11 July 2011 : Column 1P


Monday 11 July 2011



NHS (Cornwall)

The Petition of residents of West Cornwall, the Isles of Scilly and St Ives, and others,

Declares their opposition to the Health and Social Care Bill currently before Parliament as it will take away their single Cornwall National Health Service and replace it with consortia led by GPs. Further, the Bill will allow the increased involvement of profit-led companies in our health service.

The Petitioners therefore request that the House of Commons rejects the Health and Social Care Bill

And the Petitioners remain, etc.—[Presented by Andrew George , Official Report, 8 June 2011; Vol. 529, c. 246.]


Observations from the Secretary for State for Health:

The issue referred to relates to the Health and Social Care Bill, which was partially recommitted to the Public Bill Committee on 14 June.

Ministers believe that the NHS is a great institution, but that it could be still better. The Government’s plans seek to put clinicians at the heart of planning services to improve the care for their patients—there is a body of evidence both from this country and internationally about the importance of involving clinicians in commissioning decisions and this is what our proposals are built upon. Front-line clinicians will be empowered to be the leaders of a more autonomous NHS, with increased accountability to their local populations.

11 July 2011 : Column 2P

With regard to the residents of West Cornwall, the Isles of Scilly and St Ives and others’ specific concerns, the Health and Social Care Bill does provide the statutory basis for the establishment of GP-led clinical commissioning groups (called consortia in the Bill as currently drafted). These commissioning groups will be part of the NHS, which remains a comprehensive health service, free at the point of use.

Through GP commissioning, GPs will be able to use healthcare resources to transform the quality of care and health outcomes for patients. This builds on the crucial role that GPs play in co-ordinating patient care and committing NHS resources through daily clinical decisions.

We do not wish to be unduly prescriptive about the size of clinical commissioning groups. There have been widespread variations in the size and population coverage of PCTs, and there is no evidence to suggest a single “right” size. It is important that solutions develop from the bottom up and are not imposed from above. Moreover, clinical commissioning groups will have the freedom to make commissioning decisions and they may choose to act collectively, for instance by adopting a lead commissioner model to negotiate and monitor contacts with large hospital trusts or with urgent care providers.

This is not about privatising the NHS. The NHS is built on the principle that it is free at the point of use for everyone based on need, not ability to pay. This will not change. The NHS has always benefited from a mixed economy of providers and the private and voluntary sectors perform an important role in service delivery and will continue to do so. Competition in the NHS helps to improve quality and efficiency by allowing people to choose the provider that they wish from a list of accredited providers: as the patient chooses the provider for their care but does not pay for it directly, price plays no part in their decision. However, it will be in providers’ interests to maintain and improve the quality of their services to attract patients. To avoid any doubt about this, we will make it illegal for current or future Ministers, the NHS Commissioning Board or Monitor, to attempt to increase or maintain the market share of the private sector over the NHS, or vice versa.