Lord Hunt of Kings Heath (Lab)

We also have a terrible risk-averse culture among regulators in this country, which we need to tackle as well—but I really rose to support the amendment of the noble Baroness, Lady Royall. I have a later Clause 53 stand part notice, which partly covers the same ground. Nye Bevan is a great hero of mine. He founded the NHS, but he made one mistake. He beat Morrison in Cabinet in 1947 in terms of the role of local government. Morrison of course had been leader of the London County Council, which, pre-war, had certainly been the largest hospital authority in the world. He argued that local government should be at the centre of the National Health Service. That was rejected, which was a great pity. I have always believed that local government should play a much larger role, not just in health service provision, but also in health as a whole. My noble friend illustrated why that is important. She mentioned the Health Foundation’s report, which is stark in making clear that health outcomes in the UK are falling far behind those in other countries now. The country that we are most aligned with now is the US, whose health outcomes are pretty disastrous. We know that we need a co-ordinated, system-wide approach, but what we have is fragmentation. The health service is outwith a lot of the discussions that noble Lords have been having in this Committee. It is very centrally driven. I had some happy years driving it from the centre, but I have concluded that it just does not work like that. We have seriously got to devolve. Local government deals with so many issues that relate to poor health, including transport, low incomes and poor-quality housing—all the things that noble Lords have been discussing. What I am doing, basically, is encouraging my noble friend the Minister to say that her department recognises that it has a bigger role to play in health than it may think. Clause 44 is welcome. What we are trying to do is urge the Minister’s department to be as ambitious as possible and to do everything that it can to ensure that local government as a whole takes advantage of this. Mr Osborne’s agreement with the leader of Manchester City Council and its chief executive—in 2014 or 2015, I think—led to Devo Manc, which embraced health; it was the responsibility of the combined authorities rather than the mayor. There is enough evidence there to suggest that this is a good thing and that we need to build on it. My disappointment is that nothing has happened since then. The moment Mr Osborne left, no one in government was interested any more. I hope that we can resurrect it and say to local government, “We’re not going to improve our health without you being really important partners in this”.