Health and Social Care Bill

I thank the Minister for those remarks. I might be able to make him happy at least in one or two respects. This has been an interesting and useful debate, but I would like to start by making two comments. The first is about the remarks made by the noble Lord, Lord Marks. I know that he and his colleagues have been frustrated about the interpretation that has been put on the 49 per cent. The noble Lord spoke about that being there to mitigate risks. The only point that I would make to him and his colleagues is that the opportunity to mitigate those risks was there earlier this week, and they did not take it. I would also like to apologise to colleagues on the Cross Benches if they have found the adversarial style in this part of the Bill unhelpful. On these Benches, it partly stems from our very grave disappointment that we have not managed on Report to protect the NHS in the way that we felt was necessary. I am afraid that those arguments are political arguments and the arguments that we have had to have. I put that on the record. I do not apologise for the fact that they have been political, but I apologise to my colleagues that sometimes they have not been entirely comfortable with that. Moving back to the issue of 49 per cent and/or less than 50 per cent—I accept that the figure of 49 per cent is not in the Bill but of course it says ““not a majority””, so 49 per cent seems to be ““not a majority””—we believe that it is not necessary for it to be there because we believe that the ““principal purpose”” test combined with Amendment 220C addresses those risks. However, both our Amendment 220C and the noble Earl's amendments seem to have annoyed the Foundation Trust Network, which suggests that between us we have some merit here. We agree that there needs to be local consultation and local accountability, and I am grateful for the discussions that we have had about that. Either of those amendments would be better than the Liberal Democrat amendment on offer, and I am very pleased that that is not going to be accepted either. I appreciate that the Liberal Democrats will be withdrawing it, but that has also been a feature as we have proceeded through this part of the Bill. We think that government Amendment 220BZB addresses the private patient cap and we note that this is a late movement in the right direction, but we think that our Amendment 220C does a better job. We think that the government amendment proposes a different route and is not as comprehensive as ours, as the noble Baroness, Lady Finlay, said, and that consultation with CCGs and health and well-being boards is a very important part of that process. The noble Earl mentioned the cost of consultation. I have never felt that arguments about cost should be the main arguments when you are talking about accountability and democracy. We know that democracy costs, and these are organisations that have a membership. Finally, the noble Earl has made a good case about the first amendment in this group. I am very happy to please him by saying that I wish to withdraw the amendment. Amendment 218A withdrawn. Clause 163 : Goods and services Amendment 219 Clause 163 : Goods and services Amendment 219 Moved by