Local Government and Public Involvement in Health Bill

I strongly support local government—it is an important part of public life in Britain—and I should like to concentrate on two issues in the Bill: the ability of local authorities to opt for unitary status and the devolution of power to communities, certainly to parish and town councils. A lot of the rest of the Bill is about unpicking some of the mistakes that we have made in the past 10 years. I support doing that, but I am not sure whether we will find the perfect local government solution for which the Government appear to be looking. The baseline for me in local government is accountability—it has been said already that that is part of the attractiveness of local government—and it involves two things: the ability to elect someone to local office and the ability to remove someone from office, which is just as important. My concern with some of the things that have been said about the Bill and with the tenor of some of the things that the Government are doing is that, somehow, we are trying to depoliticise the process. The suggestion seems to be that using a quango, a board or something that is not directly elected by the people provides a better way to deliver services. I am sorry, but I do not agree with that because, ultimately, people must have the right to remove people from office. A classic example—which will not go down well among Government Members, but I am sure that it will among Opposition Members—is the North East assembly, which the people of the north-east rejected overwhelmingly. It is now in place, sitting there, costing £2 million a year. It is not relevant to people, but it is having a direct effect on my constituents and those of my hon. Friend the Member for City of Durham (Dr. Blackman-Woods), by coming up with the regional spatial strategy. When the two of us asked to make representations to a Minister, we were told that we could make our representations as part of the consultation process, as though we were just ordinary members of the public. The same thing has been said to local councils in Durham. It is completely wrong that an unelected body should have such influence. I also want to touch on the issue of leadership, which seems to be something that the Government have grasped, saying that it will solve all local government problems. The options available are a mayor, a directly elected executive, which the right hon. Member for Berwick-upon-Tweed (Mr. Beith) has already described as ““bonkers””—I completely associate myself with his views—and a new style of leadership, which is very interesting. I was heartened after my intervention on the Secretary of State when she said that the Government would not be prescriptive in the model that was proposed. I must tell the House that that is not what is coming from the civil service. Officers in County Durham have been told that, if they want their unitary bid to be taken seriously, it must contain an element of the new system—either a mayor, or a directly elected executive. I am pleased that the Secretary of State scotched that and said that other options can be put forward. I just hope that that is correct. The case made by my hon. Friend the Member for City of Durham for a single unitary county in Durham was strong and passionate, and I totally believe in it. I fear that, by means of this leadership method, we might get mayors by the back door. I have a copy of a briefing note that was sent to me today by the parliamentary Labour party. It is for people who cannot think for themselves. It says:"““Does the Government want more Mayors? We want stronger leadership everywhere. The success of Ken””—" he is known as ““Ken”” now—"““in London shows that directly elected mayors are highly visible and benefit from a strong mandate to take tough, but essential, decisions on issues such as congestion charging. People understand who is making these decisions and where the buck stops””." That demonstrates where the problem comes from. We are looking at the issue in the light of a London-centric model. We have to recognise that there are examples up and down the country of where the old committee system, which I served under for nearly nine years in local government, served us perfectly well. Most of the regeneration of Newcastle and Gateshead was done under the old committee system. The revitalisation of Manchester was done under the local committee system. Let us not be fooled by some of the people who write these position papers and documents. Many of them have never served in local government, but they think that they have the answer to all our prayers in these models. I do not denigrate the hard-working councillors of all political persuasions, who, let us be honest, do their work for little monetary gain and who get a lot of hassle. I strongly support the case for a single unitary in County Durham. A bid will be put forward by the deadline of this Thursday. A single unitary will, overnight, clear up the confused mess that we have at the moment. We have a county council that spends 86 per cent. of the budget, district councils that are too small and bicker among themselves and over the most small-minded things with the county council. It will do away overnight with 275 councillors. I have 60 councillors in my constituency alone. They vary in quality. We have some good county and district councillors, but all parties are struggling to get people of quality to come forward. Comment was made earlier about savings. The change will save £21 million for the council tax payers of County Durham. More importantly—this will be attractive to many council tax payers—the bid says that the precept will be moved down to the lowest, which is Chester-le-street. Six out of the seven districts will see their council tax precepts reduced. The other issue is about devolving power to the local level. That is a good aspect of the Bill and something that we should grasp. I hear people say, ““You can’t have a unitary county, because you can’t represent local people.”” That can be done. In County Durham, we have some examples of good town and parish councils. That is why I have been fighting for the last two years against Derwentside district council to form the new Stanley town council, which will deliver at a local level. Okay, it is not high politics. It is about flower beds, litter picking, street lighting, Christmas lights and so on. But that is what a lot of people want. The Bill will give them that. The bid from County Durham stresses that devolution of power to local town and parish councils. I accept that that puts some pressure on the existing ones to go for quality status and make sure that they are professional, but it is welcome. I do not know whether the Minister has worked out that the timetable for the changes means that we will have elections in May this year and, in the middle of that, we will be saying to people, ““Your council will be abolished in the next year to 18 months.”” Will the Minister think about how we can improve that in some way? It will not help turnout at those local elections. Finally, I turn to health. Ever since I was elected, I have made representations about accountability at the local level, and I feel strongly about the subject. What is proposed in the Bill is a complete dog’s breakfast. We are unpicking something that we put in place quite recently, as it does not work. It does not work for one reason, which relates to my point about accountability: there must be the ability to affect actions. People must be able to change things. Neither what is proposed in the Bill nor the system currently in place can really change decision making in health at local level, and that is because of that terrible body, the NHS Appointments Commission, which appoints staff without any reference to local people. Even if those staff commit a host of mistakes, local people cannot remove them. If local councillors had made the mistakes that some local trusts in the north-east have made, they would be out on their ear at the next local elections. That is the issue. We have missed an opportunity to democratise local health provision, after the mess of foundation hospitals. I am glad that I voted against the idea when it came before the House, and I have been proved right: it did not work, and did not make health more accountable. The Bill is a missed opportunity to introduce if not direct elections to health boards, then at least some way for local people or bodies to remove the decision makers. If we do not ensure that, we will not really interest people in local health. There are opportunities for local people under the Bill, but I do not think that it will be the panacea that people might think it is, or that it will bring about the Government’s ultimate aim of finding the perfect form of local government.