Clause 3 - Supplementary payments to NHS trusts and Primary Care Trusts
Health and Social Care Bill
5:45 pm
Dr Peter Brand (Isle of Wight, Liberal Democrat)
I am uneasy about clause 3 for several reasons. Currently there is a partnership between commissioning health authorities and trusts that deliver, in the case of primary care trusts, through secondary commissioning. The relationship is usually positive under that scheme and it is clear who does what.
I am anxious about allowing the Secretary of State to fund trusts directly and bypass health authorities because it will undermine the process of co-operating locally to find the right way forward and lead to special pleading by the trust and the authority. It will leave the Secretary of State with directive powers to determine what happens in the locality. That may not be what the Government intend, but it is almost inevitable.
The hon. Member for Hastings and Rye (Mr. Foster) raised a relevant point in his intervention. I oppose the Conservative idea of bypassing local education authorities, because that denies the support that, for instance, village schools can get from their local education authority. However, at least the Conservatives have been honest about it by proposing to abolish a tier of administration and manage it directly, so saving costs. Essentially that is what their system would do. It is central management of schools, rather than devolution down to schools.