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Health and Social Care Bill (Programme) (No. 4)

I am grateful for that intervention and I share the hon. Gentleman's concern that this amendment, which deals with the Secretary of State's powers, and, indeed, the whole thrust of the Bill, are likely to lead to a fragmented service, when what we all want to see is co-operation and integration. I am concerned about the direction of travel in that respect. The point about autonomy is relevant, because Lords amendment 2 reiterates that"““The Secretary of State retains ministerial responsibility to Parliament for the provision of””" health services. Lords amendments 4 and 17 would further amend clauses 4 and 20 in order to downgrade the duty to promote autonomy even more, through the idea that the Secretary of State must only"““have regard to the desirability of securing””" autonomy instead. When it comes to ministerial accountability for the Secretary of State, we have a yearly mandate to the NHS Commissioning Board, which will remove the Secretary of State—and therefore Parliament—from being involved in or interfering in the running of the NHS. In that case, I ask the Minister: what would be the point of Health questions? As private health care interests take over the provision of health services, they will not be subjected to freedom of information requests or other forms of accountability to which NHS providers are subjected.