Examination of Witnesses

Part of Health and Social Care(Re-Committed) Bill – in a Public Bill Committee at 4:46 pm on 28 June 2011.

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Dr Dixon: It is a concern, for the reasons I gave. You can have all sorts of laudable things that en masse can have an erosive effect and straightjacket hopefully innovative clinicians. I am concerned by the move in the language from assumed responsibility, which the NHS Alliance has always said that there must be. There must be trust in front-line clinicians and people to do these things, rather than earned autonomy, which has a slightly childish feel to it in that it has to be earned.

On the point about the board with its PCT clusters signing off those consortia and being able to commission on their behalf, I suggest that we need to ensure that there is a proper incentive arrangement for those clusters to sign off to commissioning groups in 2012 and make them ready for purpose, and not delay the process and end up with groups that are not ready for all sorts of reasons.

With such things as the senates, we must not return to the Darzi-type scenario, where we had a lot of secondary care input into how services were commissioned. There was, therefore, a linear look at different diseases rather than in the round, which is what clinical commissioning groups need to do—they need to look horizontally and adjust priorities. As far as the senates are concerned, I would suggest that rather than their seeming to hand the tablets to the commissioning groups, they should be co-owned by the groups and by the national board, so that clinical input is not something that seems to be another imposition on clinical groups.

My feeling is that in the Government’s response, it is clear why, for political reasons, more responsibility for governance has been put on commissioning groups, but that could, as a whole, stop the groups from being as free-moving as they need to be.