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Health and Social Care Bill

I was talking about accident and emergency departments, so I meant George Alberti's document. However, the same point can be made about Roger Boyle's document. He presented an argument about the need to centralise stroke services, but—as the Secretary of State knows—there is no model for doing so. There is no basis for knowing what the necessary catchment population should be, for either acute care of stroke or the concentration of services for primary angioplasty. The pilot studies on primary angioplasty have not reported, been peer reviewed or provided evidence. But Roger Boyle produces his document, and the Prime Minister and others stand at the Dispatch Box and say that services must be centralised on that basis. That is why we propose a moratorium: so that such issues—the design of stroke services or cardiac interventions based on evidence—can be structured locally on the basis of evidence, rather than assertions from the Department of Health. I shall now return to the subject of the Bill, Mr. Deputy Speaker. The House will recall the passage of the Mental Health Act 2007, and it is extraordinarily important that the introduction of community treatment orders—and the extent of compulsion under them—is the subject of independent scrutiny. That will be the role of the Mental Health Act commission, and I hope that it will be made clear during the passage of this Bill that that should happen. When the Minister of State winds up, I hope that he will tell us when we may expect the proposed section 60 order on the governance of the General Medical Council, because it would be helpful to consider that alongside the broader proposals to shift towards parity in lay and professional participation. The Secretary of State will know that we have accepted some of the principles. We accept the principle of parity, but we do so in the context of helping to support confidence in professional self-regulation, not helping to undermine it. I hope that during the passage of the Bill we will explore carefully the proper role of the office of the health professions adjudicator and why it has to be operated independently from the GMC. If we believe in professional self-regulation, we should be able to structure the regulation in a way that keeps the functions of investigation and adjudication within one body, even if they are functionally separate. The Department appears to assume that responsible officers will be in place in April 2009, but that is a heroic assumption. For a start, I am not sure that it is right to assume that in most cases the medical directors of primary care trusts should be the responsible officers.