---

Local Government and Public Involvement in Health Bill

I support everything that the noble Earl, Lord Howe, has said. I shall add a few words on Amendment No. 238SB. This deals with the matter of commissioners, to which the noble Earl referred. The reason for this amendment is that we are, as the Minister has already said, in a fast-moving scenario in terms of health service structures. This legislation is all about service providers, but commissioners make many of the decisions. Some would say that they make all the decisions. Commissioners are, themselves, changing. We will, after all, see more GP-practice-based commissioning, where GPs are also providers. PCTs commission, but are also providers. Commissioners commission from independent treatment centres and voluntary sector organisations, which often fail to respond. Unless commissioners also have a duty to respond to the LINks’ concerns, this system may well be full of holes and somewhat inadequate. This is a probing amendment to find out what the Minister thinks will be the case with commissioners. I hope the Minister will be able to reassure us that this was simply some kind of oversight.