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My local council has already lost its scrutiny of health. It is not happy about that, and nor are local people. They will not welcome a further dilution of their input in that regard. People on the street and the council are infuriated by frozen posts, massive cuts in services and, especially in my constituency, the loss of the proposed super-hospital. The Government are strong on consultation, which is an issue that I raised in relation to the Sustainable Communities Bill, but I am not sure that they are long on listening. A long consultation was undertaken on option 1 and option 2. Everyone was voting like mad, and it was covered in the local newspaper. Ultimately, however, we were told that there was no such option. It had all been a waste of energy and expectation for the local community. Local government, with its hold on the purse strings, just decided that the hospital was not going to happen. That further dilution of patient involvement, along with the lack of accountability, fills me and other hon. Members with great concern.
The proposed new LINKs need great scrutiny. The British Medical Association has some valid concerns. It observes that LINKs may not work well with those who are
“less educated or less able to dedicate time”,
It is important that people feel that they can contribute, and are not intimidated by a vast system that does not to listen to the patient’s voice. The BMA also says:
“There is a danger that LINks may be patronised and manipulated by managers”,
“Lack of Co-ordination for LINks does not formally enable sharing of information and ideas.”
Again, a larger and more unwieldly structure—the Minister tells us that hundreds of people, and almost anyone who wants to join, can be involved—will result in a worrying dilution and lack of expertise.
The hon. Member for Leicester, South (Sir Peter Soulsby), who is not in his place at present, raised valid concerns about the health aspects of the Bill. My hon. Friend the Member for Billericay (Mr. Baron) also referred to patients being marginalised. I will not revisit those concerns. I hope, however, that the Government will start listening to concerns of hon. Members who feel that the Government are moving not towards localism but to a convoluted and complicated form of bureaucracy, which will mean that the person in the street will not understand what is going on, and will feel yet again that things are being done to them, rather than for them and with them.
Were the Bill genuinely empowering local councils, and giving greater scrutiny on health, I would support it. [Interruption.] I hear the Minister muttering away, but I will not explore the jelly fish idea, which grasped our attention for a while. I share the concerns expressed that we will end up with an organism that will not deliver what people want.
8.8 pm
Clive Efford (Eltham) (Lab): I welcome parts of the Bill; there are other parts that bemuse me, and others to which I am violently opposed. As we are considering the role of local authorities in scrutiny, I will make my contribution in that spirit.
The Bill is an attempt to make local government more responsive to the needs and aspirations of local communities. That has eluded us for some time, and it has led to disaffection and a lack of engagement in local elections. We have a problem to overcome in relation to local area agreements between local statutory providers and local service providers. How do we engage the local community in those, and how do we create a dynamic relationship that responds to the local community’s aspirations and influences those local area agreements? That should be the focus of our attention. Much in the Bill moves us in the direction of bringing local authorities closer to their communities, and I very much welcome those aspects of it.
I can give examples of difficulties that have arisen in my local communities. A number of the most deprived communities in my constituency were asking for services, especially podiatry services, for elderly people. We convinced the local primary care trust to set up a pilot service in a satellite practitioner nurse-led centre financed by our single regeneration budget programme. That proved popular and was well attended by elderly residents in the local community. The pilot came to an end and in spite of the popularity of the service and the high demand, the community unfortunately failed to influence the service providers to bend their spend—a phrase we have used in the past—to meet that aspiration.
I also chair one of our local neighbourhood renewal panels. For many years, at the start of the neighbourhood renewal programme, we asked for funding for neighbourhood wardens from the neighbourhood renewal funding. However, it was difficult to get officers who supported the panel to produce a report in favour of them in spite of the fact that the whole community, covering two estates in the neighbourhood renewal area, was unanimous in its support for the idea. We finally got the report three years later and the neighbourhood wardens are now in place. They are extremely popular and are doing a very good job.
Similarly, a number of heads of local schools came up with the idea of having adult learning centres in their primary schools. They came to the neighbourhood renewal panel with the plan to work in partnership with the further education college for the borough and develop adult learning centres where parents and people from the community could come to improve their education and employability. The scale of the improvements and benefits to the local community are difficult to quantify, but with little money from our neighbourhood renewal panel the heads were able to set up those schemes. One has led to £1.4 million of additional investment to expand the adult learning centre by having a family centre on the premises and a lift to enable disabled people to access the adult college. That scheme arose from a local initiative, with the heads of local schools talking to residents on their neighbourhood renewal panel and the panel agreeing a sum to finance the improvement and introduction of those services. That is an example of people who were empowered by the resources made available to them through neighbourhood renewal programmes so that they could make a difference. There was a reason for
them engaging in the process because they made a contribution and a significant difference to their community.
Sadly, our neighbourhood renewal programme has been rolled up into a much more centralised structure in which it has to hit specific targets. The decision-making process has been taken away from local communities. A minimal sum of money is left for people to play around with in their communities. Basically, the presence of local residents in terms of neighbourhood renewal is now a box-ticking exercise to satisfy the requirement for some sort of community engagement to deliver on the core themes.
Mr. Woolas: My hon. Friend talks about the centralisation of neighbourhood renewal. The Department funds neighbourhood renewal through local authorities. In neighbourhood renewal funding areas that is a non-ring-fenced grant through the local area agreement. Is he saying that it has been centralised to borough level or to national level?
Clive Efford: I am grateful to the Minister for giving me the opportunity to clarify that. It is very much centralised at borough level. What has been drafted for the programme of expenditure is driven by the service professionals, whether they are in statutory organisations or the borough itself. The complaint from members of my neighbourhood renewal panel is that what was working well, and what empowered the local community to be very responsive to things that came out of the community at a local level, has been diminished and has almost disappeared. That is to the detriment of the programme.
Another part of the Bill that I very much welcome is the intention to expand the support and involvement of the third sector. When we do that, and in particular when we talk about introducing local parishes in London, we need to guard against those communities that have readily available to them the capacity to take advantage of those powers at the expense of those communities that are more disadvantaged and therefore less likely and less able to do so. In saying that, not only do local councillors need to play their role, but we as MPs need to play a role, too. Often when we draft this type of legislation, we overlook our role as champions within our communities.
I have been involved in setting up local community forums in my constituency, and I am currently involved in trying to set up a charitable trust involving local residents. One of the problems that we are coming up against is that we already have an existing centre that is used by young people. The charity is funded by a trust, held by a bank, and it had a capital sum invested for it. Unfortunately, as a result of the dotcom collapse, some of that capital sum disappeared. The income is now reduced and the fall means that the charity has drawn on the lump sum that it invested, making its income even lower. It has been a vicious circle.
None the less, the charity is an important voluntary organisation within my constituency and it is having serious problems in identifying a source to fund the core activities of a charitable trust. It has a number of irons in the fire with regard to applying for grants, but it does not have a means to access resources readily. It needs resources that can be underwritten for three
years or more to give it sustainability and the chance to plan ahead to perform its core functions. That is a big problem. The forthcoming taskforce report into the third sector must address the problem of core funding for the third sector to ensure that such bodies can stand up and play their role in delivering some of the strategies that the Government and the funding bodies want an organisation that engages with young people in the community to deliver. If those organisations fold because of a lack of funding for their core functions, the opportunity is lost to engage with them and with the use of their resources and links within the community. That is an essential part of ensuring that we have a vibrant and effective third sector.
I want briefly to cover one or two other things. Part of the Bill deals with the future of local government boundary review procedures. My experience when we had the local government boundary review in Greenwich was that the whole process was unsatisfactory. The local government boundary commission was not accountable to the local community. It held no public inquiry to conclude its initial findings and it split many well-established and well-understood local community boundaries across not only council wards but, inevitably, parliamentary seats, because its findings were the building blocks for the future parliamentary review. I say that having benefited slightly from the parliamentary boundary review. I do not want to give the Minister the impression that this is sour grapes. In fact the difference is marginal, so it is neither here nor there.
The Cator estate in Blackheath is run by its own trust, currently served by two wards and in future to be served by two Members of Parliament. None of the decisions made any sense, but the commission committed itself at an early stage to delivering a set of ward boundaries providing for a number within 1 per cent. of the average number per ward if the population is divided by the number of wards. By setting itself that standard it drove a coach and horses through any idea of local accountability, local knowledge and local communities.
If we are to engage with local communities and encourage people to participate in elections, we must ensure that they feel some affinity with the boundaries of the areas that are being represented. In Greenwich, we underwent the painful exercise of moving from two-member and one-member wards where we had 62 councillors to three-member wards with 51 councillors. In the process we made the wards too big. They are unwieldy and unrepresentative, and parts of communities are lumped together in a ward while half a mile away there is another part of another community, although there was a much more sensible solution to the problem in the locality.
The Bill suggests a system of directly elected mayors, leaders or executives. I believe that there have been 35 referendums on mayors, and that on 23 occasions the proposal was rejected. If we value elections and putting information before the electorate, allowing them to make up their own minds, we should recognise that communities that have been given that choice want to exercise it; but the Bill suggests that we take the choice away, and allow no referendums before introducing mayors. The Minister looks puzzled; if I am wrong he can correct me, but I believe that if a local authority
decides that it wants a directly elected mayor, it should be able to put the proposal to members of the local community in a referendum so that they can decide. Heaven help them if they are stupid enough to vote in favour of it, but that will be a matter for the community. In any event, the proposal should be put to the community in the form of a reasoned argument.
It has been said that we have diminished the role of local councillors by electing executives. I am passionately in favour of the committee structure, because when we were on committees as local government councillors we had the opportunity to scrutinise the officers who were charged with responsibility for delivering services. At present, scrutiny means scrutiny of a member elected to an executive rather than scrutiny of the officers. What used to happen was that a group of members with broad knowledge of, say, social services in an area could interrogate the officers charged with delivering those services.
Martin Salter: Will my hon. Friend give way?
Clive Efford: I will not, because I am about to sit down. I have been speaking long enough, and I know that others wish to speak as well. I could go on, though, and I hope that there will be further opportunities to scrutinise the Bill. I know that other Members will speak about the scrutiny of health services. That is what I wanted to speak about next, but in fairness to them I will sit down now.
8.25 pm
Mr. David Burrowes (Enfield, Southgate) (Con): The White Paper should bode well, in view of the names of such documents, such as “A stronger local voice” and “Our health, our care, our say”; things might seem to be moving in the right direction. However, others may understand my scepticism and that of my constituents, given the existence of similar documents produced by health managers using the phrase “in your hands” when the proposed reconfiguration of services seems to involve an inexorable slide towards the downgrading of accident and emergency, children’s and maternity services despite the wishes of thousands of people.
First, however, I want to focus on local government, in which I have a particular interest because I was a councillor in Enfield for some 11 years. The Bill appears to make the clear admission that legislation in 1999, 2000 and 2003 has not succeeded in revitalising local democracy and satisfaction with local services. In fact, it could be seen as a formal apology from the Government: “We are sorry. We accept that we made a mistake. We are going to abolish many of the inspection regimes such as best-value performance indicators, and reduce the burden on local government.”
Mr. Woolas: The hon. Gentleman says that he welcomes the changes in the performance regime. As he will know, the Government’s argument is that the regime has helped to improve the performance of local government significantly, to enable it to deliver higher-quality services. I hope he recognises that local government has improved its services.
Mr. Burrowes: I recognise that Enfield council, under Conservative control, has greatly improved local services, but that is not a result of all those inspection regimes. In fact, it may have happened despite them. It is an interesting spin on the record of best-value performance indicators to suggest that once they are supposedly fulfilling their purposes, they should be abolished. Perhaps a similar proposal is being considered for patient forums. They are fulfilling their purpose in Enfield, so I do not think that they should be abolished. I shall say more about that later.
Ironically, the Government’s interference in earlier legislation is part and parcel of the problem. Any moves to deregulate and get out of the hair of local councillors and those in control are very welcome.
Martin Salter: Will the hon. Gentleman give way?
Mr. Burrowes: I will give way very briefly, as others wish to speak.
Martin Salter: Does the hon. Gentleman share my concern about a further diminution of local councillors’ powers? He may have spotted, in clause 32, a plan to centralise the complaints process by giving the national Standards Board power to suspend a locally elected standards committee. Does he not agree that that is a move in precisely the wrong direction, and that local problems should be resolved locally?
Mr. Burrowes: As a member of one of the early standards committees, I welcomed its efforts to ensure that complaints were dealt with by local councillors and independent chairmen, rather than being second-guessed by a national board.
Why is public satisfaction so low? One question that any resident would want to ask is, “Why is my council tax rising? Who is responsible for that—who holds the purse strings?” As Members have suggested, the whole issue of local government finance is missing from the Bill. That is a big omission, because it is in terms of that that people might feel a change in their level of satisfaction. They want to ensure that their council is much more responsible—that it is responsible for the taxation raised, and that that links in with representation and expenditure. I await the Lyons review with bated breath, but we must not delude ourselves about the importance of matters such as shifting the structures and seeking to improve consultation. The crux is whether local councils have proper autonomy.
Let me turn to another significant part of the Bill. An issue for the public is whether they have a voice—whether they, or their representatives, are involved in decision making. Is there a genuine devolution of power? The Government answer that by addressing structural change, but that takes them in the wrong direction. Their structural change involves looking at the option of giving more power to executive leaders. I have not had letters in my mailbag or people banging on my door demanding that more power be given to the council leader. People do not say that they want that. What they want—and what we want when we suggest that there should be more councillors, and that perhaps they might be younger
and more able—is more power and accountability for councils and individual councillors.
That is why it is profoundly disappointing that having a committee system is not one of the options among the various structural models. When I was elected as a councillor in 1994, I was one of the youngest councillors in Enfield. It took a while for me to understand what was going on in the council, but I appreciated the signposts of the committee system. I knew where to go to get information and who to ask questions of. My party was not in control of the council at the time, but, as an opposition councillor, I appreciated having the opportunity to ask questions not only of councillors, but of council officers.
We now have a system of cabinet government, and I was a cabinet member. I appreciated the level of involvement that I had with council officers and having some kind of streamlined decision making. However, the scrutiny of my role diminished, as did the amount of information that went not only to councillors but to the public. Also, newly elected councillors, in particular, do not know where to go. They are put on a scrutiny committee and it takes them a while to get to grips with the labyrinthine ways of how to hold an executive with increasing power to account.
Other elements of the committee system that were of benefit were the degree of consensus and the cross-party working that could be achieved on a committee, for the good of a community. That now seems to be decreasing. I urge—as I will do again in Committee—that we look into at least giving local communities the option of having such committees, even though in my experience they are not perfect.
Another issue to do with structure involves the standards committee. I welcome the recognition in the Bill that things have become centralised, that we need to devolve decision making, and that the conduct regime needs to be determined locally by local councillors working with independent members. I was an inaugural member of the standards committee in Enfield. The independent chairman and councillors on both sides of the party divide worked well and diligently. However, the committee became concerned that the standards board was increasingly taking powers and control away from it.
Also of profound concern throughout the country is the increased detail and the increasingly bureaucratic nature of the code of conduct, and the fact that it lacks basic common sense. Therefore, the suggestion that there might be a clearer, simpler and more consistent and sensible code of conduct is to be welcomed. However, we will need to see how that works in practice.
I particularly welcome the suggestion that there will be a reduction in the burden of best value and inspection. It is about time that that happened, and my party has campaigned vigorously for it, not least during election campaigns. It is also welcome that the Audit Commission might have a gatekeeper role in terms of inspection, instead of its seeking to perpetuate the inspection regime, which is a circus in many respects.
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