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While the Health and Social Care Bill is top of the NHS Confederation agenda, the Government’s Localism Bill is also set to make an impact on the NHS, albeit in a more limited way.

The Localism Bill, published in December 2010, will devolve greater powers to councils and neighbourhoods and give local communities more control over housing and planning decisions.

A number of key elements of the Bill are relevant to the NHS including:

• EU fines This part creates a power for the Government to recover funds from local authorities and other public authorities (which includes NHS bodies) in England in order to pay all, or part of, a European Court of Justice (ECJ) financial sanction imposed for a failure of the United Kingdom to comply with an obligation under the EU treaties. However, to date, the UK has never been fined by the ECJ.
• Local referendums The Bill will allow local referendums to be held. There are no exemptions for health issues, although a local authority can deny a referendum if it believes the issue being proposed is not a local issue. While the results would be non-binding, NHS bodies relevant to the referendum are required to set out their decision on the referendum.
• General power of competence This is intended to provide local authorities, including certain parish councils, with all the same powers that an individual generally has, which will enable them to do anything apart from that which is specifically prohibited. The Government argues that this measure will mean that local councils will have new freedoms to run services free from Whitehall. It aims to give them increased confidence to set up banks, develop property, run new services and own assets.
• Community right to buy Communities will be allowed to bid for the ownership and management of community assets. This will require local authorities to maintain a list of public or private assets of community value put forward for consideration by communities. When listed assets come up for disposal (either the freehold or a long leasehold), communities will be given the chance to develop a bid and raise the capital to buy the asset when it comes on the open market. This will help local communities to save sites which are important to the community, which will contribute to tackling social need and building up resources in their neighbourhood.
• The Bill will give communities a right of challenge. This is a right for voluntary and community groups, social enterprises, parish councils and local authority employees delivering a service, to challenge a local authority, by expressing an interest in running any service for which they are responsible. A local authority must consider and respond to this challenge.
• Some minor changes to the role of overview and scrutiny committees are also laid out in the Bill.

Committee stage

The Bill is currently going through the Committee stage in the House of Commons. The NHS Confederation is keeping a close eye on the Bill and any amendments which are being tabled.

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