrutiny of new authorities taking new powers, in this instance over fire and rescue, so will the Minister please tell the Committee how the governance of fire and rescue services will be inspected and scrutinised, if not by this inspectorate? We have to ensure that there is an appropriate approach to scrutiny for all new mayoral combined authorities, which is exactly what the noble Baroness, Lady Pinnock, said. I look forward to the Minister’s response.

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Debate on whether Schedule 25 should be agreed.

[Baroness Scott of Bybrook (Con)]

My Lords, by opposing Schedule 25, we seek to probe and clarify what functions may be delegated to mayors under future regulations. Prior to the changes proposed by this Bill, the principal mechanisms for conferring local authority and public authority functions on combined authorities were set out in the Local Democracy, Economic Development and Construction Act 2009. More recently, equivalent provisions for combined county authorities were established through the Levelling-up and Regeneration Act 2023.

Under both frameworks, functions have generally been conferred on individual combined authorities or combined county authorities through bespoke statutory instruments, subject to the affirmative procedure. In other words, Parliament has been asked to scrutinise each discrete transfer of power on a case-by-case basis, authority by authority. However, in our reading, paragraph 2 of Schedule 25 marks a significant shift. It enables the Secretary of State to make regulations conferring functions not on individual authorities but on categories of mayors of combined authorities and combined county authorities, or to modify such functions once conferred. Clause 17 provides that those functions will then be exercisable by the mayor on behalf of the combined authority or combined county authority.

I would therefore be grateful if the Minister could explain in practical terms how this new approach differs from the position under the 2023 Act. In particular, how does conferring functions on a category of mayors differ, both operationally and constitutionally, from the authority-specific approach taken under the Levelling-up and Regeneration Act? What are the implications of this shift for democratic accountability, parliamentary scrutiny and local consent? Simply, will Parliament have more or less say and will decisions of this kind be subject to clearer democratic oversight than under the previous framework? My fear is that they will not. Additionally, is the Minister willing to illustrate this with a concrete example, perhaps in relation to transport, skills or planning, so that the Committee can better understand how Parliament’s role in scrutinising these transfers of power will change in practice?

The provision in paragraph 12 of Schedule 25 allows the Secretary of State to make regulations applying differing voting arrangements from those set out as the default in Clause 6 in relation to particular functions for one or more categories of combined authorities or combined county authorities. I have a number of questions for the Minister. First, in what circumstances do the Government envisage departing from the default voting arrangements and what criteria will guide those decisions? Secondly, how will local consent be secured where voting arrangements are altered by regulation, particularly if those changes materially affect the balance of power between constituent authorities and the mayor? Finally, what safeguards exist to ensure that such variations do not undermine transparency or local democratic accountability?

Part 6 of the schedule introduces yet another significant power: the ability of the Secretary of State to confer additional public authority or local authority functions on specific strategic authorities as part of a time-limited pilot programme. It also allows for the governance arrangements of existing functions to be modified on a similarly time-limited basis. Again, I seek assurances from the Minister. How will pilot authorities be selected and on what objective basis? What evaluation criteria will be applied before, during and after a pilot programme? Crucially, what guarantees are there that the time-limited pilots will not default and become permanent through inertia rather than explicit parliamentary approval?

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[Baroness Taylor of Stevenage (Lab)]

The competencies are there, so the powers will stay the same as in the grid that we have set out. I ask the noble Lord to have a look at it and, by all means, to come back to me if he has any questions on it.

The Government will be able to confer functions across all areas on which we expect strategic authorities to act. Also, if the Government wish to create a completely new function and confer it on a strategic authority, primary legislation would be required. This strikes the balance between delivering further devolution and ensuring that appropriate parliamentary scrutiny of more novel measures takes place.

I hope this answer is helpful to the noble Baroness, Lady Scott, and ask her not to oppose the schedule.

[Baroness Scott of Bybrook (Con)]

I thank the Minister for her response; however, I think we will need to go back to Hansard. My example, for instance, was not on the pilots. It was an example on the changes that have been made in this Bill to, in particular, the levelling-up Act. I will of course go through Hansard carefully and, if necessary, we will return to these matters.

The issue of oversight goes to the heart of how this House discharges its responsibilities, particularly in view of reorganisation and changes to how we are all governed. Processes in this place matter and, when we confer powers, particularly those that will shape local systems and local decision-making, we must do so with proper regard to localism and accountability, not just what the Secretary of State at the time would like.

Much of our consideration of this Bill has necessarily focused on the schedules. Schedules are rarely debated line by line in the same way as clauses. When powers are dispersed across multiple schedules, as they are in this Bill, it becomes more difficult for your Lordships to track precisely what authority is being granted, to whom and subject to what limits. That is not a criticism of this House, nor of the Government, but it does mean that we must consciously take the time to examine these provisions with care. Schedules also frequently rely on delegated powers, allowing Ministers to add, remove or modify functions through regulations with limited parliamentary oversight. Over time, this risks creating a ratchet effect, whereby more and more policy is shaped by executive action rather than by primary legislation. That is precisely why the questions raised in this debate deserve clear and substantive answers. When the Minister reads Hansard, maybe a letter would be sensible.

For those reasons, while I am grateful for the short debate that we have had today, I remain concerned that important issues of scrutiny and accountability have yet to be fully addressed. I hope the Government will reflect on these points as the Bill progresses. At this point, I will not press my opposition to the schedule standing part.

Schedule 25 agreed.

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[Lord Lansley (Con)]

My Lords, before we complete this group, I just want to say that what the noble Lord, Lord Hunt of Kings Heath, said by way of moving his probing amendment asks not only important questions but questions to which we will have to come back, if not in this Bill then on the NHS reform Bill. As I know the noble Lord will completely understand, in so far as that forthcoming legislation will transfer responsibilities back into the Department of Health and Social Care and, potentially, give specific statutory responsibilities to integrated care boards, neither of those will allow this legislation and the 2016 legislation to operate in the way he intends. We will, therefore, have to come back to that and how it will happen at the time.

As things stand, the Secretary of State for Health and Social Care does not devolve any of his functions to local government. In effect, he devolves the functions that would otherwise be exercised by NHS England in Manchester to the mayoral strategic authority. If we are going to do that in other mayoral strategic authorities when NHS England has disappeared, there will need to be a new structure to see how this works.

In some ways, it is entirely dependent on how the Government intend, in the NHS reform procedures, to re-establish the relationship between the NHS and local government. Nobody—I heard the noble Lord say this quite recently—has satisfactorily created that relationship. In the coalition Government, it was a very complicated process, and it did not work. There have been positive outcomes in relation to public health, but, for local government, there have not been satisfactory outcomes in relation to the management of health services—particularly in so far as they can be combined satisfactorily with social care services. This is something that we will have to return to in the NHS reform Bill.

[Baroness Scott of Bybrook (Con)]

My Lords, turning first to Clause 53, I am grateful to the noble Lord, Lord Hunt of Kings Heath, for his probing stand part notice. As we have said more than once, the devolution of health is a complex matter that raises many important questions—particularly, as we have heard, around the relationship between local authorities and the NHS. I listened to the passion of the noble Lord, Lord Hunt of Kings Heath, on this issue. I assure him that I felt as passionate as him 15 years ago; I hope that, at the end of all this, he is not as disappointed as I was.

When I was going through this in Wiltshire, the interesting thing was that the staff on the front line—those in the NHS and in local authorities—really understood this issue. They understood the importance of devolution and how they could deliver much more efficient, better services for the people whom they wanted to serve. That pushed me to do this more and more. However, as I have noted previously, many of the determinants of public health sit outside the health system. We must be clear on who is responsible for what. As we have said many times, where additional duties and responsibilities are placed on local authorities, they must be matched with sufficient resources to deliver them properly. In addition, the Government’s approach must be evidence-based and must demonstrate value for money for taxpayers.

On previous groups, the Minister mentioned the mayor’s involvement in integrated care boards, and we all welcome that. But it has to go further than that. In my opinion, being a member of an integrated care board will not deliver what we need to be delivered on the ground with health and local authorities.

This brings me to Amendment 185 in the name of my noble friend Lord Gascoigne. I thank him for making the case so compellingly. This amendment would prevent the duplication of powers between local authorities and central government. In the realm of health, for instance, we cannot risk the lines of accountability being blurred, whereby functions and responsibilities are devolved down to local authorities, yet Whitehall does not equip them to deliver effectively or continues to do the same jobs itself, leading to duplication.

This is precisely the difference between the Government’s current approach to devolution and what genuine community empowerment ought to look like. This amendment aims to correct that by ensuring that, when a function is devolved, it is also relinquished by central government, while still permitting the appropriate oversight where needed.

If the Government truly believe in local community empowerment, there can be no greater vote of confidence than supporting the principles set out here, trusting local authorities to do the jobs devolved to them fully, and giving local people clear, transparent lines of accountability. This is a matter not of meaningful devolution but of efficiencies and effective government. I look forward to hearing the Minister’s response on both these important amendments.

[Baroness Taylor of Stevenage (Lab)]

My Lords, I thank my noble friend Lord Hunt of Kings Heath and the noble Lord, Lord Gascoigne, for their amendments. I turn first to my noble friend Lord Hunt probing whether Clause 53 should stand part of the Bill.

Clause 53 places limits on the devolution of health functions to strategic authorities to ensure that the health service remains truly national. I know the noble Lord understands that. For instance, it prevents the transfer of the Secretary of State for Health’s core functions in relation to health. Where health functions are devolved to a strategic authority, it requires that provision is made to ensure that they adhere to national service standards.

Protections against devolving these functions are not new; as the noble Lord indicated, they have probably been going since the health service was first set up. They have certainly been in place since central government first began the process of devolving functions to combined authorities. The Bill merely retains those protections. I know my noble friend wishes to probe the Government’s intentions on devolving health functions in the future, and he is right to do so.

Health, well-being and public service reform is an area of competence for strategic authorities, as set out in Clause 2. The Bill also confers a new health improvement and inequalities duty on combined authorities and combined county authorities. As health is covered within the areas of competence, the Government could use the powers in this Bill to devolve health functions to strategic authorities in the future, if they believed it appropriate to do so. Mayors of established mayoral strategic authorities would also be able to request the devolution of health functions and get a response from government.

This demonstrates that the Government see a clear role for strategic authorities and mayors in health, both now and going forward. The example of Manchester is a very good one, and we will continue to look at what is happening there to make sure that lessons can be learned and that, if we get requests from other mayors to devolve health functions to them, we pick up on any lessons from Manchester. At the moment, the process is looking positive. But it will always be right, I fear, that limitations remain to make sure that the health service remains truly national. Whether that is in targeting or some of the processes, we will see.

I turn to the amendment from the noble Lord, Lord Gascoigne, which seeks to prevent the doubling up of powers and responsibilities in strategic authorities and Whitehall. I heard the Secretary of State speak over the weekend and his view is definitely that devolution by default is the way he wants to move this forward. He was very clear on that, and on the advocation of subsidiarity that sees powers and funding always held at the most appropriate level for delivering any service. The funding settlement will be announced this week; it may be out today. It is out—I thank the noble Baroness, Lady O’Neill. I had not kept up on that, although I have talked of nothing else all weekend.

Through the integrated settlement, we have instituted the principle that, where central government funding falls within the scope of an established mayoral strategic authorities’ functional responsibilities, that funding will be devolved. The Government are also committed to providing new strategic authorities with capacity funding to kick-start their organisations, so all areas on the devolution priority programme will receive mayoral capacity funding to help establish their new institutions once the legislation has been laid before Parliament. They will receive capacity funding in future years as well, so they are ready and prepared to deliver the benefits of devolution.

I agree with the noble Lord that, unless you have the funding to deliver these new functions, there is not much point in devolving them. We very much agree with the spirit of the noble Lord’s amendment. When responsibilities are devolved, they have to be devolved as thoroughly as possible to enable the true innovation and place-based approaches that we all want to see and that are the whole purpose of devolution in the first place. That is the position the Government have taken in the devolution framework in this Bill. The majority of powers will be exercised solely by the strategic authority or concurrently with the constituent authorities.

However, there are rare circumstances where the relevant Secretary of State and the strategic authority need to share powers. To give an example, the Secretary of State will retain the ability to provide funding in relation to adult education in addition to funding provided by the strategic authority. This will ensure that those areas in strategic authorities do not miss out on nationwide schemes. For example, I think there have been some announced today.

The amendment in itself is too restrictive and would prevent instances where it makes sense for powers to be held concurrently with government. I understand the noble Lord’s concern that, while functions may be devolved, funding may remain in Whitehall. However, the Government are committed to providing strategic authorities with the funding to deliver their functions.

We have committed to providing new strategic authorities with capacity funding, as I have said, and the integrated settlement institutes the principle that government funding will be devolved where the responsibilities fall within established mayoral authorities’ functional responsibilities. I hope that, with those explanations, noble Lords are able to support the clause standing part of the Bill.

--- Later in debate ---

[Lord Fuller (Con)]

My Lords, I am glad that I am following the noble Lord, Lord Bassam, because I could not disagree more with his Amendment 196C. When I was the leader of a district authority, we had control over the business rates, and we were able to get full reliefs to the last pub, shop or community sporting club in a village with a population of less than 3,000. That was the source of a huge community empowerment. The effect of the noble Lord’s amendment would be another nail in the coffin for rural pubs and small businesses, and I reject it on that basis. I will also speak to my own Amendment 256A, which is a rag bag. We are talking about Clause 56 at the moment, but this would go right at the end, beyond Clause 85; perhaps I should have asked for it to be de-grouped, but here we are.

My amendment is consistent with the Government’s Clause 11, which relates to constraining the council tax-raising ability of the larger, newly created mayoral combined authorities. But I am looking at the other end of the spectrum, because I am concerned that, following local government reorganisation, the former district councils, which are currently defined as “billing authorities” under the Local Government Finance Act 1992, will disappear. In Section 39(2), they will become local precepting authorities. In other words, the district council, once abolished, will be converted to a third-tier parish or town council. This will affect places like King’s Lynn, a historic county borough; cathedral cities like Norwich or Oxford; county towns like Ipswich and Chelmsford; and coastal communities like Hastings, Eastbourne and Great Yarmouth.

Some of these places have large populations—for example, Norwich City Council, when it is abolished, will have a population of more than 150,000—and there will be lots of new large locals formed. The problem is that the majors are constrained in their ability to put up council tax—5%—but the locals are not. This amendment would change the definition of “local precepting authority” to include authorities with a population below 49,999. Where a local precepting authority exceeds 50,000, it would become a major precepting authority for the purposes of raising council tax and be subject to the same rules as other larger councils.

Of course, it is not just the former billing authorities that will flip into parishes; the former boundaries that flowed from the hundreds, the poor law unions, the urban and rural district councils, and the predecessors of the county boroughs in the Reform Act 1832 will disappear. This is why my amendment proposes a size scale, rather than being limited solely to the former district councils. These places will be joining that benighted club: Salisbury, Shrewsbury and Scarborough, which have all fallen out of previous rounds of LGR and must now stand on their own two feet in the sense that, unlike their predecessor billing authority constructions, they will get no formula grant in the future; they will need to earn what they spend.

We already know already that over 100 councils, existing principal authorities, want exceptional financial support this year as the Government shamelessly tilt the formula away from being population based. That is a denial of the simple truth that people consume services that need to be paid for and that it is more expensive to deliver them in the countryside, but that is a debate for another time.

But, under LGR, there will be a powerful incentive for authorities to cost-shunt the most expensive things to these newly created third-level authorities to get the liabilities off their books and on to the small fry. I am thinking of leisure centres, municipal theatres, parks and open spaces, youth groups, civic activity, and community pride events such as carnivals and festivals.

My wife was a parish clerk for over 10 years in a small parish with 500 souls, spending about £3,000 a year, so I know the value of what these unsung volunteers—real community champions—in parish councils can achieve. But I am focusing on the new large class of parish, town or even small city authority, with plenty of staff, plant and equipment, miles away from that “Vicar of Dibley” stereotype.

These residents need protecting from unconstrained tax rises, cost shunts from principal authorities and the smaller populations being made to afford the costs of facilities that have been previously amortised over a much larger canvas—that hinterland of surrounding parishes where people are able to chip in. This is not an idle concern. The noble Baroness has certainly mentioned Salisbury before, which has let rip. Its precept is up 44% in just four years. Its own website tells long-suffering residents that their council tax is the highest in Wiltshire. At £383 for band D, it is over twice the level of my own district council. I have looked at Shrewsbury. Following LGR, its parishioners’ band D is up 218% in 10 years—although I will concede that, at £87, it appears to be offering slightly better value for money. To those against my amendment, I say: look to Shrewsbury, because limiting council tax in these third-tier authorities can be done.

I have also looked at Stevenage, which is likely to be consumed and subsumed into the larger construct—taking power further away from residents and damaging the distinct identity that came from it being the first post-war new town, alongside all the other accoutrements. It is funny how all my examples begin with an S. In Stevenage, the band D was raised by just 3% to £246.41. If it carries on like Salisbury, a band D in Stevenage would pay £354 by 2030—a raise of nearly 50% or over £100.

We must be clear that these are burdens in addition to the new mayoralties that will be created—the huge new bureaucracies with the ability to raise precepts for things they are not even responsible for. There will be new mayoral CIL on top of existing CIL and new authorities where the effects of council tax equalisation within the canvas have not even been ventilated yet, and the costs of LGR have not been determined. We know it is going be subject to at least a £1 billion black hole from the accelerated pension strain costs.

Do not let the Government tell you there will be fewer layers; there will be more and at more cost. The public will be rinsed by LGR. People will pay more for less—that much is certain—but my amendment would at least seek to constrain those billing authorities that are already principal authorities and are constrained in their ability to raise council tax. That will still apply to them when they are transmogrified into third-tier councils, to make sure they cannot do a Salisbury too. That is right not only by residents but by the authorities, because as they approach this forced reorganisation, which will see a transfer of assets, they will know by this amendment that there is not a blank cheque. It will sharpen the minds.

This is not a dig at parish councils or the third tier. They do a lot of valuable work at a level that is closest to the people, but I have got their back, because it will stop those councils with the broadest shoulders from imposing liabilities and cast-offs on to those with the most limited means. That is an essential safeguard if the community empowerment part of this Bill is not to be undermined. I would be creating equity between the cathedral cities, the market towns, the new towns and so forth, so that council tax after LGR does not become an intolerable burden for those who live within the cities and provide perverse incentives for those just outside to become free riders.

I know the Minister is concerned about this and we have spoken for some time about it. I have suggested a £50,000 threshold in Committee, but as we move to Report I would be open to saying that perhaps there should be a £1 million precept or some other measure. But we have to have a measure between the small and the major authorities to protect parishes from having their leg lifted and, in turn, protect their residents from being rinsed.

[Baroness Scott of Bybrook (Con)]

Before my noble friend sits down, I would like to clarify something. You cannot compare Salisbury as it is now to Salisbury as it was before as a district council. It was a far larger area; it was Sailsbury and south Wiltshire, not just Salisbury city.

[Lord Wallace of Saltaire (LD)]

I am staggered at the thought of a parish council with a population over 50,000; it does not make sense to me. I am also staggered at the thought that, if we are talking about getting back to place-based communities, we are denying to places the size of Scarborough or Harrogate, both of which I know well and which have or used to have important assets, in conference centres and major hotels, the sense of local community or parish, thus increasing the sense for most of our public of total alienation from the politics that we are providing them with.

[Baroness Scott of Bybrook (Con)]

Can I just explain to the noble Lord that a parish council is a name given to parishes, towns and cities? It all comes under the same legislation as parishes.