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Local Government and Public Involvement in Health Bill

moved Amendment No. 217A: 217A: Clause 236, page 168, line 40, leave out ““received by users”” and insert ““supplied by providers”” The noble Earl said: My Lords, new Section (1E), on page 168, states: "““The reference in each of subsections (1C)(a) and (1D)(a) to the delivery of services is to their delivery at the point when they are received by users””." What is this all about? I think it is an attempt to exclude from the scope of any public consultation services that the Government decide they want to procure from private providers. We have seen this situation on a national scale with the introduction of independent treatment centres. ISTCs were imposed on PCTs from the centre, whether they liked it or not. New Section (1E) is designed to give Ministers a reserve power to introduce services top-down in a similar way in the future. Is that right? If so, why is there no provision for consultation at a national level for any top-down decisions that Ministers choose to take? National consultation would be no less important in those sorts of circumstances than local consultation about other service issues. I say again, as I did in Committee, that if the spirit of the Bristol inquiry is to be honoured and kept alive, an equivalent form of consultation and involvement at a national level has to be provided. I do not see that anywhere. Most of us accept that the world of healthcare provision has changed from 10 years ago. Plurality of providers is a concept that is here to stay. Given that, would we not want public involvement in both procurement and changes in procurement in situations where there may be a question of a private provider being brought in or indeed dispensed with? On the contrary, patients and the public need to know about these things and make their contribution, because that is one vital way of ensuring that services are patient-focused. We need to hear from the Minister whether she agrees with that and, if she does, what she proposes to do about it. I beg to move.