[2nd Allocated Day]

I was waiting for that intervention and looking forward to it. I was slightly concerned, when the hon. Member for Central Suffolk and North Ipswich intervened and failed to mention the fair and beautiful country of Wales, that I was not going to get the opportunity to put the record straight. I hate to tell the hon. Member for Bosworth (David Tredinnick) this, but he is wrong. Waiting lists in Wales are coming down. We have been hitting 95% of our target week in, week out, month in, month out since September 2009. I will concede that the Labour Government in Wales had a problem with orthopaedic waiting lists because of a lack of capacity and too few orthopaedic surgeons, but they invested an additional £65 million to deal with orthopaedic waiting times. I am confident that that will have an effect, but the key is that we still have and observe waiting targets in Wales, and we expect that people will holds us to account in hitting them, whereas in England we are getting rid of waiting targets. What is happening as a result? Waiting times are going up, as happens every time the Tories come to power. We have also seen from the Co-operation and Competition Panel, which the Government are keen to pray in aid on other matters, that minimum wait times are now being set by PCTs in England in anticipation of the increased autonomy that they will have. They are already deciding they will carve out their budgets and curb costs by setting minimum waiting times, and by introducing independently determined—not NICE-determined—clinical thresholds for treatment. Those things are entirely unacceptable, as the Secretary of State conceded in a letter to my right hon. Friend the shadow Health Secretary. However, they are symptomatic of what we will see in a busted-up, fragmented and disaggregated NHS. Without strategic regional oversight, local decision making will compound the postcode lottery. New clause 14 is an important proposal. It is designed to prevent those who shout the loudest under the new fragmented system from gaining the most, and from gaining an inequitable share of health care resources. That has been a traditional concern of health care policy under different Governments, and it remains a concern of the Opposition. The Bill makes commissioning bodies—CCGs—responsible for both the people on their practice lists and people living within their boundary area who are not on the practice list of another CCG. The Opposition have argued against that for two key reasons. First, as Liberal Democrat Members will recognise, the measure makes population-based needs assessment impossible. That kind of structure means that totting up potential customers and patients within an area cannot be done, because they will not live in a single, defined area. Some people who do not live in the area might need to be covered because they are on the list, and others will not need to be covered even though they live in the area. Secondly, the Opposition are against the kind of system in which the most vocal and well informed, and perhaps the wealthiest, can shop around for the best GP practice, and therefore the best consortium, which could be outside their immediate area. New clause 14, alongside amendment 5, which would delete clause 10, would make the people in the area of a CCG its primary responsibility. Regulations would allow CCGs provision for other people, such as those on their practice lists, but they would always remain responsible for the people in their area. Education and training is another crucial measure in the Bill that we are shoehorning into this very short debate—it is perhaps one of the greatest concerns of the medical fraternity. We have tabled several proposals on that: new clauses 12 and 13, amendments 7 and 47. On staff terms and conditions, we have tabled amendment 1168. In addition to providing the strategic, regional tier of NHS government, SHAs have a key role in education and training, including, crucially, hosting deaneries and in work force planning. Those are obviously linked to questions of emergent innovation, changing need in a local area, and any potential consequent reconfigurations of hospitals. They are absolutely central to how we run the NHS and plan for its future. It is therefore scandalous that we come to this juncture, many months after we started our debates on the Bill, with SHAs—the repositories of the training and planning function in the NHS—on the verge of being abolished. Their abolition has shifted from seven months to around 14 months, but in legislative terms SHAs are on the verge of being done in by the Government. However, the Government have absolutely no idea what they will replace the education and training facilities with—and the Minister has had the temerity to come to the House today and inform us that a new amendment is to be tabled in the House of Lords to deal with this crucial part of the Bill.