Local Government and Public Involvement in Health Bill

I start by offering my thanks to the ministerial team, who were as obliging as they could be within the constraints they set themselves. They have at all times been as helpful and courteous as they could be. We all found the evidence session interesting and stimulating. There are lessons to be learned about the organisation of such sessions, but that point leads me to offer thanks to a part of the organisation that is often not mentioned—the Government Whip for the Committee. From that point onwards, he did his best to be helpful and allow the Opposition the chances we needed to test the Government and set out our case, in Committee and on Report. My colleagues who supported me on the Bill also did stout work, and I thank them. The broader context of the Bill is that it was preceded by a White Paper and a lot of talk by Secretaries of State about direction and speed of travel that has now been mostly forgotten. We believe that the Bill that was published was a wasted opportunity. It was not well timed, it being out of sync with the Lyons report. As a result, it does not deal with some very fundamental questions of finance and structure. It has been claimed that the tone of Opposition criticism has moderated during the Bill’s passage through the House, but any Bill that is 192 pages long will contain at least one bit that is acceptable to us, and so it has proved. I have never denied that it has some good bits, but it does not provide the fundamental devolution of power, financial resources or freedom to organise that we consider essential. On the contrary, the Bill seems to offer a narrower frame in those respects than what we had previously. We have gained some important new jargon, of course. We no longer talk about back-bench councillors, but about front-line councillors. They are the ones who get sent over the top and shot first, and many of them think that life might be a bit cosier on the back benches. The phrase ““place shaping”” suggests a degree of proactivity on the part of councils, even though—despite what Ministers have said at various stages—the capacity to place-shape will still be dramatically confined, controlled and limited. In some areas, such as the executive arrangements, the Bill represents an increase in centralised grasp. The Minister heard Opposition Members go on about that frequently in Committee, and he knows that he has taken away one of the available models. I accept that he might argue that it was non-functional, but he has put in place another model that looks likely to be demonstrably non-functional and that only Stockton appears to want. It will not give local authorities the freedom to organise themselves as they think best and as would suit them best. The same point can be made about the changes to the monitoring of health. I suppose that I should declare a long lapsed interest, as some 20 years ago I was a member of a community health council. I know that many Labour Members regret the loss of community health councils; the establishment of patient forums was very much a second-best alternative. They were introduced only because of the pressure that the Government experienced in their struggle to get community health councils out of the way. Now, patient forums are being taken away too, and we have taken a step further backwards. There are clear signs of centralisation lurking behind the face of devolution about which the Minister has spoken. The Bill does have some good bits, however, and we have made favourable comments about some of them. The reform of the Standards Board, the enhanced role for local members and the greater freedom to make electoral arrangements that suit a local community are all to be welcomed. If the local area partnerships and the multi-area agreements can develop, they could represent two very useful steps forward. However, there is still plenty more to be done. I said earlier on Report that we had got the Minister out of the front door on his journey, but we still have not got him far enough down the path and along the street in the direction that we believe he should take. As a result, we shall not support the Bill on Third Reading.