My Lords, I thank the noble Earl for his very detailed explanation of these regulations. I want to ask just a couple of questions.
First, the original plan for transferring the commissioning of services to local government from the NHS was due to start on 1 April and has now been changed to 1 October. I may have missed it in the noble Earl’s introduction, but could he explain the reason for that delay?
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I turn to what is an interesting relationship between the Government and local authorities. The EM makes clear that the full scope of the healthy child programme will not be covered by the five reviews that the noble Earl referred to. Instead, it is described in the EM as providing,
“a ‘gateway’ to identify additional needs that the HCP guidance also addresses”.
The EM goes on to say that,
“Mandating only some elements of the HCP allows LAs autonomy to determine delivery of the remainder”,
and that local authorities are,
“expected to take a reasonable approach to continuous improvement in participation in the 5 mandated reviews”.
That seems to me an eminently sensible approach. I certainly understand that, if you are transferring responsibility to local government, there is no point doing so unless you allow and respect local government autonomy.
The noble Earl also referred to the report and review that have to take place before 31 March 2017. I wonder how, in the 18-month period from the start of the new provisions two years from now, his department will monitor performance in between times. Does it have any intervention powers if it feels that a local authority is not really doing what is necessary to make sure that the programmes work effectively?
Could I also ask the noble Earl about the budget? He referred to a figure that is to be transferred. The EM states that the Government are committed to fund local authorities for these new commissioning responsibilities. What happens post 31 March 2017? At some point, a decision has to be made.
Secondly, is the money being transferred as a ring-fenced budget to local authorities, or is it going to go through the DCLG vote? I am interested to know. Behind that is the question of whether the department can guarantee that the estimate it has made of the cost to local authorities is actually going to be spent by local authorities and that they will not seek to use it for other purposes. I remind the noble Earl of the tragedy of Healthwatch. As he knows, calculations were made by his department on how much should go to local Healthwatch organisations, and local government took a very big on-cost. We know from the national Healthwatch’s work that they took about 25% in the first year. Clearly, one wants to avoid that.
On the impact assessment, I must congratulate the noble Earl’s colleague Dr Dan Poulter and officials for what is a quite remarkable piece of work. I have looked at both the summary impact assessment and policy options 1 and 2, and the only answers given in the many columns are either “No”, “Unknown” or “Nul points”. I wonder whether that stemmed from uncertainty about what local authorities are actually going to do with the money.
On the community right to challenge, can I just ask the noble Earl about the 12-month exemption period now commencing from 1 October 2015? The reason for the short exemption is clear. I just want to ask the noble Earl whether he thinks that a year is long enough for the transfer to bed down.