Health Bill [HL]

I am grateful to the noble Baroness, Lady Tonge, in particular for her support on this amendment and also to the noble Lord, Lord Walton, for his, as ever, very wise and to-the-point intervention. I am sorry that my amendments have fallen on stony ground with the Minister, although I am not entirely surprised. However, I think that there is an issue here about devolving all decision-making. The noble Baroness said that she did not wish to fetter the freedoms of PCTs. I realise that this is not quite the sense conveyed by my amendment but I spoke about having a national framework so as to arrive at PNAs that are consistent and rational across the country. There can be no better example of what I am thinking about than vascular screening. The Prime Minister announced in January last year the introduction of a uniform and universal vascular risk assessment for everyone in England between the ages of 40 and 74, which will be implemented in full by 2012. The national programme can of course be delivered in a variety of settings—not just GP practices but also pharmacies. This is what Pulse magazine had to say about the whole thing about three weeks ago: ""No Government policy illustrates localism gone mad better than the vascular screening programme, which in fact is not a programme at all. A programme implies common aims, an agreed methodology and a consistent set of criteria for evaluating success. Vascular screening has only a vague aspiration, sketched guidance and implementation plans that vary widely from one area to another … Some areas use pharmacists, others are employing battle-buses outside supermarkets. There is not even any agreement over the methods used to assess risk or consensus over how those at risk should be managed once identified"." So, by way of example, if there were a national requirement to incorporate an assessment of the needs of a PCT’s population for vascular risk assessment into PNAs, this would be a good first step towards establishing a more systematic and consistent approach to undertaking vascular screening across the country. I am troubled that we are going to leave all this to PCTs. I am afraid that, although many of them are well equipped to do it, many will struggle and will find themselves considerably at sea. There is no more that I wish to say at the moment, unless the Minister wishes to comment.