My Lords, as the noble Lord said, we have discussed this amendment since Report, and I think that it is an excellent amendment that puts in a nutshell what we think is necessary as a way of controlling the operation of devolution so that it does not break up the health service.
Local issues in relation to the health service require very careful handling, as noble Lords know. For example, in order to get sufficient expertise in a particular technique there have to be enough operations—if it is an operation technique—to give the people doing it experience and confidence. If there have to be operations in every locality, you cannot do that. There is a tension between localism and a degree of centralisation in running the health service which is absolutely essential. I agree with the noble Lords, Lord Patel and Lord Warner, and the noble Baroness, Lady Walmsley, that it is entirely right for the operations of the health service in a locality to be under the supervision of the local authority. It manages that in the particular locality rather along the lines of the Greater Manchester proposals that we have seen. I do not think that there is any question that the Secretary of State was intending to do more than transfer these particular functions that are in the local area to the control of the local authority or combined authority—the authorities relevant to localism—rather than have separate health authorities as we have seen in the past. As has been said by the noble Lord, Lord Patel, who has very much more experience than I do in this area, that has a very good potential for improvement and innovation, and therefore I sincerely hope that this can be agreed.
It has been extraordinary to see this Bill come forward with so much agreement. The noble Lord, Lord Prescott, originally had the idea of a powerhouse in the north—although I think he called it something different—and that idea has been championed by my noble friend Lord Heseltine in the report that he wrote for the Government some time ago. I am delighted to see this Bill come out of all that, with a degree of co-operation and origination from different parts of the political system. I find it extremely good that all the parties are able to agree about this sort of thing, and it strikes me as a good way forward for our country that experts such as the noble Lords, Lord Warner and Lord Patel—I think that the noble Baroness, Lady Walmsley, is also an expert in this area—should contribute immensely to that happening.
As your Lordships will have noticed, this Bill is promoted not by the Department of Health but by a different department, so it would not surprise me if my noble friend is not able to accept this amendment today, but I am sure that there is good will towards it—certainly, I undertake to do all that I can to ensure that an amendment or something very like this will go into the Bill at some stage. I certainly strongly support it, but I think that an element of agreement may be required—this was discussed at Report stage after all, and in a way it is quite a privilege to have this amendment following Report, as we have only been able to formulate it clearly following Report—and I hope that we will be able to deal with it on that basis.