Cities and Local Government Devolution [Lords] Bill

John Howell Excerpts

Wednesday 21st October 2015 Commons Chamber

[Alistair Burt]

I take the hon. Gentleman’s point. I am not sure, however, that we can be more prescriptive on the face of the Bill. The hon. Gentleman is describing the process by which an area says, “We think that, in addition to the functions already devolved, other things need to be devolved to help local health services work together”, but it is difficult to envisage the circumstances in which NHS England would say, “Well, no you can’t”. At the moment, most are working collectively in any case, so this is a matter for local decision making and agreement between the parties involved. I do not think we can say more than that directly in the Bill at this stage. The whole process of devolution will fall into disrepair if there is continual conflict between an area that says, “Look, we think we can do this”, and a central authority that says, “No, you can’t, there’s no point in that given the process we are going through”. The provision of safeguards is about ensuring that NHS England can be confident of devolving powers, because ultimately the regulatory powers and the safeguards should ensure that patients and constituents are protected by national standards remaining the same. That is how I envisage it working.

[John Howell (Henley) (Con)]

My right hon. Friend has talked a great deal about the safeguarding of NHS provision. Can he reassure me that the social care element will be protected by the same level of safeguards?

[Alistair Burt]

Yes, in that the regulatory powers of the CQC and the safeguarding inspection regime will be retained for the social care element that is covered by a devolution deal. Again, the whole point is to give as much flexibility as possible to areas that want to exercise their powers to deliver services differently, with the reassurance that there will no compromise in relation to key standards—not that that would be wished for in a local area, and not that it would be anticipated by any of the devolving powers.

Following discussions with Greater Manchester and other local areas, we are now taking the opportunity to make available further options in legislation for combined authorities and local authorities to work together with clinical commissioning groups and NHS England across a wider area—such as Greater Manchester—to improve the integration of services. Those options will sit alongside the powers provided by the Bill to devolve a range of powers and functions that are currently exercised by Whitehall departments or bodies such as NHS England to a combined authority or a local authority. Crucially, wherever responsibility for NHS functions is delegated or shared in this way, accountability will remain with the original function holder, whether that is NHS England or a CCG. The original NHS function holder will continue to be accountable via the existing mechanisms for oversight, which ultimately go to the Secretary of State, who retains ministerial responsibility to Parliament for the provision of the health service.