My Lords, I start by thanking my noble and learned friend for putting everything so succinctly and eloquently in summing up what is the case in the NHS in relation to devolution, and the noble Lord, Lord Warner, for again eloquently outlining his amendment.
Amendment 66 puts certain limitations and conditions on the conferral of health powers on a combined authority or another body working with a combined authority. In particular, it requires the Secretary of State to consider that various conditions are met; that the other body must be a body corporate with a chief accounting officer; and that a memorandum of understanding is produced and reported against. It also prevents the Secretary of State intervening except in certain circumstances.
As we have discussed, Amendment 28, which was passed, and others in its group would enable any limitations or conditions to be specified in an order transferring health functions and were intended to provide assurance that any future devolution arrangements will continue to uphold existing accountabilities and national standards for the NHS.
Most of the limitations and conditions that the noble Lord, Lord Warner, outlines could be specified in an order using those provisions if doing so were considered appropriate in the context of a bespoke devolution deal. For example, we could enable the conferral of health powers to a combined authority to be accompanied by a condition that it must also meet current statutory duties held variously by the Secretary of State for Health, NHS England and clinical commissioning groups, thereby ensuring continuation of current NHS accountabilities and standards.