My Lords, I am grateful to the noble Lord for his questions and comments.
The noble Lord asked me why we decided to delay the coming into force of these regulations until October, when the original intention was that it should be in April. We decided, after discussion with partners, that stability would be best served by transferring in October rather than April—the point at which the target of 4,200 health visitors was only just due to be met. It was felt that a six-month period when local authorities could reasonably prepare was prudent.
As regards the services we are mandating, as I think the noble Lord recognises, we are mandating the five universal health visitor assessments, and we will review that after 12 months if we are re-elected. This mandation is designed to support a smooth transfer to require local authorities to provide vital services that give parents and their baby the best start in life. However, it is true that a balance had to be struck. When we consulted on this, responses ranged from suggestions that all services should be mandated in all areas to respondents suggesting that none should be. In-between, almost the full range of health improvement and health protection services were proposed for mandation. A number of respondents agreed with the department’s intention for the list of mandatory functions to be as short as possible to give local authorities the maximum possible freedom. We hope that we have got the balance right.
The noble Lord, Lord Hunt, asked me about monitoring. We will work with Public Health England to monitor how delivery has progressed. However, it is worth noting that the new service model has been tested in early implementer sites, and case-study material has been published. Those sites saw increases in the numbers of children receiving the two to two and a half year review almost double. We have launched six priorities for demonstrating success and building sustainable services, including: transition to parenthood and the early weeks; maternal mental health; breast-feeding; healthy weight, including healthy nutrition; and other measures. So there are a number of measures by which we will be able to assess the extent to which the arrangements are gaining traction in the way that we would like.
On funding, the proposed allocations for local authorities in 2015-16 are, as I mentioned, £428 million for a half year. The department is investing £36 million in a full year to pay for additional health visitors and Family Nurse Partnership places we have created, and £2 million to ensure that £15,000 per half year is available to every local authority for commissioning costs.
As with other elements of the public health grant, local authorities will be asked to report on spend in 2015. Reporting on spend will be split into two categories: spend related to mandated functions, set out in the regulations, and non-mandated spend. Local authorities are required to report spend against the sub-categories on a quarterly basis to the DCLG, which Public Health England will review on behalf of the Department of Health. That data will be used as a means of monitoring usage, and local authorities will be required to ensure that the figures are verified and in line with
the purpose set out in the grant conditions. Local authority chief executives and the director of public health will be required to return a statement confirming that.
Local authority allocations have been determined on the basis of “lift and shift”, supported by funding adjustments, including a minimum floor. That is, we have identified the scope of NHS England’s existing obligations under service specification 27 of the Section 7A agreement between the department and NHS England, and funding relating to that will provide the main basis for local authority allocations.
The noble Lord asked me about the possibility of a ring-fence. Yes, that money will form part of the public health ring-fence which we committed to for 2015-16, but of course decisions beyond that are for the next Government to make.
I think that has answered most of the noble Lord’s questions. If I have failed to do so, I will be happy to write to him.