Clause 7 - Functions of overview and scrutiny committees

Part of Health and Social Care Bill – in a Public Bill Committee at 12:30 pm on 30 January 2001.

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Photo of Desmond Swayne Desmond Swayne Conservative, New Forest West 12:30, 30 January 2001

After that passionate debate on the principles underpinning the clauses that we shall discuss for the rest of the day, I feel that it is down to me to lower the temperature of the Committee, and to bring us back to our ``meat and two veg'' agenda of detailed scrutiny of clauses and amendments. Notwithstanding the modest arrangements that we might make at lunch, and perhaps at 7 pm, the clock beckons us until 10 pm. I am sure that my hon. Friends would want us to give detailed and thorough, if not exhaustive, scrutiny to the amendments, so that those who have gone to Fulham today to learn of the rest of the Government's health agenda will wish that they had remained to share our scrutiny this afternoon.

Amendment No. 245 would make the principle of clause 7 clear. The practical consequence of the clause is that

``any county council, . . . any county borough council''

``the council of any district comprised in an area for which there is no county council'' will have oversight and scrutiny functions. The principle underlying that is that the local authorities detailed in the Bill are those that currently have responsibility for providing social services. However, we think that it is better to put into the Bill the principle rather than the practical consequence. Reform of local government may change the arrangements, so it is better to state the underlying principle that caused the Government to choose those structures to have responsibility for oversight.

We know that the function will not necessarily be easy to perform. It is somewhat analogous to the suggestions that have been made over recent years with respect to fluoride, whereby the Government has suggested that local authorities might consult their electorates and, as a consequence, bring about greater use of fluoride in the water. The problem is, of course, that local authority boundaries are not coterminous with water authority boundaries, so there is an immediate problem of how that exercise in seeking electoral consent will give practical effect to the policy.

There is a somewhat similar problem here, in that health authority boundaries, PCTs and trusts are not coterminous with the local authority scrutiny that will be provided. That problem is significant. I draw attention to the paper that the Government have provided within the last few days, entitled ``Patient Representation in the New NHS. Part One: A new voice for patients''. On page 6, the Government acknowledge:

``In many places, scrutiny committees from more than one authority will need to work together to ensure an efficient scrutiny process. Subject to Parliament, regulations will be made setting out how OSCs can pool or share powers or cooperate together to do this.''

I look forward to hearing the Minister spell out precisely how he envisages that that will take place.

``They will also set out how district councils may participate.''

That will be a very interesting discussion, to which we look forward, because I am sure that all members of the Committee will have received the correspondence from Epping Forest district council. It is obviously enthusiastic about taking up its responsibilities with regard to scrutiny—responsibilities that it believes that the Bill, as currently structured, denies it.

The council makes an interesting point. It says in its letter:

``It is not reasonable or realistic to expect the County Council to carry out a thorough scrutiny process when some 26 plus health service organisations are involved. This includes 2 Health Authorities, 16 Primary Care Groups/Trusts and at least 8 acute or specialist provider Trusts and ignores totally those Health Trusts which provide cross border services to a large part of our population.''

The council is speaking there of its own particular circumstances in Epping Forest, but I doubt very much that other district councils find themselves in a wholly different position.

I look forward with interest to the case that the Liberal Democrats will make for their amendment because, although I have some sympathy with it, I have reservations about expecting district councils to discharge the functions—[Interruption.]—The hon. Member for Sutton and Cheam murmurs from a sedentary position but, from my experience of my own district council, I wonder whether it is equipped to carry out that function. It is already struggling, given the resources that it has, to discharge its existing duties. How much additional resource will it be provided with if it is to discharge new oversight and scrutiny functions?

I would not go so far as to say that we are in danger of a surfeit of scrutiny, but there is a possibility that, by fragmenting the arrangements that were previously undertaken by community health councils and expecting the oversight to be taken up by any number of local authorities at different levels, we are creating the danger of fragmentation and we may weaken the authority with which local authorities can scrutinise the NHS by expecting scrutiny to occur at many levels.

We expect the Government to justify their stance but we are, by and large, comfortable with the notion of scrutiny at the level at which social services responsibility is exercised. Those councils are already under a statutory obligation to co-operate, under the Health Act 1999. We are confident that that is probably the right level, although we can foresee problems.