Local Government and Public Involvement in Health Bill

moved Amendment No. 204J: 204J: Clause 106, page 67, line 15, after ““area”” insert ““or who provides such services to a significant proportion of the persons resident in the area of the responsible authority”” The noble Lord said: My noble friend Lady Hamwee has just trailed this amendment, which is about the relationship between local area agreements and the health service organisations that will take part in the agreements. It addresses the Bill’s provision about the location of the services provided and the fact that that is often quite different from the distribution of those using the services. The issue is sometimes fairly simple, as with local community services, but it can be quite complex for larger hospitals. The pattern is particularly complex in some large conurbations where there is a great deal of overlap. If the men in the ambulance come to get you in the part of the world where I live, the first thing they ask—assuming that you are capable of giving an answer—is, ““Burnley or Airedale?””. Burnley is part of the East Lancashire Hospitals NHS Trust—although, given the recent changes, they will now ask, ““Blackburn or Airedale?””. But that is another matter. Burnley and Blackburn are in east Lancashire and Airedale is over the tops in Yorkshire, in the Aire Valley, and is clearly a different set-up altogether. But traditionally people in our end of the county go to Airedale, and that is particularly true of those parts of the county that used to be in Yorkshire. Pretty well everybody goes to Airedale. So it is a question of the interaction between investment decisions and the provision of services. Presumably those are the key things that will appear in the local area agreements, linked to targets coming out of those and the location of the places that will provide those services. It may not be the organisations—the primary care trusts and NHS trusts—that will be negotiating the local area agreement in a given area. A further problem is, for example, that Blackburn is not in Lancashire anyway. It is a big black hole in the middle of Lancashire, which makes a nonsense of the whole thing. Presumably the East Lancashire Hospitals NHS Trust will have to take part in the local area agreements in the whole of Blackburn and its part of Lancashire. That is very complex. It will be interesting to know how the Government see it working in practice. I beg to move.