Cities and Local Government Devolution [Lords] Bill — House of Commons, 2015-10-21
Topic: Health
Alistair James Hendrie Burt (Conservative, Centre-right): I thank the hon. Member for Heywood and Middleton (Liz McInnes) for putting the Opposition’s case clearly and providing me with an opportunity to explain why these measures are so important and, I hope, give reassurance. I start by reminding the Committee that this is an enabling Bill, so nothing in it will force anybody to do anything. Ultimately, if local areas want to take the opportunity to apply for devolution, including the devolution of health services, they can do so, but they will not be forced to do so. Control and standards will be exercised by Parliament in securing the deals. Within that wide remit, I will come to the hon. Lady’s questions, but first let me answer a few specific points that have been raised The hon. Member for Bristol South (Karin Smyth) and my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter)—I thank him for the work he did in the Department, which I follow—in a way put both sides of the argument. In a sense, the Government cannot decide some of the issues that both my hon. Friend and the hon. Lady raised. My hon. Friend believes that where these opportunities are used for greater integration and for the best, services will be smoother and able to deliver more locally what people want. Of course, as the hon. Lady pointed out, there will be disputes within each individual area about what might be best for it. A devolution deal will make sense only if decisions have been taken locally and agreement has been reached on how to move forward. If not, I cannot imagine the hon. Lady or her area wanting to support them. Central Government cannot make all the decisions that will ultimately be taken by a group of authorities working together. Some of that will have to be decided locally, rather than at the centre. I will talk in a moment about the check that is made before anyone agrees to transfer anything. Let me make specific reference to specialised services, which are of particular interest to the hon. Member for Bristol South. NHS England may make arrangements with local partners for the commissioning of specialised services. Those arrangements will be subject to NHS England having regard to certain considerations on their appropriateness in the particular commissioning area. They might involve delegation to local partners, or NHS England might decide to work together with its local partners, who must include at least one clinical commissioning group and a combined authority, or at least one local authority. In all cases, the local partners in an arrangement must exercise the function jointly. That will allow local commissioners to shape services to best meet the needs of their local populations and make it easier to integrate specialist services with other health and social care services. However, NHS England will remain accountable for the delivery of specialised services. It will remain bound by its existing duties to promote the NHS constitution on reducing health inequalities and on effectiveness and efficiency, and to exercise its functions with a view to securing continuous improvement in the quality of services, along with its other overarching duties. NHS England has confirmed that it will be part of any arrangements concerning specialised standards, but national service standards that it sets for the provision of these services will continue to be required. Although there is provision in the Bill to devolve certain specialised services, the control, security and safeguards of the NHS remain. However, it will be possible if it is considered the right thing to do.