Health and Social Care Bill

I totally and utterly disagree. There is bags of accountability in the form of accountability to patients in the local area, accountability to the health and well-being board, and to the NHS Commissioning Board which we have debated at length. I do not understand why the noble Lord should doubt this. It permeates the Bill. Indeed, the whole thrust of our policy has been around two words: ““autonomy”” and ““accountability””. They are two sides of the same coin. You cannot have responsible autonomy without accountability, and we believe that we have built it into the system. The noble Lord may not have been in the Chamber when I answered my noble friend Lady Tonge a while ago, who asked me a similar question: why on earth are we doing this? We have published a White Paper and numerous documents to explain why we think this is the way to go and the philosophy behind what we are doing is that clinical commissioning about placing the financial power to change health services in the hands of those NHS professionals whom the public trust most. We know that the public trust them most and we believe that they are up to the task, and so do they. The noble Baroness, Lady Wilkins, asked me about the drug tariff and appliances. I am the first to recognise how important this is. I myself, when in opposition, lobbied the department rather hard on the subject on a number of occasions because I well recognise all the issues to which she referred. Appliance contractors will be consulted about appliance services and remuneration, as they are now. As now, a full range of pharmaceutical services are expected to be commissioned in the future, including appliance services, but in view of the hour the best thing for me to do is to write her a letter. She raised a number of issues and it is probably appropriate that I should write to her and copy the letter to noble Lords. I hope that I have at least illuminated these areas helpfully for noble Lords and that the amendment will be withdrawn.