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That is why it will be a gradual process. It must be remembered that there will not be a full application of the national tariff system within our desired time frame for the establishment of NHS foundation trusts. We are alert to the issue that the hon. Gentleman mentioned, and there is a way through it.
I apologise, Mr. Atkinson; the discussion has been rather wider than I intended, but I hope that it has been useful. There is one important issue for the Committee. I know that it is not in the Bill, but the funding flows of the national health service and the arrangements that any Government make will determine to a large extent the issue that clause 11 addresses, which is one of borrowing and the ability to service debt.
As I said, the overwhelming amount of resources for NHS foundation trusts will come from their commissioning arrangements with PCTs. The basis on which those commissioning arrangements are structured will have a direct impact on the level of borrowing of an NHS foundation trust, so there is a connection.
I say to the hon. Member for Oxford, West and Abingdon and the Committee that it is difficult to go down that road; I accept that. We are going to change the inertia in a system that does not provide incentives and, perversely, rewards the least productive parts of the national health service. However, we are not imposing some penal provision on NHS foundation trusts in the way that the hon. Gentleman has described. We are working with trusts through the additional resources, the extra support that CHAI is providing and the hospital improvement programme, about which my right hon. Friend the Secretary of State made a further announcement only a few weeks ago, with additional resources going to support those who are not performing to the extent that they should.
We want to bring the entire NHS up to an effective level of performance. That is our focus; we are not leaving behind those who are currently struggling with some of the problems that the hon. Gentleman
suggested. We seek to bring the NHS as a whole to a point at which it can benefit from the freedoms of the Bill and provide a better service to the public.
It is important that we do not run away from some of the difficult decisions that must be made. Let me be blunt; we should not have a system in which the least efficient and effective parts of the NHS are funded in the same way as the most efficient and effective. That is what we want to change, and we should change it. In addition, we should also make it clear to primary care trusts, as we have done, that they are free to commission from whatever provider is best in order to provide a service for their patients. That is also a very important point, because there is no better way to try to encourage stronger and better performance in the NHS than to make it clear to providers that there is no guarantee. We want to have a system that encourages good performance.