Deregulation Bill

Lord Hunt of Kings Heath Excerpts

Tuesday 18th November 2014 Grand Committee

[Lord Rooker (Lab)]

My Lords, before we leave this clause, I would like to take this opportunity to ask the Minister a question. I am a strong supporter of the Electoral Commission, with no qualification whatever; but next year’s election will be the first time that it has had four and a half years to plan for the date. Therefore, is there an absolute rock-solid guarantee that there will be no chaos in any of the polling stations in this country of the kind that occurred in 2005?

[Lord Hunt of Kings Heath (Lab)]

My Lords, I join my noble friend and add to what he said. My noble friend knows that I come from Birmingham and I was shocked by some of the behaviours I saw outside some Birmingham polling stations, to which I suspect he is referring. I particularly remember a polling station in Moseley, where large groups of men—about 20 or 30—were outside. This was clearly intimidatory; it was very difficult—particularly for women—to go and vote. The current system is so slow to react to situations like that when they arise. This is a very serious matter: in some parts of the country, people are not able to exercise their democratic right to go to a polling station free and unfettered.

For some years, the Electoral Commission took the view that it could only take measures that applied to each part of the country in an equal way. That was madness; it has been clear for a number of years that we have a real problem in some polling areas and we need a response from the Electoral Commission that recognises that.

[Lord Wallace of Saltaire]

My Lords, it would be foolhardy to give a cast-iron guarantee that no problems might break out. These are not purely matters for the Electoral Commission; as we all know; the local police and the local electoral registration officers have clear responsibilities here as well.

[Lord Hunt of Kings Heath]

In the case I mentioned, there was a police van outside; I approached the police van and the officer, of his own volition, went to speak to this group and kind of negotiated that the numbers would come down from about 20 to three or four on either side. I applaud the fact that a police constable, of his own volition, was able to make his own judgment, but that does not necessarily happen, and there is no guarantee that there will be police outside each polling station during the whole of the day. The other problem is that the polling officers are in the polling station in the school, a long way from the road where people can congregate. I accept the point he is making, which is that it is not just down to the Electoral Commission—but the Electoral Commission has a leadership role here.

[Lord Wallace of Saltaire]

My Lords, let me take that back and make sure that the Electoral Commission is informed of this. I trust that the incidents were reported to the local authorities and the local police at the time. I am conscious from my own experience with polling stations in parts of west Yorkshire that there can be problems; although my strongest memory of the last election is of passing a polling station 10 minutes before it closed and meeting a large extended family coming out of the polling station after voting, having a very sharp and loud argument as to whether each of them had voted the right way. I fear that, in this coming election, there may be rather more of that sort of confusion than any of us would really like to see. Meanwhile, I can assure the noble Lord that I will take these points back and make sure that they are reported to the Electoral Commission. I repeat that local issues like this are very much about local support. It is for the local police, local education and the local political parties, of course, to make sure that the police and the electoral authorities are doing their duty.

--- Later in debate ---

[Lord Hunt of Kings Heath]

My Lords, like the noble Earl, I make a happy, though unexpected intervention in the proceedings of this Grand Committee. I thank him for giving me advance warning that he intended to move an amendment on the question of trust mergers. I certainly would not oppose the amendment, but I should like to put some points to him. As this is being introduced at such a late stage, perhaps I could ask him about the Department of Health’s approach to deregulation, because it is entirely relevant to the amendment.

The noble Earl will know that a later clause in the Bill introduces a new duty for non-economic regulators to have regard to the desirability of promoting economic growth while exercising their regulatory functions. From the list that we have been given by the Government, we understand that the Care Quality Commission is encompassed in the list of organisations to which the new provisions may apply. The Opposition have asked the CQC for its views on the clause, but we have been informed that the Department of Health has told the CQC that it was not appropriate for the CQC to respond to our query, given that it is an arm’s-length body of government. I am surprised by that. As the noble Earl has frequently said to us, the CQC is an independent body. I am surprised that the CQC even approached the DoH for advice, and I am shocked that the DoH should prevent CQC from giving its advice to parliamentarians on the Bill. I do not expect the noble Earl to respond to this point today, because I doubt that he could, but I ask him to respond to me in due course.

What is the Department of Health’s approach to deregulation? My understanding is that it is in favour, and recently told the Health Select Committee that, unless issues of public safety are concerned, it is not in favour of extending statutory regulation to other professions within the health service, which is entirely consistent with what Ministers are saying in the Bill.

The noble Earl will not be surprised that I then want to ask why the department is still attempting to require non-doctor public health specialists to be statutorily registered. I recently asked a Written Question about that. I cannot for the life of me see that public health non-doctors pose any risk to public safety. That conviction has been reinforced by the evidence that the Professional Standards Authority for Health and Social Care, which is the overarching regulator, has now given to the Government, in which it confirms my view that minimal risks are posed by public health specialists. There is a very limited number of them. Whether they are statutorily regulated or not is not a major issue. The problem is that, by so doing, the Government are threatening the viability of a voluntary register, the UK Public Health Practitioner Register, because it depends on the fees of those non-doctor specialists for its viability. I should have thought that a voluntary register accredited by the Professional Standards Authority is just what a deregulatory approach would lend itself to.

Again, I do not expect the noble Earl to give me a response today, but I wanted to raise with him that there is considerable puzzlement that a Government who brought forward this deregulatory Bill is hell-bent—for some reason that no one can understand—on forcing a statutory approach to non-doctor public health specialists, which will put at risk a voluntary register that is entirely consistent with the deregulatory approach that the Government are taking within the Bill.

I will ask three or four questions about the noble Earl’s amendment. It arises from the issue in Staffordshire. Essentially, the services that were being run by the Mid Staffordshire foundation trust are being transferred to two other trusts: North Staffordshire and the Royal Wolverhampton, one a foundation trust and one an NHS trust. The technical amendment that the noble Earl has brought forward seems eminently reasonable in that context, but I wonder whether he would care to reflect on the process by which that has occurred. He will know of the trust’s special administrators, who were appointed to deal with the problems at Mid Staffordshire. I was very surprised that the estimated cost of that process has been between £12 million and £15 million. Can the noble Earl confirm that and say whether he really thinks that we got value for money from that process?

The second question is whether he can assure me that this new amendment will not make it easier to force through mergers without proper public consultation. Staffordshire health service has a bit of form recently. He will know that the clinical commissioning groups have made some very controversial decisions, including—I think this was announced yesterday—the outsourcing of much of their commissioning responsibility. It is notable that the CCGs are very reluctant to debate or discuss those proposals in public. We have debated Lewisham hospital in south London, which is in a special administration process, and we have had some discussion about how services in Staffordshire are to be reorganised. I have been to a number of meetings in Staffordshire and there is real concern that a lot of these major changes are taking place without adequate public consultation. For instance, in relation to services in Mid Staffordshire, assurances were given—it was called the double-lock assurance—by the Secretary of State that there would, as I understood it, be proper public involvement and support for the changes. I am not entirely sure that that has happened.

I would just like to make two further comments. As I understand it, by statute, mergers have to be approved by Monitor, the economic regulator for NHS foundation trusts—and presumably, for non-foundation trusts, by the NHS Trust Development Authority, acting on behalf of the Secretary of State. In the light of experience, does the noble Earl not think that the Secretary of State should have to give their approval to mergers even if they involve foundation trusts? I realise that this amendment is based on parent legislation that goes back further than 2006—perhaps to 2003—and that we now have a much more fragmented system than we had then.

A trust merger is not a business arrangement; essentially, what usually happens is that one trust has fallen into a great deal of trouble and has to be rescued. That will often have a dynamic impact on the services to be provided; Mid Staffordshire is a good case in point. Given that, should the Secretary of State, because of his direct accountability to Parliament, not have to sign off that merger? The noble Earl may know of Clive Efford’s Private Member’s Bill, which I think is being debated in the Commons on Friday. There is a clause in the Bill which actually says that the merger of NHS trusts or foundation trusts should require the consent of the Secretary of State, so I am sure that this is a matter to which the department will be giving consideration.

My final point is about the impact of the amendment on PFI schemes. The noble Earl has already explained about the transfer of criminal liabilities, which makes eminent sense, but let us say trust A is being acquired by trust B. As I understand it, trust B takes on the liabilities of trust A. But what happens to the indemnity that the Secretary of State has made in respect of a PFI scheme entered into by trust B? When trust A takes on trust B’s liabilities, including possibly a PFI scheme, does the Secretary of State’s indemnity also now apply to trust A? I understand that the Department of Health has said that it does not and I would be grateful for some clarity on that.

[Earl Howe]

My Lords, I am grateful to the noble Lord for his comments and questions. I shall certainly write to him on the two issues that he raised: first, in relation to the CQC and to extending statutory regulation to non-doctor public health specialists.