My Lords, no one is better placed, whether inside or outside your Lordships’ House, to advocate place-based partnerships than the noble Lord, Lord Mawson. I know he will remember that one of my first visits as a Health Minister in 2010, at his invitation, was to Bromley by Bow. What I learned that day made a deep impression on me, so I, like many noble Lords, need no convincing of the case that he and other speakers have made today.
I am aware that the noble Lord, Lord Hunt of Kings Heath, has tabled Amendment 165 on place-based arrangements, to be debated by this Committee later in our proceedings, so no doubt we will cover the issues in more detail then. For now, I say that the Government absolutely agree with the importance of having strong place-based elements in ICBs. Place-based structures will play an important role in delivering healthcare services for their population groups and we expect there to be open and clear lines of communication between the board of the ICB and place-based structures.
How is a sense of place given—as it were—tangible substance and meaning? I would argue that we do not necessarily need the Bill to articulate the reality. At a very basic level, an ICB will cover a geographic area. We would expect ICBs to be closely linked to their places via bodies such as health and well-being boards, where they will sit as the successor bodies to CCGs, and local authorities. ICBs will sit on the integrated care partnership as well as the health and well-being boards. Both bodies are vital in bringing together health, social care, public health and, potentially, wider views as well. That will be part and parcel of delivering their duty to involve patients, carers and the public when discharging their functions.
We expect ICBs to have place-based structures in place, but we do not want to prescribe what those structures are. As the noble Lord, Lord Mawson, said himself, we do not want ICBs to think that place-based partnerships are achievable via a central blueprint, or that a set of instructions from above is likely to be a substitute for learning by doing and local relationships. What we shall insist on is that an ICB sets out the arrangements for the exercise of its functions clearly in its constitution. Different areas have different needs, and I hope it is a point of agreement across the Committee that a one-size-fits-all model would not be appropriate.
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I heard what the noble Lord, Lord Mawson, said about the need to join up strategy with implementation and having an individual whose job it is to oversee this.
That may often be the way that ICBs choose to go, but we feel that requiring voting rights for place-based partnerships is simply not necessary and would come at a bureaucratic cost. Our view is that we should not attempt to overlegislate for the composition of ICBs. Instead, we should let them evolve as effective local entities to reflect their local needs. I hope the noble Lord, Lord Mawson, will forgive me for not wanting to pepper the Bill with requirements and duties for ICBs. If we want to make a thousand flowers bloom, I do not think this is the way to achieve that. I fear that the amendment would risk making the boards less nimble, undermining their ability to make important decisions efficiently.
Having said that, I am not at all suggesting that the centre should wash its hands of this agenda. In answer, in particular, to my noble friend Lady Harding, NHS England will be keeping a close eye on the constitutions of ICBs, and we expect the assessment that NHS England makes will include whether there are suitable place-based structures and whether there is clarity about the expectations and roles of those structures, including what they are responsible for commissioning, what powers have been delegated to them and what resources they are responsible for.
With those points in mind and looking forward, as I say, to our further debates on the subject, I hope that this assures noble Lords that the Government have this agenda very firmly in their sights and that NHS England has equally. Therefore, I hope that the noble Lord will be able to withdraw his amendment, in the knowledge that I am sure we shall have further things to say on this important subject.