Regulatory Reform

Debate between Graham Stringer and Richard Fuller

Tuesday 9th September 2014 Commons Chamber

[Richard Fuller (Bedford) (Con)]

It is truly a pleasure to listen to my right hon. Friend the Member for South Cambridgeshire (Mr Lansley) and to follow him in the debate. I am a member of the Regulatory Reform Select Committee and it was my vote that enabled the House as a whole to debate this measure, which might, on paper, seem rather arcane. The hon. Member for Blackley and Broughton (Graham Stringer) asked why we are debating it in this way. We are doing so because the core dilemma in much health reform involves the tension between local decision making and common advance. For many people, there is a tension between the priority to localise decision making and the need, as seen by professionals such as the doctors and clinicians whom we trust, for some decisions to be made on a common basis in order to achieve overall advances in health care. It can be difficult to find the appropriate boundaries as we try to resolve that tension.

I felt that it was important to bring this matter to the House so that other hon. Members could have a chance to talk about the experience in their own localities. The issues in Greater Manchester have already been mentioned, and my hon. Friend the Member for Stafford (Jeremy Lefroy) has mentioned the issues in his own area. I also felt that it was important to herald one of the most important attributes of the reforms that my right hon. Friend the Member for South Cambridgeshire introduced, which was to enable, as far as possible, decision making on these issues to take place locally and to ensure that those local decisions were led not by politicians or bureaucrats but by doctors. A concern has been expressed that this change would somehow draw us away from those reforms.

The shadow Minister, the hon. Member for Leicester West (Liz Kendall), asked some extremely pertinent questions, although she perhaps got off to a bad start by taking the political apparatchik line and suggesting that certain problems were the result of the reforms. This is actually about one of the best parts of those reforms, which allows local people to make decisions. That was reflected in the widely quoted comments made by Anna Bradley, the chair of Healthwatch England. In her note, she said that

“we are concerned that the proposed reforms could create the conditions for CCG decision-making to become disconnected from the transparency and accountability mechanisms put in place by the Government’s health reforms”.

She recognises, as do many hon. Members, the importance of the tension. She also referred to it in a press release, in which she stated:

“We understand the benefits of commissioners working collaboratively but it remains crucial that local people are involved, asked what they want and understand how decisions will affect the way services are delivered in their area.”

In my own area in Bedfordshire, we have been having a collaborative exercise between two clinical commissioning groups, and they have done an extraordinarily good job of communicating and maintaining local decision making.

[Graham Stringer]

The House owes the hon. Gentleman a debt of gratitude for bringing the order before us today. Will he tell us whether, in the example he is giving, the order would help, hinder or be neutral?

[Richard Fuller]

I am not an expert, but in that particular instance I do not think I would fear the joint committee making a different recommendation from the current committee in common, although it has yet to come back with its report. The point is that the hon. Gentleman and others have aired important questions for the Minister to answer. He has answered some of them, and that has been the purpose of the debate today.

Underpinning all this is the fact—whose importance I hope the Minister will emphasise in his response—that people want important health decisions to be taken locally. They can be persuaded of, and they can understand, the issue of common advance, but they want to know that a decision is being taken locally. I think that the Minister dealt with this in his response to the shadow Minister, but I would be grateful if he answered these points quite specifically. First, am I right in thinking that he said that decisions on the part of commissioning groups to go into joint committees were voluntary, rather than compulsory, and that it would therefore remain possible for them to continue to set up committees in common if they so wished? My second question—