Cities and Local Government Devolution [Lords] Bill

Karin Smyth Excerpts

Wednesday 21st October 2015 Commons Chamber

[James Wharton]

What I am saying is that, if this amendment is not made, deals with areas including Greater Manchester and the Sheffield city region would potentially be at risk; they would be open to legal challenge. The whole point of this Bill is to enable us to deliver on the deals that we are making with areas. That is the whole reason why we need this legislation. If we were able to deliver those deals without it, we would not be here debating it in this Committee today. I do not think that the loss of those deals is an outcome that many would wish to see. I therefore commend to the Committee the amendments that we need to make to ensure that we can deliver on our manifesto commitments and on those deals that we have made.

I now wish to consider amendment 51, which was tabled by my hon. Friends the Members for Hazel Grove and for Shipley (Philip Davies). It provides that a combined authority mayor can be established only after a referendum. Our manifesto commitment states that we will

“devolve far-reaching powers over economic development, transport and social care to large cities which choose to have elected mayors.”

We are committed to cities making the choice for a mayor, but, as I have made clear, a mayor will not be imposed anywhere. This principle of choice is a principle which I am confident that my hon. Friends accept.

[Karin Smyth (Bristol South) (Lab)]

rose—

[James Wharton]

If the hon. Lady will let me make a little progress, I will give way to her soon. I know that she has been keen to get in.

In the traditions of our democracy—the traditions of a representative democracy that go back to the days of Edmund Burke if not before—it would be curious if that choice could not be made by those elected at the ballot box by the people of the city to represent them. That is the approach that is provided for in the Bill. The Bill specifically provides that each council in the area must consent to any order establishing a combined authority mayor. There is a good precedent for such an approach. A council can decide to establish a directly elected mayor for its area now. It was Liverpool City Council, which, in 2012, decided that Liverpool should have a directly elected mayor. If one council can decide to have an elected mayor, why cannot a group of councils decide to have a mayor over their combined area?

To require a referendum to be the only way for a combined authority to have a mayor would seem not fully to recognise the role that those democratically elected can legitimately have. The choice at root, as Greater Manchester has shown—

[James Wharton]

My hon. Friend raises an important point. He gives me the opportunity to clarify again the difference between the local authority mayors, of whom we have talked before, who took powers up and away from people, and the metro mayors who take powers down towards people and away from central Government and public bodies. It is an important distinction and one that is at the heart of the difference that explains the approach the Government are taking to my hon. Friend’s concerns.

As Greater Manchester has shown, the choice at root is whether or not to have wide-ranging devolution. If the choice is for devolution, it goes without saying that there must be accountability arrangements commensurately strong for the scale of powers being devolved. Holding a referendum on the narrow question of whether there should be a mayor risks not fully recognising the choice that is to be made. In short, our democratic traditions do not demand the approach provided for in amendment 51. Indeed, the approach we have in the Bill of the choice for a combined authority mayor being made by councils is exactly the same approach that is open to councils for choosing a local authority mayor—accepting the difference that I have already explained in my comments to my hon. Friend the Member for Hazel Grove about these powers coming down from central Government. Accordingly, I hope that this amendment will be withdrawn.

[Karin Smyth]

I wish to come back later to make some other points, but let me raise now this issue of two-way opportunity and choice for local people, which I very much welcome. Bristol does not have the opportunity to reverse the decision it made in 2012, which is a fundamental principle of democracy and accountability. I am interested to hear whether the Minister will support clause 21, which has come from the Lords.

[James Wharton]

I hear what the hon. Lady says and that issue will be given a great deal of consideration. I will comment on the matter later in the course of the Committee, but the message has been heard loud and clear by Government. As I said in my opening remarks, we are keen to find consensus where we can on this agenda. I hope that at this stage, subject to the debate that might take place, that will sufficiently reassure the hon. Lady so that she can await those discussions in due course.

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[Mr Rees-Mogg]

May I add to what the Minister has just said? In my dealings with Mr Meacher in this House, he never put his strongly held political views above his fundamental good manners and civilisation. He was always the most decent man to talk to, even though I doubt there was a single subject of any political importance on which we agreed. He is a loss to this Chamber.

I will come on to my amendment 46, which would exempt Somerset, God’s own county, from the provisions on having a mayor. The Minister suggested that Somerset was not exceptional. I think that that was a momentary lapse because he is not only a most honourable gentleman, but somebody of fundamental good nature and wisdom. We will forgive him such a momentary mental lapse on this occasion and put it down to the wet weather or something like that.

The Government are giving fine and good undertakings. I will quote briefly from the Secretary of State on Second Reading:

“It is a fundamental tenet of this Bill, in contrast to other reforms debated over many years, that it does not give me or any of my ministerial colleagues the power to impose any arrangement on any local authority.”—[Official Report, 14 October 2015; Vol. 600, c. 326-327.]

My hon. Friend the Minister has reiterated those undertakings. They are excellent and encouraging, and they provide a solid basis for proceeding. Unfortunately, there is a “but” coming.

Everything I hear from local councillors in North Somerset and Bath and North East Somerset tells me that they are having their arms twisted. We are seeing a velvet glove today—a finely manufactured velvet glove of the highest quality velvet. Behind it, however, is a firm iron fist that expresses the Government’s will that things should go in a certain way. I encourage the Government, through my amendment, to make the background noises—the conversations in smoke-filled rooms—match the fine words that we are hearing in this House.

And so I come to why I want to exempt Somerset. Well, there is history—there is always history! I will start, as always, with Alfred the Great. If we go all the way back to 879, Bristol was in Mercia and Somerset in Wessex. One of those two kingdoms was completely under the Danes—that was obviously the Gloucestershire bit. The borderline between the two has been there for over 1,000 years. There is a strongly embedded history in Somerset and, indeed, in Bristol which means that they see themselves as independent, distinct units.

It is important that the Government go with the grain of communities that have built up over generations, centuries and, in this case, even a millennium, rather than create new administrative regions that mean very little to people. Most people have no interest in the title of their council. They have an interest in where their home is. Their home may relate to a great city, to a great county or to a village, a county and the country. The use of power needs to go with that. Therefore, devolution from the United Kingdom to an administrative body with which people do not have sympathy and about which they do not have a feeling makes things no better. People have a loyalty to the nation and a loyalty to their locality, but if interspersed between them is some random political agglomeration that came about through a sudden burst of enthusiasm by a Government, people have no association with that, no enthusiasm for it and no loyalty for the institution.

Of course, this has been tried before. This is my second and perhaps more important appeal to history in the context of Somerset, particularly in relation to North Somerset and Bath and North East Somerset. We were part of a much disliked, most unsuccessful, high-cost organisation called Avon. It is known to the cognoscenti as CUBA—the county that used to be Avon. The name CUBA was appropriate because it was almost as left-wing as Mr Castro in its approach to government and it was exceptionally expensive. It had one of the highest increases in rates in the 1980s. It was felt by people in the rural areas that it was run for the benefit of Bristol, with the cost being borne by people in rural areas.

We continue to see that in Avon and Somerset police, the cost of which is borne by the rural areas, even though—I am sorry to say this with the hon. Member for Bristol South (Karin Smyth) sitting opposite me—most of the crime is in Bristol. Inevitably, being an inner city, Bristol has more drug dealing, more armed crime and more social disorder than Nempnett Thrubwell and other villages in my constituency, which are bastions of law-abiding civility.

[Karin Smyth]

I was not going to intervene, but the hon. Gentleman is maligning the great city of Bristol, which draws in people from North East Somerset with its great employment and cultural opportunities. Indeed, that causes some great problems in my constituency in respect of travel arrangements and so on, but we are grateful to have his constituents coming to work in the city. Perhaps we can have a more balanced discussion.

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[William Wragg]

It is a pleasure to serve under your chairmanship, Mr Crausby.

I pay a warm tribute to the Minister and the Secretary of State for their approach to this Bill and the constructive dialogue that they have had with—dare I say it?—the caucus of Greater Manchester MPs, including two who are sitting next to me. The Minister warmed my heart by quoting Edmund Burke earlier. I do not know how Burke’s “Reflections on the Revolution in France” compare with my Second Reading speech, “William Wragg’s reflections on Devolution in Greater Manchester”, although in some respects my speech was probably equally as intemperate as the fiery language that Burke deployed against the French revolution. If I at all offended the Minister with my remarks on Second Reading, I wish to atone for that entirely.

The point about amendment 51 is no different to the point that I made last week about having confidence in the arguments and trusting the people to win them over. My hon. Friend the Member for Altrincham and Sale West (Mr Brady) expanded on the qualities of the Minister and the Front-Bench team in persuading and engaging with the public, and if they were to test this issue with a referendum in Greater Manchester, they might be pleasantly surprised with the result.

My neighbour, the hon. Member for Stockport (Ann Coffey), has recently left the Chamber, but I pay tribute to her work on child sexual exploitation. I was pleased to serve on one of the sub-committees of Stockport Council which took evidence from her. I say gently, however, that I would distance myself from any temptation to link the topic on which she has done a great deal of work with whether an elected mayor would impact on that, as I think it is a slightly spurious argument.

As a former teacher I should perhaps apologise to the hon. Member for Nottingham North (Mr Allen), who took issue with how the explanatory statement was drafted, and I hold my hands up as that was due to a lax approach on my part. There was never intended to be threshold on which 50% of the population would have to agree. Amendment 51 is supported by a growing list of colleagues, and it simply asks that fundamental changes to local government and the governance of my constituency are put to the test at a referendum, so that they can be endorsed and back the Government’s welcome programme of devolution.

[Karin Smyth]

I am pleased—along with my neighbour the hon. Member for North East Somerset (Mr Rees-Mogg)—to give the Committee a bit of respite from the subject of Manchester and to talk a bit about Bristol instead. Bristol has been a trailblazer for devolution and, in 2012, it was the only city to choose to have an elected mayor when the question was put in a referendum. I am a keen supporter of devolution and of transferring power closest to the people it affects, and I was proud to make my maiden speech on that subject. I am perhaps not as much of an evangelist as the hon. Member for Altrincham and Sale West (Mr Brady), but I am keen for devolution to happen.

Let me pick up on a unique issue which means that the people of Bristol do not share the same democratic rights as the rest of the country. The Bill started in the House of Lords, where Baroness Janke moved an amendment, now clause 21, which, if passed, would give Bristolians the right, after 10 years, to reverse, if they so wished, the decision we made in 2010 to have an elected mayor to govern our city. If the model is not fit in 10 years, we would like the opportunity to change it. By that time, citizens will have had ample opportunity to assess the value or otherwise of the current model, how it works in Bristol and, crucially, with the changing situation, how it would work across—I will not use the word CUBA, or indeed Avon—the wider Bristol area and with our neighbours in a combined authority.

This is not about personalities or whether we like or dislike the current mayor or would prefer a different person in office; it is about the system that works best for us in the city region. It is not about party politics either, because all the major political parties on the city council agree and supported a joint motion to that effect. I am very grateful to Baroness Janke, a Liberal Democrat peer, who did a lot of work in shaping and gaining support for the clause when it was in the House of Lords. It is about democracy. It is about whether we should have a voice and a new model. We should now be given that say. In an era when we are supposed to be seeing an increase in devolution and empowerment, it feels wrong that we as Bristolians should have to go through a long and tortuous legislation-making process to know whether we have the right to determine the way our city is governed. This clause would allow us to do that much more easily.

I hope the Government are able to support that provision, and give me and the people of Bristol a greater say in how this works for us in the future.

[Victoria Borwick (Kensington) (Con)]

Turning to another aspect of devolution, I would like to talk about the importance of health devolution. I obviously welcome the Government’s devolution revolution, which the Bill will help to deliver. In London, the Mayor has been campaigning for greater fiscal devolution and I know he applauds the recent announcement on business rate reform, as this will benefit our capital.

The devolution revolution that the Bill champions will ensure that Greater Manchester becomes the first English region to have full control of its health spending. However, as the Minister will be aware, London government has also been exploring how a similar model could work in the capital. As we all know, health is no respecter of ward or council boundaries. People live in one area and work in another, and may receive treatment for complex conditions in more than one area. That is why it is so important, in cities such as London and others that have been instanced today, that it should be viewed as a whole.

For a patient receiving many different treatments, it is far more effective for their care to be under one authority. As the previous deputy Mayor of London watching over this brief, I chaired many cross-London forums where councils and health authorities have come together to share resources and work together for better outcomes instead of being able to afford a smaller service in their locality. I would therefore argue that London, like Manchester, should explore ways to reform health and care provision, including a rebalancing towards prevention, early intervention, and proactive personal care and support. The aim should be to reduce hospitalisation, invest more in primary care, and integrate planning and decision-making for both the health and care services. Inevitably, there needs to be a review of NHS properties, including underused facilities, so that new integrated care centres can be opened and we have a more efficient use of the health estate.

There is agreement among London partners that the scale and complexity of health and care issues in London means that a model of reform should include actions at local, sub-regional and pan-London level. As part of their submission to the comprehensive spending review, London government made the case for greater devolution over health and social care. In the interests of brevity as we are short of time, I shall reduce the list substantially and just mention public health powers, including regulatory and fiscal interventions; multi-year allocations of NHS and local authority funding on a borough footprint; and London’s share of national NHS transformation funding.

As the Minister will know, representatives from the Greater London Authority, London Councils, NHS England, the London office of clinical commissioning groups and Public Health England are developing a memorandum of understanding to progress this work and to look at the powers that could and should be devolved to London. The recent London Health Commission report also advocated a London health commissioner, who could focus on the particular concerns of our growing city with its transient population. In London, we see diseases that many of us thought had died out, such as tuberculosis and rickets. They are often seen in people who were born or have grown up elsewhere, bringing pressures to the health system in London.

I am asking the Minister to welcome the approach being taken by London and support the aspiration for the greatest possible speed of reform to improve the health of Londoners.

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Clause 19 and the amendments I have described provide further clarity about the role of the Secretary of State for Health, and what will and will not be included in any future transfer order giving local organisations devolved responsibility for health services. This clear statement in legislation, making provision for the protection of the integrity of our national health service, is intended to provide further confidence for future devolution deals. I ask hon. Members to support the Government amendments and clause 19 standing part of the Bill.

[Karin Smyth]

I welcome the devolution of some health and care services to local areas. My hon. Friend the Member for Denton and Reddish (Andrew Gwynne) recalled our manifesto pledges for the “what” and the “how”, and I have a lot of concerns about the structural changes that might come as a result of all this. As has been mentioned, Bristol, an area of nearly half a million people surrounded by more rural areas, has two major acute hospitals, both of which offer a range of services, including highly specialised ones. I would like the Minister to say something on the issue of specialised commissioning. Patients are drawn from across the south-west; one hospital draws half its patients from Bristol and the other half from neighbouring South Gloucestershire. Two different clinical commissioning groups are involved, and a plethora of different organisations are involved in both the commissioning and the provision of services. In an earlier exchange on this type of devolution, the Minister sometimes talked about the provision of services and sometimes about the commissioning of services. It would be helpful to understand the devolution aspects: are we talking about provision in the new marketplace or about commissioning, and how will we bring those two things together? That is problematic for us in Bristol.

I am a former board member of a primary care trust and I spent many happy hours discussing the correct configuration of primary care and CCGs in Bristol—whether it should be a stand-alone Bristol or not. We started off with Bristol divided into two and we then talked about doughnuts. The Minister missed an earlier discussion involving the hon. Member for North East Somerset (Mr Rees-Mogg), who wanted to make sure that Bristol stayed Bristol and did not include other areas. [Interruption.] That was a shame, because it is always a joy. We never quite resolved that issue, and similar issues are applicable to many other cities and city regions. I fear that the approach being taken could make an already difficult situation for Bristol much more difficult.

The Minister and I were both at the King’s Fund discussion last week about devolution and health, and I think it was people from Manchester who talked about the fact that they had to bring 38 different organisations around the table to talk about some of these matters. My concerns relate to further structural reorganisation. Given the organisations involved and given the situation in Bristol, I wonder how I, as a patient on my pathway from prevention through primary care to community services, hospital care and possibly specialised services, would understand who is really accountable for that pathway. As we know, we can map a pathway but people do not always map closely to that. In general, I welcome this move, but of course we have concerns about financial stability, particularly of those hospitals and of wider community services. At last week’s King’s Fund event, as was quietly pointed out, we do not want a situation where money is moved from GP services into fixing potholes. We need to be very concerned about such things.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

It is a pleasure to serve under your chairmanship, Mrs Main. I rise to make a few brief remarks in support of this clause and the Government amendments. Clearly, the direction of travel that is outlined is desirable in health and care terms. The amendments will put in place clear safeguards to deal with national regulatory structures, which are there to protect patients and to ensure that the quality of care is universally high throughout the whole country.

The importance of devolving health and care at a local level is something that we have often talked about in this place, but we have sometimes struggled to find the legislative mechanisms to make it happen. These powers will be a desirable step forward in encouraging a more integrated model of health and care. We often talk about how we can move the focus in many parts of our health service towards delivering more services in the community and a more preventative approach to healthcare. Clearly, this Bill is a big step in that direction.

By 2018, we know that there will be 3 million people with three or more long-term health conditions. Many of those people will require support not just from the health service, but from adult social care services, local voluntary and charitable organisations and, in the case of some people with special educational needs, education services. It is vital that we properly link and join up the services that are in place to support these people. Personalised care and mechanisms of support are often found at a local level, which is exactly what this devolution is about.

Other measures have been put in place to integrate better adult health and social care, including the better care fund, which was part of the Care Act 2104. The coalition Government also introduced some strong measures to improve the provision for children with special educational needs. But these measures go further and allow more bespoke and personalised local solutions to be put in place to support people with more complex care needs. Importantly, they also recognise that parts of the country are different in terms of not just their geography, but their cultural make up and their demographics. That is particularly important when we talk about devolving health and care. We know that some city areas have high black and minority ethnic populations with specific healthcare needs. These measures will put us in a much better place to help such areas support those communities, as well as more rural areas, in dealing with the challenges of an ageing population and increasing numbers of people with complex healthcare needs.

This Bill is an important step forward, which builds on many strong measures that have already been put in place over the past few years by both the coalition Government and the previous Labour Government. We all believe in integration and in the need to bring healthcare services closer to the individual and make them more personalised. We know that there is too much duplication in the health service and in adult social care, which costs money. That money should be going to the frontline, but duplication often gets in the way of front-line professionals helping patients. This is a big step forward in allowing local health economies and local areas to put in place the right mechanisms to support the people they look after.

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[Karin Smyth]

I am grateful for that clarification. My concern then would be who the Minister sees as driving the development and improvement of, particularly, the specialised commissioners. We are talking in fairly transactional terms about who might be contracting or who might be accountable but, as he will appreciate, these services, as well as others, require a long lead-in time and a lot of consideration owing to their very technical and, by definition, specialised nature. Who is driving this forward—the local group, if they so choose, who may not have the expertise, or the Department?

[Alistair Burt]

NHS England and the Department must retain the overall control of the quality of the specialised services, and that will not be relinquished if there is no sense that they can be handled any better, because otherwise there is no point. The number of specialised services that are devolved might ultimately be very few. Of course, there is only any point in devolving them if they are going to improve, and that must be demonstrated before they are devolved and moved on.

Let me say a little about the wider concern of the hon. Member for Heywood and Middleton that by devolving these powers and running with the grain of greater devolution, we are losing the “national” in the national health service. We are absolutely determined that that will not be the case. The safeguards that are now in the Bill as a result of concerns expressed elsewhere were never going to be lost, but they are now made more explicit to demonstrate that what she worries about cannot happen. It is not the case that an authority will apply for these powers and they will be handed over without no further consideration, because there is the transfer order that Parliament will be involved in.

What are the Government going to think about when people ask to do this? The Government have invited local areas to develop their own proposals. There is no blueprint for the devolution of health and social care. The substance of devolution deals will be determined on a case-by-case basis, with Government agreeing bespoke deals that correspond to the needs and specific context of each area. There are some important preconditions that we might expect to support the development of local devolution deals, including health and social care. These include a clear vision for the benefits to the local area; a history of successful collaboration and partnership working; support and input from local health and social care organisations for the proposals being put forward; a strong commitment to further engagement with local patients and communities as plans develop; upholding the standards set out in national guidance; and continuing to meet statutory requirements and duties, including the NHS constitution and the Government’s mandate to NHS England. Most importantly, the first overarching principle of any agreement is that all areas will remain part of the NHS. This requirement to adhere to the constitution of the NHS and the ultimate safeguard of the Secretary of State’s responsibilities answers the point about a local area getting hold of NHS money and then deciding to build a new leisure centre. It would not be able to do that because it would not be complying with its duties under the NHS. It would fail and the duties and responsibilities would soon be taken away. That is why the safeguard is there.

To deal with the hon. Lady’s concerns about potential confusion, let me say a little more about the role of NHS England under devolved arrangements. NHS England and CCGs would continue to be bound by their duties under the National Health Service Act 2006 even after devolution of functions. For example, NHS England will remain bound by duties to promote the NHS constitution, and to exercise its functions effectively, efficiently and economically and with a view to securing continuous improvement in the quality of services, including in terms of outcomes.

NHS England must exercise its functions having regard to the need to reduce inequalities in relation to both access to health services and outcomes achieved for patients. When NHS England exercises its functions, it must also promote the involvement of patients and their carers and representatives in decisions made about diagnosis, prevention and care and treatment. It must take appropriate advice and act with a view to enabling patients to make choices with respect to aspects of the health service provided to them.

Those safeguards show that the powers simply cannot be devolved to people who want them without any check or balance on how they would exercise them, even if they persuade people locally that signing a blank cheque for help is in any way acceptable. I cannot see local representatives agreeing to that. That is where the control comes in.

How will the Department of Health and NHS England be involved in agreeing the deals? We have been working closely with other Government Departments to respond to proposals. NHS England has developed its own set of assessment criteria, by which it will assess the potential of proposals from a particular local area. It is not an automatic process: if the deal will not work in terms of the quality of healthcare provided, the House will not pass a transfer order because the proposal will not pass the test set by NHS England and the Department of Health.

Will devolution mean that local areas can set their own strategy for NHS capital estates and management? No, we do not envisage any changes to capital financing and asset ownership.

Finally, I want to address a very important issue raised by the hon. Lady. Who will have the final say over the opening and closing of hospitals and other services? This is issue concerns every single one of us in the Chamber. Reconfiguration of NHS services will continue to be a matter for the local NHS. However, proposals for service change must meet the Government’s four tests: support from local GP commissioners; clarity on the clinical evidence base; robust patient and public engagement; and support for patient choice. The same elements of contest available when reconfiguration has been proposed will remain even after devolution, so nothing is taken away.

I hope that has been helpful. Working with the grain of what people want, we all think this is a better idea, but there are safeguards to make sure that people’s worries will not come to fruition.

Amendment 32 agreed to.

Clause 8, as amended, ordered to stand part of the Bill.

Clause 17

Power to transfer etc. public authority functions to certain local authorities

Amendment made: 33, page 17, line 32, at end insert—

‘( ) See also section 19 (devolving health service functions) which contains further limitations.”—(Alistair Burt.)

This amendment inserts a new subsection into clause 17 which alerts the reader to clause 19 which contains limitations on the power to make regulations under that clause.

Clause 17, as amended, ordered to stand part of the Bill.

Clause 18

Section 17: procedure etc.

Amendment made: 15, page 18, line 6, after “make” insert “incidental, supplementary, consequential,”—(Alistair Burt.)

This amendment provides that the power to make regulations under clause 17 of the Bill includes a power to make incidental, supplementary and consequential provision.

Clause 18, as amended, ordered to stand part of the Bill.

Clause 19

Devolving health service functions

Amendments made: 34, page 18, leave out lines 29 to 33 and insert—

‘(1) Regulations under section 17 of this Act or an order under section 105A of the Local Democracy, Economic Development and Construction Act 2009 (transfer of public authority functions to combined authorities) (“the 2009 Act”)—

(a) must not transfer any of the Secretary of State’s core duties in relation to the health service;”

This amendment confines the limitations contained in clause 19 to the exercise of the power to make regulations under clause 17 or an order under section 105A of Local Democracy, Economic Development and Construction Act 2009. Those powers concern the transfer of public authority functions to local or combined authorities. New clause 19(1)(a) prevents those powers being used to transfer any of the Secretary of State’s core duties in relation to the health service (as defined in clause 19(2) which is inserted by Amendment 38).

Amendment 35, page 18, line 34, leave out “or supervisory”

This amendment removes the prohibition in clause 19(b) on the transfer of health service supervisory functions of national bodies by regulations under clause 17 or an order under section 105A of the Local Democracy, Economic Development and Construction Act 2009.

Amendment 36, page 18, line 36, leave out from “must” to first “the” in line 37 and insert

“, if transferring functions relating to the health service to a local authority or a combined authority, make provision about the standards and duties to be placed on that authority having regard to”

This amendment and Amendment 37 replace the limitation in clause 19(c) with a requirement that regulations under clause 17 or an order under section 105A of the Local Democracy, Economic Development and Construction Act 2009 which transfer functions relating to the health service to a local or combined authority must make provision about the standards and duties to be placed on that authority having regard to certain standards and obligations placed on the authority responsible for the functions being transferred.

Amendment 37, page 18, line 38, leave out from “on” to “being” in line 39 and insert

“the authority responsible for the functions”

See the statement for Amendment 36.

Amendment 38, page 18, line 40, at end insert—

‘(2) For the purposes of subsection (1)(a), “the Secretary of State’s core duties in relation to the health service” means the duties of the Secretary of State under—

(a) sections 1 to 1G of the National Health Service Act 2006 (“the NHSA 2006”) (duty to promote comprehensive health service etc.),

(b) sections 6A to 6BB of that Act (duties regarding the reimbursement of costs of services provided in another EEA state),

(c) section 12E of that Act (duty as respects variation in provision of health services),

(d) sections 13A, 13B, 13U and 223B of that Act (duties regarding mandate to, and annual report and funding of, the NHS Commissioning Board),

(e) section 247C of that Act (duty to keep health service functions under review),

(f) section 247D of that Act (duty to publish annual report on performance of the health service in England),

(g) section 258 of that Act (duty regarding the availability of facilities for university clinical teaching and research), and

(h) sections 3 to 6 of the Health Act 2009 (duties in relation to the NHS Constitution and the Handbook to it),

in so far as those duties would (apart from subsection (1)(a)) be transferable by regulations under section17 or an order under section 105A of the 2009 Act.

(3) For the purposes of subsection (1)(b)—

(a) “health service regulatory function” means a function in relation to the health service which is a regulatory function within the meaning given by section 32 of the Legislative and Regulatory Reform Act 2006,

(b) the functions of the National Health Service Commissioning Board under sections 14Z16 to 14Z22 of the NHSA 2006 (assessment of clinical commissioning groups and intervention powers) are to be treated as “health service regulatory functions” in so far as they do not fall within the definition in paragraph (a), and

(c) functions exercisable by a body by virtue of directions given under section 7 of the NHSA 2006 (functions of Special Health Authorities) are not “vested in” that body.

(4) But subsection (1)(b) does not prevent the transfer of functions of the National Health Service Commissioning Board which—

(a) arise from arrangements under section 1H(3)(a) of the NHSA 2006 (provision of services for the purpose of the health service), and

(b) relate to those providing services under those arrangements.

(5) For the purposes of subsection (1)(c), “national service standards” means the standards contained in any of the following—

(a) the NHS Constitution (within the meaning of Chapter 1 of Part 1 of the Health Act 2009);

(b) the standing rules under section 6E of the NHSA 2006 (regulations as to the exercise of functions by the NHS Commissioning Board or clinical commissioning groups);

(c) the terms as to service delivery required by regulations or directions under the NHSA 2006 for contracts or other arrangements for the provision of primary medical services, primary dental services, primary ophthalmic services or pharmaceutical services under Part 4, 5, 6 or 7 of that Act;

(d) the recommendations or guidance of the National Institute for Health and Care Excellence made or given pursuant to regulations under section 237 of the Health and Social Care Act 2012;

(e) the quality standards prepared by that Institute under section 234 of that Act;

(f) the guidance published under section 14Z8 of the NHSA 2006 (guidance on commissioning by the NHS Commissioning Board);

and such standards are “placed on” a body if the body is required to have regard to or comply with them.

(6) For the purposes of subsection (1)(c)—

(a) “national information obligations” means duties regarding the obtaining, retention, use or disclosure of information, and

(b) “national accountability obligations” means duties (for example, those to keep accounts or records, or to provide or publish reports, plans or other information) which enable the management of a body, or the way in which functions are discharged, to be examined, inspected, reviewed or studied.

(7) For the purposes of this section, a function is transferred by regulations under section 17 or by an order under section 105A of the 2009 Act, if—

(a) provision is made under subsection (1)(a) of the section in question for the function to be the function of a local authority or a combined authority, or

(b) provision is made under subsection (1)(b) of that section for a function corresponding to the function to be conferred on a local authority or a combined authority.

(8) Nothing in this section prevents the conferral on a local authority or a combined authority of duties to have regard to, or to promote or secure, the matters mentioned in sections 1 to 1F of the NHSA 2006 when exercising a function transferred to it by regulations under section 17, or by an order under section 105A of the 2009 Act.

(9) In this section, “the health service” has the meaning given by section 275(1) of the NHSA 2006.”—(Alistair Burt.)

This amendment adds provision to clause 19 which defines terms used in, and clarifies the scope of, the limitations contained in paragraphs (a) to (c) of the clause.

Clause 19, as amended, ordered to stand part of the Bill.

Clause 9 ordered to stand part of the Bill.

Schedule 3 agreed to.

Clause 10

Funding of combined authorities

Amendment made: 9, page 11, line 26, at end insert—

‘( ) In section 105 of the Local Democracy, Economic Development and Construction Act 2009 (constitution and functions of combined authorities: economic development and regeneration), omit subsection (4).”—(Alistair Burt.)

This amendment removes the restriction on orders under section 105 of the Local Democracy, Economic Development and Construction Act 2009 only being able to make provision in relation to the costs of a combined authority that are reasonably attributable to the exercise of its functions relating to economic development and regeneration.

Amendment proposed: 58, page 11, line 26, at end insert—

‘(5) The Secretary of State may by order make provision for conferring powers on a combined authority to set multi-year finance settlements.” —(Jon Trickett.)

This amendment is intended to offer financial stability to city regions, allowing them long-term planning which is something not currently offered by the finance settlement or the funding of local enterprise partnership (LEPs).