Health and Social Care Bill

My Lords, I rise to speak to Amendments 209 and 212, to which I have put my name. I spoke earlier about the issue of commissioning for less common conditions when I expressed my concern that CCGs governing small populations would not be able to deliver a service to patients in these categories. We heard from my noble friend Lord Warner earlier today and in earlier debates about the reduction of PCTs from 302 to something like 51. This would cover enough of the population to ensure effective commissioning. However, despite all his best efforts, there are many long-term conditions still falling between all stools. We heard from the noble Baroness, Lady Finlay, about the difficulties in different parts of the country; she referred to Southampton, for example. Those with an interest in this matter will have been briefed by the neurological alliance about the paucity of the present Lincolnshire service. The PCT there has never implemented its own plan to address the problems for patients with less common conditions. A Lincolnshire neurological alliance tried to get the prototype CCGs engaged with that issue, but so far to no avail. When they called a meeting to try to bring the matter forward not one of the CCGs sent anyone to the meeting. This is what many of us feared and why we need these amendments or something like them on the face of the Bill. If we will deliver a better, more coherent and joined-up service, we cannot just rely on the promise that all will be all right when the Bill becomes law. The Commissioning Board must have the ability to see how CCGs plan to commission services for people with less common conditions, and be able to take a country-wide view of what is going on. Services for patients are patchy in many parts of the country, and if this Bill becomes an Act there will need to be considerable improvement on that. I hope that the Minister can tell us tonight that the necessary steps will be taken to ensure that that patchiness will end, and that guidance is developed as set out in Amendment 209.