Health Bill [HL]

My Lords, first, I declare an interest. I work in two NHS organisations that provide specialised services commissioned by specialist commissioners. I am sympathetic to the amendment and I understand why the noble Earl is seeking to ensure that we do not lose sight of specialised services. The NHS Constitution and the duty to have regard to it apply to specialised services as much as any other kind of NHS service, as adequately described by the noble Baroness, Lady Tonge. The Government remain committed more broadly to the collaborative commissioning functions of specialised commissioning groups, spending about £5 billion of the NHS budget every year on such services. However, as pointed out by the noble Baroness, Lady Murphy, the amendment is not necessary, because it does not address the issue raised by noble Lords in this Chamber. Noble Lords passionately believe that we have a strong history of providing excellence when it comes to specialised services. I agree with them. The noble Lord, Lord Walton, gave one example and there are many examples of excellence across the country. We need to ensure that we have the adequate support and funding to continue to provide excellence in such services. But I do not believe that the amendment addresses that. It creates a regard by the specialist commissioners, who themselves are a consortium of primary care trusts. There is no such thing as specialist commissioners with their own separate governance structures: they are part of a consortium of primary care trusts. The duty would require primary care trusts to have regard to the NHS constitution when performing any NHS function, including the function of commissioning specialised services. I hope that I have reassured the House that the amendment is not necessary. I support noble Lords who made a strong case for why the NHS needs to look at commissioning functions in greater detail. I hope that in High Quality Care For All we made a strong case for specialist providers—there are many in London and outside—and why such services should be supported and funded. We also acknowledge that in these cases we also need specialist commissioners with the expertise in commissioning such services. I hope that I have reassured the noble Earl that specialist commissioners have not been overlooked and that he feels able to withdraw his amendment.