Health and Social Care Bill

My Lords, I am grateful to the Minister for that very comprehensive response. There are just two points to make. First, I thought that the noble Baroness, Lady Finlay, raised a very interesting question about the test of reasonableness. I come back to the issue of PCTs delaying treatment but keeping it within the 18-week wait, which the Secretary of State intervened on. CCGs may well do the same because it is a way of saving money but keeping within the target set, which no doubt will be reinforced by the mandate. I am not expecting him to answer, but it is an interesting question of whether that is reasonable or not. On the question of the relationship between the health and well-being board and CCGs on their clinical commissioning plans, I realise that I caused great offence to the noble Baroness, Lady Eaton, and my noble friend Lord Beecham by describing the esteemed Local Government Association as a pressure group. I meant it in the context of tabling amendments here; although we are often helped by groups outside, we none the less stand on our own two feet. Now that my noble friend has given me the LGA evidence, I have to say that it was pretty weak and woeful stuff in relation to health and well-being boards. I have another document here from the Association of North East Councils which has produced an excellent paper on health and well-being boards that really gets to the heart of how these could be the engine room of change, collaboration and co-operation across public health, health and social care. I understand the point the noble Earl has made about CCGs being accountable—I am not sure who they are accountable to, but they are accountable—for the commissioning plans, but my amendment allows for that. Essentially it says that the health and well-being board has the leverage to be able to call in the commissioning plans. In the end, if there is no agreement, although I suspect that normally there would be agreement, it will be up to the board to decide how to go forward, so there is a kind of mechanism for dealing with that. However, we underestimate the potential of health and well-being boards at our peril. I hope that I can persuade the Liberal Democrat Benches to have the courage of their convictions and support giving local authorities, through the health and well-being boards, much greater clout in this in the future. I beg leave to withdraw my amendment. Amendment 176B withdrawn. Amendments 177 to 178A not moved. Amendment 178B had been withdrawn from the Marshalled List. Amendments 179 to 184B not moved. Amendment 185 Moved by