Devolution in England — House of Commons, 2015-03-02
Topic: Health
Graham Eric Stringer (Labour, Centre-left): I do not disagree with my hon. Friend about that, although we do disagree on other parts of this devolution. The gap between what we have now and an elected mayor is too long. Appointing a mayor is almost a contradiction in terms; mayors should be elected and then they should take the responsibility that the electorate give them, having stood on a manifesto. I would prefer the 10 leaders, who do have an elected mandate, to continue. Having an appointed mayor is a halfway house—a solution that is not really a solution—and it would be better to move earlier to an elected mayor and not have an interim situation. Having made that criticism, I do not think it spoils the whole broth—the essential elements of the decentralisation The next part of the decentralisation that seemed to cause some difficulty to some of my hon. Friends, and to some other right hon. and hon. Members, is the devolution of the health budget, so that health and social care can work together in Greater Manchester and deliver better services. When it was announced on the "Today" programme—six days ago, I believe—the presenter said, "This will mean that local councillors will get their grubby hands on the health service." That represents not only an appalling statement by a supposedly neutral BBC presenter, but an attitude of contempt for local democracy. There is absolutely no guarantee that when locally elected councillors, working with the clinical commissioning groups, get together the service will be better, but the expectation must be that it will be, because when decisions are taken locally, the decisions are usually better. That is not always the case and it is not inevitable, but usually when people of good will try to make things better and they can see the detail on the ground, we get a better service I have been fighting the Healthier Together proposals in Greater Manchester, which are all about bringing care for the elderly and the ordinary services together. I have been fighting them not on principle, because the principle of what they are saying is right, but on detail and procedure. In every case, we go back to NHS England. I would much rather discuss my disagreements over detail with people who are elected locally and with local clinicians than with some distant bureaucrat in London. I do not believe that this measure is being imposed; it is being negotiated by properly elected local government leaders. One objection that may be made before a general election—I had better be up front about this—is that Labour councillors should not be sitting down with the devil of a Conservative Chancellor. Well, I think they should. It would be an absurd position if any elected leader of any district or city said, "I will not accept something that I think is good for my area because the person who is proposing it is of a different political colour." There are still many details to be decided and some obvious pitfalls. We need to ensure that at least the amount of money that was scheduled to go into the NHS actually goes in and is transferred to Greater Manchester. If that money goes across but there is a deficit, we come back to that most difficult decision—I will finish on this point because I know many Members wish to speak—which is the closure of a hospital. If care for the elderly works in combination with the NHS and many people who should not be in hospital are taken out of hospital, hospitals may have to be reduced in size. If that happens, who would Members like to take that decision: somebody sat in Whitehall or locally elected people who have to face the electorate daily? That is the toughest decision, and I would prefer it to be made by local people, which is why I am pleased to support the proposals for Greater Manchester. I hope that this Government and the next one get more enthusiastic about devolution.