Local Government and Public Involvement in Health Bill

I note the hon. Gentleman’s comment from a sedentary position: not having been a member of the GLC, I would not know. Given the Government’s propensity to trample over local opinion, clause 8(2)(a) contains a worrying phrase:"““the Boundary Committee may recommend to the Secretary of State such boundary change as, in consequence of the review, seems to them desirable having regard to the need to secure effective and convenient local government””." That prompts the question of what is local. As we have regional targets left, right and centre, I would dispute that ““local”” means my district. It also prompts the question of what is effective and convenient and for whom; I would suggest that it is not for my constituents, but possibly, for regional or even national government. I do not believe that the needs of my constituents are at the heart of the Bill. This Bill has far-reaching implications and I look forward to debate it in Committee. Briefly, as I am conscious that other Members wish to contribute to the debate, I shall address the apparent democratic deficit for health in the Bill. That issue has been raised by many Members, and concerns were expressed about inspections with LINKs, to which the Minister responded that people were entitled to do reviews. If reviews and inspections are similar, I do not know why we need a change of words. If they are not similar, it is a definite change of emphasis, which I do not welcome. My local council has already lost its scrutiny of health. It is not happy about that, and nor are local people. They will not welcome a further dilution of their input in that regard. People on the street and the council are infuriated by frozen posts, massive cuts in services and, especially in my constituency, the loss of the proposed super-hospital. The Government are strong on consultation, which is an issue that I raised in relation to the Sustainable Communities Bill, but I am not sure that they are long on listening. A long consultation was undertaken on option 1 and option 2. Everyone was voting like mad, and it was covered in the local newspaper. Ultimately, however, we were told that there was no such option. It had all been a waste of energy and expectation for the local community. Local government, with its hold on the purse strings, just decided that the hospital was not going to happen. That further dilution of patient involvement, along with the lack of accountability, fills me and other hon. Members with great concern. The proposed new LINKs need great scrutiny. The British Medical Association has some valid concerns. It observes that LINKs may not work well with those who are"““less educated or less able to dedicate time””," It is important that people feel that they can contribute, and are not intimidated by a vast system that does not to listen to the patient’s voice. The BMA also says:"““There is a danger that LINks may be patronised and manipulated by managers””," and,"““Lack of Co-ordination for LINks does not formally enable sharing of information and ideas.””" Again, a larger and more unwieldly structure—the Minister tells us that hundreds of people, and almost anyone who wants to join, can be involved—will result in a worrying dilution and lack of expertise. The hon. Member for Leicester, South (Sir Peter Soulsby), who is not in his place at present, raised valid concerns about the health aspects of the Bill. My hon. Friend the Member for Billericay (Mr. Baron) also referred to patients being marginalised. I will nor revisit those concerns. I hope, however, that the Government will start listening to concerns of hon. Members who feel that the Government are moving not towards localism but to a convoluted and complicated form of bureaucracy, which will mean that the person in the street will not understand what is going on, and will feel yet again that things are being done to them, rather than for them and with them. Were the Bill genuinely empowering local councils, and giving greater scrutiny on health, I would support it. [Interruption.] I hear the Minister muttering away, but I will not explore the jelly fish idea, which grasped our attention for a while. I share the concerns expressed that we will end up with an organism that will not deliver what people want.