Clause 45 - Care Trusts where voluntarypartnership arrangements

Part of Health and Social Care Bill – in a Public Bill Committee at 10:45 am on 6 February 2001.

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Photo of George Young George Young Conservative, North West Hampshire 10:45, 6 February 2001

I welcome the co-pilot to the controls after a long wait to get to part III of the Bill.

I want to argue for the consultation process to include certain key matters, some of which were touched on by the hon. Member for Sutton and Cheam and my hon. Friend the Member for New Forest, West. Clause 45 has enormous implications for local government. Social services is one of the most important local authority functions—the most important function after education—and the clause proposes the voluntary transfer of a key responsibility of local authority to a body that is, in effect and in law, a national health service body. When consultation is entered into at local level, I hope that people will ask whether taking such a radical step is the right way forward.

Many people believe in local government as an important element of a decentralised society and as a counterbalancing democratic body to central Government. If one takes away services from local government one begins to alter the balance of the constitution. I see that as a step away from a decentralised society towards a more centralised one and from a democratic society to a slightly less democratic one. One is potentially removing a chunk of important services from a body that is democratically accountable to local people to one that comes under the control of the Secretary of State.

Some 10 years ago, the Conservative Government looked into setting up an alternative primary care trust as an interface between social services and the health service. We decided not to go down that path, but to give responsibility to local government, partly because we did not want to set up two extra interfaces—one between the care trust and the rest of local government and one between the care trust and the rest of the NHS. When local people are consulted, I hope that a number of questions will be asked: first, about accountability. At the moment if something goes wrong in social services people know who to complain to—their local councillor. There is a clear chain of accountability. If social services are provided by a care trust it is less clear to me what the local councillor would be able to do about a complaint. He would simply say, ``I'm very sorry, but these arrangements no longer come under the county council or district council. They are now in a care trust with its own budget and it is run by a body—yes, we have one or two representatives on it but it is an NHS body.'' I hope therefore that issues of accountability will be raised in consultation.