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NHS: Primary Care Trusts and Ambulance Trusts

My Lords, let me remind the noble Baroness that before the election many PCTs were queuing up to merge because they had found that they could not discharge their obligations effectively and some had struggled with recruiting staff. This issue has been put into the public arena on a number of occasions. The situation has changed since PCTs were introduced. As I have said, we have practice-based commissioning coming along and the focus on commissioning services is much stronger now than was previously the case. We think the time is right to make this change now so that we can have a strong commissioning function. Alongside the changes caused by the introduction of foundation trusts and a national tariff through payment by results, we need a strong commissioning function. It is a new equation which has to be taken into account in making changes now.