Local Government and Public Involvement in Health Bill

My Lords, I begin by declaring my interest as leader of Wigan Council. In that role I do not recognise the negative description of local government that we have heard from several previous speakers in the debate. I would temper the kind of nostalgic reflections or longing for the past with the suggestion that noble Lords read the biography of Herbert Morrison to see what he thought about the role of back-benchers and strong leadership in local authorities. Most local government that I know in Britain today is confident and is delivering good-quality services for local people and improving performance. Despite their unpopularity, best value and inspection have helped significantly to deliver that, but the Government are right now to reduce the burden of those particular things. I welcome the Bill because it gives local government the opportunity to continue to flourish. I say that for two main reasons. It is an enabling Bill. It is not prescriptive as many previous local government Bills have been. It allows local authorities to choose which way they want to go within a particular area. In Parts 1, 2 and 3 there is significant choice so I welcome that. Unlike the noble Lord, Lord Greaves, I am confident that it is not a centralising but a devolving Bill. It will give local authorities more power. Local area agreements are key to the Bill; they are at its heart. They will allow us to shape the place, as Sir Michael Lyons said. I shall concentrate my remarks on that part, but before I do so, I shall make three brief comments on other parts of the Bill. My noble friend Lord Clarke of Hampstead gave an eloquent exposition of the need for unitary authorities. I experienced a metropolitan county system, a two-tier system, and unitary authorities are certainly better. But there is always a danger for local authorities of being hidebound by boundaries. However good the boundaries may seem in a geographical or place sense, issues, problems and people cross those boundaries. In the city region of Manchester, we are beginning to learn, as are other city regions, that we have to work together. If we are to achieve the big changes to our economy, to transport and crime—all the things that we want to achieve across the city region—we will have to collaborate. That is a message for all authorities, whether in a city region or in districts: they must learn to work together better. That will be the future. My second point is about leadership. The Government are right, as they did in the White Paper, to emphasise the value of strong local leadership. However, I am a bit concerned that the Government—and the Opposition, if we are to believe the media reports of the review of the noble Lord, Lord Heseltine—are putting too much emphasis on structure, on an arrangement, rather than on what leadership is. Leadership and executive arrangements should not be confused. Local leadership is about developing a vision for an area, communicating that vision to others within the council, to local people and to other partners and ensuring that it is implemented. Whereas some executive arrangements may make that easier, you do not get strong, effective leadership just because you change those executive arrangements. Perhaps Governments think that local government Bills get too boring for those not involved in local government, because in my experience, they always introduce into a local government Bill a clause or a part that is not directly about local government, but excites your Lordships more than others. In my maiden speech in 1999 on what became the Local Government Act 2000, it was the clause to repeal Section 28. I remember that on Second Reading, the majority of the speeches were not on the 99 clauses about local government but on the one clause about Section 28. Perhaps today we are in danger of concentrating overmuch on Part 14 compared to the rest of the Bill. However, I welcome that responsibility coming to local authorities and I thought that the noble Baroness, Lady Campbell, explained the thinking behind it very effectively. I am sure that local authorities will welcome and will be able to organise those arrangements for monitoring the performance of both health and social care. To bring them together is very logical. In his reflection on his achievement in creating the NHS, Aneurin Bevan admitted to one mistake. That was that he should not have removed local authorities from the healthcare system, as he did in 1948. At least in those clauses the Government are partially rectifying that mistake. As I said, it is on Part 5 and local area agreements that I want to concentrate my comments today. I think that local area agreements have made a great difference in local authorities and to local people. What local people want is good delivery of a range of services. If we are honest, they do not care who does it. They do not care whether it is staff from social services or health staff who come to deliver a service, as long as it is timely and done well. Local area agreements have allowed local authorities to get involved with a range of areas in which they are not directly involved. With a democratic mandate, we have been able to get involved with a much wider area of things that really matter to people, to their lives and to the places where they live. It is devolution to local authorities. I am pleased that the number of targets essentially is reducing. My authority was a pilot authority for LAAs. It has been a very positive experience, has fostered closer working relationships with a range of partners and has given satisfaction in achieving a range of ambitious targets. However, we had three difficulties with the LAA. The first difficulty was the approval of the LAA. We had a really constructive relationship with the government office, but when the plans came to Whitehall, the dead hand of the Civil Service unfortunately said that the plans were too innovative and that it did not think that it could do that. It eventually took an intervention from the Minister to overcome that handicap. The Government should approve LAAs because they are important, but we will not use them to stifle innovation or the way in which local areas deliver for local people. Secondly, the recognition of LAAs across government departments was not always there. That was particularly true for health, which had a range of national targets to deliver. The LAA targets were not always regarded as important. Clause 118 addresses this issue. To bring together the evidence base of what is needed in health and social care is important. When the Secretary of State agrees the LAA, I hope that it is implicit that it is not being signed on behalf of the Department for Communities and Local Government, but that it is being signed on behalf of the Government overall and that each department is signed up to making sure that the LAA is important to it. The third difficulty is the ability of local partners to divert some of their mainstream resources to LAA targets, which was not always the case in the past. I am pleased to see that the duty on local partners is to have regard to targets. We may want to raise later whether this is strong enough. Perhaps we should have achievement of the targets rather than having to have regard to them, which would give a greater incentive to many of the partners to divert resources and make sure that that happens. During the passage of the Bill through another place, the Government listened to representations and in Clause 106 broadened the list of organisations to be partners to local authorities. However, despite the improvement, the list is incomplete. I cannot believe—certainly, it will not happen in my area—that the local area agreement will not have targets for education, achievement, participation, life-long learning and so on. If we are to achieve these things, we need to bring along those who will deliver those targets in the local area, but no examples of local colleges are on thelist. In most cases, local colleges are good, strong partners and willing participants. I do not believethat there should be any problem in including local colleges. I understand the Government’s reluctance in relation to schools, partly because the number of schools makes them problematic. But schools should be at the heart of local communities and should be involved in setting and delivering targets. I hope that the Government will think about that. I do not think that it is satisfactory to allow schools simply a voluntary process of involvement in the LAA process. The problem is that those schools which are least likely to get involved are the ones that probably most ought to do so. I hope that my noble friends will think about how we can have further discussions with the Department for Education and Skills on how to get schools involved, even if we do not have to name every school as a partner on the list. While I look forward to the detailed scrutiny of the Bill in your Lordships’ House—I am sure that we will find ways of improving it—we should accept its Second Reading with a positive view. It is a good Bill, it may be improved, but I welcome it.