Clause 11 - Power of Secretary of State to give
Health and Social Care (Community Health and Standards) Bill
11:15 am
Dr Evan Harris (Oxford West and Abingdon, Liberal Democrat)
I accept that it is vital that commissioners have the freedom to choose from whom they commission services, and realise that they have and can use that freedom. That is how we will get a more responsive NHS. Does the Minister accept that equity is involved? For example, a commissioner may wish to commission services locally—even at a less efficient rate—to ensure that there is equitable access for those who are unable to travel to where there is a more efficient provider. Although it may not be his preference, does he accept that an alternative way of solving that problem is to allow commissioners to raise revenue locally in a democratically accountable way? He could put it to the people that they must pay a premium if they want local services that may not be as efficient as those elsewhere. If he does not do that and cuts back on the availability of central funds—which will dampen the market that he wants—how will he solve the problem of equity that concerns all of us on the centre-left?