Cities and Local Government Devolution Bill [Lords]

Lord Brady of Altrincham Excerpts

Monday 7th December 2015 Commons Chamber

[Mr Betts]

Absolutely, and therefore I support the principles of the Bill, but having said that, and while agreeing with my hon. Friend, if we can do something to improve the devolution process, which this amendment does, we should be looking to do that as well. I want devolution to happen, but I want it to work. There is a danger in the Sheffield city region proposals that, without those North Derbyshire and North Nottinghamshire districts, and without a true reflection of the whole travel-to-work area, the devolution will not be as economically successful.

I accept in the end that it is a matter of consensus, however. This amendment allows those districts to express their own view about where they think their economic future lies without pulling out of the county for all other services. It allows devolution to go forward without a veto from the county over the particular issues of economic devolution and transport powers. It makes a lot more sense for the Sheffield city region. It also offers the same opportunities for the same way forward for the West Yorkshire combined authority and probably for the west midlands as well.

[Mr Graham Brady (Altrincham and Sale West) (Con)]

I shall be brief. I am pleased to follow the Chair of the Select Committee, not least because I thought one of his closing lines summed up our objective here this afternoon: we want devolution to happen, but we want it to work. I want to speak to new clause 8 and amendment 57 in my name and also touch on amendment 2 in the name of my hon. Friend the Member for Hazel Grove (William Wragg), all of which share exactly that objective.

Dealing with the question of consent and the referendum contained in amendment 2, it seems to me that if this process is to work it is essential that it should have the consent of the people who are going to be governed under these new structures. If the argument can be made for the new structures and new form of governance, the Government ought to have the self-confidence to give people a direct say on the changes that are about to be introduced. From a Greater Manchester perspective, I think it is entirely possible that the Government could put a case that would persuade people that the new arrangements should be approved in a referendum, but the very act of withholding that opportunity for them to express their will and to show real consent for what is being done in itself sows the seeds of difficulty and discord and makes it less likely that the new arrangements will work.

[Mr David Nuttall (Bury North) (Con)]

In his speech on 14 May, the Chancellor of the Exchequer said:

“I will not impose this model on anyone.”

Does my hon. Friend agree that the best way to demonstrate that local people want the new system would be to hold a referendum?

[Mr Brady]

I agree wholeheartedly. I devoutly hope that Ministers even at this late hour will recognise that it is very much in their own interests and those of the Government, and entirely in the interests of the people of the combined authority areas which may face these new arrangements of governance, to accept the point. I am especially hopeful given the sterling work my hon. Friend the Minister did in the last Parliament trying to ensure that people had the opportunity to give consent on the arrangements surrounding our membership of the European Union. I know he will recognise that, given his deep commitment to democracy, it would be entirely consistent for him to recognise the wisdom of the proposal.

New clause 8 is in tune with the essence of the Bill and the essence of the Government’s intentions. There are very few of us on either side of the House who would argue with the proposition that it is generally better for power and decisions to be exercised as close to the people as possible. It is almost invariably better for decisions, including spending decisions, to be taken more locally, and new clause 8 seeks to place an extra protection in the Bill: a safeguard seeking to limit the occasions on which the legislation could be used to permit devolution in the wrong direction. That is not really devolution at all, of course. Rather, it is the opposite of devolution: it is the capacity that exists in the Bill as it currently stands for powers to be moved up, away from the people and away from local authorities which currently exercise powers, to the combined authority or to mayoral authority level. It is a very modest measure—[Interruption.] My hon. Friend the Member for Bury North (Mr Nuttall) endorses that view, and I was surprised at just how modest my aspiration had become during the course of this process, perhaps due to the endless courtesy and charm of the Secretary and State and the Minister.

All new clause 8 seeks to do is ensure that, if a local authority decides to transfer a power to the mayoral level, there would be a cooling-off period before it became permanent, and crucially that a local election must be held before such time that that transfer of power away from the people in the wrong direction—this anti-devolution—can become permanent. That is a modest but important safeguard, and I hope Ministers will accept it would be in their interests and the interests of good governance to incorporate it.

Perhaps the most important measure in this group is amendment 57, which sits, almost naturally, as a part of a couplet with the proposition for a referendum. In a way, if we do not have one of them, it becomes even more important that we have the other. If the Government are not going to consult the people directly on the new governance arrangements that will apply to them by allowing a referendum, it is even more important that the arrangements set out in amendment 57 should be incorporated, which would allow a local authority, in the event that the new arrangements do not work in the interests of that local authority area, to seek at a future date to leave, with a fair distribution of both the liabilities and assets of the combined authority.

I have sought to ensure proper fairness and a reasonable arrangement in the unlikely eventuality that a local authority would reach the point where it was convinced that the new arrangements were not in its best interests. That would provide the necessary reassurance to people that this is not an irrevocable step, and that if it does not work, there is a way out of it. Perhaps most importantly, it would also place a real discipline on an elected mayor and ensure that the holder of that office would at all times seek to behave reasonably and reflect the interests not just of the majority of the area of the mayoral authority, but of the whole of it. The risk that an elected mayor may at some point in the future seek to govern in a way that is clearly contrary to the interests of any one part of a conurbation would be massively greater if the Bill were to proceed unamended. Again, I very much hope Ministers will recognise that the Bill would be strengthened and improved by amendment 57.

[Norman Lamb]

I want to speak in support of new clause 10 and to make a brief comment on amendment 7. The new clause seeks to reinstate in the Bill, as brought from the Lords, the provision to allow votes for 16 and 17-year-olds in local government elections. As a matter of principle, I support the idea of votes for 16 and 17-year-olds, whether in national elections, local government elections or referendums. I supported the case for 16 and 17-year-olds to vote in the Scottish referendum. I have also argued the case, along with many others, for them to be able to vote in the European Union referendum, because it is their future that we will be debating.

In the context of the Bill, I strongly support the case for 16 and 17-year-olds having a say, for goodness’ sake, in the election of their local councillor. I find it extraordinary that the Government oppose the proposal so strongly. I appreciate that the Secretary of State has indicated that there is a debate to be had on the subject, and that we might explore it more fully on other occasions, but how long does this have to take? Those 16 and 17-year-olds can join our armed forces to defend the country, they can marry and they can pay taxes on their income if they are in work, yet they cannot have a say on how those taxes might be raised, on the extent of them or on how they might be applied. As citizens they ought to have the same rights as the rest of us enjoy, and I urge the Government to think further on this.

We often make points about the low turnout among those young people who are entitled to vote, and about the low engagement in the political process. I made the point in our previous debate on the issue that young people are very interested in a range of political issues, but there is no doubt that in many cases many of them are disengaged from the political process. If we are to seek to change that, surely giving these young people the right to a say in the political process would help. The turnout among 16 and 17-year-olds in the Scottish referendum, at about 75%, is indicative of a level of interest in the issues, which the Government ought to recognise.

David Willetts, the well respected former Minister in the coalition Government, has made a point about the breaking of the generational contract. This is a serious concern. Political parties tend to focus a lot of their attention on the interests of older people, who of course tend to vote. I would argue that there is a lack of attention being paid to the interests of young people, particularly 16 and 17-year-olds, who have no vote at all.

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[Mr Rees-Mogg]

I do not accept that. I am not a big-is-good advocate. I think that small can well be beautiful. The individual leaders of councils are the doughty defenders of the interests of the population that has chosen them, and they are in their way like Members of Parliament in that they represent a specific area and a specific interest, and they can combine with others to see how decisions can be made. I see no lack of democracy in a group of people coming together, each one of whom has an individual mandate. Indeed that can be a better democratic mandate than having a highfalutin mayor.

[Mr Graham Brady]

I am enjoying my hon. Friend’s speech very much and following it closely. He may be interested to know—he may already be aware of this—that in Greater Manchester, which is really the point of origin of many of the things that we are discussing today, the combined authority has worked extraordinarily well, and that those elected council leaders have worked very well together. It seems odd to many of us that we should move from a structure that is working well, and to which nobody has any objections, to the imposition of a completely different structure without popular consent.

[Mr Rees-Mogg]

I agree with my hon. Friend. Imposing structures does not give them legitimacy. What gives them legitimacy is that they should be built from the ground upwards. Fundamentally, that is a Conservative view of how Governments are constructed. I am talking about the little battalions coming together to do big things jointly, rather than a hierarchical system that says, “We know what’s best for you.” That is the approach of those on the Opposition Benches. The socialist approach, as it is now, once again, a Socialist party, is about telling people what to do and giving them the figures who do it. The Conservative evolutionary approach is to allow people to come together, each one of whom individually has legitimacy to do things. I absolutely accept his point that combined authorities have worked by consent and that they do not necessarily need super-mayors or metro mayors put on top of them. If that is done without referendums, we will be back here in 20 years’ time—[Interruption.] I very much hope that the hon. Member for Bolsover (Mr Skinner) is still here in 20 years’ time so that we can discuss these important matters.

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[Mr Allen]

I beg to ask leave to withdraw the clause.

Clause, by leave, withdrawn.

New Clause 9

Consultation on changes to healthcare provision

‘(1) Part 4 of the Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013 is amended as follows—

“(1) In section 20 (Interpretation) insert after “for which there is a country council (a);”—

“(c) combined authorities and each constituent part of a combined authority””—(Mr Graham Brady.)

This amendment requires that constituent parts of combined authority are consulted on any major healthcare reorganisation in their area in addition to the combined authority being consulted. It also allows constituent parts of a combined authority to refer any such reorganisation to the Secretary of State for Health without such a referral having to be made by the combined authority to which they are part.

Brought up, and read the First time.

[Mr Graham Brady]

I beg to move, That the clause be read a Second time.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

With this it will be convenient to discuss the following:

New clause 12—Review of devolution of health services—

‘(1) The Secretary of State must, within 15 months of this Act being passed, publish a review of health services devolved under the provisions of this Act.

(2) The review must make an assessment of the extent to which the health services devolved under any of the provisions of this Act have maintained standards and, in particular, of the quality of services and outcomes achieved by those devolved health services over the first 12 months from this Act being passed.”

This Clause would require a review, after 12 months of the Bill being passed, of the impact of devolving health services in order to make sure that standards and the quality of services and outcomes have not declined.

Government amendment 34

Amendment 60, in clause 17, page 19, line 30, at end insert—

‘(2C) The Secretary of State may revoke health functions from the relevant local authority under subsection (2A) only following advice from an independent panel, whose membership must include representation from local government and the NHS and which is to be convened as and when necessary.”

This amendment would safeguard the devolution of health functions by ensuring that any revocation of these functions is done under the advice of an independent panel, whose membership includes representatives from local government and the NHS.

Government amendments 35 and 46 to 49.

[Mr Brady]

It might help if I indicate now that at the appropriate time I shall seek the leave of the House not to press new clause 8 and amendment 57. Ministers should not take that as indicating that I am entirely satisfied with the responses I have received, but I may be able to find other ways of expressing that dissatisfaction.

The immediate reason for tabling new clause 9 and why I am so concerned about this aspect of the Bill is that we already have a live example in Greater Manchester. I shall not go into huge detail, but because of the difficulties relating to the Healthier Together proposals for the reorganisation of hospital services, the matter will be decided by judicial review this week.

The new clause was tabled in the hope that we can frame the legislation in such a way that proper protection can be given to local authorities and local communities to ensure that this sort of development is not necessary in future. Should, furthermore, the judicial review overturn the existing proposals, it is important to ensure that they cannot simply be imposed in a different way.

The crucial problem is that the existing combined authority arrangements have combined the overview and scrutiny functions of individual local authorities. With the potential downgrading of the University hospital of South Manchester, for example, the usual route of going through Trafford’s or Manchester’s overview and scrutiny committee and referring the matter to the Secretary of State, asking for it to be put to an independent reconfiguration panel, was not available because the overview and scrutiny function was exercised not at the individual local authority level but at the combined authority level.

The Minister for Community and Social Care looks confused, but I assure him that when I had discussions with the Secretary of State he advised me that this was the route to be taken. I then took it to Trafford council, which said that it did not have the overview and scrutiny function and that it was exercised at the combined level. That is the nub of the problem. Significant parts of a conurbation such as Greater Manchester, which may in due course become a mayoral authority, might have no recourse, should a significant reorganisation of health services be proposed that was evidently not in the interest of the local community.

It is a simple proposition that I make in new clause 9. The Minister and I have had some extremely constructive conversations prior to this point, and I hope that he will reassure me that some measure will be introduced—if not today, via a Government amendment in the House of Lords—given that changes to these aspects of the Bill might be made through Government amendment 34. There is, I understand, a peg on which to hang that provision. All I am looking for is the simple reassurance that the Government will ensure that there will always be a route for an individual local authority to make the kind of reference that would have saved enormous cost, uncertainty and trouble in Greater Manchester had it been in place as of today. I very much look forward to hearing the Minister’s response and any reassurance that he might give.

[Mr Graham Allen]

I would like to comment on this group, which includes my own amendment 60. It is relevant to what the hon. Member for Altrincham and Sale West (Mr Brady) has talked about in moving his new clause 9. My anxiety is that the welcome devolution that is taking place—the precedent of devolving health powers to localities is particularly welcome—suggests something of “the Empire striking back”, with the Whitehall Leviathan seeking to place a caveat on the devolution of health powers. What is being set up is the ability of the Secretary of State to revoke health functions from the relevant local authority.

I fear that somebody in the Department of Health might not approve of a devolution proposal within a given area. Let us say that the cities of Nottingham or Manchester—or indeed anywhere represented by hon. Members in their places for this evening’s debate—wished to do something innovative and interesting on public health because it matched the demography in the area. What it might not match, however, is the view of people in the Department of Health. Such people might have a one-size-fits-all masterplan that they would like to impose on everybody.

My difficulty is that if we allow the Secretary of State to pull back to the centre any of these powers, there will be no safeguard in law to prevent that from happening. The Secretary of State could attempt to launch an effort at devolution, but we see again and again what can happen when the dead hand of Whitehall lies upon local government and the charitable and voluntary sectors. A year could be granted to get on with it, with a local authority either allowed to raise its own money or be given some money. If, however, the Department does not like it, it could be pulled up by the roots.

[Mr Allen]

The Secretary of State does have the power to pull back those experiments and those efforts at devolution. That is why I am bringing forward my proposal. If the Secretary of State is not concerned, he would have no worry about the ability of an independent panel to say, “Hang on—give these guys the amount of time they need to experiment” rather than have to deliver to a Whitehall timetable. That amounts to a contradiction in terms: devolution on the one hand, with the Secretary of State pulling things back into the centre on the other hand. My proposal—which I am sure the Minister can understand—is for the establishment of an independent panel, which would not consist of the Secretary of State and his advisers, but would include representatives of local government where the devolution was taking place and representatives of the national health service. That would enable the medical side to be looked at effectively, and separately from the Secretary of State. It would end the constant process that has driven devolution: the interference of Whitehall, often in the very short term, because someone somewhere in the Department of Health—some unknown person—does not like what is being done in the locality.

[Mr Graham Brady]

Is not the fundamental point that the Bill that we are about to pass may remain on the statute book for many years? The current Secretary of State may be fully committed to devolving these powers, but a future Secretary of State might wish to suck all of them back to Whitehall.

[Mr Allen]

That is always a problem, but in that eventuality, if the amendment were passed, an independent panel would keep an eye on it to ensure that, if the Minister were not the one who is in the Chamber now but someone more malign than he, it would be possible for the independent panel to blow the whistle and say, “You have not given people in this particular area”—whether it was Enfield, Stoke or anywhere else in the country—“a chance to prove that this part of the devolution of the health service is working effectively. You have a particular view”—perhaps in connection with the need to react to a scandal or a financial problem—“and you are not acting on the basis of the good of the people in the area, but retrieving from them their ability to devolve effectively and use health powers effectively.”

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[Alistair Burt]

I am happy to respond to this short debate dealing with new clause 9, tabled by my hon. Friend the Member for Altrincham and Sale West (Mr Brady), amendment 60—to which the hon. Member for Nottingham North (Mr Allen) has just spoken—new clause 12, tabled by the hon. Member for Hemsworth (Jon Trickett), and the Government’s three technical amendments.

New clause 9 would amend secondary legislation to require that each constituent part of a combined authority should be consulted on any major healthcare reorganisation in its area, as well as the combined authority’s being consulted. Each constituent local authority would be able to refer any such reorganisation to the Secretary of State, without such a referral having to be made by the combined authority.

As my hon. Friend knows, proposals for reconfiguration must currently meet the Government's four tests for service change: support from local GP commissioners, clarity on the clinical evidence base, robust patient and public engagement, and support for patient choice. At present, any local authority has the right and, indeed, the responsibility to raise issues about a reconfiguration. My understanding is that that right remains. I take my hon. Friend’s point about its having been given to the combined authority, but, because I do not know about the relationships between the local authorities in question, I do not know whether the combined authority would at any stage reserve the right back to itself if it wished to do so. In the meantime, however, I have one safeguard, and perhaps another, to mention to him. This also applies to the hon. Member for Nottingham North, because it is part of the same thing.

The Secretary of State is only going to accept a recommendation for devolution if it is in the best interests of health in the area and if it will improve health outcomes. He must do so by order. There is nothing in the Bill that requires an authority to take on a national health service function. Authorities can do so if they so wish, but the Secretary of State must be able to see a clear outcome, and he retains his duties and responsibilities for ensuring that the NHS mandate is maintained and that all his statutory duties and responsibilities are observed. The Secretary of State is not going to sign an order, therefore, if he does not think that the health outcomes for the area will be improved. The Secretary of State is entitled to put in the order what he wishes. That order is then debated in the House and has to be passed as an order.

It would be possible for the Secretary of State to include in the order the fact that the individual authorities that make up a combined authority have the right to make representations to him about any reconfiguration. I can give my hon. Friend the Member for Altrincham and Sale West that assurance, and if we find that the legislation is not as I believe it to be, which is that it has retained that right for the local authority, an order in relation to his local authority will contain that safeguard.

I also offer this to my hon. Friend: if he will consider withdrawing the new clause, we will check, before the matter goes before the House of Lords again, to see whether the legislation is as I believe it is, because if it is, the new clause will not be necessary; but if it is not as I believe it to be, the safeguard—the double assurance—will be included in the order and the present Secretary of State would intend to deliver on it.

[Mr Brady]

My right hon. Friend is seeking to be very helpful. The difficulty that exists is that the safeguards he proposes apply at the moment of devolution. My concern is that a reconfiguration might happen when a power has been devolved, which might not be in the interests of one of the constituent parts of a conurbation. What can be done at that point is what is crucial.

[Alistair Burt]

At that point, the order that the Secretary of State has signed to allow the devolution in the first place will allow the authority to make a representation to that effect. The order does not just apply to the moment of devolution; it applies to the substance of the devolution, which is the exercise of the health powers the combined authority will have taken on. In respect of a reconfiguration that takes place under the combined authority, the order will safeguard the right of the local authority individually to make representations to the Secretary of State. It is guaranteed not just at the point of devolution, but in the exercise of powers under devolution.

[Mr Brady]

Might I press my right hon. Friend a little further? I am avoiding being too specific about the Healthier Together proposals for obvious reasons, but in the event that those proposals were to be set aside this week and new reorganisation proposals were to be brought forward, can he give me an absolute assurance that, either under the existing legislation or measures he would introduce in the House of Lords, the individual local authority would retain the freedom to refer any reorganisation to the Secretary of State? If he can do that, I would be satisfied.

[Alistair Burt]

I believe that that assurance is present in existing legislation. If it is not, we will make sure in the House of Lords that it is. I would also query why my hon. Friend’s local authority has given up this right in the first place to the combined authority, because it if wants to retain that right, perhaps it might want to take it back from the combined authority.

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[Mr Brady]

The Minister has to understand that this is endemic in the nature of the process. It will become more and more commonplace as we see more powers being transferred from the local authorities to combined authority level, and the new arrangements will become entrenched. That is why it is so important that we ensure that the safeguards are in place at this point—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order.

[Mr Brady]

I am trying to assist the Minister, who I think needs just a moment longer.

[Mr Deputy Speaker]

Unfortunately it is me that makes the decisions—we could do this over two days—but I would have thought the Minister had at least some indication.

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[Liz McInnes]

I want to support new clause 12, although the Minister has made his case for turning it down. I think it is important that we build a review stage into the devolution of health simply because the implications of the Bill for the English NHS and social care system are not clear. The Bill regulates for important new powers to remove functions from NHS hospitals, commissioners and other bodies and to transfer them to the local regional authority. Depending on the implementation, interpretation and limits of the powers, such transfers might fundamentally reshape the health service in the years to come. We must ensure that the national health service stays national. We do not want a postcode lottery for healthcare.

Accountability and scrutiny remain crucial for a well-run national health service, delivering the best care it can for everyone no matter where they live. The Bill’s light-touch nature and the pace with which the agenda is moving leave a number of crucial and unresolved questions, some of which I would now like to ask. Will central and regional government argue over the responsibility for meeting population needs and making difficult decisions, such as those on whether to close hospitals or prop up overspending healthcare providers? What will happen to neighbouring areas?

Deals permissible under the Bill create the possibility of NHS funding melting into wider regional authority budgets, making ring-fencing or protecting impossible. Given the importance of healthcare spending as an issue, it needs clarity and scrutiny. Devolution to combined authorities under the Bill might actually have a centralising effect for many health and social care functions, taking power away from councils that represent smaller communities and the clinical commissioning groups that represent clinicians. Although that might be desirable in some cases, it is also important to consider how the positive developments brought to health and social care by these bodies can be preserved.

Clauses 7, 16 and 17 allowed the piecemeal transfer of health care commissioning responsibilities from clinical commissioning groups and NHS England to local government. I am concerned about the impact that will have on the NHS, especially as regards local variation in service levels, further allocation of resources and the cross-border impact of decisions. The Opposition believe that there should be a statutory duty on the Secretary of State for Health to secure and provide universal health care and that core national NHS standards should remain in place.

[Mr Brady]

I want to make it very clear, and this might be helpful to the hon. Lady, that after the Minister’s assurances to me I will seek the leave of the House to withdraw new clause 9. She might, of course, wish to do other things with her new clause.

[Liz McInnes]

I thank the hon. Gentleman for that intervention.

Although I see a range of possible potential benefits arising from the devolution agenda, particularly the opportunity for greater integration of services between health and social care and bringing public health and other areas under local government control, a number of outstanding questions will need to be resolved, largely focused on resolving the tension between local and national arrangements and the extent to which the “national” in the national health service will be preserved. What we are witnessing is not devolution. The models adopted in the deal so far appear to be closer to delegation than the formal devolution outlined in the Bill.

As the Opposition understand it, there are no plans to use the order-making power created through the Bill to transfer additional health functions to local authorities. Any health-related orders will be used only to enable combined authorities to share the health duty that already sits with local authorities. I seek the Minister’s assurance that the devolution of health service will be reviewed in a year to ensure that standards and quality of services and outcomes have not declined. That is what new clause 12 outlines—it seems an eminently reasonable request given an issue as important as our nation’s health.

[Mr Brady]

I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.