Let us look at what is going to happen in 18 days’ time when the Health And Social Care Act 2012 comes into force. I do not want to rerun the arguments about the Act, but let us look at what is to come. Let us look at the accountability of the structures under the Act. The NHS Commissioning Board becomes the conduit for everything, including the flow of money, and all the strategic decisions filter down. If anyone cares to look at the Department of Health website and the new structure, they will see a series of concentric circles. Parliament, the Department and the Secretary of State all appear to be in the outer circle, running round in circles. Where is the accountability in that?
I have to tell the Secretary of State—although I am pleased to see him here, this is a Back-Bench business debate—that section 75 regulations were signed off, under a negative resolution, by a Minister who is not accountable to the House. Section 75 says that everything has to be tendered except for technical reasons, or reasons of extreme urgency. That had to be changed to state that contracts can be tendered if the relevant body is satisfied that the services to which the contract related are capable of being provided only by that provider.
Regulation 10 previously said that commissioners may not engage in anti-competitive behaviour; otherwise, Monitor will be after them. Sorry, those are my words. That was changed to say that commissioners must not be anti-competitive unless it is in the interests of patients.
What of the future? I pay tribute to the right hon. Member for Charnwood (Mr Dorrell), who made an excellent speech. I want to draw attention to a report that our Select Committee produced on complaints and litigation in June 2011. I urge the Secretary of State, if he cares to listen, to read that report and consider all the recommendations. Even then, we called for all providers to have a duty of candour to patients. We also said that we found it striking that the Government did not mention complaints in the information revolution consultation and were surprised that they did not see how complaints information could help people see what is going on. My hon. Friend the Member for West Lancashire (Rosie Cooper), who is no longer in her place, was right to say that complaints can provide information about what needs to be put right.
Mr Deputy Speaker, I am not sure whether you are aware that the NHS litigation bill has now reached £1.3 billion. I urge the Secretary of State to look into the reasons why that is happening. We have to redress negligence, but there are other reasons why that bill is rising. There are remedies that do not involve money or changes in structures or reorganisations.