Clause 45 - Care Trusts where voluntarypartnership arrangements
Health and Social Care Bill
10:30 am
Mr Desmond Swayne (New Forest West, Conservative)
I share the concern and hence understand the motive behind the amendment. Indeed, it sets the theme for many of our amendments to this and the next three clauses. The Bill makes no provision for local authorities to take any responsibility for health services, or even to share the responsibility equally with health trusts. In essence, we are talking about the removal of statutory responsibilities from democratically elected local authorities and local government management by what is fundamentally an NHS body. That begs all the questions that were raised in previous sittings about the centralised nature of the NHS, about micro-management and about the lack of accountability and scrutiny. That is all reinforced in the clause, which changes an accountable local authority function to one that is less accountable.
On Second Reading, the Secretary of State said:
``Incidentally, I do not believe that the best way forward for local government and social services is to have a national health service takeover.''—[Official Report, 10 January 2001; Vol. 360, c. 1089.]
We share that view. We believe that the accountability of local authorities is an important principle that should be preserved within care trusts. It should not be diluted in the provision of services to local people.
The Leonard Cheshire organisation states:
``Trusts will effectively be NHS bodies. This signals real dangers. Firstly and most importantly, that the whole culture underpinning the commissioning process for primary/community care services will be medicalised. This poses a direct and significant threat to the understanding and use of the social model of disability by providing agencies.''
I take that last stanza, so far as I understand it, to mean that local authority provision has had the objective of supporting people in their own homes where possible. The emphasis of the NHS may be different, with its concerns for treating ill health.
We share the concerns behind the amendment and are favourable to it.