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Local Government and Public Involvement in Health Bill
Mr. David Burrowes (Enfield, Southgate) (Con): Will the statutory duty to co-operate deliver what everyone wants to achieve? The example of primary care trusts appears in the commentary on the Bill. Withdrawal from the local area agreements due to a lack of funding is a problem that we face in Enfield, where the primary care trust has withdrawn a vital part of the area agreement concerning alcohol services and rehabilitation, and £80,000 has been withdrawn from alcohol screening in local accident and emergency units. Will the London health economy be able to deliver, given the problems with top-slicing of funding?
Robert Neill: My hon. Friend raises a hugely important point. Although we have not yet reached the degree of crisis that exists in Enfield, the risk applies right across London boroughs, particularly those in outer London, where I regret to say that the health economy is strained and also, for reasons that we have discussed in the Chamber, the financial settlements to local government have been hugely constrained, so any withdrawal puts the whole of service provision into considerable jeopardy. We need to consider that.
It is interesting that we have some evidence of the extent to which the duty to co-operate works in practice from the audit carried out by the Audit Commission of crime and disorder reduction partnerships. In its 2002 report, its last work on the subject, the Audit Commission noted that
“co-operation across the country was variable from probation services, health and fire services, though all of these are covered by a statutory duty to co-operate”.
That did not always work on the ground. In the past, I have found that one or two of those services in my locality were not co-operating to the degree that we all wished. We were able to fix it, but it would be better if we had more tools to ensure that delivery.
It is also interesting to see a Home Office document, “Making Partnerships Work”, which again highlighted concerns at the CDRP level at failure to achieve co-operation in practice on multi-agency agreements, even though those agreements had been made through the statutory partnerships. That comes close to the point raised by my hon. Friend the Member for Enfield, Southgate (Mr. Burrowes). Clear areas of concern are flagged up by such empirical evidence as we have.
It is against that background that I hope that Ministers will consider sympathetically two suggestions by the Local Government Information Unit. First, the Bill should specify a minimum standard of 12 weeks for responding to consultation. That would apply the Cabinet Office guidelines to those partnerships. A partner that did not respond within those periods could be considered to have breached the duty to co-operate. That would give the provisions some teeth—something to pull people together and get them round the table.
Secondly, the Bill should identify a performance improvement process that could be triggered when there is a breakdown. We do not want to watch a train crash in slow motion—we want a practical means of taking matters forward. The Audit Commission will co-ordinate inspection in localities across its four inspectorate areas, so it would not be too difficult for it to co-ordinate information on breaches of duty to co-operate, which could be fed to the relevant inspectorate of the partner organisation. That would have the advantage of giving an incentive to partner organisations to co-operate, because if its own inspectorate was aware of failures on its part, that could be reflected in its performance assessment.
Those are two straightforward, practical and not in the least bit costly things that could be done to improve the working of local area agreements and other partnerships. I hope that Ministers will consider them sympathetically.
The broad issues raised in this part of the Bill are very significant, but they have been well outlined by my hon. Friend the Member for North-East Bedfordshire. I hope that the practical points that I have raised flesh out his principal argument.
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