Health and Social Care Bill

My Lords, this has been a very worthwhile discussion. As I said at the outset, there are two issues here. I am grateful to the noble Earl for reassuring us about the issues to do with quality, which he has done very satisfactorily indeed. I should give the noble Baroness, Lady Finlay, a vote of thanks. I knew that she would explain the issues about area-based clinical commissioning groups much more clearly than I. Moreover, the noble Lord, Lord Newton, put his finger on it when he asked whether the clinical commissioning groups will be structured on the basis of clearly defined geographical areas contiguous with each other and inclusive of the entire population. I think the noble Earl said ““yes”” to that question. I am less happy about something that I think we will return to, which is how people who already fall through the gaps in care and access to primary care will be treated and whether their situation will be worse. That is because right from the outset I said that what we had to do was apply what is in this Bill to patients and conditions to see how it works for them. In Kingston at the moment, for example, a GP practice has been able to deregister 48 people with mental illnesses who live in a home. They have been scattered among GPs throughout the area. I think that that is very unsatisfactory and there does not seem to be any way of challenging the decision. It worries me that if we are establishing clinical commissioning groups that will have even more independence to take those kinds of decisions, things will get worse for those who need primary care rather than better. I will not press any of the amendments tabled in my name, but we will return to this issue. I beg leave to withdraw the amendment. Amendment 9 withdrawn. Amendments 10 to 11A not moved. Amendment 11 Moved by