Health and Social Care Bill

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Mr. Denham: The hon. Member for New Forest, West is right about the need to be able to scrutinise both health and social services. I am advised that this is not a necessary provision, and that the combination of the measures that we are taking in this Bill and those that are already in the Local Government Act 2000 make it possible for scrutiny committees to undertake that function.

Mr. Swayne: In view of what the Minister says, I accept his assurances and beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Mr. Denham: I beg to move amendment No. 187 in

page 6, line 32, leave out `or other specified body'.

This is a minor amendment concerning the arrangements that the scrutiny committee will make with the NHS for its scrutiny. The Secretary of State is permitted under the terms of this clause to make regulations concerning the requirement for NHS officers to appear before the scrutiny committee. It is envisaged, for example, that the scrutiny committee may call the chief executive of the trust to account twice a year. The scrutiny committee will assess, among other things, how well the trust has carried out its duties to consult and involve the public under clause 9. It is not necessary for the Secretary of State to be able to regulate for any ``other specified body'' to appear before the scrutiny committee. It should be just involve the health service, so the amendment removes the reference to ``other specified body''.

Mr. Swayne: I was intrigued about who else the Government thought might have been summoned when they drafted the clause, given that they have now changed their minds?

Mr. Denham: Ours is not to speculate on the workings of the minds of parliamentary counsel. Various suggestions are made to Ministers to be helpful, but after close scrutiny it is sometimes possible to identify helpful things that one should not take a power to do.

Amendment agreed to.

Mr. Swayne: I beg to move amendment No. 244, in

page 6, line 33, at end add--

    `( ) requiring any member of an overview and scrutiny committee who is also a member of a Health Authority, NHS Trust or Primary Care Trust not to take part in the discharge by the Committee of the functions described in subsection (1) above.'.

It strikes me that there is an opportunity to discuss at some length Dame Fritchie's report on appointments in the NHS, but given the lateness of the hour, and knowing that we only have until 10 o'clock, I shall pass up that opportunity.

There has been a sharp increase in the number of local government representatives, to which Dame Fritchie's report bears testimony. I commend that report to all members of the Committee. NHS trusts, PCTs and health authority boards will inevitably have a not insignificant number of councillors of a political persuasion. It will make nonsense of the scrutiny function if members of local authority scrutiny committees scrutinise the responsibilities that they have discharged as board members. The amendment is entirely proper, as it would require them not to do so, and would exclude such conflicts of interest from the Bill.

Mr. Denham: I am happy to accept and to echo the sentiment behind the amendment.

Dr. Peter Brand (Isle of Wight): I am grateful to the Minister, and I think he is sensible to accept the spirit behind this amendment. Would he go a little further and say something about members of social services committees and those members of the executive of local authorities who are responsible for social services matters? They, too, should not be members of this scrutiny committee, as with joint commissioning the same conflict of interest may well arise.

Mr. Denham: The hon. Gentleman makes a helpful point. A conflict of interest may arise in a number of different circumstances with the operation of overview and scrutiny committees. The Department for the Environment, Transport and the Regions is working with the Local Government Association to produce a code of conduct for overview and scrutiny committees across a range of possible conflicts of interest, including financial conflicts of interest and conflicts of responsibility. We are working together on that code.

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I understand that a draft code of conduct will be published within the next two weeks; it will certainly be available before the full parliamentary scrutiny of the Bill has been completed. It is worth saying that executive members on local authorities cannot be members of overview and scrutiny committees, but the hon. Member for New Forest, West makes a fair point about councillors who may also be board members.

Mr. Swayne: When the Minister said that he accepted it, I thought for a moment that he meant the amendment and not merely the sentiment behind it. In view of what he has said about the imminence of the code of conduct, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Mr. Denham: I beg to move amendment No. 188, in page 6, line 34, leave out subsection (4).

The Chairman: With this it will be convenient to discuss the following: Amendment No. 227, in page 6, line 37, at end insert—

`(4A) Regulations under this section may also provide for functions under section 21(2)(f) of the Local Government Act 2000 to be performed under joint arrangements, to be determined locally, between a county council and any or all districts within the county council area.'.

Government new clause 9— Joint overview and scrutiny committees etc.—

Mr. Denham: We flagged up this group of amendments and the Government new clause before lunch. We are trying to set up an improved joint scrutiny committee structure that allows flexibility for local authorities and for the NHS. Amendment No. 188 and Government new clause 9 allow for a range of options from which local authorities may choose the most appropriate format.

The new clause allows two or more authorities, which can include district councils, to form themselves into a single overview and scrutiny committee to scrutinise health organisations. If a district council joins with a county council, the scrutiny is the county council's responsibility; the county council therefore remains in the lead.

The new clause provides for two or more authorities whose scrutiny committees are responsible for scrutinising the NHS to give the lead to one authority so that it exercises the others' functions in relation to health scrutiny. Two or three local authorities could agree that one of them would exercise the scrutiny function. The clause also provides for a county council and a district council to arrange for the district to undertake the county council's responsibility of scrutinising health services in the district. That is likely to happen when a primary care trust is being reviewed. The clause provides for a county council to co-opt one or more district councils' OSC members on to its own OSC; and the county council may also co-opt district council OSC members if the county is part of a joint scheme with another OSC.

The aim is to allow flexibility and to enable the building of local scrutiny models that are fit for the purpose. The clause specifies that regulations relating to the joint arrangements will set out the circumstances and conditions under which joint schemes can be established. It should be noted that district council involvement in the joint scheme arrangements will be set out in regulations.

As I said earlier, the lead will always be with local social services authorities, and regulations and directions may also provide for those circumstances in which authorities will be required to put joint scheme arrangements in place. The regulations that relate to the normal arrangements for scrutiny and review of the NHS by OSCs will also apply to the scrutiny and review of the NHS when joint schemes are in operation.

New clause 9 provides real flexibility for local authorities when undertaking

their health scrutiny role. It will result in the most effective use of resources, and when appropriate district council involvement can be included. The Committee will know that that has been a particular concern to the Local Government Association and will have noted that the LGA has warmly welcomed new clause 9 in its briefing note.

Mr. Swayne: I shall not go back over ground that was covered this morning on amendment No. 245. However, I had hoped that the Minister would say rather more than that the regulations will cover the operation of the overview and scrutiny committees. I seek some understanding of how the Minister sees the system operating. Many people, including myself, are not clear about how it will operate and how the local authorities will divide up the patch between them.

We know of the correspondence from Epping Forest district council, but I shall quote the Democratic Health Network, as it is time that it had a second outing after its tour de force last week, which provoked a response of stony silence from Labour Members. It states:

    ``one health scrutiny area might include a Health Authority, several PCTs, a Care Trust and several acute Trusts as well as services provided under partnership arrangements''.

If, as a minimum, we expect the scrutiny committee to deal with the chief executive twice a year, its burden and work load may be significant. I would like to follow the Minister's concept of how the overlapping local authority responsibilities knit together. Rather than simply being told that regulations will provide that the process works, I want an understanding of how it will work.

Dr. Brand: Clearly, our amendment No. 227 is in the spirit of Government new clause 9. I recognise that the new clause is essential in areas not blessed with coterminosity, such as the Isle of Wight.

Will the Minister explain how the joint committees will address the democratic deficit that he says is behind some of the changes? Committees will be composed of democratically elected individuals who may be democratically accountable as individuals. However, I cannot see that a joint body of perhaps four or five local authorities, and a local authority that perhaps has to service two or three joint authorities, creates a direct link between a democratic process and the scrutiny that is so important to the community. We will not end up with anything more directly accountable than a CHC, as it has elected members.

The nearest pattern that I could think of was the local land drainage committees, one of which I was a member of for some years. They travel around the country and see splendid things, but have no influence over anything. I am concerned that we will set up a mechanism to produce window dressing that is not accountable for the work that it does. I would like the Minister to explore what would happen on a joint committee, as opposed to a lead authority, if members of it or the sub-sets of the lead authority committee were of completely different political flavours, persuasions and backgrounds.

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