Health and Social Care Bill
Liz Kendall (Shadow Minister (Health); Leicester West, Labour)
I shall give way to the hon. Gentleman in a moment. If the consortia are responsible for a smaller number of people than primary care trusts, as in some parts of the country the pathfinder projects already are, just a couple of patients with very expensive health care needs could put them into debt.
We know that the Government are aware of the problem, because Jennifer Dixon revealed to the Committee that she had been commissioned by the Department to do some economic modelling to show the optimum number of patients for a consortium—the population coverage that would reduce the risk of being put into debt by one or two expensive patients. I respectfully ask the Minister whether he would be prepared to publish that modelling and evidence if it is ready during the passage of the Bill.
My point is that the key challenge for the NHS, as for any other health care system in the world, is how to get the best value and best care in the context of growing—if not infinite—demand, within finite resources. That is the key decision. The Bill simply shifts that challenge from primary care trusts to GP consortia, which may be less well able to deal with it because they cover a smaller population.
If we believe that the NICE guidelines are some of the best standards in the world, and we want them to be implemented—and Opposition Members do, as I am sure the Minister does, or he would not support them—it is right for the Secretary of State to have a clear responsibility to ensure that they are implemented, as amendment 39 would provide. Instead, therefore, of requiring the Secretary of State to “have regard to” the standards, under the amendment the clause would give him a duty to “seek to deliver” them.
We need to strengthen the Secretary of State’s duty to improve quality continuously for the reasons I have given. Quality is important and Members on both sides of the Committee support it. We need to be aware of people’s concerns that the Bill could negatively affect quality and that it is unclear who is responsible for it or how it would be secured. The amendment would resolve that.