Health and Social Care Bill

My Lords, I rise to speak to Amendments 238AA, 238AB, 238BZA and 238BA and to declare my interest as a member of Newcastle City Council. These amendments relate to the membership of health and well-being boards. As currently proposed, the boards will have at least one councillor of the relevant local authority—so it could be one councillor, or it could be more. The choice will be with the council. However, several other people who have membership will be officers or unelected co-optees. This means that the board as currently proposed is effectively a board of directors, not a council committee which—unlike all other council committees—is made up of those who are publicly elected. Yet the board as proposed is legally a council committee; and because it is legally a council committee, only councillors can vote—officers must advise. For officers to vote, specific regulations will have to be put in place, and of course they can be. However, I hope that the Minister is willing to think further about this. Councillors, being elected, have both a democratic mandate—unlike officers—and a perception of service provision which comes from a geographical perspective as well as a service perspective. At times that can be very valuable, particularly in a geographically large council area. To have just one councillor—which is what the Bill permits—would be a mistake. It would mean a council committee, the health and well-being board, would be dominated by officers and co-optees. It would also mean that only one political group was in membership of the board, which in my view would be deeply unwise. Given the board's terms of reference, I do not argue that councillors have to be in majority. However, I do argue that councillors are important; that geographical differences in a council area should be acknowledged; and that more than one political group should be fully represented on a board. Amendment 238AA solves this problem. It defines the minimum number of councillors as three. That would give the board greater breadth and enable political proportionality to be effective. Amendment 238AB states that where a council is a county council and part of a two-tier system of local government there should be a district council representative as well as county representatives, because district councils have statutory duties in relation to health and well-being. Having one district councillor appointed in this way as a representative of several district councils is normal procedure for those councils when duties span the two tiers. The other two amendments are simply enabling amendments assuming that Amendments 238AA and 238AB are agreed. In Committee there was a discussion about councillor membership—how many there should be, whether they should be in a majority and whether they should have powers over the budgets of other health organisations not managed by the council. There was no conclusion to that debate, but I have thought long and hard about it. I have concluded that the amendments in my name and those of the noble Lord, Lord Bichard, and the noble Baronesses, Lady Eaton and Lady Henig, which reflect all parts of this Chamber, give a solution to this problem and would enable us to balance professional knowledge with the necessary democratic accountability. I do not propose to press this to a vote, but I hope that the Minister will be willing to engage in discussion on it. What is being proposed from all parts of the House is a solution to a problem that needs to be resolved. It will prevent difficulties arising further down the line should a council decide to have only one councillor as a member of the board.