I beg to move amendment 95, in clause 21, page 27, line 18, leave out ‘and’ and insert—

‘() that the applicants have made appropriate arrangements to ensure that the consortium will have a governing body which satisfies any requirements imposed by or under this Act and is otherwise appropriate, and’.

With this it will be convenient to discuss amendment 5, in clause 21, page 27, line 18, at end insert—

‘(ea) that the constitution contains provision for an executive board of the consortium, which must—

(i) meet in public,

(ii) publish agendas and minutes of its meetings,

(iii) include appropriate representation of a range of clinicians among its membership,

(iv) include appropriate local democratic representation among its membership, and

(v) include appropriate patient representation among its membership,

(eb) that the area specified by the constitution contains a sufficiently large population for the consortium to be able to commission health services for that population effectively.’.

Government amendments 96 to 105.

Amendment 52, in schedule 2, page 256, line 14, after ‘determine’, insert—

‘having due regard to the NHS pay scales agreed following recommendations by the NHS Pay Review Body and the Doctors and Dentists Pay Review Body, or any successor bodies,’.

Amendment 53, in schedule 2, page 256, line 16, after ‘determine’, insert—

‘having due regard to agreements made by the NHS Staff Council’.

Government amendment 106.

I will speed through these amendments quickly, because we are pressed for time. They return to territory that is familiar from the previous Committee. We discussed the concerns of right hon. and hon. Members about the need for appropriate governance arrangements for clinical commissioning groups, and the need to ensure that that was balanced by not imposing micro-management on the commissioners. Our previous discussions of amendments that were proposed by the Opposition to require consortia to have a governing body resulted in the amendments being withdrawn, which is a clear sign that getting prescriptions about governance arrangements right is a tricky business.

Amendments 52 and 53 were discussed in the 13th session of the first Commons Public Bill Committee, and were accordingly voted against. We have always regarded it as essential that statutory requirements that are placed on clinical commissioning groups do not stifle local organisational development or inhibit the potential of those groups to develop arrangements locally to meet the needs of their patients and their populations. The programme of local pathfinders is the practical result, as groups of GPs come together to develop emerging CCGs and to explore key issues with PCTs.

It is for those reasons that the Government have not hitherto proposed requiring a particular model of governance for CCGs. The Bill as currently drafted and scrutinised has many requirements relating to CCG governance. Developing commissioning groups would need to take account of these, as would the NHS commissioning board as part of its scrutiny of a clinical commissioning group’s competence to deliver its statutory functions, before granting authorisation. Since then, both the Health Committee and the Future Forum have made recommendations pertaining to the need to ensure robust governance in CCGs, reflecting the concerns raised by stakeholders.

There were similarities between the recommendations, which might be divided into three categories: a concern that CCGs should conform to the highest standards of governance; that the governance arrangements should ensure absolute transparency and probity in the way in which CCGs conduct their business, particularly in reaching the key commissioning decisions; and the need to ensure that lay members and professionals such as nurses or hospital doctors are represented in the governing body of a GP-led CCG.

We fully support Future Forum’s recommendation that

“commissioners of NHS services should have a governing body that holds meetings in public, with independent members, to provide independent challenge, including ensuring that consortia fulfil their duty for genuine patient and public involvement.”

We do not need to debate in detail the principles on which we are in agreement. Clearly, we all want clinical commissioning groups to attain the highest standards of public sector governance, particularly ensuring probity and managing any potential conflicts of interest, engaging meaningfully with patients, the public and other health professionals locally as well as with democratic representatives and always acting transparently.

In our response to the Future Forum, we indicated our willingness to make the necessary legislative changes to deliver them. The necessary amendments will introduce a more robust and comprehensive framework for CCGs than the proposals of Opposition Members. The Government amendments deliver some duties similar to those in Opposition amendment 5, but they reflect more effectively what is required to provide the safeguards needed to ensure that CCGs attain those high standards of governance. We accept the need for a governing body within the CCGs with responsibility for ensuring good governance, and amendments 95, 98, 100 to 101 and 104 to 106 provide for that.

Unlike amendment 5, our amendments provide a high-level function of the governing body to ensure that the CCG has appropriate arrangements in place to exercise its functions effectively, efficiently, economically and in compliance with principles of good governance. That, of course, embraces such standards as the Nolan principles, which the Future Forum recommended. The Future Forum recommendation that

“Transparency and openness should run throughout the health and wellbeing system, particularly in relation to how public money is spent” is one with which we entirely concur.

Our amendments 96, 97 and 104 require that CCGs meet in public, except when discussing confidential issues. Commissioning groups will also be required to publish their constitutions and to give the commissioning board a power to publish guidance on the publication of these constitutions. The constitution of a CCG is already required to set out arrangements to be followed by the group in reaching decisions. Government amendment 102 adds that each CCG should set out specific arrangements in the constitution for ensuring transparency on the decisions of the consortium and the manner in which those decisions are made. These arrangements might include building on the proposals for a governing body with lay membership, with the potential to scrutinise commissioning decisions and provide what the NHS Future Forum termed “independent challenge”'; developing  their relationship with local stakeholders and democratically elected representatives in the health and well-being board, with whom the CCG must consult on their commissioning plans; or developing the relationship with patients and their representatives.

Clearly, there are many ways in which this duty might be fulfilled, and we do not want to be too prescriptive and risk preventing innovative and imaginative approaches, as clinicians locally develop the groups that best enable them to fulfil their statutory functions. As these arrangements will be set out in the constitution, they will be considered by the NHS commissioning board as part of its scrutiny of a CCG’s competence to deliver its statutory functions before granting authorisation and its ongoing oversight of the competence of CCGs. In addition, the public will now also be able to scrutinise the document when it is published. These amendments help to ensure quality outcomes by putting in place safeguards and allowing the public a clear view of how the business of commissioning is undertaken, and how they can be major participants in the crucial decisions that affect their health and well-being.

The governing body will also have the function of determining the remuneration of commissioning group employees and others providing services to it, and it must have a remuneration committee. This committee will make recommendations to the commissioning board’s governing body on remuneration, fees and allowances with the scope for further functions to be assigned to it as set out in the CCG’s constitution or in regulations.

New section 14JA(7), which amendment 98 inserts, will enable regulations to require governing bodies to publish prescribed information relating to the determination of remuneration, fees and allowances payable to the employees of the clinical commissioning group or others providing services to it. Under new section 14JA(8), the board may publish guidance for governing bodies on the exercise of these functions. I hope that that reassures Opposition Members that amendments 52 and 53 are not necessary and are over-prescriptive.

In responding to recommendations of the Future Forum, we have taken great care to ensure that the statutory duties on CCGs are wholly proportionate. We also recognise the need for ensuring, via the flexibility of regulations, that CCGs are fully supported in establishing these governing bodies. Regulations may make provision for the qualification or disqualification of members, as happens currently for PCT boards, and for the way in which members are to be appointed, clarifying eligibility and tenure of members.

By describing our amendments in some detail, I hope that I have reassured Opposition Members that their amendments are no longer necessary, where they address the same issues. However, there are some points raised by amendment 5 that I have not yet addressed, and I would like to take the opportunity to do so now.

Amendment 5 would put in the Bill requirements for appropriate representation. We support the principle of involving patients and non-GP clinicians in the work of the CCG and involving them as members of a governing body. However, requiring in the Bill that the membership should include appropriate representation of a range of clinicians is imprecise and might be satisfied by clinicians entirely associated with general practice, such a practice nurse, GP or a GP with a special interest. It would be for the commissioning board to satisfy itself on the  appropriate representation. Our proposed amendment would allow us, through permissive regulation-making powers, to specify the types of clinicians who must be represented. We have made a commitment in our response to the Future Forum that this should be a minimum of a doctor working in secondary care and a registered nurse. The regulations will ensure that this commitment is reflected in legislation.

There are some issues around a doctor who works in secondary care. Might we see a situation in which a retired doctor could be appointed to a commissioning group, or would it have to be a working doctor who is up to speed on modern medicine?

I hope that this reassures the right hon. Gentleman, because it could be a retired doctor, if they fit the criteria.

In a briefing sent to the Committee yesterday, the Royal College of Nursing welcomed this intention. It explained that nurses have a pivotal role in being able to stand back and view the whole care pathway, taking a holistic perspective to look above the day-to-day clinical issues and effectively commission services.

The president of the Royal College of Physicians, Sir Richard Thompson, has also said that the RCP welcomes the Government’s commitment that hospital doctors will be on the board of commissioning groups. We believe that such a move will benefit patient care by bringing together clinical colleagues in commissioning decisions.

With regard to lay membership, we intend to go beyond the proposal tabled by the Opposition. We will require through regulations not simply a patient representative but a minimum of two lay members—one who will champion the interests and rights of patients and one with the appropriate expertise to take an informed and independent view of the performance of the CCG against its financial responsibilities. The latter will act in the role of a non-executive director with responsibility for audit with a dedicated sub-committee of the governing body. As we heard in the evidence sessions, there is wide support for that, especially from patient groups such as National Voices, Rethink Mental Illness and Macmillan Cancer Support.

In response to the requirement for local democratic representation, I remind the Committee that health and well-being boards, with their functions of collaborating with CCGs on joint health and well-being strategies and their proposed role in scrutinising CCG annual commissioning plans, will provide a powerful local hub for local democratic involvement in commissioning, which is clearly set out in the Bill.

Finally, amendment 5 seeks to make specific provision in the Bill for the NHS commissioning board to ensure, when it considers an application from a prospective CCG, that the area that the group covers contains a sufficiently large population. We all agree that it is essential for CCGs to be able to commission to meet the needs of the population for whom they have responsibility. However, the amendment is unnecessary, because under clause 21 the board must be satisfied that the area specified in the commissioning group’s constitution is  appropriate, and that the CCG has made appropriate arrangements to ensure that it can discharge its statutory duties.

Although amendment 5 is on the right track, it would respond neither practically nor proportionately to concerns about CCGs and good governance. For those reasons, I urge Opposition Members not to press the amendments to a vote. Instead, the Committee should support Government amendments 95 to 106.

This is an unbelievable U-turn by the Government. We argued strongly that there was an astonishing omission from the Government’s first Bill relating to people in clinical commissioning consortia. Such people were to be responsible for £80 billion—now it is to be £60 billion; I do not know when or how that was changed. There was no requirement to have any kind of effective board or governing body, and there was an astonishing lack of concern about public money. For a Government who claim to be concerned about spending public money, it was an astonishing omission. It is Opposition Members who are concerned about effective spending of taxpayers’ money, and I am glad that the Government now agree that we were right all along.

In addition, when the Bill was first in Committee, we debated an Opposition amendment. Government Members, particularly the hon. Member for Southport, who is not here, sadly, to represent the Liberal Democrats, who are very concerned about democratic accountability, said that our amendment was too prescriptive, referring to a series of clinicians, health professionals, lay members and democratic representatives. Now, however, lo and behold, the Government have completely changed their mind and included the changes.

I withdrew that amendment, Dr McCrea—you appeared to enjoy that part of the debate—because I wanted to consider whether it was over-prescriptive, but the Government have now tabled an amendment that goes into minute detail in micro-managing the NHS. The regulations will give the board the ability to determine the minimum and maximum number of people in the CCGs; it will be able to determine the frequency of their meetings; and it will even be able to determine the names of CCGs and, according to the Government’s briefing on the amendment, insert “NHS” before such names. Perhaps NHS Leicester City, my old primary care trust, will become NHS Leicester City again. It is astonishing.

The Minister now accuses us of being too imprecise in amendment 5, because we want “a range of clinicians” to be on the board. That would give clinical commissioning groups the ability to specify not only doctors or nurses, but other professions allied to medicine, such as dentists or pharmacists, if they see fit.

It is astonishing that we are the ones who, in amendment 5, are specifying broadly the different groups who should be included in the group without going into excessive detail and micro-management. I will press the amendment to a vote, because the Government have failed to give us enough time to scrutinise the legislation. We include the requirement for commissioning consortia to cover a sufficiently large population, because, as hon. Members should remember, we are worried that if groups are too small, and they have one or two expensive  patients, particularly at the end of the year, they would go bust. Hon. Members should also remember that the Nuffield Trust has been commissioned by the Government to model how big clinical commissioning groups should be, so that they do not go bust. We are trying to do the Government’s work for them in this area.

I would like to put on the record my congratulations to my Front-Bench colleagues on leading the Government in this area. Does my hon. Friend agree that the new team sheet looks suspiciously like a team sheet for a pulmonary care trust?

My right hon. Friend is right. That is exactly what will happen in my constituency. We have had a massive reorganisation of NHS Leicester City involving GPs, lay representatives and so on, whom we said at the beginning of the Bill should be included.

We welcome the requirement, as we argued at our previous sitting, that the governing bodies—the clinical commissioning groups—should meet in public, but the Government have added a line about excluding discussion of confidential matters. I am keen for the Minister to say exactly what sort of confidential matters—

Oh, God!

Yet again, the Minister has said, “Oh, God.” I am sorry, but I am asking questions about his Bill. That is my job, and I hope that he will respond.

I want to put on the record the fact that members of the NHS Future Forum will be hugely disappointed that the Government have completely ignored its recommendation that all providers of services to NHS patients should also meet in public and publish their agendas. The Government have not responded to that real concern of the Future Forum to make sure that anyone who provides services to NHS patients should be required to publish their agenda and meet in public, to ensure the openness and transparency of which the Government are supposedly great champions.

I have some questions for the Minister about concerns raised by the Nuffield Trust and the NHS Confederation in their briefings on the recommitted Bill. First, the amendments now say that the doctor and nurse must be from outside the area of the clinical commissioning group to avoid conflict of interest. How practical is that? If GPs can be on the board, and they deliver services in the area, why cannot nurses and doctors? Would that not give them knowledge and insight about the patients and population for whom they are commissioning?

Secondly, how will lay and professional members be selected? How will they be remunerated and trained? Will there be national guidelines for clinical commissioning groups, as there are now for primary care trusts, on how people are chosen? They will have responsibility for the future of health services in their area, and Labour Members want to be assured that lay members and others will have sufficient training and support to be able to do their job properly.

I have already asked this, but how will the advice given by the doctors and nurses on the clinical commissioning groups differ from the advice from a clinical senate? The Minister said earlier that the senates  will provide advice about any major service reorganisation, so what are the clinical commissioning groups doing? That is precisely what commissioning is. If the Minister does not understand that, he will not enable the changes that the NHS needs to make to deliver efficiency savings and improve patient care.

On funding, what money will be made available to provide the locum cover for clinical representatives or to pay lay representatives? Where is the costing for that? How will that money be found?

I want to make a serious point about safeguarding. I tried to raise the issue in the evidence session, and it is something my local council is concerned about. I have no idea who will be responsible for appointing the person responsible for safeguarding children in different services in the NHS. Many local councils are concerned that GPs have not often been as fully engaged in the issue as they should have been, but they will now be responsible for it. Will the Minister clearly say who will be responsible for defining safeguarding leads throughout the NHS?

I want to reinforce that point, and I am so pleased that my hon. Friend has raised it. Successive inquiries into tragedies where children have been abused, or, even worse, have died, have shown that the root of the problem is often where communication has broken down between the people involved in the care of that child and the family. We cannot have a backward step here. We need clarification, so that children can continue to be safeguarded.

I thank my hon. Friend. This issue is something I am genuinely concerned about. The Bill is completely unclear about where that responsibility should lie. I suggest to the Government that the responsibility for deciding who will be the main person responsible for safeguarding within the NHS should move to local councils as part of their new responsibilities on health, because they may have more knowledge and understanding.

We want to put our remaining amendments to the vote. Amendment 51 states that the constitution of the clinical commissioning group must make clear provision

“for dealing with any other personal and prejudicial interests of members or employees.”

Order. I should tell the hon. Lady that amendment 51 is not in this group.

Sorry, Dr McCrea. I will move on to amendments 52 and 53. Amendment 52 would require consortia or their governing bodies to ensure that they have regard to

“NHS pay scales agreed following recommendations by the NHS Pay Review Body and the Doctors and Dentists Pay Review Body, or any such successor bodies”.

Many staff are concerned that the Bill will not protect the current national agreements, on which the previous Government worked extremely hard in the “Agenda for Change”, to ensure fair pay and that staff can progress in their careers.

Amendment 53 would require consortia to have regard to

“agreements made by the NHS Staff Council.”

The NHS staff council and the social partnership forum have been important mechanisms for ensuring that the views of staff and their representatives have been heard. That is not enshrined in the Bill at the moment. Staff are concerned that, with the changes to the Bill, agreements made nationally, including on pay and remuneration, will not be honoured. That is the reason for the amendment, which we will press to a Division.

I apologise for not being here earlier on, Dr McCrea. I would just like to ask the Minister a question. We have all had correspondence with the National Children’s Bureau. There is a governing body called Every Disabled Child Matters, which consists of four groups. One of those groups is Mencap, which is the organisation that contacted me. It is, by and large, comparatively supportive of the Government’s proposals, but it has a question I would like to put to the Minister.

The question relates to children with complex needs and to those who are disabled. I do not want to be disrespectful to GPs, but nobody knows everything. GPs have a lot of knowledge but do not necessarily know everything they need to know. Sometimes help is needed for disabled children, or for children with complex needs. If that help is needed, we need to ensure that GPs are supportive and are able to offer that. Will the Minister provide assurances that the regulations will ensure that the governing body of each commissioning consortia must include a clinician with experience of providing health care for children with complex needs? That is the question Mencap asked me to put to the Committee. In his response, can the Minister give conclusive evidence and support for the point of view expressed by Mencap?

I want to touch on a couple of points. The first concerns the openness of meetings of commissioning groups. We already have legislation in place: the Public Bodies (Admission to Meetings) Act 1960, which presently applies to PCTs and strategic health authorities. I see no reason why that should not apply in this case. That would remove any suspicion. We keep talking about trust on this side of the Committee, and it is so important.

On the amendment relating to pay and negotiations, and the terms and conditions of staff employed by the commission, I know the Government are very concerned about bad headlines in the Daily Mail. There is real potential here for that to happen. I can just see stories saying, “GP gets new Jag off the back of underpaid nurse.”

I am delighted that the hon. Lady is taking an interest in the pay of front-line staff. She will be aware that her Government allowed management to gain year-on-year pay rises of 7%, whereas front-line staff were given a pay rise of only 1.8%. How does she reconcile that with the comments she has just made?

This Government have an admirable aim to do better than previous ones, but I have to say that in the case of this Bill, they are failing miserably. I ask the Minister to reassure me, given the concerns  raised in the House yesterday during the Finance Bill debate, that all these workers will continue to be classed as public service workers. For example, on the question of a £250 tax break for low-paid public sector workers, I want an assurance that all workers employed will still be categorised as public sector workers.

I cannot praise enough the contributions from my hon. Friend the Member for Leicester West. I have seen Government Members’ jaws hitting the table, thinking that she is making a meal of the Bill and the amendments, but the that it is the Government who have made this process incredibly complex and difficult. It has fallen to my hon. Friend and me to explain to those hon. Members exactly what the Bill and their amendments mean.

Amendment 95 agreed to.

Amendment proposed: 5, in clause 21, page 27, line 18, at end insert—

‘(ea) that the constitution contains provision for an executive board of the consortium, which must—

(i) meet in public,

(ii) publish agendas and minutes of its meetings,

(iii) include appropriate representation of a range of clinicians among its membership,

(iv) include appropriate local democratic representation among its membership, and

(v) include appropriate patient representation among its membership,

(eb) that the area specified by the constitution contains a sufficiently large population for the consortium to be able to commission health services for that population effectively.’.—(Liz Kendall.)

Question put, That the amendment be made.

The Committee proceeded to a Division.

On a point of order, Dr McCrea. For clarification, those of us who asked questions were hoping for a reply from the Minister. Does he intend to reply now, or will he write to us.

We are in the middle of a Division, so I will not answer questions now.

The Committee having divided: Ayes 10, Noes 13.

Question accordingly negatived.

On a point of order, Dr McCrea. I am sorry to be so pushy on this matter, but we asked some questions and would like clarification. Will the Minister respond verbally now or write to us?

I have already stated that the Minister can take the opportunity to do so during clause stand part debate, because there was an oversight. However, I am sure that he will be happy to put in writing the answers to any questions not answered in Committee.

Amendments made: 96, in clause 21, page 29, line 28, at end insert—

14IA Publication of constitution of consortia

(1) A commissioning consortium must publish its constitution.

(2) If the constitution of a commissioning consortium is varied under section 14E or 14F, the consortium must publish the constitution as so varied.’.

Amendment 97, in clause 21, page 29, line 35, at end insert—

‘() the publication of the constitutions of commissioning consortia under section 14IA.’.

Amendment 98, in clause 21, page 29, line 35, at end insert—

Governing bodies of consortia

14JA Governing bodies of commissioning consortia

‘(1) A commissioning consortium must have a governing body.

(2) The main function of the governing body is to ensure that the consortium has made appropriate arrangements for ensuring that it complies with—

(a) its obligations under section 14K, and

(b) such generally accepted principles of good governance as are relevant to it.

(3) The governing body also has—

(a) the function of determining the remuneration, fees and allowances payable to the employees of the consortium or to other persons providing services to it, and

(b) such other functions connected with the exercise of its main function as may be specified in the consortium’s constitution or by regulations.

(4) Only the following may be members of the governing body—

(a) a member of the consortium who is an individual;

(b) an individual appointed by virtue of regulations under section 14JC(2);

(c) an individual of a description specified in the constitution of the consortium.

(5) A commissioning consortium may pay members of the governing body such remuneration and allowances as it considers appropriate.

(6) Regulations may make provision requiring a commissioning consortium to obtain the approval of its governing body before exercising any functions specified in the regulations.

(7) Regulations may make provision requiring governing bodies of commissioning consortia to publish, in accordance with the regulations, prescribed information relating to determinations made under subsection (3)(a).

(8) The Board may publish guidance for governing bodies on the exercise of their function under subsection (3)(a).

14JB Audit and remuneration committees of governing bodies

‘(1) The governing body of a commissioning consortium must have an audit committee and a remuneration committee.

(2) The audit committee has—

(a) such functions in relation to the financial duties of the consortium as the governing body considers appropriate for the purpose of assisting it in discharging its function under section 14JA(2), and

(b) such other functions connected with the governing body’s function under section 14JA(2) as may be specified in the consortium’s constitution or by regulations.

(3) The remuneration committee has—

(a) the function of making recommendations to the governing body as to the discharge of its function under section 14JA(3)(a), and

(b) such other functions connected with the governing body’s function under section 14JA(2) as may be specified in the consortium’s constitution or by regulations.

14JC Regulations as to governing bodies of commissioning consortia

‘(1) Regulations may make provision specifying the minimum number of members of governing bodies of commissioning consortia.

(2) Regulations may—

(a) provide that the members of governing bodies must include the accountable officer of the consortium;

(b) provide that the members of governing bodies, or their audit or remuneration committees, must include—

(i) individuals who are health care professionals of a prescribed description;

(ii) individuals who are lay persons;

(iii) individuals of any other description which is prescribed;

(c) in relation to any description of individuals mentioned in regulations by virtue of paragraph (b), specify—

(i) the minimum number of individuals of that description who must be appointed;

(ii) the maximum number of such individuals who may be appointed;

(d) provide that the descriptions specified for the purposes of section 14JA(4)(c) may not include prescribed descriptions.

(3) Regulations may make provision as to—

(a) qualification and disqualification for membership of governing bodies or their audit or remuneration committees;

(b) how members are to be appointed;

(c) the tenure of members (including the circumstances in which a member ceases to hold office or may be removed or suspended from office);

(d) eligibility for re-appointment.

(4) Regulations may make provision for the appointment of chairs and deputy chairs of governing bodies or their audit or remuneration committees, including provision as to—

(a) qualification and disqualification for appointment;

(b) tenure of office (including the circumstances in which the chair or deputy chair ceases to hold office or may be removed or suspended from office);

(c) eligibility for re-appointment.

(5) Regulations may—

(a) make provision as to the matters which must be included in the constitutions of commissioning consortia under paragraph 5B of Schedule 1A;

(b) make such other provision about the procedure of governing bodies or their audit or remuneration committees as the Secretary of State considers appropriate, including provision about the frequency of meetings.

(6) In this section—

“health care professional” means an individual who is a member of a profession regulated by a body mentioned in section 25(3) of the National Health Service Reform and Health Care Professions Act 2002;

“lay person” means an individual who is not—

(a) a member of the consortium,

(b) a health care professional, or

(c) an individual of a prescribed description.’.—(Mr Simon Burns.)

Question proposed, That the clause, as amended, stand part of the Bill.

Clause stand part is an ideal opportunity for me to deal with the plethora of questions raised by hon. Members during the course of our debate on the amendments. I am slightly surprised that they asked so many questions, given that they generally welcomed our amendments as an improvement.

I begin with an issue raised by the hon. Member for East Lothian about child protection, because it is important to put the response on the record. We believe that safeguarding children is of paramount importance and we expect the NHS to continue to improve how it does that. We will ensure that clinical commissioning groups and the NHS commissioning board are required to make arrangements to safeguard and promote children’s welfare and maintain providers’ responsibilities for safeguarding. Furthermore, we will explore with our key partners how best to ensure that professional leadership and expertise for safeguarding children is retained in the new system, including the continuing key role of named and designated safeguarding professionals, whose critical importance was highlighted recently in the Munro review of child protection. I hope that the hon. Members for Leicester West and for East Lothian find that helpful.

The hon. Member for Leicester West asked earlier what would be classified as confidential matters. Obviously, they could include a range of things, such as matters relating to employees or commercially sensitive topics, in line with the issues specified in the Public Bodies (Admission to Meetings) Act 1960.

Liz Kendall rose—

I will give way to the hon. Lady, but I advise her that we have nine minutes to go and her hon. Friends asked a number of questions. If she keeps intervening, I will not have the opportunity to answer as many of those questions as possible.

Take the knives out.

As my hon. Friend says, take the knives out or we will face a longer discussion. If a group of GPs who were part of a clinical commissioning group made a bid to run a service instead of the local hospital and they both submitted a business plan, would that be classified as a commercially sensitive topic?

The hon. Lady asks me to speculate again, but I am afraid that, at this time of the evening, I will not do so. I will, however, continue to answer some more questions.

The hon. Lady asked about safeguarding and who would be responsible. The functions of primary care trusts will transfer to the clinical commissioning groups  and the NHS board as part of its responsibilities as a commissioner. Local authorities will continue to have their existing safeguarding functions.

The hon. Lady also speculated, if I heard her correctly, that governing bodies would be just the same as senates, or the other way around.

What I asked was, if doctors, nurses and clinicians on the boards of clinical commissioning groups will not be giving advice on major changes to local services—which is what the Minister previously said the clinical senates will be doing—what on earth will they be doing? That is what commissioning is.

Let me classify and explain what the two groups will do. A governing body is focused on governance issues, whereas clinical advice from senates is focused on bringing together clinicians from different settings to discuss how to provide joined-up care across an area. I hope that that satisfies the hon. Lady.

The hon. Member for Strangford asked whether a CCG’s governing body will include secondary care doctors with experience of caring for children with complex needs. We will not make that a requirement, because it would be too prescriptive, but I take the point, which is important. We want to ensure that CCGs have access to expertise through, for example, the senate and the networks. That is the way in which we want to input the expertise, help and guidance needed to achieve those aims.

Will the CCGs have a right to veto any recommendations from the clinical senates, or will they be duty bound to take their advice on clinical issues?

No, they will not, because the system will not work like that. The senates are there to input advice. By definition, advice can be taken, rejected, or partly taken. A senate is an advisory body that will input advice based on its expertise.

Another point was made about the cost of the governing bodies of CCGs. The hon. Member for Leicester West will groan at this, but we are awaiting the updated impact assessment, which will reflect the additional costs, if any, of the amendment.

The hon. Lady mentioned conflicts of interest and asked why a secondary care doctor in the same area as a CCG would not be able to participate in its proceedings. The answer, as we have said all along, is that we are seeking to ensure that there are no conflicts of interest with such individuals, which is why secondary care doctors should come from outside the immediate area of the CCG, so as not to arouse the suspicion, the allegation or the reality of a conflict of interest. We have introduced that provision with the best of intentions and we believe that it will work.

The hon. Lady also said that the board has wide-ranging regulation-making powers, but it is not the board that has the regulation-making powers. The Secretary of State makes regulations in agreement with Parliament, and we will use the regulations only to set the core requirements for governing bodies. Anything further is for local determination, based on organisational needs. [Interruption.] That is the right way forward, whatever the hon. Lady is chirping from the sidelines.

The hon. Lady also suggested—this is now one of her old chestnuts—that the provision represents gross micro-management. Nothing could be further from the truth. It is not micro-management to set down some basic parameters for a governing body. We do it for PCTs and other public bodies and it is a proportionate approach for bodies that are stewards of billions of pounds of public money. If we were not taking such a reasonable and proportionate approach, the hon. Lady, given the mood she is in, would be criticising us from the other side of the argument. The hon. Lady’s approach to debating leaves me in a no-win situation.

The regulations will allow us to set out processes to be observed by CCGs when making arrangements for their governing bodies and their committees. The regulations are a safeguard to prevent inadequate arrangements that fail to ensure good governance, which I do not think the hon. Lady wants. That is the purpose of our amendments. A governing body of two people that meets once a year is not likely to be very effective, so we have a regulation-making power should we need to make requirements that ensure adherence to good practice. There is, of course, no requirement for the Secretary of State to make regulations, but he certainly will to ensure good governance.

As we are coming so near to the knife, I will conclude my comments. If there are any questions that I have not answered, which I do not think is the case, I will ensure that we write to hon. Members.

Question put and agreed to.

Clause 21, as amended, accordingly ordered to stand part of the Bill.